Epidemiological survey on atopic dermatitis in children: origin, clinical diagnosis and treatment
December 13, 2014
Louze M. 1, Chavagnac-Bonneville M.1, Denis A.1 and Sayag M.1. 1Research and Development Department, Laboratoire Dermatologique Bioderma, Lyon, France
INTRODUCTION Atopic dermatitis (AD) is an itchy, inflammatory and chronic skin disease affecting mainly newborns and children. It reflects the development of an inflammatory immune response occurring in a genetically atopic background (AD, asthma, allergic rhinitis) with a predisposition to this response. Its prevalence in industrialised countries has increased over the last two decades , however few studies were performed on the epidemiology of this pathology in France. The aim of this epidemiological investigation carried out on cases of AD in children was to gather data relating to the origin, clinical forms and treatment of this pathology in France. This work has therefore enabled us to evaluate the situation four years after the Consensus Conference which culminated in a set of recommendations for the improved and harmonised treatment of AD .
MATERIAL AND METHODS This epidemiological investigation was carried out in France with the collaboration of 200 private dermatologists, enabling collection of data on 600 children suffering from acute outbreaks of AD, seen in medical pratices from April to September 2008. All of the qualitative variables have been expressed in terms of percentage of children.
The results obtained on 489 children (average age 6.4 ±5.4 years) suffering from AD shows that 75% of them present family history with atopic suffer very frequent in parents from first grade (89%) (table 1a). Moreover, 79 of the children live in town or suburbs and 47% not school age children are looked after at home (table 1b).
Clinical diagnosis: On average, the children presented 3 outbreaks of AD over the past year, with moderate severity in 54% of them. In 28% of cases, triggering factors are identified including the stress which is often mentioned. 53.5% of the children examined in the medical practices present a moderate AD according to the SCORAD index (table 2). For only 25% of the dermatologists the SCORAD helped them to define a treatment while 46% of them found that an evaluation of the patients' quality of life would be useful, in particular for severe AD cases. Treatment: 84% of dermatologists prescribe a dermocorticoid, usually class II (60.3%), in the form of a cream (82%), to be used once a day (71.5%) for an average of 11 days, most frequently on a daily basis until the lesions disappear (45%) (table 3).
CONCLUSION Recent data obtained in our investigation show the importance of genetic factors but also of the environment at the origin of AD. Indeed, current life-style and stress seem to be potential triggering factors that may explain the increase in the number of children affected with AD over the last twenty years. Moreover, these clinical data on a significant number of patients show that treatment of AD by dermatologists generally follows the recommendations made by the Consensus Conference, even though the use of SCORAD remains marginal.
References: 1. Torres-Borrego et al.(2008) Prevalence and associated factors of allergic rhinitis and atopic dermatitis in children. Allergol Immunopathol (Madr) 36:90-100 2. Prise en charge de la dermatite atopique. Ann Dermatol Venereol. (2005; 132:1S19-33
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