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.
引用
收藏
页码:634 / 640
页数:7
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