Información de la revista
Vol. 63. Núm. 6.
Páginas 480-488 (Diciembre 2005)
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Vol. 63. Núm. 6.
Páginas 480-488 (Diciembre 2005)
Originales
DOI: 10.1016/S1695-4033(05)70246-0
Acceso a texto completo
Factores de riesgo y prevalencia familiar de la dermatitis atópica en España (estudio ELIHO)
Risk factors for atopic dermatitis and familial prevalence in spain (eliho study)
Visitas
...
A. Blanco Quirósa,??
Autor para correspondencia
ablanco@ped.uva.es

Correspondencia: Dr. A. Blanco Quirós. Área de Pediatría. Facultad de Medicina. Ramón y Cajal, 5. 47005 Valladolid. España.
, J.M.ª Díaz Castellab, M. Balañá Vilanovac, N. Valveny Llobetd
a Facultad de Medicina. Universidad de Valladolid. España
b Novartis Farmacéutica, S.A.Departamento I + D. Barcelona. España
c CDC Spain. Barcelona. España
d Infociencia S.L. Barcelona. España
Información del artículo
Introducción

La dermatitis atópica (DA) es una enfermedad de etiología desconocida, con clara predisposición genética y una probable participación de factores ambientales. El objetivo del estudio era evaluar los factores de riesgo asociados al diagnóstico y aparición de brotes de DA en niños españoles.

Pacientes y métodos

Estudio observacional, multicéntrico, retrospectivo de casos y control que incluyó una muestra de 4.243 niños menores de 14 años afectados de DA y 978 controles ajustados por edad y sexo. Se recogieron datos de antecedents familiares y características del entorno familiar en ambos grupos y características clínicas de la DA en los pacientes.

Resultados

Los factores de riesgo significativos para la aparición de DA fueron los antecedentes familiares y las infecciones concomitantes de la piel. La prevalencia de DA en familiars de primer grado fue del 39 % y en familiares de Segundo grado, del 19 % (superior en línea materna que paterna).a edad media de los niños afectados fue de 4,2 (desviación estándar [DE] 3,4) años y la edad media en el diagnóstico fue de 1,5 (DE 2,2) años, con un número medio de brotes de la enfermedad de 2,9 (DE 2,6) en el año previo. En las zonas de España con clima más frío (cantábrico y continental) se observó mayor número de brotes.Los niños con DA presentaron mayor coincidencia de enfermedades cutáneas e infecciosas que los niños control.

Conclusiones

La DA es una enfermedad con una gran predisposición genética, modulada por factores climáticos y que acarrea alteraciones inmunológicas. Por el contrario no encontramos influencias significativas de factores ambientales domésticos.

Palabras clave:
Dermatitis atópica
Eccema
Epidemiología
Hipersensibilidad
Genética
Clima
Acné
Factores de riesgo
Introduction

Atopic dermatitis (AD) is a cutaneous disease of unknown etiology. It shows a clear genetic predisposition with probable environmental modulation. This study evaluated risk factors associated with diagnosis and flares of AD in Spanish children.

Patients and methods

We performed an observational, multicenter, retrospective case-control study that included 4243 children aged less than 14 years old with AD and 978 controls matched for age and sex. Family history of disease and environmental variables were collected in both groups and clinical history of AD was recorded in the case group.

Results

Significant risk factors for AD were: a family history of the disease and concomitant cutaneous infections. The prevalence of AD in first degree relatives was 39 % and that in second degree relatives was 19 % (higher in maternal than paternal lines). The mean age of children with AD was 4.2 (SD 3.4) years and the mean age at diagnosis was 1.5 (SD 2.2) years, with a mean of 2.9 (SD 2.6) flares during the previous year. Cold weather (Cantabrian and Continental Iberian Peninsula areas) was related to a greater number of flares. Children with AD had a greater number of concomitant cutaneous diseases and infections than children in the control group.

Conclusions

AD is mainly a genetic disease, with climatic factors involved in severity modulation, and with important immunological alterations. In contrast, this study found no domestic environmental factors that were associated with disease onset.

