Atopic dermatitis: frequency of associated disorders in children

ABSTRACT

Atopic dermatitis is a chronic inflammatory disease of multifactorial origin. It is the most common type of childhood eczema seen in our community. Most of these patients have a positive family or personal history of atopy in the form of asthma, allergic rhinitis or hay fever. Multiple dermatological disorders are associated with the atopic dermatitis. The study was aimed to see the frequency of these associations in children with atopic dermatitis in our community and to compare these results with international literature. The study was carried out in the department of dermatology, "Ziauddin Medical University, KDLB Campus" from 1[st] September 2003 to 31[st] August 2004. All the freshly registered patients up to 15 years of age suffering from atopic dermatitis were enrolled in the study. The clinical diagnosis was made on the basis of diagnostic criteria for atopic dermatitis described by UK's working party. All the findings were recorded on a preformed pro forma and relevant investigations carried out. Results were compiled and tabulated. The family history of atopy was positive in 78 patients [68.4%] while the personal history of atopy in 48 [42.1%]. Irritant contact reactions were commonly observed in 52 patients [45.6%]. Dry and cold weather exacerbated the disease in 85 patients [74.5%] while 3 patients [2.6%] suffered aggravation in summer. Among endogenous eczemas discoid eczema was seen in 27 patients [30.8%], pityriasis alba in 21 [18.4%], and seborrheic dermatitis in 10 patients [8.8%]. The most common infections were bacterial, seen in 1 2 patients [1 0.5%] 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 were seen in 7 patients [6.1%]. Other findings observed in our patients were Dennie-Morgan fold in 4 patients [3.5%] and cataract in 5 patients [4.5%]. Atopic dermatitis is associated with multiple conditions. A high percentage of patients have a positive family or personal history of atopy. Environmental factors like weather, irritants and infections cause worsening of the disease. Atopic patients have an increased frequency of other endogenous eczemas and nail and eye changes