dermatologiapediatrica.net

Comunidad de Especialistas en la piel de los más pequeños

Prediction of atopic dermatitis in 2-yr-old children by cord blood IgE, genetic polymorphisms in cytokine genes, and maternal mentality during pregnancy

Abstract

Atopic dermatitis (AD) is the most common skin disease in childhood and the first step of atopic march. This study aimed to investigate whether AD in children could be better predicted by biologic markers (cord blood IgE [cbIgE], LT-αNcoI alleles, and FcεRI-β E237G genotypes) and maternal mentality during pregnancy, taking into account gender, socio-demographic factors, and parental atopy. From 2001 to 2005, 1264 mother–infant pairs were recruited to participate in a birth cohort study. Prenatal questionnaire was used to collect family history, maternal gestational conditions and mentality, and environmental exposures. Cord blood was collected and assayed for genotypes and IgE levels. Phone interviews at 6 months and 2 yrs of age were conducted to inquire children’s health status, including AD occurrence. In addition to the known risk factors such as gender, maternal education, and parental atopy, biomarkers and maternal mentality during pregnancy were screened by logistic regression as candidate predictors of AD. Area-under-curve (AUC) statistic from receiver-operating characteristic (ROC) curve analysis was used to compare two predicting models with and without biomarkers and maternal mentality. A total of 730 pairs completed the prenatal questionnaire and phone interview and were included in final analysis. The prevalence of ever having physician-diagnosed AD by 2-yr-olds was 5.9%. Elevated cbIgE levels (≥0.5 kU/l), LT-αNcoI alleles, FcεRI-β E237G genotype, and maternal psychologic stress during pregnancy were significantly associated with AD. Comparison with AUCs of the classic model (including gender, maternal education, and parental atopy), the model adding cbIgE levels, genotypes in cytokine genes, and maternal stress (model 2) showed higher ability to discriminate between children with and without AD (AUC statistics: 0.63 [95% CI = 0.60–0.67] vs. 0.73 [95% CI = 0.70–0.76], respectively; model comparison, p = 0.027). We conclude that elevated cbIgE, LT-α and FcεRI-β genotypes, and maternal stress during pregnancy were associated with ever having physician-diagnosed AD in 2-yr-old children and increased the predictive ability for AD after taking into account gender, maternal education, and parental atopic history

Ampliar

Churg-strauss syndrome without respiratory symptoms in a child

Abstract
Churg-Strauss Syndrome (CSS) is rare in children. It consists of a small- and medium-sized vessel vasculitis, with skin and peripheral nerve involvement. It is characterized by eosinophilia, extravascular necrotizing granuloma, and eosinophilic infiltration of multiple organs particularly the lungs, but may also involve the gastrointestinal tract, the heart, and the kidneys. The condition is usually associated with a preceding history of asthma or allergic sinusitis. It has rarely been reported in children, where most of the cases had pre-existing asthma, allergic rhinitis, or atopic disease. We report a 10-year-old Arab girl proven to have CSS, with no history of asthma or allergic rhinitis, who presented with tender cutaneous nodules of lower extremities, foot drop, and peripheral eosinophilia, without any clinical respiratory symptoms or signs.

 

Keywords: Churg-Strauss Syndrome, ANCA, vasculitis

 

Ampliar

Caso Nº 160 Mayo 17, 2011 (Con Respuesta)

Caso Nº 160 Mayo 17, 2011 (Con Respuesta)

Cual es su diagnóstico ?
Puede provocar la ingesta de solución de hierro este tipo de lesión ?

Dr. Muris Saad
Dra. Martyer Hernandez
Dra. Ana Maria Saenz
Dr. Francisco Gonzalez
Dra. Rosmary Martin
Hospital de Clínica Caracas

 


 

Respuesta

Se interpretó el caso como pigmentación residual a la ingesta de hierro en jarabe. Se descartó Lengua negra Vellosa porque lo que presentaba el paciente era unicamente cambios en la coloración. No permitieron toma de biopsia
Es un caso inusual
Dr. Francisco Gonzalez .
Servicio de Dermatología
Hospital de Clínica Caracas

Ampliar

Few epidemiological studies are available on childhood psoriasis

 

 

Methods

Between 2005 and 2008, information was collected about all children diagnosed with psoriasis in the Pediatric Dermatology Unit of Andreas Sygros Skin Hospital, in Athens, Greece. Results

A total of 125 children with psoriasis were examined, the male to female ratio was 1.4 : 1 and the peak age of onset was in the 9- to 10-year-old age group. Only 16% of the patients had a positive family history. Plaque type psoriasis was the most prevalent type at presentation with 56.8% of the children affected, followed by scalp involvement (33.6%). The limbs were the most prevalent site of involvement (70 children, 56%), followed by the body (59 children, 47.2%) and scalp (60 children, 48%) equally affected. Most of the children had <5% of their skin affected by psoriasis (53.2%). Age of onset had no influence on the severity of the disease (P = 0.107), whereas a positive correlation was found with sex and severity of the disease, with male patients being more severely affected (P = 0.008). Family history did not influence the age at presentation (P = 0.68). Topical steroids were used in most commonly followed by keratolytics, calcipotriol, topical tacrolimus and topical pimecrolimus. Conclusion

Our study reflects the patterns of presentation of childhood psoriasis in sunny countries like Greece.

Ampliar