Tay Y K, Khoo B P, Goh C L
National Skin Centre, Singapore.
Asian Pac J Allergy Immunol. 1999 Sep;17(3):137-41.
Atopic dermatitis is a common chronic, relapsing, pruritic ecematous skin condition with a predilection for the flexural areas and occurs 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 the National Skin Centre in Singapore. 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 whose ages ranged from one 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 the 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. Two hundred and thirty-eight patients (48%) suffered from a "mixed" type, with 23% having allergic rhinitis, 12% having asthma and 13% having both asthma and allergic rhinitis. Two hundred and thirty-one patients (47%) had at least one first-degree family member with atropy: atopic dermatitis (17%), asthma (15%) and allergic rhinitis (15%). Most of the patients, 416 (84.5%), had subacute eczema 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 eczema, folliculitis, cellullitis) present in 95 patients (19%) followed by viral infections (eczema herpeticum, viral warts and molluscum contagiosum) in 17 patients (3%). Allergies were noted in 43 patients (9%) based on the history given. The most common was drug allergies (penicillin and co-trimoxazole) in 28 patients followed by food allergies in 11 patients. Common aggravating factors reported include 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 UVAB and one on 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、复发性、瘙痒性湿疹样皮肤病，好发于屈侧部位，见于有特应性个人史或家族史的患者。本研究的目的是描述新加坡国家皮肤中心所见特应性皮炎的概况。对1994年头6个月期间诊治的所有特应性皮炎患者进行了回顾性病历审查。有492例患者，年龄从1个月至74岁不等，男女比例相同。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“单纯性”特应性皮炎，无合并呼吸道过敏。238例患者（48%）患“混合型”，其中23%有过敏性鼻炎，12%有哮喘，13%既有哮喘又有过敏性鼻炎。231例患者（47%）至少有一名患有特应性疾病的一级家庭成员：特应性皮炎（17%）、哮喘（15%）和过敏性鼻炎（15%）。大多数患者，416例（84.5%）就诊时为亚急性湿疹。38例患者（8%）有寻常性鱼鳞病，13例患者（3%）有白色糠疹。最常见的感染并发症是细菌感染（脓疱性湿疹、毛囊炎、蜂窝织炎），95例患者（19%）出现，其次是病毒感染（疱疹样湿疹、病毒疣和传染性软疣），17例患者（3%）出现。根据所提供的病史，43例患者（9%）有过敏。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、厚衣服和对草不耐受。大多数患者通过使用保湿剂、外用类固醇和抗生素治疗急性发作的相当简单的方案即可得到控制。78例患者（16%）使用了短疗程的系统性类固醇。三名患者接受了光疗，两名接受UVAB治疗，一名接受PUVA治疗。新加坡特应性皮炎的模式与西方文献报道的相似，只是患病率较低，且有相当比例的成人发病特应性皮炎。
