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diagnostic criteria for atopic dermatitis

Sunna Thorsteinsdottir, Jakob Stokholm, Jacob P Thyssen, Sarah Nørgaard, Jonathan Thorsen, Bo L Chawes, Klaus Bønnelykke, Johannes Waage, Hans Bisgaard
Importance: Knowledge about factors associated with persistence of atopic dermatitis (AD) during childhood is sparse. Objective: To explore heritable, environmental, and clinical factors associated with persistent AD based on 13 years' follow-up of an at-risk birth cohort. Design, Setting, and Participants: In the Copenhagen Prospective Study on Asthma in Childhood 2000 (COPSAC2000) clinical birth cohort study, 411 children born to mothers with asthma were followed up until the age of 13 years at a clinical research unit in Copenhagen, Denmark, from August 1998 to June 2015...
November 14, 2018: JAMA Dermatology
Nikolaos A Kitsioulis, Nikolaos G Papadopoulos, Sophia Kostoudi, Emmanouil Manousakis, Nikolaos Douladiris, Paraskevi Xepapadaki
Background: Atopic dermatitis (AD) and chronic spontaneous urticaria (CSU) represent two of the most common chronic inflammatory pruritic skin diseases. Any relationship between atopic skin disorders and CSU is controversial, mostly due to the paucity of relevant epidemiologic and pathogenetic data. Objective: To evaluate whether a history of AD in early childhood represents a risk factor for the subsequent occurrence of CSU in a pediatric population. Methods: Retrospective data of new cases of patients who visited the outpatient allergy unit of a tertiary pediatric hospital in Athens, Greece, between June 2014 and August 2016, were analyzed...
November 1, 2018: Allergy and Asthma Proceedings:
Miriam Santer, Kate Rumsby, Matthew J Ridd, Nick A Francis, Beth Stuart, Maria Chorozoglou, Amanda Roberts, Lyn Liddiard, Claire Nollett, Julie Hooper, Martina Prude, Wendy Wood, Emma Thomas-Jones, Taeko Becque, Kim S Thomas, Hywel C Williams, Paul Little
BACKGROUND: Childhood eczema is very common. Treatment often includes emollient bath additives, despite there being little evidence of their effectiveness. OBJECTIVES: To determine the clinical effectiveness and cost-effectiveness of emollient bath additives in the management of childhood eczema. DESIGN: Pragmatic, randomised, open-label, multicentre superiority trial with two parallel groups. SETTING: Ninety-six general practices in Wales, the west of England and southern England...
October 2018: Health Technology Assessment: HTA
Catalina Rincón-Pérez, Désirée Larenas-Linnemann, Marco Antonio Figueroa-Morales, Jorge Luna-Pech, Linda García-Hidalgo, Alejandra Macías-Weinmann, Javier Gómez-Vera, José Fernando Barba-Gómez, Juan José Matta-Campos, Esther Guevara-Sangines, Fermín Jurado-Santacruz, Adriana López Tello-Santillán, José Antonio Ortega-Martell, Nancy Pulido-Díaz, Liliana Guadalupe Serrano-Jaén, Mirna Toledo-Bahena, Guadalupe Villanueva-Quintero, José Luis Mayorga-Butrón
BACKGROUND: The diagnostic approaches and therapeutic strategies of atopic dermatitis (AD) are generally inconsistent among physicians and health institutions. OBJECTIVE: To develop a consensus statement among experts to reduce the variations in practice regarding the diagnosis and treatment of patients ≥ 12 years with AD to improve their care. METHODS: Systematic literature search in PubMed and GREAT. With methodological support and using the Delphi method, a formal consensus was developed among 16 experts in Dermatology and Allergology, based on the current evidence and its applicability in the Mexican context...
2018: Revista Alergia Mexico: Organo Oficial de la Sociedad Mexicana de Alergia e Inmunología, A.C
Sandeep Kapur, Wade Watson, Stuart Carr
Atopic dermatitis (AD) is a common, chronic skin disorder that can significantly impact the quality of life of affected individuals as well as their families. Although the pathogenesis of the disorder is not completely understood, it appears to result from the complex interplay between defects in skin barrier function, environmental and infectious agents, and immune dysregulation. There are no diagnostic tests for AD; therefore, the diagnosis is based on specific clinical criteria that take into account the patient's history and clinical manifestations...
