소아 아토피피부염 환자의 부증상 빈도 및 특징에 대한 연구 = A study of the frequency and characteristics of minor clinical manifestations in children with atopic dermatitis

다국어 초록 (Multilingual Abstract)

Purpose : We aimed to evaluate the frequency and characteristics of minor clinical manifestations of atopic dermatitis (AD) in Korean children to aid the diagnosis and treatment of AD.
Methods : From April 2007 to December 2007, we enrolled 106 children (aged 1 month [infants] to 15 years) diagnosed with AD at the Pediatric Allergy Respiratory Center in Soonchunhyang University Hospital. Clinical manifestations were examined and laboratory findings (total and specific immunoglobulin E [IgE] levels and peripheral blood eosinophil count) were analyzed and compared.
Results : Minor symptoms, in order of frequency, included xerosis (78.3%), aggravation due to environmental or emotional stress (43.4%), lichenification (35.8%), orbital darkening (34.0%), periauricular eczema (33.0%), and cutaneous infection (31.1%). Older children (≥2 years) showed more orbital darkening (P=0.01), horizontal crease (P=0.01), and lichenification (P=0.001) than infants. Patients with severe AD (scoring atopic dermatitis [SCORAD] score, ≥40) showed higher frequencies of xerosis (P= 0.04), cutaneous infection (P=0.03), ichthyosis (P=0.18), keratosis pilaris (P=0.02), pityriasis alba (P=0.07), recurrent conjunctivitis (P=0.02), orbital darkening (P=0.001), aggravation due to environmental or emotional stress (P=0.05), facial eczema (P=0.001), lichenification (P=0.001), and hand/foot eczema (P=0.04) than those with mild-to-moderate AD. Children with atopic eczema showed more facial eczema (P=0.01) and lichenification (P=0.04) than those with non-atopic eczema.
Conclusion : The clinical manifestations of AD were similar to those established by Hanifin and Rajka. However, we need to develop our own diagnostic criteria for AD, because the frequencies shown by our subjects differed from those observed in other countries.

국문 초록 (Abstract)

목 적 : 국내 소아 아토피피부염 환자의 부증상의 빈도 및 연령과 중등도에 따른 차이를 분석하여 아토피 피부염의 진단 및 치료에 도움이 되고자 본 연구를 시행하였다.
방 법 : 2007년 4월부터 12월까지 순천향대학교 병원 소아알레르기 호흡기센터에 내원하여 아토피피부염으로 진단 받은 106명 환아를 대상으로 하였다. 대상 환자들은 첫 내원시 3명의 소아과 전문의에 의해 아토피피부염 부증상이 평가 되었으며 Hanifin과 Rajka의 부증상 항목과 2001년 아토피피부염 국제진단기준을 바탕으로 한 20가지 항목을 작성하였다. 대상 환자들은 2세 미만과 2세 이상으로 연령군을 분류하고 SCORAD 점수를 이용하여 중증도를 분류하였으며 원인 항원 특이 IgE 항체를 측정하여 아토피군과 비아토피군으로 분류하였다.
결 과 : 아토피피부염 환자에서 부증상으로 피부건조증(78.3 %), 환경이나 감정요인에 의한 악화(43.4%), 태선화(35.8%), 눈 주위 색소 침착(34.0%), 이개 균열(33.0%), 피부 감염(31.1%)이 높은 빈도를 보였다. 2세 이상인 군에서 눈주위 색소 침착(P= 0.01), 목주름(P=0.01), 태선화(P=0.001) 항목에서 통계학적으로 유의하게 높은 빈도를 보였고중증 아토피피부염에서 피부 건조증(P=0.04), 피부 감염(P=0.03), 모공 각화증(P=0.02), 반복적인 결막염(P=0.02), 눈 주위 색소침착(P=0.001), 안면 피부염(P= 0.001), 태선화(P=0.001), 손/발 습진(P=0.04) 항목이 높은 빈도를 보였다. 아토피군에서 안면 피부염(P=0.01)과 태선화(P=0.04) 항목이 유의하게 높은 빈도를 보였다.
결 론 : 국내 소아 아토피피부염 환아에서 흔히 관찰되는 부증상의 빈도 및 나이, 중증도에 따른 차이를 확인하였고 국내 소아 아토피피부염 진단 및 중증도 평가에 있어 부증상의 몇몇 항목이 유의하게 활용될 수 있는 가능성을 제시할 수 있었다.

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