Research Article: Clinical profile, reported triggers, and comorbidity pattern in children and adolescents with atopic dermatitis: a cross-sectional study from Fujian, China

Abstract:
Detailed clinical descriptions of paediatric atopic dermatitis from southern China are scarce; available Chinese data are largely modelled burden estimates or laboratory series of allergen sensitisation. This single-centre cross-sectional study included 47 children and adolescents aged 3.6–19.0?years meeting the UK Working Party criteria at a tertiary dermatology clinic in Fuzhou, Fujian Province, China. Triggers, comorbidities and family history were extracted from routine records and are reported as recorded histories, not as verified diagnoses or as prevalence estimates. Severity was assessed by body surface area (BSA), a score the assessing dermatologist reports having assigned as a global clinical impression rather than computed from the SCORing Atopic Dermatitis (SCORAD) components, as well as the Patient-Oriented Eczema Measure (POEM) and the Children’s Dermatology Life Quality Index. The two source workbooks were audited for copying artefacts, and every value flagged by the audit was checked against the original clinic record. Proportions are reported with Wilson 95% confidence intervals. Median age was 11.0?years (interquartile range 6.0–13.5?years). House dust mite was the most frequently reported trigger (27/47, 57.4%), followed by seafood or crustaceans (40.4%) and a damp environment (21.3%); most participants reported more than one trigger. No specific IgE or skin prick testing was performed, so these are reported triggers only and not sensitisations. A family history of allergic disease was recorded in 95.7% (95% CI 85.8–98.8) and allergic rhinitis in 70.2% (56.0–81.3); the rhinitis figure is partly constitutive of the enrolment criteria, and the family history figure reflects a deliberately broad definition. Recorded asthma was rare (1/44, 2.3%), a record-keeping observation rather than a prevalence estimate. Seventeen values in 10 records were residues of copying between the workbooks and were corrected against the original records. BSA and the severity score correlated within each batch ( ? =?0.71 and 0.58) but not when pooled ( ? =?0.03), whereas POEM correlated with BSA throughout; severity is therefore reported by batch. House dust mite was the most frequently reported trigger, a recorded history of allergic rhinitis was common, and the disease was predominantly moderate within each batch. Every figure is a recorded-history count reflecting one clinic's ascertainment and its enrolment criteria, not a population prevalence estimate. These are preliminary observations requiring confirmation in larger, prospectively defined, multi-centre cohorts.

Introduction:
Detailed clinical descriptions of paediatric atopic dermatitis from southern China are scarce; available Chinese data are largely modelled burden estimates or laboratory series of allergen sensitisation.

Read more