2018: Allergy, Asthma, and Clinical Immunology
Jonathan I Silverberg, Joel M Gelfand, David J Margolis, Mark Boguniewicz, Luz Fonacier, Mitchell H Grayson, Eric L Simpson, Peck Y Ong, Zelma C Chiesa Fuxench
BACKGROUND: The patient burden and quality of life (QOL) impact of atopic dermatitis (AD) in the United States population is not well established. OBJECTIVE: To elucidate the patient burden of AD in the US population. METHODS: A cross-sectional, population-based study of 602 adults was performed. Atopic dermatitis was determined using modified UK Diagnostic Criteria for AD. Its severity was assessed using self-reported global AD severity, Patient-Oriented Eczema Measure (POEM), Patient-Oriented Scoring AD (PO-SCORAD), PO-SCORAD-itch, and sleep...
September 2018: Annals of Allergy, Asthma & Immunology
Jonathan I Silverberg, Joel M Gelfand, David J Margolis, Luz Fonacier, Mark Boguniewicz, Lawrence B Schwartz, Eric Simpson, Mitchell H Grayson, Peck Y Ong, Zelma C Chiesa Fuxench
BACKGROUND: Patient-Oriented Eczema Measure (POEM) is the preferred patient-reported outcome (PRO) for assessing symptoms of atopic dermatitis (AD). Dermatology Life Quality Index (DLQI) is commonly used to assess the burden of skin disease. Previous severity strata were developed for POEM and DLQI in clinical cohorts, which may be biased toward more severe disease. Severity strata were not previously examined in population-based cohorts. Patient-Oriented Scoring AD (PO-SCORAD) is another commonly used PRO for assessing AD symptoms; however, severity strata are not established...
October 2018: Annals of Allergy, Asthma & Immunology
Belinda Sheary
BACKGROUND: Concerns about topical steroid withdrawal (TSW) are leading some patients to cease long-term topical corticosteroid (TCS) therapy. Diagnostic criteria for this condition do not exist. OBJECTIVE: The aim of this study was to examine the demographics and outcomes in adult patients who believe they are experiencing TSW following discontinuation of chronic TCS overuse. METHODS: This was a retrospective cohort study of patients in an Australian general practice presenting with this clinical scenario between January 2015 and February 2018...
July 2018: Dermatitis
Harrison H Lee, Kevin R Patel, Vivek Singam, Supriya Rastogi, Jonathan I Silverberg
BACKGROUND: Previous studies found conflicting results about whether atopic dermatitis (AD) begins in adulthood. OBJECTIVE: To determine rates, predictors and phenotypical differences of adult-onset AD. METHODS: A systematic review was performed of all published observational studies in MEDLINE, EMBASE, GREAT, LILACS, Cochrane Library, and Scopus that analyzed the age of AD onset beyond 10 years of age. Two reviewers performed study title/abstract review and data abstraction...
June 1, 2018: Journal of the American Academy of Dermatology
Miriam Santer, Matthew J Ridd, Nick A Francis, Beth Stuart, Kate Rumsby, Maria Chorozoglou, Taeko Becque, Amanda Roberts, Lyn Liddiard, Claire Nollett, Julie Hooper, Martina Prude, Wendy Wood, Kim S Thomas, Emma Thomas-Jones, Hywel C Williams, Paul Little
OBJECTIVES: To determine the clinical effectiveness and cost effectiveness of including emollient bath additives in the management of eczema in children. DESIGN: Pragmatic randomised open label superiority trial with two parallel groups. SETTING: 96 general practices in Wales and western and southern England. PARTICIPANTS: 483 children aged 1 to 11 years, fulfilling UK diagnostic criteria for atopic dermatitis. Children with very mild eczema and children who bathed less than once weekly were excluded...
May 3, 2018: BMJ: British Medical Journal
Grace C Brummer, Lawrence T Wang, Richard D Sontheimer
Aging individuals can develop generalized, exquisitely-pruritic, eczematous eruptions of uncertain etiology that can be therapeutically-refractory and life-altering. Limited information exists in the literature to guide clinicians in the diagnosis and management of such patients. It is suggested that in approximately 40% of such patients a known cause for their chronic pruritic eruptions cannot be identified. In this report we will refer to this subgroup of patients as having idiopathic chronic eczematous eruption of aging (CEEA)...
February 15, 2018: Dermatology Online Journal
Z Ali, C Suppli Ulrik, T Agner, S F Thomsen
Obesity has been associated with atopic dermatitis (AD); however, the results have been conflicting. Our aim was to provide an update on current knowledge from observational studies addressing the possible association between obesity and AD. Systematic literature review was performed by identifying studies addressing a possible link between AD and overweight/obesity from PubMed, EMBASE and the Cochrane Library in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines...
February 14, 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
Z Reguiaï
Atopic dermatitis (DA) is a chronic inflammatory skin disease. Its incidence and prevalence is increasing, especially in industrialized countries. The prevalence of AD in adults is estimated at 1-3 % of the general population and can present as adult-onset AD, or as infantile/childhood AD that persists, or recurs in adulthood. There are no specific diagnostic criteria for adult AD. Diagnosis may be also complicated by the fact that the clinical manifestations sometimes differ from pediatric AD. Moreover, many recent studies have identified adult AD as a systemic disease...
