title: The natural course of childhood atopic dermatitis: a retrospective cohort study.
abstract: BACKGROUND
  Atopic dermatitis (AD) is generally considered to be the initial step of the so-called atopic march, which following steps are allergic rhinitis (AR) and asthma. There are few data about the progression of AD, including factors associated with the remission of AD in Asians and further research is needed.
  
  
  OBJECTIVE
  To study the progression and factors associated with the remission of childhood AD diagnosed by pediatric dermatologists.
  
  
  METHODS
  This study included 303 AD patients who visited the pediatric dermatology unit at King Chulalongkorn Memorial Hospital, Thailand, between 2002 and 2010. An interview, performed by a physician via telephone using a preformed questionnaire, was completed for 205 children.
  
  
  RESULTS
  A total of 205 children were observed, with a median observation time of 5.2 (3.5-8.0) years, and an initial AD severity score of mild (61.0%), moderate (29.3%) and severe (9.7%). The prevalence of AD during the first two years of life was 64.4%. AD completely disappeared in 102 cases (49.8%) by the median age of 3.5 (1.5-7.8) years. Early onset and severity of AD were major determinant of prognosis. The prevalence of AR and asthma was 36.6%, and 9.3%, respectively. The risk factors associated with respiratory allergy were the onset of AD after aged two years, a family history of atopy, increased serum IgE level, and sensitization to inhalant allergens.
  
  
  CONCLUSIONS
  Half of AD had completely disappeared at preschool age. Good prognosis was mostly determined by early onset AD and mild severity. Late onset, family history of atopy and increased serum IgE level are associated with respiratory allergy.
authors.affiliation: Division of Pediatric Dermatology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
authors.forename: Siriwan
authors.initials: S
authors.lastname: Wananukul
authors.forename: Susheera
authors.initials: S
authors.lastname: Chatproedprai
authors.forename: Therdpong
authors.initials: T
authors.lastname: Tempark
authors.forename: Weena
authors.initials: W
authors.lastname: Phuthongkamt
authors.forename: Pantipa
authors.initials: P
authors.lastname: Chatchatee
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001249:Asthma / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003876:Dermatitis, Atopic / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology; D018450:Disease Progression; D005260:Female; D006306:Health Surveys; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D007223:Infant; D008297:Male; D015995:Prevalence; D011379:Prognosis; D012074:Remission Induction; D012189:Retrospective Studies; D065631:Rhinitis, Allergic / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology; D012307:Risk Factors; D012720:Severity of Illness Index; D013785:Thailand / Q000453:epidemiology; D013997:Time Factors
chemical_list: D015415:Biomarkers; D007073:Immunoglobulin E