[Risk factors for atopic dermatitis and familial prevalence in Spain (ELIHO study)]. / Factores de riesgo y prevalencia familiar de la dermatitis atópica en España (estudio ELIHO).

INTRODUCTION: Atopic dermatitis (AD) is a cutaneous disease of unknown etiology. It shows a clear genetic predisposition with probable environmental modulation. This study evaluated risk factors associated with diagnosis and flares of AD in Spanish children. PATIENTS AND METHODS: We performed an observational, multicenter, retrospective case-control study that included 4243 children aged less than 14 years old with AD and 978 controls matched for age and sex. Family history of disease and environmental variables were collected in both groups and clinical history of AD was recorded in the case group. RESULTS: Significant risk factors for AD were: a family history of the disease and concomitant cutaneous infections. The prevalence of AD in first degree relatives was 39 % and that in second degree relatives was 19 % (higher in maternal than paternal lines). The mean age of children with AD was 4.2 (SD 3.4) years and the mean age at diagnosis was 1.5 (SD 2.2) years, with a mean of 2.9 (SD 2.6) flares during the previous year. Cold weather (Cantabrian and Continental Iberian Peninsula areas) was related to a greater number of flares. Children with AD had a greater number of concomitant cutaneous diseases and infections than children in the control group. CONCLUSIONS: AD is mainly a genetic disease, with climatic factors involved in severity modulation, and with important immunological alterations. In contrast, this study found no domestic environmental factors that were associated with disease onset.

Factores de riesgo y prevalencia familiar de la dermatitis atópica en España (estudio ELIHO) / Risk factors for atopic dermatitis and familial prevalence in Spain (ELIHO study)

Introducción: La dermatitis atópica (DA) es una enfermedad de etiología desconocida, con clara predisposición genética y una probable participación de factores ambientales. El objetivo del estudio era evaluar los factores de riesgo asociados al diagnóstico y aparición de brotes de DA en niños españoles. Pacientes y métodos: Estudio observacional, multicéntrico, retrospectivo de casos y control que incluyó una muestra de 4.243 niños menores de 14 años afectados de DA y 978 controles ajustados por edad y sexo. Se recogieron datos de antecedentes familiares y características del entorno familiar en ambos grupos y características clínicas de la DA en los pacientes. Resultados: Los factores de riesgo significativos para la aparición de DA fueron los antecedentes familiares y las infecciones concomitantes de la piel. La prevalencia de DA en familiares de primer grado fue del 39 % y en familiares de segundo grado, del 19 % (superior en línea materna que paterna). La edad media de los niños afectados fue de 4,2 (desviación estándar [DE] 3,4) años y la edad media en el diagnóstico fue de 1,5 (DE 2,2) años, con un número medio de brotes de la enfermedad de 2,9 (DE 2,6) en el año previo. En las zonas de España con clima más frío (cantábrico y continental) se observó mayor número de brotes. Los niños con DA presentaron mayor coincidencia de enfermedades cutáneas e infecciosas que los niños control. Conclusiones: La DA es una enfermedad con una gran predisposición genética, modulada por factores climáticos y que acarrea alteraciones inmunológicas. Por el contrario no encontramos influencias significativas de factores ambientales domésticos

Introduction: Atopic dermatitis (AD) is a cutaneous disease of unknown etiology. It shows a clear genetic predisposition with probable environmental modulation. This study evaluated risk factors associated with diagnosis and flares of AD in Spanish children. Patients and methods: We performed an observational, multicenter, retrospective case-control study that included 4243 children aged less than 14 years old with AD and 978 controls matched for age and sex. Family history of disease and environmental variables were collected in both groups and clinical history of AD was recorded in the case group. Results: Significant risk factors for AD were: a family history of the disease and concomitant cutaneous infections. The prevalence of AD in first degree relatives was 39 % and that in second degree relatives was 19 % (higher in maternal than paternal lines). The mean age of children with AD was 4.2 (SD 3.4) years and the mean age at diagnosis was 1.5 (SD 2.2) years, with a mean of 2.9 (SD 2.6) flares during the previous year. Cold weather (Cantabrian and Continental Iberian Peninsula areas) was related to a greater number of flares. Children with AD had a greater number of concomitant cutaneous diseases and infections than children in the control group. Conclusions: AD is mainly a genetic disease, with climatic factors involved in severity modulation, and with important immunological alterations. In contrast, this study found no domestic environmental factors that were associated with disease onset