Premium
Phenotypes of atopic dermatitis identified by cluster analysis in early childhood
Author(s) -
Seo Euri,
Yoon Jisun,
Jung Sungsu,
Lee Jina,
Lee Beom Hee,
Yu Jinho
Publication year - 2019
Publication title -
the journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.9
H-Index - 65
eISSN - 1346-8138
pISSN - 0385-2407
DOI - 10.1111/1346-8138.14714
Subject(s) - atopic dermatitis , medicine , sensitization , eosinophil , immunology , immunoglobulin e , scorad , allergy , atopy , dermatology , filaggrin , antibody , asthma , psoriasis , dermatology life quality index
Atopic dermatitis is a chronic, relapsing, inflammatory skin disease that usually appears in early childhood and develops into a heterogeneous disease during childhood. The clinical course and treatment for atopic dermatitis can differ according to its phenotype and/or endotype. This study aimed to identify clinical phenotypes of atopic dermatitis in early childhood. Data were obtained from 572 children under 3 years of age with atopic dermatitis. Cluster analysis applied to 11 variables, and we identified four clusters of atopic dermatitis. Children in cluster A ( n = 141) had early‐onset atopic dermatitis with high blood eosinophil counts, serum total immunoglobulin E and rates of sensitization to food allergens. Children in cluster B ( n = 218) had early‐onset atopic dermatitis with low blood eosinophil counts, serum total immunoglobulin E and rates of sensitization to both food and inhalant allergens. Children in cluster C ( n = 53) had early‐onset atopic dermatitis with high C‐reactive protein levels and white blood cell counts. Children in cluster D ( n = 160) had middle‐onset atopic dermatitis with high serum total immunoglobulin E and rates of sensitization to inhalant allergens. Cluster A had the highest Scoring for Atopic Dermatitis and transepidermal water loss values. Age at onset, age at diagnosis, white blood cell count, eosinophil count, C‐reactive protein and serum total immunoglobulin E level were the strongest predictors of cluster assignment. Analysis of these six variables alone resulted in correct classification of 95.5% of the subjects. These results support the heterogeneity of atopic dermatitis, even in early childhood.