This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (10)  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in this journal  Topic Collections  • Dermatologic Disorders  • Dermatologic Disorders, Other  • Alert me on articles by topic  Social Bookmarking   What's this?

The Copenhagen Prospective Study on Asthma in Childhood Cohort Study in High-Risk Children

Liselotte Brydensholt Halkjær, MD; Lotte Loland, MD, PhD; Frederik F. Buchvald, MD, PhD; Tove Agner, MD, DMSci; Lone Skov, MD, PhD; Matthew Strand, PhD; Hans Bisgaard, MD, DMSci

Arch Dermatol. 2006;142:561-566.

Objectives  To describe the development of atopic dermatitis (AD) during the first 3 years of life and identify the localization of the early skin lesions that predicts the development of AD.

Design  Prospective, longitudinal, birth cohort study of children born to mothers with a history of asthma, followed up for 3 years with scheduled visits every 6 months as well as visits for onset or acute exacerbations of skin symptoms.

Setting  The cohort was recruited from greater Copenhagen, Denmark, and followed up at a clinical research unit, which controlled all diagnoses and treatment of skin diseases.

Participants  A total of 411 infants were enrolled in the cohort; 55 had incomplete follow-up and were excluded from certain analyses.

Main Outcome Measures  Atopic dermatitis was defined based on the criteria of Hanifin and Rajka, and severity was assessed by the SCORAD (Scoring Atopic Dermatitis) index. Predictive odds ratios of early skin lesions for those who developed AD vs those who did not were calculated.

Results  The cumulative incidence of AD by age 3 years was 44% (155/356). The prevalence rate peaked at age 2 years for boys and at age 2.5 years for girls, but there were no other sex differences in the proportion of children developing AD. Skin involvement in infants with AD was found to begin at the scalp, forehead, ear, and neck in a balaclava-like pattern and continue to the extensor sides and trunk, finally affecting the flexor sides of the extremities. Early skin lesions of arms and joints best predicted AD at age 3 years.

Conclusions  Atopic dermatitis begins at the scalp, forehead, ear, and neck in a balaclava-like pattern. Eczema at the arms and joints provides the highest predictive value for the development of AD at age 3 years. This may be used for early prediction and intervention of AD.

Author Affiliations: Danish Pediatric Asthma Centre, Department of Pediatrics (Drs Brydensholt Halkjær, Loland, Buchvald, and Bisgaard), and Danish Research Centre of Allergy, Department of Dermatology (Drs Agner and Skov), Copenhagen University Hospital, Gentofte, Denmark; and Division of Biostatistics, National Medical Jewish and Research Center, Denver, Colo (Dr Strand).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLES

Successful Treatment of Severe Atopic Dermatitis in a Child and an Adult With the T-Cell Modulator Efalizumab
Jeffrey M. Weinberg and Elaine C. Siegfried
Arch Dermatol. 2006;142(5):555-558.
EXTRACT | FULL TEXT  

Topical Calcineurin Inhibitors for Atopic Dermatitis: Balancing Clinical Benefit and Possible Risks
Abrar A. Qureshi and Michael A. Fischer
Arch Dermatol. 2006;142(5):633-637.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Chromosome 17q21 Gene Variants Are Associated with Asthma and Exacerbations but Not Atopy in Early Childhood
Bisgaard et al.
Am. J. Respir. Crit. Care Med. 2009;179:179-185.
ABSTRACT | FULL TEXT  

Early Arm or Leg Lesions Predict Development of Atopic Dermatitis
Dinulos
AAP Grand Rounds 2006;16:27-28.
FULL TEXT  

Atopic Dermatitis in Infants: The "Balaclava Area," Arms, and Joints Are Most Significant
Journal Watch Dermatology 2006;2006:4-4.
FULL TEXT