Factors associated with persistence of early-onset atopic dermatitis up to the age of 12 years: a prospective cohort study in China

Abstract

Background: Atopic dermatitis (AD) can remit as age increases. However, long-term follow-up studies evaluating disease evolution and related factors of persistence of early-onset AD are sparse. Objectives: This study aimed to identify factors associated with the persistence of early-onset AD. Materials & Methods: In this prospective cohort study, 260 patients with onset of AD before age two years old were enrolled. Clinical examination was performed and a questionnaire survey completed at enrolment. In addition, the filaggrin gene (FLG) of all participants was sequenced to identify mutations within this gene. Patients were followed at age six and 12. Results: The remission rate was 50.8% at age six and 70.3% at age 12. Persistent AD was associated with a higher SCORAD index at baseline (p < 0.001), a family history of asthma (p = 0.003) and food allergen sensitization (p = 0.033). However, the presence or absence of FLG mutation did not show any significant association with persistent AD. Prognostic factors for persistence of AD were analysed by logistic regression analysis. Disease severity according to SCORAD index at baseline (OR: 1.039; 95% CI: 1.018–1.059; p < 0.001) and family history of asthma (OR: 3.008; 95% CI: 1.297–7.007; p = 0.011) were risk factors that may predict persistent AD based on multivariate regression analysis. Conclusion: It is important to stratify early-onset AD according to severity and investigate family allergic history in order to establish appropriate individual management. Moreover, genetic factors other than FLG mutation may play more important roles in persistent early-onset AD.