A Study on Clinical Features and Laboratory Findings According to the Severity of Atopic Dermatitis

Choi, Yu Sung; You, Chung Eui; Park, Mi Youn; Son, Sook Ja; Whang, Kyu Uang

Abstract

BACKGROUND
Although atopic dermatitis (AD) is a very common disease, there is no specific diagnostic or prognostic marker for it. Minor clinical features and a few laboratory findings can be used as ancillary diagnostic criteria and reflect the present state of AD, but cannot predict the disease severity.
OBJECTIVE
We performed this study to find out if there is any correlation among minor clinical features, laboratory findings such as blood eosinophil count and serum IgE levels, and the severity of AD.
METHODS
One hundred patients with AD were involved in the study. They were divided into two groups by the age of 12 years; group 1(< or = 12-year-old, n=47) represented childhood AD and group 2 (> or = 12-year-old, n=53) represented adolescence and adult AD. Subsequently, the severity of AD was assessed by the SCORAD index, and then all the patients were classified into 3 subgroups; mild, moderate and severe groups. They were evaluated for 28 minor clinical features of AD. In addition, blood samples were measured for blood eosinophil count and serum IgE levels.
RESULTS
The pattern of minor clinical features correlated significantly with the disease severity was quite different between the two groups, except ventral wrist eczema and eyelid eczema. Blood eosinophil count and serum IgE levels increased significantly as the SCORAD index increased. While perifollicular accentuation was a significant minor clinical feature that correlated with blood eosinophil count in the both groups, there were no minor features showing statistically significant correlation with serum IgE levels. In group 1, keratosis pilaris and infragluteal eczema appeared more frequently as all 3 variables such as the SCORAD index, blood eosinophil count and serum IgE levels, increased simultaneously. However, no minor clinical features which correlated significantly with all variables were observed in group 2.
CONCLUSION
We concluded that minor clinical features such as keratosis pilaris and infragluteal eczema reflect the disease severity and can be used as an anticipating sign of severe disease, especially in childhood AD.