Department of Medicine, Section of Dermatology and Venerology, University of Verona, Verona, Italy.
Allergy Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy.
Ital J Pediatr. 2021 Apr 16;47(1):92. doi: 10.1186/s13052-021-00987-9.
Atopic dermatitis (AD) is the most common immune-mediated skin disease in childhood. Several treatment options for pediatric AD, both topical and systemic, are currently available. We carried out a single-center observational study with the aim of describing characteristics and treatment patterns in pediatric AD patients.
The study included 867 patients aged ≤16 years (females 50.5%, mean patient's age 5.9 years, standard deviation ±3.6 years) with a previous doctor-confirmed diagnosis of AD who underwent balneotherapy at the Comano Thermal Spring Water Center (Comano, Trentino, Italy) from April to October 2014.
Among the patients included in the study, 41.2% had mild (SCORing Atopic Dermatitis, SCORAD 0-15), 43.6% moderate (SCORAD 16-40) and 15.2% severe AD (SCORAD > 40). A higher occurrence of reported food allergy was observed among children with more severe AD (p < 0.0001), while no association was found between AD severity and reported inhalant allergy or passive smoking (p = 0.15 and 0.92, respectively). Emollients (55.1%) and topical corticosteroids (TCS; 45.7%) were the main treatment options used in the previous month. The use of oral steroids and topical calcineurin inhibitors (TCI) was considerably less common (6.3 and 4.5%, respectively), while no patients were on systemic agents other than steroids. Among patients with severe AD, 9.8% had not used TCS, TCI or any systemic treatments. Moreover, 20.0% of the patients in the study population had followed elimination diets, although only 27.2% of them had a reported food allergy.
A significant difference in the prevalence of reported food allergy emerged across the different AD severity categories. Furthermore, although further data are necessary to confirm our findings, undertreatment in children with AD appeared to be very common, at least among those attending the Comano Thermal Spring Water Center. Moreover, many patients followed elimination diets in the absence of reported food allergy.
特应性皮炎（AD）是儿童中最常见的免疫介导性皮肤病。目前有多种治疗儿童 AD 的方法，包括局部和全身治疗。我们进行了一项单中心观察性研究，旨在描述儿科 AD 患者的特征和治疗模式。
该研究纳入了 2014 年 4 月至 10 月在意大利特伦蒂诺的科马诺温泉水中心接受水疗的 867 名年龄≤16 岁（女性占 50.5%，平均患者年龄 5.9 岁，标准差±3.6 岁）且经医生确诊的 AD 患者。
在研究纳入的患者中，41.2%为轻度（SCORing 特应性皮炎，SCORAD 0-15），43.6%为中度（SCORAD 16-40），15.2%为重度 AD（SCORAD >40）。报告的食物过敏在 AD 更严重的儿童中更为常见（p<0.0001），而 AD 严重程度与报告的吸入性过敏或被动吸烟之间无相关性（p=0.15 和 0.92）。保湿剂（55.1%）和局部皮质类固醇（TCS；45.7%）是前一个月的主要治疗选择。口服皮质类固醇和局部钙调神经磷酸酶抑制剂（TCI）的使用明显较少（分别为 6.3%和 4.5%），而除皮质类固醇外，无其他系统药物。在重度 AD 患者中，9.8%未使用 TCS、TCI 或任何系统治疗。此外，研究人群中有 20.0%的患者遵循了消除饮食，但只有 27.2%的患者报告有食物过敏。
不同 AD 严重程度类别中报告的食物过敏发生率存在显著差异。此外，尽管需要进一步的数据来证实我们的发现，但 AD 患儿的治疗不足似乎非常普遍，至少在那些在科马诺温泉水中心就诊的患者中是这样。此外，许多患者在没有报告食物过敏的情况下遵循了消除饮食。