Key words:
Atopic dermatitis
Eczema
Epidemiology
Hypersensitivity.Genetics
Climate
Acne vulgaris
Risk factors
El Texto completo está disponible en PDF
Bibliografía
[1.]
G. Rajka.
Natural history and clinical manifestations of atopic eczema.
Clin Rev Allergy, 4 (1986), pp. 326
[2.]
M.L. Johnson, J. Roberts.
Prevalence of dermatologic disease in the United States: a review of the National Health and Nutrition Examination Survey, 1971-1974.
Am J Ind Med, 8 (1985), pp. 451-460
[3.]
A. Zambrano, E. Zambrano.
Dermatitis atópica.
Tratado de Pediatría Extrahospitalaria, (2001), pp. 764-769
[4.]
F. Muñoz López.
Dermatitis atópica en la edad infantil. Valoración de la gravedad y tratamiento.
Jano, 62 (2002), pp. 52-57
[5.]
I. Bielsa.
Dermatitis atópica.
FMC, 9 (2002), pp. 719-729
[6.]
F.S. Larsen, J.M. Hanifin.
Epidemiology of atopic dermatitis.
Immunol Allergy Clinics, 22 (2002), pp. 1-25
[7.]
The International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee.
Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema: ISAAC.
Lancet, 351 (1998), pp. 1225-1232
[8.]
K. Thestrup-Pedersen.
Treatment principles of atopic dermatitis.
JEADV, 16 (2002), pp. 1-9
[9.]
Consenso Nacional de Dermatitis Atópica en la Infancia.
Comité de la SAP.
Arch Argent Pediatr, 97 (1999), pp. 285-288
[10.]
M. Bradley, C. Soderhall, H. Luthman, C.F. Wahlgren, I. Kockum, M. Nordenskjold.
Susceptibility loci for atopic dermatitis on chromosomes 3, 13, 15, 17 and 18 in a Swedish population.
Hum Mol Genet, 11 (2002), pp. 1539-1548
[11.]
C. Soderhall, M. Bradley, I. Kockum, H. Luthman, C.F. Wahlgren, M. Nordenskjold.
Analysis of association and linkage for the interleukin-4 and interleukin-4 receptor b; alpha; regions in Swedish atopic dermatitis families.
Clin Exp Allergy, 32 (2002), pp. 1199-1202
[12.]
L.F. Schultz.
Genetic epidemiology of atopic dermatitis.
Atopic Dermatitis: The epidemiology, Causes and Prevention of Atopic Eczema, pp. 113-124
[13.]
K. Buser, F. Von Bohlen, P. Werner, E. Gernhuber, B.P. Robra.
The prevalence of neurodermatitis among school children in the Hannover administrative district.
Dtsch Med Wochenschr, 118 (1993), pp. 1141-1145
[14.]
K. Buser, S. Werner, P. Volk.
Illness and social status. The special case of neurodermatitis.
Gesundheitswesen, 60 (1998), pp. 311-316
[15.]
H.C. Williams, D.P. Strachan, R. Hay.
Childhood eczema: disease of the advantaged?.
BMJ, 308 (1994), pp. 1132-1135
[16.]
S. Werner, K. Buser, A. Kapp, T. Werfel.
The incidence of atopic dermatitis in school entrants is associated with individual life-style factors but not with local environmental factors in Hannover, Germany.
Br J Dermatol, 147 (2002), pp. 95-104
[17.]
D.P. Strachan.
Hay fever, hygiene, and household size.
BMJ, 299 (1989), pp. 1259-1260
[18.]
C.S. Benn, M. Melbye, J. Wohlfahrt, B. Bjorksten, P. Aaby.
Cohort study of sibling effect, infectious diseases, and risk of atopic dermatitis during first 18 months of life.
[19.]
J.E. Gern, C.L. Reardon, S. Hoffjan, D. Nicolae, Z. Li, K.A. Roberg, et al.
Effects of dog ownership and genotype on immune development and atopy in infancy.
J Allergy Clin Immunol, 113 (2004), pp. 307-314
[20.]
R. Luoma, A. Koivikko.
Occurrence of atopic diseases in three generations.
Scand J Soc Med, 10 (1982), pp. 49-56
[21.]
S.T. Remes, M. Korppi, M. Majosaari, A. Koivikko, L. Soininen, J. Pekkanen.
Prevalence of allergic rhinitis and atopic dermatitis among children in four regions of Finland.
Allergy, 53 (1998), pp. 682-689
[22.]
A. Broberg, A. Svensson, M.P. Borres, R. Berg.
Atopic dermatitis in 5-6 year old Swedish children: cumulative incidence, point prevalence, and severity scoring.
Allergy, 55 (2000), pp. 1025-1029
[23.]
R. Gupta, A. Sheikh, D.P. Strachan, H.R. Anderson.
Burden of allergic disease in the UK: secondary analysis of national databases.
Clin Exp Allergy, 34 (2004), pp. 520-526
