Factors predictive of AD incidence and recurrence in adolescence identified
MedWire News: German researchers have determined factors predicting incidence and recurrence or persistence of atopic dermatitis (AD) in adolescence.
Astrid Peters (University Hospital of Munich) and colleagues used data collected from 2857 German adolescents who took part in a follow-up study of the Phase II International Study of Asthma and Allergies in Childhood (ISAAC), called the Study on Occupational Allergy Risks (SOLAR). The researchers assessed incidence, recurrence, and persistence of AD in the cohort as well as associated risk factors.
At the end of the initial ISAAC phase II study (1995-1996), 76.7% of the participants (aged 9-11 years) had not developed AD, 5.7% without a prior history had developed AD, 9.1% with a prior history continued to have symptoms of AD, and 8.5% of those with prior AD were in remission.
At the end of SOLAR (2002-2003), 75.0% of the participants (aged 16-20 years) remained unaffected, 1.7% had developed AD since ISAAC phase II, 7.1% with a prior history of AD continued to have symptoms, 7.8% and 6.1% with AD prior to SOLAR and ISAAC phase II, respectively, were in remission, and 2.4% with AD prior to ISAAC phase II had recurrence.
Peters and team found that high socioeconomic status, female gender, presence of asthma, a positive skin prick test for common allergens, parental history of rhinitis or AD, and having worked in a high-risk job such as nursing, healthcare assistance, bakery, or cleaning significantly increased risk for AD.
Presence of all these factors, compared with none, increased the risk for AD incidence by a significant 21.4%, risk for recurrence by 81.7%, and risk for persistence by 87.6%.
Of note, early life exposures did not significantly influence the course of AD over puberty.
"Children who were breast-fed, have siblings and attended kindergarten tend not to develop the condition in early childhood," said Peters.
"Strikingly, these factors have much less effect on risk for the late-onset form. Occupational exposure to irritating substances seems to be the only predisposing factor of major significance in cases of late-onset neurodermatitis [AD]."
She added: "Even short-term exposure to the chemicals one encounters in these settings can have a negative effect. Allergologists should take these findings into account when dispensing career counseling to young patients or adolescents at risk for neurodermatitis."
The results of this study are published in the Journal of Allergy and Clinical Immunology.
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By Helen Albert