Jiang X, Zhao J H, Tang H Y, Wang R J, Zhang D J, Wang Y, Li H, Hao F
Dermatology and Plastic Surgery Center, the Third Affiliated Hospital of Chongqing Medical University, Chongqing 401120, China.
Department of Dermatology and Venerology, Peking University First Hospital & National Clinical Research Center for Skin and Immune Disease & Beijing Key Laboratory of Molecular Diagnosis of Dermatoses & NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics, Beijing 100034, China.
Zhonghua Yi Xue Za Zhi. 2023 Aug 29;103(32):2495-2501. doi: 10.3760/cma.j.cn112137-20230517-00814.
To investigate and analyze the clinical features of elderly atopic dermatitis (AD) in China. Based on the National Clinical Research and Homogeneous Diagnosis and Treatment Project for Type 2 Inflammation Dermatosis, a total of 2 281 patients aged 65 years or older were enrolled from 172 grade A tertiary hospitals who were diagnosed as atopic dermatitis from June 2021 to February 2023, and their demographics, clinical feature, and disease severity, etc. were collected. Elderly AD patients were divided into groups based on gender, history of allergic diseases (with or without a personal or family history of allergic diseases), and clinical features (site of onset, AD signs) and scales were compared within the groups. Median (, ) was used for quantitative data. The age of 2 281 elderly AD patients was 73.02 (68.83, 79.62) years old, among whom there were 1 649 males (72.29%) and 632 females (27.71%). A total of 2 244 cases were recorded with the information of the onset stage, of whom 1 713 cases (76.34%) occurred in the elderly stage. A total of 2 136 cases were recorded with the information of personal or family history of allergic diseases, of which 1 076 cases (50.37%) had a personal or family history of allergic diseases, and 1 060 (49.63%) had no history of allergic diseases. Skin lesions were predominantly involved in the waist, back, buttocks, and AD signs were mainly eczema-like skin lesions on the cheek and/or scalp and/or limb extension. Patients with moderate to severe AD accounted for 60.58% (1 327 cases), moderate to severe itching accounted for 81.32% (1 781 cases). Patients with anxiety and depression accounted for 46.14% (1 011 cases) and 39.27% (860 cases), respectively. Men had a higher EASI score than women [9.67 (4.77, 19.28) vs 8.45 (3.98, 17.11), =0.040]. EASI, HADS-anxiety and WI-NRS scores were higher in patients with history of allergic diseases than those without allergy history [ (9.79 (4.84, 19.96) vs 8.96 (4.05, 18.31), =0.015; 7.22 (3.49, 10.00) vs 6.81 (3.12, 9.33), =0.012; 7.64 (5.62, 9.07) vs 7.38 (5.35, 8.91), =0.036]. Elderly AD patients have their own exclusive clinical manifestations, and the understanding of these characteristics is beneficial for guiding clinical development of targeted management plans. Elderly AD patients are mostly senile onset, and male patients are more than female patients, skin lesions are mainly distributed on the extended side, and the disease burden is heavy.
调查分析我国老年特应性皮炎（AD）的临床特征。基于国家2型炎症性皮肤病临床研究与同质化诊疗项目，从172家三级甲等医院纳入2021年6月至2023年2月期间诊断为特应性皮炎的2281例65岁及以上患者，收集其人口统计学资料、临床特征、疾病严重程度等。老年AD患者根据性别、过敏性疾病史（有无个人或家族过敏性疾病史）、临床特征（发病部位、AD体征）分组，并比较组内量表情况。定量资料采用中位数（，）表示。2281例老年AD患者年龄为73.02（68.83，79.62）岁，其中男性1649例（72.29%），女性632例（27.71%）。共记录2244例发病阶段信息，其中1713例（76.34%）发生于老年期。共记录2136例个人或家族过敏性疾病史信息，其中1076例（50.37%）有个人或家族过敏性疾病史，1060例（49.63%）无过敏性疾病史。皮肤损害主要累及腰、背、臀部，AD体征主要为面颊和/或头皮和/或肢体伸侧的湿疹样皮肤损害。中度至重度AD患者占60.58%（1327例），中度至重度瘙痒患者占81.32%（1781例）。焦虑和抑郁患者分别占46.14%（1011例）和39.27%（860例）。男性的EASI评分高于女性[9.67（4.77，19.28）对8.45（3.98，17.11），=0.040]。有过敏性疾病史患者的EASI、HADS焦虑和WI-NRS评分高于无过敏史患者[（9.79（4.84，19.96）对8.96（4.05，18.31），=0.015；7.22（3.49，10.00）对6.81（3.12，9.33），=0.012；7.64（5.62，9.07）对7.38（5.35，8.91），=0.036]。老年AD患者有其独特的临床表现，了解这些特征有利于指导制定针对性的临床管理方案。老年AD患者多为老年期发病，男性多于女性，皮肤损害主要分布于伸侧，疾病负担较重。
