Support for 2 variants of eczema
Support for 2 variants of eczema
复制标题
DOI：
10.1016/j.jaci.2005.06.038
复制
发表时间：
2005-11-01
影响因子：
14.2
通讯作者：
Sly, PD
中科院分区：
文献类型：
--
作者：
Kusel, MMH;Holt, PG;Sly, PD
背景：研究湿疹的自然病史和危险因素的研究历来认为湿疹是一个单一的实体，而不考虑个体的特应性状态。特应性与湿疹之间的关系是复杂的，多达(2)/(3)的湿疹患者不是特应性。目的：在一组高危儿童中调查湿疹的危险因素与儿童特应性状态的关系。方法：对263名儿童进行5年的前瞻性出生队列跟踪调查湿疹。通过访谈收集出生前和出生后环境暴露的数据。在6个月、2岁和5岁时进行皮肤点刺试验以确定特应性状态。结果：受试者中66.1%的人在前5年出现湿疹，大多数人(85.5%)报告在第一年起皮疹。三分之一的湿疹患者不是特应性(非特应性/内在湿疹)。患有特应性湿疹(外源性湿疹)的儿童更有可能是男性，母乳喂养时间更长，有食物过敏、过敏性鼻炎和目前喘息的病史。非特应性湿疹在女孩中更常见，并且发现与早期日托服务有关。结论：这项研究支持湿疹的两种变种：儿童早期特应性湿疹和早期日托服务的非特应性湿疹。环境因素很可能对湿疹的这两种变种有不同的影响，因此未来的研究应该考虑将湿疹作为两种变种来确定归因风险的影响。
Background: Studies investigating the natural history and risk factors for eczema have historically considered eczema as a single entity, without regard for the individual's atopic status. The association between atopy and eczema is complex, and as many as (2)/(3) of patients with eczema are not atopic.Objective: To investigate the risk factors for eczema in relation to the child's atopic status in a cohort of high-risk children.Methods: A prospective birth cohort of 263 children was followed for 5 years and closely examined for eczema. Antenatal and postnatal data on environmental exposures were collected by interview. Skin prick test to define atopic status was performed at 6 months and 2 and 5 years of age.Results: Of the subjects, 66.1% had eczema in the first 5 years, and the majority, (85.5%) reported onset of rash in the first year. A third of those with eczema were not atopic (nonatopic/intrinsic eczema). Children with atopic eczema (extrinsic eczema) were more likely to he male, to have been breast-fed longer, and to have a history of food allergies, allergic rhinitis, and current wheeze. Nonatopic eczema was more common in girls, and an association was found with early daycare attendance.Conclusion: This study supports the presence of 2 variants of eczema: atopic eczema occurring early in childhood and nonatopic eczema with early daycare attendance. It is likely that environmental factors have a different effect on these 2 variants of eczema, and future studies should thus consider eczema as 2 variants in determining the effect of attributable risks.