Factors of influencing epidermal permeability barrier defects in atopic dermatitis children

Background:  Even though eczema herpeticum and hypoalbuminemia are serious and increasingly prevalent complication of AD, just little studies have investigated in AD children. So we investigated the relationship between the clinical factors and the allergic laboratory features in a group of the AD children depending on the presence of eczema herpeticum and hypoalbuminemia.

Method: This cross-sectional study was carried out on 105 patients aged 3 months to 18 years between June 2007 and April 2015. A retrospective data collection through individual medical record, depending on the presence of EH and hypoalbuminemia, AD children were divided into three groups- EH⁺ (group 1), hypoalbuminemia (group 2) and severe AD (group 3).

Results: The male gender was related to the presence of EH (OR, 2.56; 95% CI, 1.19-5.53, P=0.01), but age were not related. The age was related to the presence of hypoalbuminemia (OR, 3.12; 95% CI, 2.21-6.33, P=0.01), but gender were not related. Serum total IgE and ECP levels were higher in the EH group, but serum total eosinophil count levels were higher in the severe AD. There was a statistical difference between three groups in the skin culture (P<0.05). Even after adjusting for age and gender the correlation between the positive result of skin cultures and the presensce of EH was significant (P<0.01), and MRSA was related to only the EH⁺group (OR, 0.19; 95% CI, 0.04-0.92, P=0.03)

Conclusion: We have identified the male gender, the positive result of skin cultures, and MRSA, as factors influencing factors of EH and age is as influencing factors of hypoalbuminemia in AD children.