Alexopoulos Alex, Kakourou Talia, Orfanou Irene, Xaidara Athina, Chrousos George
First Department of Pediatrics, University of Athens, Aghia Sofia Children's Hospital, Athens, Greece.
Pediatr Dermatol. 2014 Mar-Apr;31(2):125-30. doi: 10.1111/pde.12216. Epub 2013 Nov 13.
A growing number of dermatologists dispute the existence of infantile seborrheic dermatitis (ISD) as an independent clinical entity. Therefore the aim of the present study was to estimate the epidemiologic features of ISD in a defined population of Greek children, assess its course, and identify associations, if any, with other common dermatoses of childhood. Children from the region of Athens who were examined and diagnosed with typical clinical features of ISD between 1997 and 2011 were included in the study. The relevant data were collected retrospectively from their medical records using a standardized form. Eighty-seven children were enrolled (50 boys, 37 girls; mean age 3.1 mos at the time of ISD diagnosis). The main body areas affected were the scalp and face for the majority of the children (78/87), whereas the trunk and limbs were less frequently involved (9/87). In all cases, erythema and scaling of affected patients were mild to moderate. Forty-nine of the 87 children were followed up over a period of 5 years. Thirty children in this group developed features of atopic dermatitis (AD) at a later stage, according to the UK diagnostic criteria of AD, and 23 of these children were diagnosed with AD, at an average time interval of 6.4 months from ISD onset, and seven presented with clinical features of AD at the time of ISD diagnosis. The remaining 19 children in the follow-up group progressed without developing any other chronic skin disease, and all recovered within 6 months of its onset. Thirty-eight had no further follow-up after their initial ISD diagnosis. In spite of the lack of information on the disease course for the last group, assuming they all recovered, the prevalence of AD (34.4%) in our ISD sample was significantly higher than the prevalence of AD (10.7%) in the general population for the same age group, as shown in a previous study performed in the municipality of Athens (p < 0.001). A significant number of children were found to develop AD shortly after their ISD diagnosis. This finding demonstrates a strong association in the clinical course between the two diseases or indicates that the two diseases may be in the same clinical spectrum. Further epidemiologic studies must be conducted to assess the significance of this finding.
越来越多的皮肤科医生质疑婴儿脂溢性皮炎（ISD）作为一种独立临床实体的存在。因此，本研究的目的是评估希腊特定儿童群体中ISD的流行病学特征，评估其病程，并确定其与儿童期其他常见皮肤病之间是否存在关联（若有）。本研究纳入了1997年至2011年间在雅典地区接受检查并被诊断为具有典型ISD临床特征的儿童。相关数据通过标准化表格从他们的病历中进行回顾性收集。共纳入87名儿童（50名男孩，37名女孩；ISD诊断时平均年龄3.1个月）。大多数儿童（78/87）受影响的主要身体部位是头皮和面部，而躯干和四肢受累较少（9/87）。在所有病例中，受影响患者的红斑和脱屑为轻度至中度。87名儿童中有49名接受了为期5年的随访。根据英国AD诊断标准，该组中有30名儿童在后期出现了特应性皮炎（AD）特征，其中23名儿童被诊断为AD，从ISD发病起平均时间间隔为6.4个月，7名儿童在ISD诊断时表现出AD临床特征。随访组中其余19名儿童病情进展但未发展为任何其他慢性皮肤病，且均在发病后6个月内康复。38名儿童在首次ISD诊断后未进一步随访。尽管最后一组缺乏疾病病程信息，但假设他们均康复，我们ISD样本中AD的患病率（34.4%）显著高于雅典市同一年龄组普通人群中AD的患病率（10.7%），如先前在雅典市进行的一项研究所示（p<0.001）。发现大量儿童在ISD诊断后不久就发展为AD。这一发现表明这两种疾病在临床病程中存在密切关联，或者表明这两种疾病可能处于同一临床谱系。必须进行进一步的流行病学研究以评估这一发现的意义。
