Four Years Prospective Study of Natural History of Atopic Dermatitis Aged 7~8 Years at an Individual Level: A Community-Based Survey by Dermatologists' Skin Examination in Childhood

Ann Dermatol. 2016 Dec;28(6):684-689. doi: 10.5021/ad.2016.28.6.684. Epub 2016 Nov 23.

Abstract

Background: The age-dependent change in atopic dermatitis (AD) at an individual level has mostly performed in a hospital-setting.

Objective: We evaluated the age-dependent change of AD symptoms at an individual level in a community-setting.

Methods: For the diagnostic accuracy, all participants of schoolchildren were received skin examination by dermatologists (twice a year for the same group), instead of questionnaire-based surveys. For this study, sequential check-ups of 273 elementary school children, aged 7~8 years, were performed for 4 years up to the age of 10~11 years.

Results: Among the 47 AD children, who had been diagnosed as having AD at the first-year check-up, spontaneous remission was detected in nine children during the follow-up periods (remission rate of 19.1%). As a consequence, the one-year AD prevalence was decreased by 5.9% in the elementary schoolchildren over four years. Unexpectedly, late onset (after 8 years of age) AD was observed in 21.7% of AD children. There was no statistically significant relationship between spontaneous remission and host factors including sex and family history of atopic diseases.

Conclusion: We observed that 19.1% of AD children in the age group of 7~11 years showed spontaneous remission based on skin examination by dermatologists. There might be an increase in the prevalence of late onset AD in Korea.

Keywords: Age-dependent change; Childhood atopic dermatitis; Dermatologists' skin examination; Spontaneous remission.