Disease severity and quality of life in children with atopic dermatitis: PO-SCORAD in clinical practice.

BACKGORUND: Atopic dermatitis (AD) can significantly compromise the quality of life (QoL). The aim of our investigation was to evaluate whether QoL correlates with AD severity, evaluated through the physician and the patient perspective, in a sample of Italian children. METHODS: Forty children with AD were evaluated. Disease severity was assessed by the physician and the patients (or their parents) using the SCORAD and the patient-oriented SCORAD (PO-SCORAD) tools, respectively. Patients or their parents completed specific QoL questionnaires (IDQOL/CDLQI). Spearman's correlation coefficient and non-parametric analysis of covariance were used to analyze the data. RESULTS: SCORAD e PO-SCORAD were moderately but significantly correlated (ρ Spearman=0.55, P<0.01). QoL scores ranged from 1 to 23, with a median score of 4.0 (higher scores represent more impaired QoL). After adjustment for age and sex, children with SCORAD>40 had significantly higher QoL scores (more impaired QoL) than those with SCORAD≤40 (median QoL of 5 and 4, respectively, P=0.048). Even higher differences emerged when AD severity was self-assessed (median QoL of 6 and 3.5 for children with PO-SCORAD>40 and PO-SCORAD≤40, respectively, P=0.01). AD children with concomitant food allergy had a significantly more impaired QoL than those with AD only (P=0.040). No significant difference in QoL was observed according to sex or age. CONCLUSIONS: In our sample of AD children, QoL appeared slightly-moderately altered, and increasing disease severity was associated with greater impairment in QoL. SCORAD and PO-SCORAD were fairly correlated and the association of QoL was somewhat stronger with the PO-SCORAD than the SCORAD Index. This supports the usefulness of PO-SCORAD for the self-assessment of AD in children, and suggests the importance to integrate physician and patient perspectives in the management of AD.

Vitamin D status and body mass index in children with atopic dermatitis: A pilot study in Italian children.

BACKGROUND: Vitamin D (vitD) is involved in important regulatory functions of the innate and adaptive immune system. So, it has been hypothesized that vitD might influence the course of atopic dermatitis (AD). Also obesity may have impact on immune system. The aim of our study was to investigate vitamin D status and body mass index (BMI) in urban children with AD. METHODS: 52 children with AD and 43 healthy children were enrolled. SCORAD, BMI and serum vitD levels were evaluated. RESULTS: There was an association between vitamin D and the AD occurrence but neither between vitamin D and the AD severity, nor between vitamin D and BMI. A positive correlation was observed between BMI and the AD severity in males. CONCLUSIONS: This study highlights the complex inter-relationships among atopic dermatitis severity, vitamin D and body mass index and suggests the need to investigate the role of genetic factors and/or gender-related differences to possibly identify new prevention strategies.

Spatial and temporal attention in developmental dyslexia.

Although the dominant view posits that developmental dyslexia (DD) arises from a deficit in phonological processing, emerging evidence suggest that DD could result from a more basic cross-modal letter-to-speech sound integration deficit. Letters have to be precisely selected from irrelevant and cluttering letters by rapid orienting of visual attention before the correct letter-to-speech sound integration applies. In the present study the time-course of spatial attention was investigated measuring target detection reaction times (RTs) in a cuing paradigm, while temporal attention was investigated by assessing impaired identification of the first of two sequentially presented masked visual objects. Spatial and temporal attention were slower in dyslexic children with a deficit in pseudoword reading (N = 14) compared to chronological age (N = 43) and to dyslexics without a deficit in pseudoword reading (N = 18), suggesting a direct link between visual attention efficiency and phonological decoding skills. Individual differences in these visual attention mechanisms were specifically related to pseudoword reading accuracy in dyslexics. The role of spatial and temporal attention in the graphemic parsing process might be related to a basic oscillatory "temporal sampling" dysfunction.

Birthmarks and transient skin lesions in newborns and their relationship to maternal factors: a preliminary report from northern Italy.

BACKGROUND: A total of 620 healthy term neonates, randomly selected among babies born at the San Paolo Hospital in Milan (Italy), were examined to study the relationship between birthmarks and transient cutaneous lesions in newborns of different ethnic groups. METHODS: Information on sociodemographic factors and on physiopathological variables of the pregnancy was collected. Multiple logistic analyses were performed to assess associations between diagnosed skin lesions and various factors. Odds ratios (OR) as a measure of association and the corresponding 95% confidence intervals were estimated. RESULTS: A positive association was found between reduced hypoderm and pregnancy illness (OR = 2.78), hypertrophy genitalia and use of drugs (OR = 1.86) and illnesses in pregnancy (OR = 1.61). Hyperpigmentation in the genital area and Mongolian spot showed significant positive association with geographical area of origin, being systematically more frequent in non-European neonates, while for melanocytic congenital nevi a positive association was observed only for Asiatic newborns (OR = 4.67); salmon patch on the nape showed a significant OR of 1.81 among mothers aged > or = 35. CONCLUSIONS: Significant associations between some sociodemographic factors and cutaneous lesions of the newborn and anamnestic data related to the pregnancy were found. Dermatologic conditions are common in the newborns and may justify dermatologic examination.

Association of psoriasis-like eruption and Kawasaki disease.

We report a case of a 3-month-old female baby showing clinical and hematological signs compatible with Kawasaki disease. A few days after the beginning of the specific therapy, the young patient developed asymptomatic erythematous plaques appearing on the trunk. The histology disclosed a psoriasic pattern. To the best of our knowledge, we describe the youngest baby in the published work developing a psoriasis during the course of Kawasaki disease.

[Neonatal toxic erythema : clinico-epidemiologic characteristics and recent pathogenic hypothesis]. / Eritema tossico del neonato: caratteristiche clinico- epidemiologiche e recenti ipotesi patogenetiche.

Erythema toxic neonatorum (ETN) is a common, self-limiting condition of term infants, appearing particularly within the first 48 hours of life. ETN has a worldwide distribution, with a frequency variable from 19% to 72%. Erythematous macules, wheals, papules and pustules in varying combination occur, with crops of lesions waxing and waning and spontaneous resolution within hours to days. It's important the differential diagnosis from other pustular neonatal conditions, some of which are severe. The etiology of ETN remains unknown. Recent studies reveal an activation of immune cells in the lesions of ETN and a high presence of peptide antibiotics, suggesting that ETN is an inflammatory skin reaction to the microbial colonization at birth.