Perinatal factors and the risk of atopic dermatitis: a cohort study.

OBJECTIVE: To analyze the effects of pregnancy and early events in the newborn on the risk of subsequent atopic dermatitis (AD) during the first year of life. PATIENTS AND METHODS: This is a prospective multicenter cohort study of newborns during the first year of life. Newborns identified on random days in three obstetrics departments in the area of Bergamo, Lombardy, Northern Italy, were eligible. At baseline, the mothers were interviewed by medical staff during their stay in hospital after delivery. At 6 and 12 months after delivery, a postal questionnaire was sent to the parents. Relative risks were calculated with and without adjustment by multiple regression analysis. RESULTS: A total of 1081 newborns entered the study: 796 (74%) parents answered the 12-month questionnaire. Hundred and thirty-eight (17%) reported a diagnosis of AD at 6 months and 222 (28%) at 12 months. Parental history of AD and/or asthma was associated with an increased risk of AD (RR 1.5, 95%CI 1.1-2.0). Birth weight was slightly associated with an increased risk of AD: RR 1.04, 95%CI 1.001-1.08 (continuous variable, increment of 100 grams). No association emerged between breast feeding, smoking, and risk of AD. CONCLUSIONS: This study in an Italian offspring cohort points to family history of atopic diseases and body weight at birth as relevant risk factors. The study was unable to document associations with other perinatal factors particularly breast feeding and parental smoking in the perinatal period.

Family history, body mass index, selected dietary factors, menstrual history, and risk of moderate to severe acne in adolescents and young adults.

BACKGROUND: Genetic and environmental components may contribute to acne causation. OBJECTIVE: We sought to assess the impact of family history, personal habits, dietary factors, and menstrual history on a new diagnosis of moderate to severe acne. METHODS: We conducted a case-control study in dermatologic outpatient clinics in Italy. Cases (205) were consecutive those receiving a new diagnosis of moderate to severe acne. Control subjects (358) were people with no or mild acne, coming for a dermatologic consultation other than for acne. RESULTS: Moderate to severe acne was strongly associated with a family history of acne in first-degree relatives (odds ratio 3.41, 95% confidence interval 2.31-5.05). The risk was reduced in people with lower body mass index with a more pronounced effect in male compared with female individuals. No association with smoking emerged. The risk increased with increased milk consumption (odds ratio 1.78, 95% confidence interval 1.22-2.59) in those consuming more than 3 portions per week. The association was more marked for skim than for whole milk. Consumption of fish was associated with a protective effect (odds ratio 0.68, 95% confidence interval 0.47-0.99). No association emerged between menstrual variables and acne risk. LIMITATIONS: Some degree of overmatching may arise from choosing dermatologic control subjects and from inclusion of mild acne in the control group. CONCLUSIONS: Family history, body mass index, and diet may influence the risk of moderate to severe acne. The influence of environmental and dietetic factors in acne should be further explored.

Improving sun-protection behavior among children: results of a cluster-randomized trial in Italian elementary schools. The "SoleSi SoleNo-GISED" Project.

A history of sunburns in early life nearly doubles the risk of developing malignant melanoma in adulthood. From 2001 to 2004, we conducted a cluster-randomized trial of an educational intervention to reduce sunburn rates (primary outcome) and improve sun-protection behavior (secondary outcome) in schoolchildren. A total of 122 Italian primary schools (grades 2 and 3) were randomized to receive, or not, an intervention consisting of an educational curriculum at school, conducted by trained teachers, which included the projection of a short video and the distribution of booklets to children and their parents. Behavior while in the sun was assessed at baseline and 14-16 months after baseline. In a subgroup (44% of the total sample), melanocytic nevi were also counted. Of the 11,230 children enrolled, 8,611 completed the study. A total of 1,547 children (14%) reported a history of sunburns at baseline. At follow-up, no difference in sunburn episodes was documented between the study groups (odds ratio 0.97, 95% confidence interval 0.84-1.13) and similar sun-protection habits were reported. No significant impact of the proposed educational program was documented at 1-year follow-up. Innovative strategies need to be developed to increase the effectiveness of future educational interventions in this area.