Evaluation of the factors affecting the severity of the disease in children aged TWO YEARS and younger diagnosed with atopic dermatitis

209 patients with a mean age of 11.3±6 months (2-24 months) who have been followed for atopic dermatitis (AD) in The Pediatric Allergy and Immunology outpatient clinic of the Tekirdağ Namık Kemal University were included in this study. 57% (n=120) of the patients were girls and %43 (n=89) were boys. Gender, mode of delivery, gestational age, breastfeeding duration, use of formula feeding, characteristics of complementary feeding, irritant exposure (soap, woolen clothes), presence of complaints with sweating, economical status of the family and laboratory results were similar among the patients. There were more patients born weighing 1,000-1,999 grams among severe AD patients (p=0,025); and they had a family (p=0,004) and maternal (p=0,028) history of atopy more frequently. History of bathing more than 3 times a week were more frequent in patients with mild AD (p=0.028). Skin rashes of the patients were mostly seen on their faces with 79,4%, their cheeks with 78,5%, their necks with 73.2% and their arms with 45,9%; and the rashes on the arms, legs, back, trunk and overall body were seen more frequently in the patients with severe AD (p<0.001). Accompanying symptoms were mostly restlessness (46.4%), diaper dermatitis (21.5%) and failure to thrive (9.6%); and 50.7% of the patients experienced continuous itching. Itching (p<0.001), restlessness (p<0.001), failure to thrive (p=0.002) and nocturnal coughing (p=0.013) were more frequent in patients with severe AD. Treatments of the 47.4% of the patients were commenced before their pediatric allergy immunology visits; and while TKS usage rates were similar (p=0.868), moisturizers (p<0.001) and antihistaminic agents (p<0.01) were commenced more frequently for moderate and severe AD patients. 52.6% of the patients had food sensitization and 20% had multiple food sensitization. Food sensitization (p<0.01) and multiple food sensitization (p=0.024) were more frequent among the severe AD patients. Sensitized foods were egg (43%), cow's milk (20%), hazelnut (11.9%), peanut (4.8%) and walnut (1.9%); and egg sensitization were more frequent among the severe AD patients (p<0.001). Egg sIgE and egg in SPT were seen more frequently positive among the severe AD patients (p<0.05). Total IgE were increased in the 87.1% (n=182) of the patients, 27.3% (n=57) had peripheral eosinophilia and 27.3% (n=57) had decreased vitamin D levels. Egg sensitivity, a positive egg specific IgE, leg rash and restlessness were detected as the parameters associated with the severe AD. According to results of this study, we think that the identification of the factors that affect the AD severity is important for the monitoring of the patient and the course of the disease. Key words: child; atopic dermatitis, SCORAD index, disease severity