중증 소아 아토피피부염 환자의 임상적 특징
Clinical Investigation of Children with Severe Atopic Dermatitis
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목 적 : 중증의 소아아토피피부염 환자에 대한 임상양상의 연구를 통해 중증의 소아아토피피부염 환자의 특징을 파악하고자 하였다. 방 법 : 2006년 6월부터 2008년 6월까지 부산 성모병원 소아청소년과 알레르기클리닉에 내원한 204명의 아토피피부염 환자를 대상으로 하였다. 아토피피부염의 중증도는 SCORAD점수에 의거하여 임상적 중증도를 평가하였으며, SCORAD 점수가 15점 미만인 경우를 경증, 15점 이상이고 40점 이하인 경우를 중등증, 40점 초과를 중증으로 구분하였다. 그리고 대상자의 생활환경, 가족력을 조사하고, 혈청 총 IgE, 총 호산구수, ECP, 특이 IgE (유럽집먼지진드기, 아메리카집먼지진드기, 계란, 우유, 메밀, 땅콩, 대두)에 대한 검사를 실시하였다. 결 과 : 204명의 대상자 중 중증군은 100명(49.02%), 중등증군은 51명(25.0%), 경증군은 53명(25.98%)이었다. 중증군과 중등증군 간에 총 IgE, 총 호산구수, ECP농도의 비교에서는 유의한 차이가 없었고, 중증군과 경증군 간의 총 IgE, 총 호산구수, ECP농도의 비교에 있어서는 중증군이 경증군보다 유의하게 높았다. 그리고 중증의 영아 연령군이 중증의 소아 연령군보다 식품 알레르겐에 감작된 수에서 유의하게 많았고, 흡입 알레르겐에 감작된 수에 있어서는 중증의 소아 연령군이 중증의 영아 연령군보다 유의하게 많았다. 중증군에서 SCORAD 점수와 총 IgE, 총 호산구수, ECP, 감작된 알레르겐의 개수와는 유의한 상관관계가 없었다. 그리고 중증의 소아 아토피피부염 환자에서는 피부병변이 광범위하고 심해서 입원한 경우가 가장 많았다. 결 론 : 총 IgE, 총 호산구, ECP, 특이 IgE는 중증의 소아 아토피피부염 환자의 임상적 특징을 반영하고 있으나, 중등증의 소아 아토피피부염 환자와의 차이에 관해서는 추가적인 광범위한 연구가 필요하다고 생각된다.
Abstract
Purpose : We attempted to investigate clinical characteristics of children with severe atopic dermatitis. Methods : A total of 204 children diagnosed with Atopic dermatitis at the Pediatric Allergy Respiratory Center in Busan St. Mary's Medical Center from June 2006 to June 2008 were enrolled in this study. Cases were divided into 3 groups according to SCORAD index: severe, moderate and mild groups. We collected birth, environment, and allergic family history, and tested serum IgE, total eosinophil count, specific IgE, ECP (Eosinophil Cationic Protein) and the SCORAD index between the 3 groups. Results : Of the 204 patients, 100 (49.02%) were included in the severe group, 51 (25.0%) in the moderate group, and 53 (25.98%) in the mild group. There were no differences in serum total IgE, serum total eosinophil counts and ECP between the severe and moderate groups. Serum total IgE, serum total eosinophil counts and ECP were relatively higher in the severe group than mild group. Food allergen sensitization rate was relatively higher in the infantile severe group than in the childhood severe group, while inhalant allergen sensitization rate was relatively higher in the childhood severe group than in the infantile severe group. There was no correlation between serum total IgE, serum total eosinophil counts, ECP and the number of sensitized allergens relative to SCORAD index in the severe group. Conclusion : Serum IgE, total eosinophil count, specific IgE and ECP may be specific indicators of children with severe atopic dermatitis. Further studies are needed to determine a clear distinction between severe and moderate atopic dermatitis patients.
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