Risk Factors for the Development of a Progressive Course of Atopic Dermatitis in Children and Adolescents

Abstract

Study Objective: To determine the risk factors for the development of a progressive course of atopic dermatitis (AD) in children and adolescents. Study Design: Observational prospective cross-sectional study. Materials and Methods. The study enrolled 89 outpatients with AD aged 2 months — 17 years. The diagnosis was verified based on Hanifin and Rajkа criteria (1980); skin disorders were assessed via SCORAD followed by statistical analysis. Family history, breastfeeding duration and symptoms manifestation were assessed. Study Results. Based on our results, compared to children with erythemato-squamous plaques with lichenization AD (ESPL) and lichenoid AD (L), children with erythemato-squamous plaques of AD (ESP) predominated (ESP vs. ESPL vs. L: 44 (50%) vs. 28 (31%) vs. 17 (19%) respectively (p < 0.05). Progressive AD was noticed in more than 50% (p < 0.05). SCORAD index was maximal in lichenoid AD (p < 0.05). Progressive AD is frequently accompanied with genetic predisposition on the mother’s side as well as early AD manifestation and shorter breastfeeding. Prolonged course of the disease influences the risks for lichenoid forms. Conclusion. Risks for progressive course of AD is higher in children with genetic predisposition on the mother’s side, duration of breastfeeding with regard to early AD manifestation. Basically, clinical symptoms of the atopic march were related to seasonal allergic rhinitis, less often with asthma. Кeywords: atopic dermatitis, severe cases, children, adolescents.