[24.]
H.C. Williams, P.G. Burney, A.C. Pembroke, R.J. Hay.
The UK working party's Diagnostic Criteria for Atopic Dermatitis. III independent hospital validation.
Br J Dermatol, 131 (1994), pp. 406-416
[25.]
S.M. Mucha, F.M. Baroody.
Relationship between atopy and bacterial infections.
Curr Allergy Asthma Rep, 3 (2003), pp. 223-227
[26.]
M. Kerkhof, L.P. Koopman, R.T. Van Strien, A. Wijga, H.A. Smit, R.C. Aalberse, et al.
PIAMA Study Group. Risk factors for atopic dermatitis in infants at high risk of allergy: the PIAMA study.
Clin Exp Allergy, 33 (2003), pp. 1336-1341
[27.]
D. Martín Fernández-Mayoralas, J.M. Martín Caballero, L. García-Marcos Álvarez.
Prevalencia de la dermatitis atópica en escolares de Cartagena y su relación con el sexo y la contaminación.
An Pediatr (Barc), 60 (2004), pp. 555-560
[28.]
S.K. Weiland, A. Husing, D.P. Strachan, P. Rzehak, N. Pearce, ISAAC Phase Study Group.
Climate and the prevalence of symptoms of asthma, allergic rhinitis and atopic eczema in children.
Occup Environ Med, 61 (2004), pp. 609-615
[29.]
M.M. Moore, S.L. Rifas-Shiman, J.W. Rich-Edwards, K.P. Kleinman, C.A. Camargo Jr, D.R. Gold, et al.
Perinatal predictors of atopic dermatitis occurring in the first six months of life.
Pediatrics, 113 (2004), pp. 468-474
[30.]
M. Bohme, M. Wickman, N.S. Lennart, M. Svartengren, O. Wahlgren.
Family history and risk of atopic dermatitis in children up to 4 years.
Clin Exp Allergy, 33 (2003), pp. 1226-1231
[31.]
N. Wadonda-Kabondo, J.A.C. Sterne, J. Golding, C.T.C. Kennedy, C.B. Archer, M.G.S. Dunnill.
the ASPAC Study Team.
Arch Dis Child, 89 (2004), pp. 917-921
[32.]
B. Laubereau, I. Brockow, A. Zirngibl, S. Koletzko, A. Gruebl, A. Von Berg, et al.
Effect of breast-feeding on the development of atopic dermatitis on the first 3 years of life. Results from the GINI-birth cohort study.
J Pediatr, 144 (2004), pp. 602-607
[33.]
A. Zirngibl, K. Franke, U. Gehring, A. Von Berg, D. Berdel, C.P. Bauer, GINI study group, et al.
Exposure to pets and atopic dermatitis during the first two years of life. A cohort study.
Pediatr Allergy Immunol, 13 (2002), pp. 394-401
[34.]
C.G. Bornehag, J. Sundell, L. Hagerhed, S. Janson, DBH Study Group.
Pet-keeping in early childhood and airway, nose and skin symptoms later in life.
Allergy, 58 (2003), pp. 939-944
[35.]
R. Luoma.
Environmental allergens and morbidity in atopic and non-atopic families.
Acta Paediatr Scand, 73 (1984), pp. 448-453
[36.]
A. Stipic-Markovic, B. Pevec, M. Radulovic Pevec, A. Custovic, J. Predovic.
Allergic diseases in relationship with environmental factors in a population of school children in Zagreb, Croatia.
Arh Hig Rada Toksikol, 55 (2004), pp. 221-228
[37.]
C. Stabell Benn, J. Wohlfahrt, P. Aaby, T. Westergaard, E. Benfeldt, K.F. Michaelsen, et al.
Breastfeeding and risk of atopic dermatitis, by parental history of allergy, during the first 18 months of life.
Am J Epidemiol, 160 (2004), pp. 217-223
[38.]
G. Girolomoni, D. Abeni, C. Masini, F. Sera, F. Ayala, A. Belloni-Fortina, et al.
The epidemiology of atopic dermatitis in Italian schoolchildren.
Allergy, 58 (2003), pp. 420-425

Declaración de conflicto de intereses: Este trabajo ha sido realizado con el apoyo económico de Novartis Farmacéutica, S.A.

Copyright © 2005. Asociación Española de Pediatría
Idiomas
Anales de Pediatría

Suscríbase a la newsletter

Opciones de artículo
Herramientas
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

es en
Política de cookies Cookies policy
Utilizamos cookies propias y de terceros para mejorar nuestros servicios y mostrarle publicidad relacionada con sus preferencias mediante el análisis de sus hábitos de navegación. Si continua navegando, consideramos que acepta su uso. Puede cambiar la configuración u obtener más información aquí. To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here.