Clinic Features Of Two Hundred And Ninty Eight Children With Atopic Dermatitis

Objective: To investigate the onset age, seasonal variation of atopic dermatitis(AD)and the impact of disease on quality of life and to find out the clinic features among Chinese AD children in different age.Methods: 298 AD children confirmed by Hanifin and Rejka criteria were investigated by questionnaire. The onset age, seasonal variation and the life quality of AD patients were obtained after the analysis of data. 3 groups were separated according to age in order to find out the clinic features among Chinese AD children in different age. EXCEL software and SPSS17.0 for windows were used for statistical analysis.Results: 298 AD children were composed of 62(20.8%) below the age of 2, 152(51.0%) at the age of 2~6, 76(25.5%) at the age of 7~11, and 8(2.7%) over the age of 12, with an average age of 60.3±40.8m. There were slightly more boys than girls with a male: female ratio 1.1:1. 59.1% of the patients had an onset age below 6 months old. Seasonal variation was observed in 63.8% of the patients: 40.9% of the 298 AD children aggravating in winter and 40.6% mitigrating in summer. 77.9% of the patients reported a family or personal history of atopic disease. The history of allergic rhinitis was found more than that of asthma. 68.2% of the patients suffered from food intorlerence. Xerotes and effusion were found to predominate in infants with AD; xerotes was found predominate in childhood of AD; while the lesion of most adolescent AD patients presented as lichenification. The area of lesion was significantly larger in infantile patients than that of patients above 2 years old. Head, flexor aspect of limbs and trunk were most often involved in infant; flexor aspect of limbs, especially cubital fossa and popliteal fossa were involved in most patients in childhood and adolescence. Every patient accompanied with 8.3±2.3 of the 23 secondary symptoms in Hanifin and Rejka criteria on average. Hyperlinear palm(78.2%), anterior neck folds(76.2%), pruritus when perspiration(73.8%), orbital darkness(73.2%), early onset age(72.5%), course of disease affected by envioroment and emotion(66.4%), xerotes(58.1%) and Dennie-Morgan folds(52.0%) were found in most of patients, while anterior subcapsular cataract and keratoconus were rare among the patients. The frequencies of nipple eczema, perifollicular accentuation, food intolerance and pruritus when perspiration were higher in infantile AD, however, the frequencies of pityriasis alba and nonatopic extremity dermatitis were higher in childhood and adolescence. Besides the secondary symptoms in Hanifin and Rejka criteria above-mentioned, some other symptoms were found prevalent in AD patient, such as nail dystrophy (75.5%), eyelid eczema (43.3%), infraauricular fissuring (37.2%) and frictional lichnoid eruptions (33.2%). Nail dystrophy often occurred in patients with hand involved. At the time of examination pruritus was present in 100% of patients. In 97.7% of patients pruritus caused difficulty in falling asleep. We didn't find ny relationship between pruritus and xerotes; however, a positive correlation between pruritus and the severity of lesion was comfirmed. Sweating was an aggravating factor of pruritus.Conclusions:1. For most of the AD patients, the onset of disease occurs in postinnatal 6 months.2. There is a seasonal variation of AD, i.e. AD usually aggravats in winter and mitigrates in summer.3. Most of the AD patients accompany with a family or personal history of atopic disease; and food intorlerence is prevalent in AD patients.4. It is different in the patten and area of lesion, the severity of AD, and involved part among patients in different age5. Hyperlinear palm, anterior neck folds, pruritus when perspiration, orbital darkness, early onset age, course of disease affected by envioroment and emotion, xerotes and Dennie-Morgan folds are prevalent in Chinese AD patients, however, anterior subcapsular cataract and keratoconus are rare in Chinese AD patients.6. The frequencies of nipple eczema, perifollicular accentuation, food intolerance and pruritus when perspiration are higher in infantile AD, however, the frequencies of pityriasis alba and nonatopic extremity dermatitis are higher in childhood and adolescence.7. Nail dystrophy often occurres in AD patients with hand involved.8. There is no relationship between pruritus and xerotes; however, a positive correlation between pruritus and the severity of lesion is comfirmed. Sweating is an aggravating factor of pruritus.