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SCORing Atopic Dermatitis (scoring + atopic_dermatitis)
Selected AbstractsLesson from performing SCORADs in children with atopic dermatitis: Subjective symptoms do not correlate well with disease extent or intensityINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 6 2006K. L. E. Hon MBBS Background, Atopic dermatitis (AD) is a distressing disease associated with pruritus and sleep disturbance. It is not known how well these symptoms correlate with the extent and intensity of eczematous involvement. We evaluated whether: (i) the level of sleep loss correlates with pruritus and (ii) the level of pruritus correlates with the extent or severity of AD in children according to the SCORing Atopic Dermatitis (SCORAD) index. Method, Patients with AD younger than 18 years old were recruited from the pediatric dermatology clinic of a university teaching hospital, and AD severity was evaluated by the SCORAD index. Results, One hundred and eighty-two Chinese children with AD (107 boys and 75 girls) [mean (SD) age of 9.6 (4.2) years] were recruited. Their mean (SD) overall SCORAD was 30.1 (19.2). Sleep loss was strongly correlated with pruritus (r = 0.57, P < 0.001). However, the two subjective symptoms were only weakly correlated with the objective signs (extent and intensity) of AD. The correlations between pruritus and extent and intensity were 0.42 (P < 0.001) and 0.38 (P < 0.001), respectively, and the correlations between sleep loss and extent and intensity were 0.38 (P < 0.001) and 0.34 (P < 0.001), respectively. Conclusion, We speculate that the lack of a better correlation was either because pruritus and sleep loss as reported by parents were imprecise, or that mechanisms other than disease extent or severity are responsible for the pathogenesis of these subjective symptoms. [source] Serum concentration of macrophage-derived chemokine may be a useful inflammatory marker for assessing severity of atopic dermatitis in infants and young childrenPEDIATRIC ALLERGY AND IMMUNOLOGY, Issue 4 2003Ting Fan Leung Chemokines are responsible for the trafficking of leukocytes to sites of inflammation. Serum chemokine levels were previously shown to be increased in adult patients with atopic dermatitis (AD). We tested whether serum concentrations of chemokines, including macrophage-derived chemokine (MDC), thymus and activation-regulated chemokine (TARC), eotaxin (EOX), interferon gamma inducible protein 10 (IP-10) and monocyte chemotactic protein 1 (MCP-1), are useful inflammatory markers for assessing AD severity in infants and young children. To investigate this, we assessed the severity of AD clinically using the SCORing Atopic Dermatitis (SCORAD) index system. Serum chemokine concentrations were determined by sandwich enzyme immunoassay. Twenty AD patients with a median age of 2.1 years [interquartile range (IQR): 0.6,4.2] were recruited. Their SCORAD score was 23.5 (12.5,33.5). Serum concentrations of MDC, TARC, EOX, IP-10 and MCP-1 were 2551 (1978,3935), 1469 (1125,3070), 68 (57,85), 126 (101,226) and 518 (419,614) pg/ml, respectively. Serum MDC levels correlated with SCORAD (r =,0.608, p = 0.004) and its extent (r =,0.629, p = 0.003) and intensity (r =,0.557, p = 0.011) components. Serum TARC concentration showed weaker correlation with extent (r =,0.474, p = 0.035) and intensity (r =,0.465, p = 0.039) of skin involvement but not SCORAD. The median serum levels of MDC (3131 vs. 2394 pg/ml; p = 0.031) and EOX (80 vs. 61 pg/ml; p = 0.046) were also higher in children with moderate as compared with mild AD. The other chemokines did not correlate with AD severity. In conclusion, our results suggest that serum MDC concentration may be a useful inflammatory marker for assessing AD severity in infants and young children. [source] Is the effect of probiotics on atopic dermatitis confined to food sensitized children?CLINICAL & EXPERIMENTAL ALLERGY, Issue 5 2006D. Sistek Summary Background Probiotics have previously been shown to reduce the severity of atopic dermatitis (AD) in infants and children. Objective To examine the effect of two probiotics (Lactobacillus rhamnosus and Bifidobacteria lactis) on established AD in children. Subjects and methods Atopic children with current dermatitis received 2 × 1010 colony forming units/g of probiotic (n=29) or placebo (n=30). Both were given daily as a powder mixed with food or water. SCORing Atopic Dermatitis (SCORAD; developed by the European Task Force on Atopic Dermatitis) a measure of the extent and severity of AD, was assessed at baseline, 2 and 12 weeks after starting treatment and 4 weeks after treatment was discontinued. Results SCORAD geometric mean score at baseline was 26.0 (21.9,30.8) in the probiotic group and 35.1 (28.9,42.8) in the placebo group (P=0.02). After adjustment for these between-group baseline differences there was no significant improvement in AD at 12 weeks, SCORAD geometric mean ratio: 