The Clinico-Epidemiological Profile and
the Risk Factors Associated with
the Severity of Atopic Dermatitis (AD)
in Eastern Indian Children
Dr. Mani Kant Kumar
Assistant Professor, Department of Pediatrics,
Narayan Medical College and Hospital, At+PO- Jamuhar,
Sasaram, Dist- Rohtas, Bihar, Pin-821305 , India.
Phone: +919162095353, +919234461396
To study the clinical features and the various epidemiological risk factors and their correlation with the severity of atopic dermatitis in eastern Indian children (Bihar).
A prospective hospital based study.
The Paediatrics OPD and the Dermatology OPD of a tertiary care teaching hospital which was located in the Rohtas district of Bihar, India. The study was carried out over a period of 2 years from January 2010 to December 2011.
One hundred and thirty two children of the ages of zero months to 15 years, who were diagnosed with atopic dermatitis. Main Outcome: The demographic profile, the common clinical features and the various risk factors and their correlation with the severity of atopic dermatitis in eastern Indian children.
Out of a total of 1829 paediatric patients of the ages of zero months to 15 years with paediatric dermatoses, 132 (7.21 %) had atopic dermatitis. Of the 132 patients, 57 (43.2%) were boys and 75 (56.8%) were girls, with a male to female ratio of 1: 1.3. Among these, 29 were infants and 103 were children. Two (62.1%) patients belonged to rural areas, while 50 (37.9%) belonged to urban areas. A personal history, a family history (up to the third degree relatives) and both a personal and a family history of atopy were present in 43.18 %, 33.34 % and 12.1 % of the patients respectively. Forty (30.3 %) patients had been exclusively breast fed during the first six months of their lives. A majority (89.4 %) of the patients had the onset of the disease before they were five years of age. In infantile AD, the mean age Â± SD at onset was 5.2 Â± 3.01months. In the infantile group, 8 (27.6 %) patients had mild, 14 (48.3 %) had moderate and 7 (24.1 %) had severe atopic dermatitis. Infantile AD had a statistically significant higher SCORAD (SCORing Atopic Dermatitis)index score in all the three grade of severity of the disease. One hundred and three patients had childhood AD, out of which 40 (38.8 %) were boys and 63 (61.2 %) were girls, with a male to female ratio of 1: 1.57. In childhood AD, the mean age Â± SD at the onset of the disease was 3.47 years Â± 3.02. . Sixty three (61.1 %) patients belonged to the rural areas, while 40 (38.9 %) were from urban areas. In the first six months of their lives, 31 (30 %) children had been exclusive breast fed, 64 (62.23 %) had been mixed fed and 8 (7.77 %) had been exclusively bottle fed. One hundred and thirty (98 %) patients presented with itching. The exclusively breast fed children were more likely to have mild AD. The mixed fed and the bottle fed children had a higher risk for developing moderate and severe AD, with an odds ratio of 2.24 (95 % CI 0.58-8.3) and 2.741 (95% CI 0.397- 18.9) respectively. In winter season, statistically significant risk to had moderate and severe form atopic dermatitis than other seasons (rainy and summer).
Although the prevalence of AD has been considered to be increasing, it still remains low in comparison to that in the developed countries. In Indian children, the disease is relatively milder than in the children of the developed countries. This study identified the winter season, bottle feeding during the first six months of life and infantile AD as the risk factors for moderate and severe AD. Exclusive breast feeding during the first six months of life seemed to protect against moderate and severe AD.