Watching for the initial symptoms of the inflammatory skin disease atopic dermatitis (AD) — and where they occur on the body — may aid doctors in the earlier diagnosis and treatment of the condition in young children, say researchers from Copenhagen University in Denmark and the National Medical Jewish and Research Center in Denver, Colorado.
Researchers tracked 356 1-month-old infants whose mothers had a history of asthma (kids who develop atopic dermatitis often have family members with asthma) from birth to age 3. Half of the moms also had a history of AD themselves. Every 6 months, the children underwent skin exams to look for symptoms of AD. If the child had any symptoms, the doctors recorded where on the child's body they occurred, the severity of the symptoms, and the treatment used (such as skin moisturizers, creams, or corticosteroids).
In this group of kids at higher risk for developing AD, 31% showed symptoms of the condition by the first birthday, 41% had symptoms by age 2, and 44% had symptoms at age 3. Most of the kids who developed symptoms first experienced mild symptoms. As they got older, they were less likely to develop severe symptoms. Over the first 3 years of life, the children with AD needed about seven treatments with corticosteroids, with each treatment session lasting an average of 2 weeks.
In infants, AD tended to start at the scalp, forehead, ears, neck, and cheeks. Later it tended to spread to the arms, legs, the rest of the face, and the trunk of the body. The most common spots where AD developed included the cheeks, the bend of the knees, and the chin. The study authors suggest that this information may aid doctors in diagnosing and treating AD earlier in infancy and early childhood.
What This Means to You. The highest rates of AD tend to occur during the second year of life and most often affect kids' cheeks, knees, and chins, according to the results of this study. If your child develops itchy, dry, red skin or small bumps on the cheeks, forehead, or scalp, talk to your child's doctor. If your child is diagnosed with atopic dermatitis, the doctor may recommend taking preventive steps to avoid skin irritation and using a topical cream to reduce inflammation.
Source: Liselotte Brydensholt Halkjoer, 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; Archives of Dermatology, May 2006.
Reviewed by: Steven Dowshen, MD
Date reviewed: June 2006