Atopic dermatitis: frequency of associated disorders in children

Abstract

Background Atopic dermatitis is a chronic inflammatory disease of multifactorial origin. It isthe most common type of childhood eczema seen in our community. Most of these patientshave a positive family or personal history of atopy in the form of asthma, allergic rhinitis orhay fever. Multiple dermatological disorders are associated with the atopic dermatitis.Objective The study was aimed to see the frequency of these associations in children withatopic dermatitis in our community and to compare these results with international literature.Patients and methods The study was carried out in the department of dermatology, “ZiauddinMedical University, KDLB Campus” from 1st September 2003 to 31st August 2004. All thefreshly registered patients up to 15 years of age suffering from atopic dermatitis wereenrolled in the study. The clinical diagnosis was made on the basis of diagnostic criteria foratopic dermatitis described by UK’s working party. All the findings were recorded on apreformed pro forma and relevant investigations carried out. Results were compiled andtabulated.Results The family history of atopy was positive in 78 patients (68.4%) while the personalhistory of atopy in 48 (42.1%). Irritant contact reactions were commonly observed in 52patients (45.6%). Dry and cold weather exacerbated the disease in 85 patients (74.5%) while3 patients (2.6%) suffered aggravation in summer. Among endogenous eczemas discoideczema was seen in 27 patients (30.8%), pityriasis alba in 21 (18.4%), and seborrheicdermatitis in 10 patients (8.8%). The most common infections were bacterial, seen in 12patients (10.5%) followed by viral and fungal infections seen in 9 (7.8%) and 4 patients(3.5%), respectively. Nail changes like pitting, ridging, thickening and discoloration wereseen in 7 patients (6.1%). Other findings observed in our patients were Dennie-Morgan foldin 4 patients (3.5%) and cataract in 5 patients (4.5%).Conclusion Atopic dermatitis is associated with multiple conditions. A high percentage ofpatients have a positive family or personal history of atopy. Environmental factors likeweather, irritants and infections cause worsening of the disease. Atopic patients have anincreased frequency of other endogenous eczemas and nail and eye changes.