文献简介

出版社:Current Allergy and Asthma Reports

作  者:Evie Huang & Peck Y. Ong

编  号:

关键字:特应性皮炎;儿童

年  份:2018   点击量:24

文献摘要 全文翻译

Atopic dermatitis (AD) is the most co mmon chronic inflammatory skin disease of childhood characterized by pruritic lesions. In the USA, AD affects up to 18% of children. For more than 85% of patients, AD begins during the first 5 years with 50% of children improving significantly or outgrowing the disease by age 7. The majority of the remaining children with AD continue to have significant AD into their adulthood. Overall, the national direct cost of AD in children has been estimated to be $364 million/year in the USA. This estimate includes professional fees, hospitalizations, laboratory testing, prescription and over-the-counter medications, dietary/environmental changes, and special clothing. It does not include indirect cost such as pain, suffering, school performance/ absence, or parental work performance/absence. AD, especially those with moderate to severe disease, is associated with significant morbidity due to sleep disruption, which leads to poor school performance, low self-esteem, and familial stress. Additionally, patients with severe AD are at increased risk of psychiatric morbidities including depression and anxiety disorders. The infectious morbidity for individuals with AD is secondary to increased susceptibility to skin infections. The colonization of AD skin with Staphylococcus aureus contributes to its being the most common skin infection in AD. Skin infections with S. aureus can lead to invasive infections in children with moderate to severe AD. These infections include bacteremia, endocarditis, septic arthritis, and osteomyelitis. Eczema herpeticum, an infection caused by the herpes simplex virus (HSV), may lead to additional serious complications of AD including viremia, fever, lymphadenopathy, keratoconjunctivitis, and meningitis.

特应性皮炎(AD)是儿童期最常见的慢性炎症性皮肤病,以瘙痒性皮损为特征。在美国,高达18%的儿童受AD影响。85%以上的儿童,5岁前出现AD,50%的儿童7岁显著改善或者痊愈。其余大多数AD患儿在成年后仍有严重AD。总体而言,美国儿童AD全国直接成本预估为3.64亿美元/年。该预估包括专家费用,住院治疗,实验室检测,处方药和非处方药,饮食/环境改变和特殊服装。不包括间接费用,如疼痛、痛苦、在校表现/缺勤或父母工作表现/缺勤费用。AD,特别是那些患有中度至重度疾病的患者,由于睡眠中断导致发病率升高,导致在校表现不佳、自尊低下和家庭压力大。此外,患有严重AD的患者精神疾病发病风险增加,包括抑郁症和焦虑症。AD患者感染继发于皮肤感染易感性增加。AD皮肤中金黄色葡萄球菌定殖是AD中最常见的皮肤感染。AD皮肤中金黄色葡萄球菌定植是AD最常见的皮肤感染。这些感染包括菌血症、心内膜炎、化脓性关节炎和骨髓炎。疱疹样湿疹,由单纯疱疹病毒(HSV)引起的感染,可导致其他AD严重并发症,包括病毒血症、发热、淋巴结病、角膜结膜炎和脑膜炎。