0.80 (95% confidence level (CI) 0.62,1.04, P=0.10). Among the food sensitized children, there was an improvement in those treated with probiotics, SCORAD geometric mean ratio: 0.73 (95% CI 0.54,1.00, P=0.047). Conclusion In this study a combination of Lactobacillus rhamnosus and Bifidobacteria lactis improved AD only in food sensitized children. [source] Natural course of sensitization to cow's milk and hen's egg in childhood atopic dermatitis: ETACTM Study GroupCLINICAL & EXPERIMENTAL ALLERGY, Issue 1 2002A. Wolkerstorfer Background Sensitization to food allergens has been implicated in the pathogenesis of atopic diseases, in particular atopic dermatitis (AD). The aim of the present paper is to investigate the natural course of sensitization to egg and to cow's milk and its relationship with the severity of AD. Methods The placebo intention-to-treat population of the ETACTM (Early Treatment of the Atopic Child) study consisted of 397 children with AD aged 12,24 months (mean±,SD: 17.2 ± 4.1 months) who were followed for 18 months. All children were examined for objective SCORing Atopic Dermatitis (SCORAD) and specific IgE amongst other, to egg and to cow's milk at inclusion and after 3, 12 and 18 months. Fifteen patients were excluded from this analysis due to major protocol violations thus leaving 382 patients in the analysed population. Results Sensitization to egg and to cow's milk was more common in atopic children with severe AD at all time-points. At inclusion, children sensitized to both egg and to cow's milk had the most severe AD (Kruskall-Wallis test P = 0.007). The degree of sensitization expressed in RAST classes was significantly related to the severity of AD. Furthermore, children sensitized to egg or to cow's milk at inclusion had a higher risk of persistence of AD (84% and 67%, respectively, vs. 57% in those not sensitized) and a higher objective SCORAD after 18 months follow-up. Conclusion We found an association between severity of AD and sensitization to egg or to cow's milk. Moreover, sensitization to egg, and to a lesser extent cow's milk, indicates a worse outcome of AD in terms of persistence and severity of the disease. [source] A randomized double-blind controlled trial to compare a triclosan-containing emollient with vehicle for the treatment of atopic dermatitisCLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 4 2010W. P. Tan Summary The use of topical antiseptics in the treatment of atopic dermatitis (AD) has previously been explored. However, no triclosan-containing leave-on emollient has been evaluated previously, to our knowledge. The aims of this study were to assess the safety and efficacy of an emollient containing triclosan compared with the emollient alone (vehicle) for the treatment of AD. Eligible patients with mild to moderate AD were randomized to receive either the study cream or vehicle. All patients also received a low-potency corticosteroid cream to use during the treatment phase of the study if necessary. Patients were assessed for severity according to the SCORing Atopic Dermatitis (SCORAD) Index, amount of corticosteroid used, patient assessment of cream, and adverse events (AEs). In total, 60 patients received either the study cream or vehicle, and an intention-to-treat analysis was performed. At day 14, there was a significant decrease in SCORAD from baseline for the study cream compared with vehicle (P < 0.05). At day 27, although there was an improved mean reduction from baseline, this was no longer significant (P > 0.05). Only four patients had mild treatment-related AEs. The mean total amount of topical steroid applied by the patients using the study was significantly lower than that used by controls (P = 0.40). Triclosan-containing leave-on emollient was safe and highly acceptable to patients. However, the overall benefit on day 27 was not significant. Nevertheless, the amount of topical steroid used by patients was significantly less with the study cream than with the vehicle, thus further studies are needed to confirm its steroid-sparing effect. [source] Serum Concentration of IL-18 Correlates with Disease Extent in Young Children with Atopic DermatitisPEDIATRIC DERMATOLOGY, Issue 6 2004Kam Lun Ellis Hon F.A.A.P. Previous studies have suggested that IL-18 may be an inflammatory marker for atopic dermatitis (AD). The purpose of our study was to test whether the serum concentration of IL-18 is a useful inflammatory marker for assessing AD severity in young children. Nineteen AD patients with a median age of 2.2 years (interquartile range 0.7,4.6 years) were recruited. The severity of AD was clinically determined using the Scoring Atopic Dermatitis (SCORAD) index. Their SCORAD score was 23.9 (range 18.6,34.8). Serum IL-18 levels were determined by sandwich enzyme immunoassay. The median serum concentration of IL-18 was 394 pg/ml (interquartile range 204,612 pg/ml). Serum IL-18 levels correlated with SCORAD scores (r = 0.502, p = 0.029) and