Tay Y K, Khoo B P, Goh C L
National Skin Center, Singapore.
Int J Dermatol. 1999 Sep;38(9):689-92. doi: 10.1046/j.1365-4362.1999.00667.x.
Atopic dermatitis is a common, chronic, relapsing, pruritic, eczematous skin condition occurring in patients with a personal or family history of atopy. The aim of this study is to describe the profile of atopic dermatitis seen at a tertiary referral skin center in a tropical multiracial country.
A retrospective chart review was conducted of all the patients with atopic dermatitis seen during the first six months of 1994.
There were 492 patients, age range from 1 month to 74 years, with an equal sex ratio. The prevalence was 2%. The onset of the disease occurred before the age of 10 years in 61.2% of patients. In 13.6% of patients, the onset was after the age of 21 years. Two hundred and fifty four patients (52%) had "pure" atopic dermatitis without concomitant respiratory allergies; 238 patients (48%) suffered from a "mixed" type, with 23% having allergic rhinitis, 12% having asthma, and 13% having both asthma and allergic rhinitis; 231 patients (47%) had at least one first-degree family member with atopy: atopic dermatitis (17%), asthma (15%), and allergic rhinitis (15%). Most of the patients, 416 (84.5%), had subacute dermatitis at presentation. Ichthyosis vulgaris was present in 38 patients (8%) and pityriasis alba in 13 patients (3%). The most common infective complication was bacterial infection (impetiginized dermatitis, folliculitis, cellulitis) present in 95 patients (19%), followed by viral infections (dermatitis herpeticum, viral warts, and molluscum contagiosum) in 17 patients (3%). Allergies were noted in 43 patients (9%). The most common was drug allergy (penicillin and cotrimoxazole) in 28 patients, followed by food allergy in 11 patients. Common aggravating factors reported included heat, sweating, stress, thick clothing, and grass intolerance. Most patients could be controlled with a fairly simple regimen of moisturizers, topical steroids, and antibiotics for acute flares. Short courses of systemic steroids were used in 78 patients (16%). Three patients were treated with phototherapy: two on combined UVA and UVB (UVAB) and one on oral psoralen photochemotherapy (PUVA).
The pattern of atopic dermatitis in Singapore is similar to that reported in the Western literature, except for a lower prevalence and a significant proportion of adult-onset atopic dermatitis.
特应性皮炎是一种常见的、慢性的、复发性的、瘙痒性的、湿疹样皮肤病，见于有个人或家族特应性病史的患者。本研究的目的是描述在一个热带多民族国家的三级转诊皮肤中心所见到的特应性皮炎的概况。
对1994年上半年就诊的所有特应性皮炎患者进行回顾性病历审查。
共有492例患者，年龄范围从1个月至74岁，男女比例相等。患病率为2%。61.2%的患者在10岁之前发病。13.6%的患者在21岁之后发病。254例患者（52%）患有“单纯”特应性皮炎，无合并呼吸道过敏；238例患者（48%）患有“混合型”，其中23%患有过敏性鼻炎，12%患有哮喘，13%同时患有哮喘和过敏性鼻炎；231例患者（47%）至少有一位一级亲属患有特应性疾病：特应性皮炎（17%）、哮喘（15%）和过敏性鼻炎（15%）。大多数患者，即416例（84.5%），就诊时为亚急性皮炎。38例患者（8%）有寻常型鱼鳞病，13例患者（3%）有白色糠疹。最常见的感染性并发症是细菌感染（脓疱性皮炎、毛囊炎、蜂窝织炎），95例患者（19%）出现，其次是病毒感染（疱疹样皮炎、病毒疣和传染性软疣），17例患者（3%）出现。43例患者（9%）有过敏情况。最常见的是药物过敏（青霉素和复方新诺明），28例患者出现，其次是食物过敏，11例患者出现。报告的常见加重因素包括热、出汗、压力、厚衣服和不耐草。大多数患者可以通过相当简单的方案得到控制，即使用保湿剂、外用类固醇和抗生素治疗急性发作。78例患者（16%）使用了短疗程的系统性类固醇。3例患者接受了光疗：2例采用联合UVA和UVB（UVAB），1例采用口服补骨脂素光化学疗法（PUVA）。
新加坡特应性皮炎的模式与西方文献报道的相似，但患病率较低，且成人发病的特应性皮炎比例较高。
