Department of Dermatology, Northwestern University, Chicago, Ill; St Luke's-Roosevelt Hospital Center, New York, NY.
Department of Dermatology, Northwestern University, Chicago, Ill; St Luke's-Roosevelt Hospital Center, New York, NY.
J Allergy Clin Immunol. 2014 Apr;133(4):1041-7. doi: 10.1016/j.jaci.2013.08.012. Epub 2013 Oct 4.
Previous studies suggested that atopic dermatitis (AD) is associated with aberrant immune responses, which might predispose toward both cutaneous and extracutaneous infections. The goal of this study was to determine whether childhood AD is associated with increased risk of warts, extracutaneous infections, and other atopic diseases and how these disorders cosegregate.
The 2007 National Health Interview Survey from a nationally representative sample of 9417 children age 0 to 17 years was used.
Children with AD and other atopic disease had higher odds of warts. In contrast, children with AD with or without other atopic disease had higher odds of extracutaneous infections, including strep throat, other sore throat, head or chest cold, influenza/pneumonia, sinus infections, recurrent ear infections, chickenpox, and urinary tract infections (P < .0001). Children with AD and other atopic disease had a higher number of infections than those with either disorder by itself (P < .0001). Warts were also associated with increased odds of all extracutaneous infections (P < .0001), except recurrent ear infections. Children with warts and AD had a higher number of infections than those with either disorder alone (P < .0001). Finally, children with AD and warts had higher odds of ever receiving a diagnosis of asthma, current asthma, asthma exacerbation in the past year, hay fever, and food allergy. Children with AD with warts had even higher odds of asthma, hay fever, and food allergies than those with AD and no warts.
The associations between childhood AD, atopic disease, warts, and extracutaneous infections suggest that barrier disruption, immune disruption, or both contribute to susceptibility to warts and extracutaneous infections in children.
先前的研究表明，特应性皮炎（AD）与异常的免疫反应有关，这可能使皮肤和皮肤外感染更容易发生。本研究的目的是确定儿童 AD 是否与疣、皮肤外感染和其他特应性疾病的风险增加有关，以及这些疾病如何共同发生。
本研究使用了来自全国代表性样本的 9417 名 0 至 17 岁儿童的 2007 年全国健康访谈调查。
患有 AD 和其他特应性疾病的儿童患疣的几率更高。相比之下，患有 AD 和/或其他特应性疾病的儿童患皮肤外感染的几率更高，包括链球菌性喉炎、其他喉炎、头或胸部感冒、流感/肺炎、鼻窦感染、复发性耳部感染、水痘和尿路感染（P <.0001）。患有 AD 和其他特应性疾病的儿童比仅患有其中一种疾病的儿童发生感染的次数更多（P <.0001）。疣也与所有皮肤外感染的几率增加有关（P <.0001），但不包括复发性耳部感染。患有疣和 AD 的儿童比仅患有其中一种疾病的儿童发生感染的次数更多（P <.0001）。最后，患有 AD 和疣的儿童比仅患有 AD 的儿童更有可能被诊断出患有哮喘、当前哮喘、过去一年哮喘加重、花粉热和食物过敏。患有 AD 和疣的儿童比仅患有 AD 且没有疣的儿童患哮喘、花粉热和食物过敏的几率更高。
儿童 AD、特应性疾病、疣和皮肤外感染之间的关联表明，屏障破坏、免疫破坏或两者都导致儿童易患疣和皮肤外感染。
