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不同表型小儿特应性皮炎的实验室及严重程度评估与保湿剂反应

Laboratory and severity evaluation of pediatric atopic dermatitis and moisturizer response in different phenotypes.

作者信息

Batmaz S B

机构信息

Department of Pediatric Allergy and Immunology, Tokat State Hospital, Tokat, Turkey.

出版信息

Allergol Immunopathol (Madr). 2018 Nov-Dec;46(6):571-577. doi: 10.1016/j.aller.2018.03.007. Epub 2018 Jul 4.

Abstract

INTRODUCTION AND OBJECTIVES

Atopic dermatitis (AD) is an eczematous skin disease. Our aim was to evaluate the clinical and laboratory findings of children with AD and identify the higher responsive group to moisturizers.

MATERIALS AND METHODS

Total and specific IgE, eosinophil count, prick/patch test results of patients with AD were retrospectively analyzed. The presentation SCORAD was compared between the demographic and clinical subgroups. The SCORAD change (presentation to third month) between the intrinsic and extrinsic groups was compared. The effect of age, sex, disease duration, presentation SCORAD, being intrinsic/extrinsic, exclusive breastfeeding duration, familial atopy, total IgE, eosinophil count, concomitant illness presence, moisturizer use frequency and exacerbation frequency on SCORAD change was examined.

RESULTS

The mean age was 3.65±3.77 years. Food allergy was found in 5.90% and inhalant allergy was found in 12.67% of patients. 158 (44.5%) were mild, 154 (43.4%) were moderate and 43 (12.1%) were severe AD. 141 (39.7%) were intrinsic AD. The SCORAD at 3rd visit and SCORAD change was different between the intrinsic and extrinsic groups. SCORAD change was positively associated with presentation SCORAD, eosinophil count, moisturizer use frequency and being extrinsic AD.

CONCLUSIONS

The clinical and laboratory findings of AD patients in our community were revealed. Higher SCORAD and eosinophils at presentation, frequent daily moisturizer use and being extrinsic increased the moisturizer response. Although the barrier defect was shown to be lesser in intrinsic AD by considering transepidermal water loss, this study is the first to evaluate intrinsic and extrinsic AD patients according to response to moisturizers.

摘要

引言与目的

特应性皮炎(AD)是一种湿疹性皮肤病。我们的目的是评估AD患儿的临床和实验室检查结果,并确定对保湿剂反应较高的组别。

材料与方法

对AD患者的总IgE和特异性IgE、嗜酸性粒细胞计数、点刺/斑贴试验结果进行回顾性分析。比较了人口统计学和临床亚组之间的初始SCORAD。比较了内源性和外源性组之间(从初始到第三个月)的SCORAD变化。研究了年龄、性别、病程、初始SCORAD、内源性/外源性、纯母乳喂养持续时间、家族性特应性、总IgE、嗜酸性粒细胞计数、伴随疾病的存在、保湿剂使用频率和病情加重频率对SCORAD变化的影响。

结果

平均年龄为3.65±3.77岁。5.90%的患者发现食物过敏,12.67%的患者发现吸入性过敏。158例(44.5%)为轻度AD,154例(43.4%)为中度AD,43例(12.1%)为重度AD。141例(39.7%)为内源性AD。内源性和外源性组在第三次就诊时的SCORAD和SCORAD变化不同。SCORAD变化与初始SCORAD、嗜酸性粒细胞计数、保湿剂使用频率和外源性AD呈正相关。

结论

揭示了我们社区AD患者的临床和实验室检查结果。初始时较高的SCORAD和嗜酸性粒细胞、每天频繁使用保湿剂以及外源性因素增加了对保湿剂的反应。尽管通过经表皮水分流失考虑显示内源性AD的屏障缺陷较小,但本研究是首次根据对保湿剂的反应对内源性和外源性AD患者进行评估。

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