title: Risk factors of severe atopic dermatitis in childhood: single-center experience.
abstract: The aim of this study was to evaluate the risk factors of disease severity to facilitate better management of children with severe atopic dermatitis (AD). All the patients were diagnosed using Hanifin-Rajka criteria. After medical and family histories were obtained and a detailed physical examination was performed, disease severity was determined with the objective SCORing Atopic Dermatitis (SCORAD) index. Skin prick tests were performed, and percent of peripheral blood eosinophils, total serum IgE and specific IgE were measured. The median age of the 501 patients was 15 months (interquartile range [IQR]: 6-40 months), and 62.9% (315) were male. Sensitization to at least one allergen and foods was observed in 40.3% (202) and 30.9% (155) of all patients, respectively. Of the study group, 17.6% (88) had severe disease. When logistic regression analyses were performed, with adjustments, the risk factors for severe AD were determined to be eosinophilia (odds ratio [OR] 1.137, 95% confidence interval [CI] 1.062-1.217; p=0.003) and food allergen sensitization (OR: 1.937, 95%CI: 1.217-3.084; p=0.005). The patients with severe AD had sensitization to common allergens, food allergens and eosinophilia more frequently than those with mild-moderate disease (p=0.001, p=0.001 and p=0.005, respectively). Eosinophilia may predict severe disease and allergic sensitization. Further large-scale follow-up studies are needed to improve the reliability and relevance of this relation.
authors.affiliation: Division of Pediatric Allergy and Immunology, Department of Pediatrics, Ankara Children's Hematology Oncology Training and Research Hospital, Ankara, Turkey.
authors.forename: Ayşegül
authors.initials: A
authors.lastname: Akan
authors.forename: Dilek
authors.initials: D
authors.lastname: Azkur
authors.forename: Ersoy
authors.initials: E
authors.lastname: Civelek
authors.forename: Mustafa
authors.initials: M
authors.lastname: Erkoçoğlu
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Yılmaz-Öztorun
authors.forename: Ayşenur
authors.initials: A
authors.lastname: Kaya
authors.forename: Celal
authors.initials: C
authors.lastname: Ozcan
authors.forename: Emine
authors.initials: E
authors.lastname: Vezir
authors.forename: Müge
authors.initials: M
authors.lastname: Toyran
authors.forename: Emine
authors.initials: E
authors.lastname: Dibek-Mısırlıoğlu
authors.forename: Can Naci
authors.initials: CN
authors.lastname: Kocabaş
mesh_terms: D000485:Allergens / Q000276:immunology*; D002675:Child, Preschool; D003876:Dermatitis, Atopic / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D015994:Incidence; D007223:Infant; D008297:Male; D015203:Reproducibility of Results; D012307:Risk Factors; D012720:Severity of Illness Index; D012882:Skin Tests; D014421:Turkey / Q000453:epidemiology
chemical_list: D000485:Allergens; D007073:Immunoglobulin E