Thorsteinsdottir et al evaluated pediatric patients with atopic dermaitits. They identified features which can help to identify a patient who may have persistent disease. The authors are from the University of Copenhagen and Naestved Hospital in Denmark.
Patient selection: child with atopic dermatitis
Atopic dermatitis was considered persistent if it was still present at age 13 years. Most children have a transient condition during early childhood.
Risk factors for persistent atopic dermatitis:
(1) heredity (high AD genetic risk score based on FLG gene mutations, paternal atopic dermatitis)
(2) environmental exposures
(3) paternal asthma
(4) allergic sensitization (as evidenced by elevated serum IgE levels against a panel of allergens)
(5) more severe disease at onset (based on SCORAD)
(6) higher socioeconomic circumstances (based factors such as maternal education and household income)
(7) presence of Hanifin and Rajka minor criteria (Dennie-Morgan folds, anterior neck folds, white dermographism, intolerance to wool, itching when sweating, tendency to skin infection, food intolerance, food allergy)
A patient with persistent atopic dermatitis tends to have multiple risk factors.
