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Are children with atopic eczema more likely than other children to develop serious internal infections?
Publication year - 2021
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/bjd.20446
Subject(s) - atopic dermatitis , danish , medicine , citation , pediatrics , family medicine , dermatology , world wide web , philosophy , linguistics , computer science
Linked Article: Droitcourt et al . Br J Dermatol 2021; 185 :119–129. As a background to this study it is known that children with atopic dermatitis (AD) have an increased risk of developing skin infections caused by bacteria such as Staphylococcus aureus as well as viruses including herpes simplex. This then raises the question as to whether children with AD are, in addition, at greater risk from internal infections. In this Danish study the investigators used their national eczema registry, which was set up to record information on the progress of patients with eczema, in order to discover whether children with AD were more likely than non‐atopic children to have been hospitalized because of an infection other than one originating on the skin. They found that there was an increased risk of the development of certain non‐skin infections such as those affecting the throat and lungs as well as kidney or bladder and gastrointestinal infections. They also found that these were not associated with the severity of the eczema and could occur in children with mild, as well as severe, skin disease. Although there are some potential weaknesses in this study, such as the possibility that some children hospitalized with infections of the lung might have had underlying but unrecognized asthma, these were thought to be rare occurrences and unlikely to affect the results. Possible explanations for the increased risk of infection include the increased scratching seen in skin sites that might provide a route of entry for microbes or that there could be an associated defect in immunity leading to an increased likelihood of infection. However, there was no association between internal infection and the use of medications to treat eczema such as ciclosporin that reduce immunity. In practice, therefore, the true reason for increased susceptibility to internal infections amongst children who are atopic, although real, remains to be explained.