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Symptom burden of atopic dermatitis in early childhood assessed from daily monitoring of symptoms and topical steroid use - 15/02/21

Doi : 10.1016/j.jaad.2020.09.038 
Iben Frier Ruge, MD, Sunna Thorsteinsdóttir, MD, PhD, Sarah Nørgaard, MSc, Bo L. Chawes, MD, DMSc, PhD, Klaus Bønnelykke, MD, PhD, Jakob Stokholm, MD, PhD, Hans Bisgaard, MD, DMSc
 Copenhagen Prospective Studies on Asthma in Childhood, Faculty of Health and Medical Sciences and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark 

Correspondence to: Hans Bisgaard, MD, DMSc, Copenhagen Prospective Studies on Asthma in Childhood, COPSAC, Gentofte Hospital, University of Copenhagen, Ledreborg Alle 34, DK-2820 Gentofte, Denmark.Copenhagen Prospective Studies on Asthma in Childhood, COPSACGentofte HospitalUniversity of CopenhagenLedreborg Alle 34GentofteDK-2820Denmark

Abstract

Background

To our knowledge, disease burden of atopic dermatitis (AD) as number of days with symptoms and medical treatment has never been studied as measure of severity.

Objectives

To investigate risk factors for AD burden in the first 3 years of life.

Methods

The Copenhagen Prospective Studies on Asthma in Childhood2010 included 700 children. AD burden was assessed by daily diary entries with information on AD and steroid days measuring 18 possible heritable, prenatal, and postnatal environmental exposures.

Results

The children with AD had a median (interquartile range) of 136 symptom days (61-294 days) and 72 steroid days (27-145 days) during the first 3 years of life, with the highest disease burden in the second year of life. The multivariable risk factor analysis showed that maternal AD and childhood allergic sensitization were associated with a higher number of AD days and maternal AD, filaggrin mutation, and allergic sensitization were associated with a higher number of steroid days.

Limitations

Participants with a personal interest in atopic diseases could be more likely to participate.

Conclusion

Children's burden of AD, assessed quantitatively as AD and steroid days, demonstrated positive associations with maternal AD, filaggrin mutation, and early-life allergic sensitization, with the highest disease burden in the second year of life.

Le texte complet de cet article est disponible en PDF.

Key words : atopic dermatitis, burden of disease, corticosteroids, eczema severity, filaggrin, pediatrics

Abbreviations used : AD, aIRR, CI, COPSAC2010, COPSAC2000, IRR, IQR, SCORAD


Plan


 Drs Ruge and Thorsteinsdóttir contributed equally to this article.
 Funding sources: Copenhagen Prospective Studies on Asthma in Childhood (COPSAC) is funded by private and public research funds, all listed on www.copsac.com. The Lundbeck Foundation, The Ministry of Health, Danish Council for Strategic Research, The Danish Council for Independent Research, and The Capital Region Research Foundation have provided core support for COPSAC. Novo Nordisk Foundation has funded the specific project in terms of the author's salary. The funding agencies did not have any role in the design and conduct of the study; collection, management, and interpretation of the data; or preparation, review, or approval of the manuscript.
 Conflicts of interest: None disclosed.
 IRB approval status: Reviewed and approved by the Ethics Committee for Copenhagen (H-B-2008-093) and the Danish Data Protection Agency (2015-41-3696).
 Reprints not available from the authors.


© 2020  American Academy of Dermatology, Inc.. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 84 - N° 3

P. 725-734 - mars 2021 Retour au numéro
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