Clinical detection of icthyosis vulgaris in an atopic dermatits clinic: Implications for allergic respiratory disease and prognosis
Clinical detection of icthyosis vulgaris in an atopic dermatits clinic: Implications for allergic respiratory disease and prognosis
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DOI：
10.1016/j.jaad.2008.03.029
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发表时间：
2008-07-01
影响因子：
13.8
通讯作者：
Simpson, Eric L.
中科院分区：
文献类型：
--
作者：
Bremmer, Sam E.;Hanifin, Jon M.;Simpson, Eric L.
背景资料：最近的遗传学研究表明，聚丝蛋白突变，显示出寻常鱼鳞病（IV）的基础，也可能使特应性皮炎患者易患过敏性呼吸道疾病。我们的目的是确定IV的临床存在是否影响特应性皮炎的严重程度和发病年龄或患过敏性呼吸道疾病的可能性。方法：我们回顾了1187例特应性皮炎患者首次就诊时收集的数据。结果：哮喘症状在有IV的特应性皮炎患者中比没有IV的患者更常见（39.9% vs 32.9%，比值比[OR] = 1.35，P = 0.050），与重度IV最相关（OR = 2-52，P = 0.002）。在控制了特应性皮炎的基线严重程度后，这种关系仍然存在。临床IV也与过敏性鼻结膜炎、特应性皮炎的早期发作、特应性皮炎的严重程度、手掌线过长和毛发角化病的症状相关。局限性：我们的局限性包括主观分级、某些组的数据点少以及无法证明因果关系。这些结果表明，IV的临床证据，无论聚丝蛋白基因型，作为那些发展成过敏性呼吸道疾病和更严重皮肤表型的特应性皮炎患者的潜在标志物。
Background: Recent genetic studies have demonstrated that filaggrin mutations, shown to underlie ichthyosis vulgaris (IV), may also predispose patients with atopic dermatitis to allergic respiratory disease.Objective. Our objective was to determine whether the clinical presence of IV influences the severity and age at onset of atopic dermatitis or the probability of having allergic respiratory disease.Methods: We reviewed data collected from the initial visits of 1187 patients with atopic dermatitis.Results: Asthma symptoms were more common in atopic dermatitis patients with IV than in those without (39.9% vs 32.9%, odds ratio [OR] = 1.35, P = .050) and were most associated with severe IV (OR = 2-52 P = .002). This relationship remained after controlling for the baseline severity of atopic dermatitis. Clinical IV was also associated with symptoms of allergic rhinoconjunctivitis, earlier onset of atopic dermatitis, severity of atopic dermatitis, hyperlinear palms, and keratosis pilaris.Limitations: Our limitations include subjective grading, few data points in some groups, and an inability to demonstrate causality.Conclusion: These results suggest that clinical evidence of IV, irrespective of filaggrin genotype, serves as a potential marker for those patients with atopic dermatitis who develop allergic respiratory disease and a more severe skin phenotype.