Retrospective Analysis of the Natural History of Atopic Dermatitis Occurring in the First Year of Life in Korean Children

The aim of this study was to analyze the natural history of atopic dermatitis (AD) and the risk factors associated with the remission of AD in Korean children. We enrolled 597 children with AD that occurred in the first year of life. A variety of factors influencing the prognosis were assessed by medical records and telephone interviews. Their outcome was classified into complete remission, intermittent, and persistent AD. AD had completely disappeared in 422 cases (70.6%), while 149 (25%) and 26 cases (4.4%) showed intermittent and persistent skin symptoms, respectively. The average healing time was 29.6 months in complete remission group and expected healing time of the AD was 60 months. None of risk factors were significant by multivariate analysis. But, in moderate-to-severe AD group, maternal diet restriction during lactation (P = 0.046) and no sensitization to cow's milk (P = 0.017) were significantly associated with remission of AD in the multivariate analysis. In conclusion, AD occurring in the first year of life disappears in a significant proportion of patients. In addition, in Korean children with moderate-to-severe AD, maternal diet restriction of allergenic food during lactation and sensitization to cow's milk seem to predict the prognosis of AD.

Effects of Family History on the Occurrence of Atopic Dermatitis in Infants / 소아알레르기및호흡기학회지

PURPOSE: The prevalence of atopic dermatitis (AD) has been increased in Korea. We aim to investigate the risk factors for development of AD in infants, especially those factors related to the family history. METHODS: The data from 542 infants in our prospective birth cohort study were analyzed. The data from their parent were collected by questionnaires and skin prick tests. They were regularly followed up at 1 year of age when the presence of AD and allergen sensitization was determined. Various factors such as sex, cesarean section delivery, duration of breast feeding, presence of siblings, vaccination, antibiotic use and pet keeping were also assessed. RESULTS: AD developed in 109 infants (20.4%). In univariate analysis, the presence of either maternal or paternal allergic diseases increased the risk for development of AD in their infants. Multivariate logistic analysis, however, showed that only the presence of maternal allergic diseases correlated with the development of AD (P=0.018). While AD developed in 14.7% in infants of parents with no allergic history, the incidences of AD in infants with a single parent allergy history and in those with 2 parent allergy history were 27.0% and 41.7%, respectively. Their adjusted relative risks (95% confidence intervals) were 1.85 (1.24-2.89) and 2.93 (1.68-4.96), respectively. CONCLUSION: Parental allergic diseases, especially maternal allergic diseases, are possible risk factors for development of AD in Korean infants.