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Variations in risk of asthma and seasonal allergies between early- and late-onset pediatric atopic dermatitis: A cohort study
被引:27
|作者:
Wan, Joy
[1
,2
]
Mitra, Nandita
[2
]
Hoffstad, Ole J.
[2
]
Gelfand, Joel M.
[1
,2
]
Yan, Albert C.
[3
]
Margolis, David J.
[1
,2
]
机构:
[1] Univ Penn, Sch Med, Dept Dermatol, Philadelphia, PA 19104 USA
[2] Univ Penn, Sch Med, Dept Biostat & Epidemiol, Philadelphia, PA 19104 USA
[3] Childrens Hosp Philadelphia, Dermatol Sect, Philadelphia, PA 19104 USA
基金:
美国国家卫生研究院;
关键词:
allergic rhinitis;
asthma;
atopic dermatitis;
atopic march;
eczema;
epidemiology;
hay fever;
seasonal allergies;
NATURAL-HISTORY;
PERSISTENCE;
CHILDHOOD;
MUTATIONS;
CHILDREN;
ECZEMA;
MARCH;
BOYS;
D O I:
10.1016/j.jaad.2017.06.013
中图分类号:
R75 [皮肤病学与性病学];
学科分类号:
100206 ;
摘要:
Background: Atopic dermatitis is associated with other allergic conditions, but variations in this "atopic march'' are poorly understood. Objective: To determine the impact of the age of atopic dermatitis onset on the risk for asthma and seasonal allergies. Methods: A cohort study was performed using the Pediatric Eczema Elective Registry, which is an observational cohort of subjects with pediatric onset atopic dermatitis. Results: In total, 3966 children were included, and 73% reported atopic dermatitis onset before age 2 years. At baseline, subjects with atopic dermatitis onset at ages 3 to 7 or 8 to 17 years had significantly lower rates of seasonal allergies and asthma than those with onset before age 2. During follow-up, the adjusted relative risks for incident seasonal allergies were 0.82 (95% confidence interval, 0.72-0.91) and 0.64 (95% CI confidence interval, 0.47-0.83) in the 3-to 7- and 8- to 17-years-old at onset groups compared with the age 2 years or younger at onset group. The adjusted risk for incident asthma was not significantly different between the older onset groups and the earliest onset group. Limitations: Misclassification bias may arise from using self-reported onset age data. Conclusions: The timing of atopic dermatitis onset may explain part of the variation in the atopic march. These findings may improve future risk stratification of patients for treatment.
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页码:634 / 640
页数:7
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