Clinical Significance of Atopic Dermatitis with Hypoalbuminemia in Korean Children

Background: Hypoalbuminemia can be a life-threatening complication of severe atopic dermatitis (AD). Objectives: The aim of this study was to evaluate correlations between clinical features and laboratory tests of AD children with scoring atopic dermatitis (SCORAD) scores ≥ 40, according to the presence of hypoalbuminemia. Methods: Children with AD between 3 and 24 months of age with SCORAD score ≥ 40 (n = 82), admitted to our unit from June 2007 to March 2016, were categorized to two groups of hypoalbuminemic (n = 27) and non-hypoalbuminemic (n = 55). A blood albumin level of ≤ 3.5 g/d on the first day of admission was considered as hypoalbuminemia. The results of clinical and laboratory tests of the two groups were evaluated and compared. Results: Significant differences were observed in different genders, age at AD onset, and duration of AD between the groups. Compared with non-hypoalbuminemia group, significantly more patients in hypoalbuminemia group had positive test results for methicillin-resistant Staphylococcus aureus (MRSA) as well as allergen sensitization (P < 0.05). After adjusting for age and gender, male gender (odds ratio (OR) 5.962; 95% confidence interval (CI) 2.136 - 16.644, P = 0.001), positive MRSA (OR, 10.625; 95% CI, 2.823 - 39.982, P < 0.001) and allergen (OR, 4.622; 95% CI, 1.573 - 13.578, P = 0.005) test results were strongly related to the presence of hypoalbuminemia. Conclusions: Hypoalbuminemia in AD children with SCORAD score ≥ 40 is associated with increased complications.