Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Safat, Kuwait.
Division of Epidemiology, Biostatistics and Environmental Health, School of Public Health, University of Memphis, Memphis, Tennessee, USA.
Clin Exp Allergy. 2022 Mar;52(3):416-425. doi: 10.1111/cea.14068. Epub 2021 Dec 12.
Eczema is a common inflammatory skin disease with varying developmental trajectories/patterns that are influenced by different risk factors. The aim of this study was to investigate eczema development from infancy to early adulthood by identifying distinct developmental trajectories that describe disease patterns over time and evaluate the role of prenatal and early-life risk factors.
The Isle of Wight Birth Cohort (n = 1456) was prospectively assessed at birth, 1, 2, 4, 10, 18 and 26 years. In all assessments, eczema was defined as chronic or chronically relapsing itchy dermatitis lasting >6 weeks with characteristic morphology and distribution in the past 12 months. Developmental trajectories of eczema between 1 or 2 and 26 years were identified separately for males and females by applying semiparametric mixture models. Associations were assessed by applying a modified Poisson regression to estimate adjusted risk ratios (aRR) and 95% confidence intervals (CI).
In both males and females, the following eczema developmental trajectories were identified: unaffected/transient (males: 77.7% vs. females: 73.0%), mid-onset late-resolving (males: 7.8% vs. females: 4.4%), late-onset (males: 5.2% vs. females: 9.5%) and early-onset persistent (males: 9.3% vs. females: 5.4%). In females, an additional trajectory was identified as follows: early-onset early-resolving (7.7%). Among males, filaggrin gene (FLG) variants (aRR = 2.45, 95% CI: 1.34-4.46) and paternal eczema (2.66, 1.39-5.08) were associated with the early-onset persistent trajectory. Among females, maternal eczema (2.84, 1.42-5.70) and high birthweight (2.25, 1.08-4.69) were associated with the early-onset persistent trajectory.
Four and five trajectories represented eczema development among males and females, respectively, with different predisposing risk factors. Our results indicate that males and females may experience a different course of eczema.
湿疹是一种常见的炎症性皮肤病，其发展轨迹/模式存在差异，受不同风险因素影响。本研究旨在通过识别描述疾病随时间变化模式的不同发展轨迹，探讨从婴儿期到成年早期的湿疹发展，并评估产前和生命早期危险因素的作用。
前瞻性评估了威特岛出生队列（n=1456）在出生、1、2、4、10、18 和 26 岁时的情况。在所有评估中，湿疹定义为过去 12 个月中持续>6 周的慢性或慢性复发瘙痒性皮炎，具有特征性形态和分布。分别为男性和女性应用半参数混合模型识别 1 或 2 岁至 26 岁之间的湿疹发展轨迹。应用改良泊松回归估计调整后的风险比（aRR）和 95%置信区间（CI）来评估关联。
在男性和女性中，均确定了以下湿疹发展轨迹：未受影响/短暂（男性：77.7%比女性：73.0%）、中发病晚缓解（男性：7.8%比女性：4.4%）、晚发病（男性：5.2%比女性：9.5%）和早发病持续（男性：9.3%比女性：5.4%）。在女性中，还确定了另一种轨迹如下：早发病早缓解（7.7%）。在男性中，丝聚蛋白基因（FLG）变体（aRR=2.45，95%CI：1.34-4.46）和父亲的湿疹（2.66，1.39-5.08）与早发病持续轨迹相关。在女性中，母亲的湿疹（2.84，1.42-5.70）和高出生体重（2.25，1.08-4.69）与早发病持续轨迹相关。
本研究分别在男性和女性中确定了 4 种和 5 种轨迹来代表湿疹的发展，其中具有不同的易患风险因素。我们的研究结果表明，男性和女性可能经历不同的湿疹病程。
