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Phenotypes of atopic dermatitis depending on the timing of onset and progression in childhood

Roduit, Caroline and Frei, Remo and Depner, Martin and Karvonen, Anne M. and Renz, Harald and Braun-Fahrländer, Charlotte and Schmausser-Hechfellner, Elisabeth and Pekkanen, Juha and Riedler, Josef and Dalphin, Jean-Charles and von Mutius, Erika and Lauener, Roger Pascal and Pasture Study Group, and Hyvärinen, Anne and Kirjavainen, Pirkka and Remes, Sami and Roponen, Marjut and Dalphin, Marie-Laure and Kaulek, Vincent and Ege, Markus and Genuneit, Jon and Illi, Sabina and Kabesch, Micahel and Schaub, Bianca and Pfefferle, Petra Ina and Doekes, Gert. (2017) Phenotypes of atopic dermatitis depending on the timing of onset and progression in childhood. JAMA Pediatrics, 171 (7). pp. 655-662.

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Official URL: http://edoc.unibas.ch/55638/

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Abstract

Atopic dermatitis is an inflammatory, pruritic skin disease that often occurs in early infancy with a chronic course. However, a specific description of subtypes of atopic dermatitis depending on the timing of onset and progression of the disease in childhood is lacking.; To identify different phenotypes of atopic dermatitis using a definition based on symptoms before age 6 years and to determine whether some subtypes are more at risk for developing other allergic diseases.; The Protection Against Allergy Study in Rural Environments (PASTURE) is a European birth cohort where pregnant women were recruited between August 2002 and March 2005 and divided in 2 groups dependent on whether they lived on a farm. Children from this cohort with data on atopic dermatitis from birth to 6 years of age were included.; Atopic dermatitis, defined as an itchy rash on typical locations from birth to 6 years.; The latent class analysis was used to identify subtypes of atopic dermatitis in childhood based on the course of symptoms. Multivariable logistic regressions were used to analyze the association between atopic dermatitis phenotypes and other allergic diseases.; We included 1038 children; of these, 506 were girls. The latent class analysis model with the best fit to PASTURE data separated 4 phenotypes of atopic dermatitis in childhood: 2 early phenotypes with onset before age 2 years (early transient [n = 96; 9.2%] and early persistent [n = 67; 6.5%]), the late phenotype with onset at age 2 years or older (n = 50; 4.8%), and the never/infrequent phenotype (n = 825; 79.5%), defined as children with no atopic dermatitis. Children with both parents with history of allergies were 5 times more at risk to develop atopic dermatitis with an early-persistent phenotype compared with children with parents with no history of allergies. Both early phenotypes were strongly associated with food allergy. The risk of developing asthma was significantly increased among the early-persistent phenotype (adjusted odds ratio, 2.87; 95% CI, 1.31-6.31). The late phenotype was only positively associated with allergic rhinitis.; Using latent class analysis, 4 phenotypes of atopic dermatitis were identified depending on the onset and course of the disease. The prevalence of asthma and food allergy by 6 years of age was strongly increased among children with early phenotypes (within age 2 years), especially with persistent symptoms. These findings are important for the development of strategies in allergy prevention.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Environmental Exposures and Health > Physical Hazards and Health (Röösli)
UniBasel Contributors:Braun-Fahrländer, Charlotte
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:American Medical Association
ISSN:2168-6203
e-ISSN:2168-6211
Note:Publication type according to Uni Basel Research Database: Journal article
Identification Number:
Last Modified:23 Oct 2017 09:49
Deposited On:23 Oct 2017 09:49

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