Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Institute of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China.
J Eur Acad Dermatol Venereol. 2019 Aug;33(8):1569-1576. doi: 10.1111/jdv.15618. Epub 2019 May 17.
Atopic dermatitis (AD) is the most common skin disorder in infancy. However, the diagnosis and definite significance of infantile AD remains a debated issue.
To analyse the phenotypes of AD in infancy, to establish diagnostic criteria and to estimate the prevalence of this condition in China.
This is a multicentric study, in which 12 locations were chosen from different metropolitan areas of China. Following careful and complete history-taking and skin examination, the definite diagnosis of AD was made and the severity based on the SCORAD index was determined by local experienced dermatologists. Based on the detailed phenotyping, the major and representative clinical features of infantile AD were selected to establish the diagnostic criteria and evaluate their diagnostic efficacy.
A total of 5967 infants were included in this study. The overall point prevalence of AD was 30.48%. The infantile AD developed as early as at the second month of life, and its incidence peaked in the third month of life at 40.81%. The proportion of mild, moderate and severe AD was 67.40%, 30.57% and 2.03%, respectively. The most commonly seen manifestations in the infantile AD were facial dermatitis (72.07%), xerosis (42.72%) and scalp dermatitis (27.93%). We established the novel diagnostic criteria of infants, which included: (i) onset after 2 weeks of birth; (ii) pruritus and/or irritability and sleeplessness comparable with lesions; and (iii) all two items above with one of the following items can reach a diagnosis of AD: (i) eczematous lesions distributed on cheeks and/or scalp and/or extensor limbs, and (ii) eczematous lesions on any other parts of body accompanied by xerosis.
In China, the prevalence of AD in infancy is 30.48% according to clinical diagnosis of dermatologists. The novel Chinese diagnostic criteria for AD in infants show a higher sensitivity and comparable specificity.
特应性皮炎（AD）是婴儿期最常见的皮肤疾病。然而，婴儿 AD 的诊断和明确意义仍然存在争议。
分析婴儿期 AD 的表型，建立诊断标准，并估计中国该病的患病率。
这是一项多中心研究，在中国的 12 个不同大都市地区选择了 12 个地点。在进行仔细和完整的病史采集和皮肤检查后，由当地有经验的皮肤科医生根据 SCORAD 指数确定 AD 的明确诊断和严重程度。根据详细的表型分析，选择婴儿 AD 的主要和代表性临床特征来建立诊断标准并评估其诊断效果。
本研究共纳入 5967 名婴儿。AD 的总现患率为 30.48%。婴儿 AD 最早在出生后第二个月发病，发病高峰在第三个月，达 40.81%。轻度、中度和重度 AD 的比例分别为 67.40%、30.57%和 2.03%。婴儿 AD 最常见的表现是面部皮炎（72.07%）、干燥（42.72%）和头皮皮炎（27.93%）。我们建立了婴儿的新诊断标准，包括：（i）出生后 2 周发病；（ii）瘙痒和/或烦躁不安与皮损相当；和（iii）以上两项均存在，同时具备以下一项即可诊断为 AD：（i）湿疹样皮损分布于面颊和/或头皮和/或伸肌侧，和（ii）任何其他部位的湿疹样皮损伴干燥。
根据皮肤科医生的临床诊断，中国婴儿期 AD 的患病率为 30.48%。婴儿 AD 的新的中文诊断标准具有较高的敏感性和相当的特异性。