December 2017: Annales de Dermatologie et de Vénéréologie
K A Engebretsen, J Bandier, S Kezic, C Riethmüller, N H H Heegaard, B C Carlsen, A Linneberg, J D Johansen, J P Thyssen
BACKGROUND: Atopic dermatitis (AD) is characterized by skin barrier dysfunction. Notably, a high number of nano-scale protrusions on the surface of corneocytes, which can be expressed by the Dermal Texture Index (DTI), were recently associated with paediatric AD, loss-of-function mutations in filaggrin gene (FLG) and reduced levels of natural moisturizing factors (NMF). No study has so far examined the association between these parameters and monomeric filaggrin levels in adults. OBJECTIVE: To determine DTI, monomeric filaggrin and NMF in healthy controls and a group of patients with controlled dermatitis...
May 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
T Arikoglu, S B Batmaz, D D Yildirim, Ö Tezol, G Bozlu, S Kuyucu
BACKGROUND: The identification of children who will have persistent asthma has become a focus of recent research. The aim of this study was to assess whether impulse oscillometry (IOS) has a diagnostic value to predict modified API (asthma predictive index) in pre-schoolers with recurrent wheezing. METHODS: Pre-school children aged 3-6 years with recurrent wheezing were enrolled. The study population was divided into two groups based on mAPI criteria. Lung function was assessed by IOS...
March 2018: Allergologia et Immunopathologia
Maxwell M Tran, Diana L Lefebvre, Christoffer Dharma, David Dai, Wendy Y W Lou, Padmaja Subbarao, Allan B Becker, Piush J Mandhane, Stuart E Turvey, Malcolm R Sears
BACKGROUND: The atopic march describes the progression from atopic dermatitis during infancy to asthma and allergic rhinitis in later childhood. In a Canadian birth cohort we investigated whether concomitant allergic sensitization enhances subsequent development of these allergic diseases at age 3 years. METHODS: Children completed skin prick testing at age 1 year. Children were considered sensitized if they produced a wheal 2 mm or larger than that elicited by the negative control to any of 10 inhalant or food allergens...
February 2018: Journal of Allergy and Clinical Immunology
Y M F Andersen, A Egeberg, C R Hamann, L Skov, G H Gislason, T Skaaby, A Linneberg, J P Thyssen
BACKGROUND: The association between atopic dermatitis (AD) and cardio-metabolic risk factors is not yet established. Furthermore, no validated questionnaire-based method of identifying adults with AD is currently available. OBJECTIVES: To assess the cardio-metabolic risk in adults with a history of AD using 3 different questionnaire-based diagnostic criteria. METHODS: We utilized data from a general population study including questionnaire data and objective measurements of 9656 Danish adults...
April 2018: Allergy
Mary Laird, Kristen Lo Sicco
Atopic dermatitis (AD) has no definitive diagnostic test and has a large range of phenotypes, making it a difficult disease to assess and define. However, an agreed-upon definition of AD is important for clinical trials, population-based studies, and clinical practice. Several diagnostic criteria systems have been proposed to fill these needs, with none considered the gold standard. To further aid in standardized assessment of AD patients, numerous disease severity and quality of life measurement tools have been proposed...
2017: Advances in Experimental Medicine and Biology
Tetyana O Kryuchko, Inna M Nesina, Olha Ya Tkachenko
INTRODUCTION: The most common medical conditions in infants, which belong to pediatric and gastroenterological disease areas, are functional gastrointestinal disorders, food hypersensitivity and food allergy. First of all, these symptoms can disguise lactase deficiency, cow's milk protein allergy, eosinophilic gastroenteritis, allergic proctocolitis, gastrointestinal manifestations of atopic dermatitis, functional disorders of gastrointestinal and biliary tract, etc. The aim of our study was to develop an algorithm of monitoring for infants with disorders of the gastrointestinal tract and to study the efficacy of probiotic and enzyme replacement therapy...
2017: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Carmela Avena-Woods
Atopic dermatitis (AD), also known as atopic eczema, is a chronic relapsing inflammatory skin condition. Incidence of AD has increased 2- to 3-fold in industrialized nations, impacting approximately 15% to 20% of children and 1% to 3% of adults worldwide. AD has a wide-ranging impact on a patient's quality of life and the burden from direct and indirect costs (approximately $37.7 billion in out-of-pocket costs) is shared by the families and caregivers of patients with AD. This article reviews the epidemiology, burden of disease, pathophysiology, and diagnostic criteria important for early diagnosis and treatment...
June 2017: American Journal of Managed Care
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