The prevalence of atopic dermatitis in Puerto Rican school children.

BACKGROUND: Atopic dermatitis is a common inflammatory disease of the skin that usually begins in childhood and its diagnosis depends on clinical criteria. Recent reports have indicated that the worldwide prevalence of atopic dermatitis is increasing. The objective of this study was to determine the prevalence of atopic dermatitis in schoolchildren between the ages of six and seven in two school districts in Puerto Rico. METHODS: The Laughter questionnaire, developed to determine the prevalence of atopic dermatitis in schoolchildren was translated and validated in Spanish. A population-based prevalence survey was conducted among second grade students in the districts of Guaynabo and Humacao, Puerto Rico. The prevalence of atopic dermatitis was determined by sex, school type (private or public), and geographical location (urban or rural) using the questionnaire. RESULTS: Ninety-two percent (92 %) of the eligible schools participated in the study. A total of 2,393 questionnaires were distributed with a response rate of 53 %. The prevalence of atopic dermatitis among the population surveyed was 24.8%. The prevalence of atopic dermatitis by sex or geographic location was not significantly different (p>0.05). An excess of atopic dermatitis was observed in private schools (31.0%) when compared to public schools (19.9%). The effect remained after controlling potential confounders (POR Mantel-Haenszel = 1.37; 95%CI: 1.07 - 1.42). CONCLUSION: This study presents evidence of a significant public health problem in Puerto Rico. The prevalence of atopic dermatitis in Puerto Rico is high and possibly a large percentage (70%) of the patients is not been diagnosed.

A randomized, double-blind, placebo-controlled trial of the combined effect of doxycycline hyclate 20-mg tablets and metronidazole 0.75% topical lotion in the treatment of rosacea.

BACKGROUND: Subantimicrobial doses of doxycycline may improve outcomes in rosacea when combined with topical metronidazole and used as maintenance monotherapy. OBJECTIVE: The purpose of this study was to evaluate the safety and efficacy of doxycycline hyclate 20 mg (subantimicrobial dose doxycycline) administered twice daily as an adjunct to metronidazole 0.75% topical lotion in the treatment of rosacea. METHODS: Patients received subantimicrobial doses of doxycycline twice daily plus metronidazole (n = 20) or placebo plus metronidazole (n = 20) for 12 weeks. Subantimicrobial-dose doxycycline or placebo monotherapy continued for 4 weeks. The primary efficacy measure was change from baseline in total inflammatory lesions at weeks 2 and 16. RESULTS: Total inflammatory lesions were reduced significantly (P =.048) by week 4 and by all subsequent visits in the subantimicrobial-dose doxycycline/metronidazole group compared with placebo/metronidazole. Changes from baseline increased over time and were maintained during subantimicrobial-dose doxycycline monotherapy. CONCLUSION: Adjunctive use of subantimicrobial dose doxycycline significantly reduced the clinical signs of rosacea compared with metronidazole alone and may be useful maintenance monotherapy.