BACKGROUND: Atopic dermatitis (AD) represents the most common chronic inflammatory skin disease in childhood. Few data are available about the different AD phenotypes and their nationwide distribution. METHODS: We performed a cross-sectional multicentre study involving some of the main Italian paediatric allergy centres in 9 Italian cities. A structured questionnaire was administered to 371 children with AD. Patients were divided in two groups: preschool children (aged <5 years) and schoolchildren (aged 6-14 years). A latent class analysis (LCA) was used to detect AD phenotypes and to investigate their association with risk factors and other atopic diseases. RESULTS: LCA identified five AD phenotypes in preschoolers group (8% "moderate-severe AD, high comorbidity", 35% "moderate-severe AD, low comorbidity", 20% "mild AD, low comorbidity", 32% "mild AD, respiratory comorbidity", 5% "mild AD, food-induced comorbidity") and four AD phenotypes in schoolchildren (24% "moderate-severe AD, high comorbidity", 10% "moderate-severe AD, low comorbidity", 16% "mild AD, low comorbidity", 49% "mild AD, respiratory comorbidity"). Parental history of asthma and eczema, early day-care attendance and mould exposure were associated significantly to the "moderate-severe AD, high comorbidity" phenotype in preschool children (p<0.05). The "moderate-severe AD" phenotypes showed also to have the higher burden in terms of medication use and daily activities limitation. CONCLUSIONS: The detection of different AD phenotypes suggests the importance of a stratified approach to the management of this complex disease and the need of further studies to predict AD course and to develop more efficient therapeutic strategies.

Atopic dermatitis phenotypes in preschool and school-age children: a latent class analysis

Licari, A;
2020-01-01

Abstract

BACKGROUND: Atopic dermatitis (AD) represents the most common chronic inflammatory skin disease in childhood. Few data are available about the different AD phenotypes and their nationwide distribution. METHODS: We performed a cross-sectional multicentre study involving some of the main Italian paediatric allergy centres in 9 Italian cities. A structured questionnaire was administered to 371 children with AD. Patients were divided in two groups: preschool children (aged <5 years) and schoolchildren (aged 6-14 years). A latent class analysis (LCA) was used to detect AD phenotypes and to investigate their association with risk factors and other atopic diseases. RESULTS: LCA identified five AD phenotypes in preschoolers group (8% "moderate-severe AD, high comorbidity", 35% "moderate-severe AD, low comorbidity", 20% "mild AD, low comorbidity", 32% "mild AD, respiratory comorbidity", 5% "mild AD, food-induced comorbidity") and four AD phenotypes in schoolchildren (24% "moderate-severe AD, high comorbidity", 10% "moderate-severe AD, low comorbidity", 16% "mild AD, low comorbidity", 49% "mild AD, respiratory comorbidity"). Parental history of asthma and eczema, early day-care attendance and mould exposure were associated significantly to the "moderate-severe AD, high comorbidity" phenotype in preschool children (p<0.05). The "moderate-severe AD" phenotypes showed also to have the higher burden in terms of medication use and daily activities limitation. CONCLUSIONS: The detection of different AD phenotypes suggests the importance of a stratified approach to the management of this complex disease and the need of further studies to predict AD course and to develop more efficient therapeutic strategies.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11571/1348718
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