Al-Naqeeb Jinan, Danner Sankirtana, Fagnan Lyle J, Ramsey Katrina, Michaels LeAnn, Mitchell Julie, Branca Kelsey, Morris Cynthia, Nease Donald E, Zittleman Linda, Levy Barcey, Daly Jeanette, Hahn David, Dolor Rowena J, Williams Hywel C, Chalmers Joanne R, Hanifin Jon, Tofte Susan, Zuckerman Katharine E, Hansis Karen, Gundersen Mollie, Block Julie, Karr Francie, Dunbrasky Sandra, Siebe Kathy, Dillon Kristen, Cibotti Ricardo, Lapidus Jodi, Simpson Eric L
From Department of Dermatology, Oregon Health and Science University, Portland (JA, JH, ST, ELS); Oregon Rural Practice-based Research Network, Oregon Health and Science University, Portland (SD, LJF, LM, KB, KD); Public Health and Preventive Medicine, Oregon Health and Science University, Portland (KR, KEZ, JL); Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland (JM, CM); High Plains Research Network, University of Colorado, Denver (DEN, LZ); Iowa Research Network, University of Iowa, Iowa City (BL, JD); Wisconsin Research and Education Network, University of Wisconsin, Madison (DH); Primary Care Research Consortium, Duke University, Durham, North Carolina (RD); Centre of Evidence-Based Dermatology, University of Nottingham, England (HCW, JRC); Division of General Pediatrics, Oregon Health and Science University, Portland (KEZ); Patient Advocate (KH, MG); National Eczema Association, San Rafael, CA (JB); Mid-Columbia Medical Center, The Dalles, OR (FK); Treasure Valley Pediatric Clinic, Ontario (SD); Winding Waters Clinic, Enterprise (KS); National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institute of Health, Bethesda, MD (RC).
J Am Board Fam Med. 2019 Mar-Apr;32(2):191-200. doi: 10.3122/jabfm.2019.02.180225.
Little is known about the burden of atopic dermatitis (AD) encountered in US primary care practices and the frequency and type of skin care practices routinely used in children.
To estimate the prevalence of AD in children 0 to 5 years attending primary care practices in the United States and to describe routine skin care practices used in this population.
A cross-sectional survey study of a convenience sample of children under the age of 5 attending primary care practices for any reason.
Ten primary care practices in 5 US states.
Among 652 children attending primary care practices, the estimated prevalence of ever having AD was 24% (95% CI, 21-28) ranging from 15% among those under the age of 1 to 38% among those aged 4 to 5 years. The prevalence of comorbid asthma was higher among AD participants compared to those with no AD, namely, 12% and 4%, respectively ( < .001). Moisturizers with high water:oil ratios were most commonly used (ie, lotions) in the non-AD population, whereas moisturizers with low water:oil content (ie, ointments) were most common when AD was present.
Our study found a large burden of AD in the primary care practice setting in the US. The majority of households reported skin care practices that may be detrimental to the skin barrier, such as frequent bathing and the routine use of moisturizers with high water: oil ratios. Clinical trials are needed to identify which skin care practices are optimal for reducing the significant burden of AD in the community.
对于美国初级保健机构中遇到的特应性皮炎（AD）负担以及儿童常规使用的皮肤护理方法的频率和类型，人们了解甚少。
估计在美国初级保健机构就诊的0至5岁儿童中AD的患病率，并描述该人群常规使用的皮肤护理方法。
对因任何原因在初级保健机构就诊的5岁以下儿童便利样本进行横断面调查研究。
美国5个州的10家初级保健机构。
在652名到初级保健机构就诊的儿童中，曾患AD的估计患病率为24%（95%CI，21-28），其中1岁以下儿童为15%，4至5岁儿童为38%。与未患AD的儿童相比，AD患者中合并哮喘的患病率更高，分别为12%和4%（P<0.001）。在非AD人群中，水油比高的保湿剂（即乳液）使用最为普遍，而在患有AD时，水油含量低的保湿剂（即软膏）最为常见。
我们的研究发现美国初级保健机构中AD负担很大。大多数家庭报告的皮肤护理方法可能对皮肤屏障有害，如频繁洗澡和常规使用水油比高的保湿剂。需要进行临床试验以确定哪种皮肤护理方法最适合减轻社区中AD的重大负担。