their extent component (r = 0.633, p = 0.004). When compared with mild disease with low SCORAD scores, the serum concentration in moderate to severe disease was significantly higher (p = 0.014). We concluded that serum IL-18 concentration is elevated in young children with AD. It may be a useful inflammatory marker that correlates with the extent component of AD in particular, and differentiates mild disease from more severe disease when used for assessing AD severity in young children. [source] Time Spent on Treatment of Atopic Dermatitis: A New Method of Measuring Pediatric Morbidity?PEDIATRIC DERMATOLOGY, Issue 6 2004Elisabeth A. Holm M.D. The TSOT (min/day) was studied in a group of 42 children with atopic dermatitis (AD) (16 girls and 26 boys; mean age 7.07 years). The TSOT included time spent on all types of topical treatment, on extra cleaning, and on visits to doctors. Objective Scoring Atopic Dermatitis (SCORAD) assessment was performed at each visit. A significant correlation was found between TSOT and SCORAD scores for all visits (p < 0.0001). There was no correlation between TSOT and age or sex or between TSOT/SCORAD and age (p < 0.08). For the 65 visits (by 42 children), TSOT/SCORAD ranged from 0.08 min/point to 28.67 min/point. Older children (10,15 years of age) had a lower TSOT/SCORAD ratio compared to younger children (1,5 years of age). Our data suggest that TSOT in itself may be a useful measure of morbidity among pediatric AD patients. It is speculated that patients with a very high TSOT/SCORAD rate or a very low rate have coping problems and would therefore be suitable candidates for intensified efforts in programs such as "eczema schools." [source] Validation of a Self-Administered Questionnaire in Chinese in the Assessment of Eczema SeverityPEDIATRIC DERMATOLOGY, Issue 6 2003Kam Lun Hon F.A.A.P. Each parent or patient filled out a questionnaire in Chinese based on the NESS. A physician then repeated the NESS independently. Finally, the severity of AD was evaluated according to the Scoring Atopic Dermatitis (SCORAD) scale. The NESSs, severity grades, and SCORAD were analyzed for agreement and correlation. The severity grading agreed with the physician's grading in 38 of 52 parents (73%) and in 16 of 18 children (89%) who self-evaluated the severity of their AD. The weighted kappa (95% confidence interval [CI]) for parents with children less than 10 years old, parents with children ,10 years old, and patients who self-evaluated their AD were 0.79 (0.66,0.91), 0.85 (0.69,1.00), and 0.74 (0.36,1.00), respectively. The R2 for the NESS by parents, the NESS by patients, and the SCORAD scores was 42.1%, 47.5%, and 49.8%, respectively. When compared with the parents, the older children who self-evaluated their AD showed a better correlation of the NESS with the SCORAD index. The self-administered questionnaire appears to be useful in assessing AD severity in Chinese children. [source] Circulating levels of brain-derived neurotrophic factor correlate with disease severity in the intrinsic type of atopic dermatitisALLERGY, Issue 12 2006U. Raap Background:, Recent studies have shed light on the complex regulation of genetic, environmental, immunologic and pharmacologic factors, which contribute to the development of atopic dermatitis (AD). However, it is still unclear to which extent neuroimmune mediators have a role in AD. Aims of the study:, To assess peripheral neurotrophin levels and their correlation with scoring atopic dermatitis (SCORAD) scores in both the intrinsic and extrinsic types of AD compared with patients with psoriasis and nonatopic healthy subjects. Methods:, Levels of brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) were assessed in peripheral blood with enzyme-linked immunosorbent assay. Based on IgE-mediated sensitization, AD was divided into the extrinsic and intrinsic type. Severity of AD was assessed with SCORAD score and with psoriasis area and severity index (PASI) in patients with psoriasis. Results:, Brain-derived neurotrophic factor and NGF were detectable in all the subjects studied. However, the levels of both neurotrophins were significantly higher in patients with extrinsic and intrinsic types of AD compared with patients with psoriasis and nonatopic healthy subjects (NGF: P < 0.001, BDNF: P < 0.001). NGF and BDNF levels were similar in the intrinsic and extrinsic type of AD. There was a significant correlation between BDNF and SCORAD score only in patients with the intrinsic type of AD (r = 0.57, P < 0.05). Conclusions:, This study shows for the first time that NGF and BDNF are increased in both, the extrinsic type and the intrinsic type of AD. This finding points to a similar pathophysiologic background implicating a neuroimmune network in both variants of this chronic inflammatory skin disease. Future studies are needed to show the direct mechanisms of neurotrophin action in chronic inflammatory skin. [source] | ||||||||||||||||||||||