A comparison study of age-related clinical features and complicating factors in children hospitalized for severe atopic dermatitis

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  • Watanabe Yohei
    Department of Pediatrics, Sendai Medical Center Department of General Pediatrics, Miyagi Children's Hospital
  • Hayashi Chiyo
    Department of General Pediatrics, Miyagi Children's Hospital
  • Kurokouchi Akiko
    Children's Medical Center, Fujisawa City Hospital Department of General Pediatrics, Miyagi Children's Hospital
  • Abe Hiroshi
    Department of Pediatrics, Japan Community Health Care Organization, Sendai Hospital Department of General Pediatrics, Miyagi Children's Hospital
  • Miura Katsushi
    Department of General Pediatrics, Miyagi Children's Hospital

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  • 入院治療を要した小児重症アトピー性皮膚炎患者における年齢別臨床像・重症化因子の検討

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Background: The clinical course of childhood atopic dermatitis (AD) is affected by age-related physical and social factors. Childhood AD can be complicated by allergens, bacterial infection, stress, and inadequate treatment with skin care and topical corticosteroids, resulting in deterioration; moreover, some of severe AD cases require hospitalization. Aim: The aim of this study was to analyze the clinical characteristics and complicating factors of childhood AD by age group through the analysis of hospitalized cases. Methods: We retrospectively analyzed 82 cases of severe AD hospitalized in Miyagi Children's Hospital from November, 2003 to November, 2012. Results: Twenty-seven out of the 82 cases (33.0%) were infantile cases, that presented with significantly more electrolyte imbalance and lower protein levels than the older cases. In addition, more of the infantile cases were born in the autumn months, and hospitalized in the winter months, compared with the older cases. In all age groups, the major complicating factors were inadequate skin care, and the prescription and application of topical corticosteroids. Doctors and parents tended to apply corticosteroids less frequently in the infantile cases, and the older cases were often severe because of poor adherence to the prescribed topical therapy. Conclusion: Adequate skin care and application of topical corticosteroids are standard therapies in childhood AD, and these are essential for the prevention of severe childhood AD. Infantile AD should be treated carefully, particularly because they are more severe AD cases in infants than in other age groups.

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