Clinical features of atopic dermatitis and evaluation of its diagnostic criteria: a retrospective analysis of 165 inpatients with atopic dermatitis from 2000 to 2020 / 中华皮肤科杂志

ABSTRACT

Objective:To analyze and summarize clinical characteristics of atopic dermatitis (AD) , and to discuss differences and consistency among the Williams′, Japanese and Chinese diagnostic criteria for AD.Methods:A retrospective analysis was performed on 165 hospitalized patients with AD diagnosed according to the Williams′ criteria or the Chinese Zhang′s criteria in Southwest Hospital of Army Medical University from October 2000 to May 2020. Clinical data were re-evaluated according to the Williams′, Japanese and Chinese diagnostic criteria, and differences were analyzed among these criteria. Measurement data were compared by using t test, analysis of variance or rank sum test, and enumeration data were compared by using chi-square test or Fisher′s exact test. Results:Among the 165 patients, 66 (40.00%) developed AD before the age of 2 years; 95 (57.58%) had a personal and/or family history of atopic diseases, of whom 75 had a personal history of atopic diseases (mainly including allergic rhinitis [28.48%] and asthma[20.00%]) , 50 had a family history of atopic diseases, and 30 had both a personal and a family history of atopic diseases. A total of 98 patients (59.39%) were allergic to dust mites, including 48 with grade Ⅵ allergy. According to the total IgE level, 130 (78.79%) patients were diagnosed with exogenous AD, and 35 (21.21%) with endogenous AD. There were significant differences in the age at onset and blood eosinophil count between the patients with exogenous AD and those with endogenous AD (both P < 0.001) . After re-evaluation, 142 (86.06%) patients met the Williams′ criteria, 23 did not, and there was a significant difference in the age at onset between the two groups of patients ( P = 0.007) ; 150 (90.91%) patients met the Chinese Zhang′s criteria, 15 did not, and there was a significant difference in blood eosinophil counts between the two groups of patients ( P = 0.001) ; 160 (96.97%) patients met the Chinese Yao′s criteria; all patients met the Japanese criteria. There were no significant differences in the age at onset, total IgE level or blood eosinophil counts among patients meeting the Williams′ criteria, meeting the Japanese criteria, meeting the Zhang′s criteria, and those meeting the Yao′s criteria (all P > 0.05) . Conclusion:Patients with early-onset AD were prone to develop the highest-grade dust mite allergy; patients with exogenous AD were characterized by lower age at onset and higher eosinophil counts compared with those with endogenous AD; patients who met the Williams′ criteria showed lower age at onset than those who did not, while patients who met the Chinese Zhang′s criteria showed higher eosinophil counts than those who did not.