A protocol for recording the sign of flexural dermatitis in children.

The presence of visible flexural dermatitis is a key feature in diagnosing atopic dermatitis. We describe a protocol for recording this sign in population-based studies, which could be used by suitably trained non-dermatologists. The protocol was developed using a standard set of photographs and accompanying instructions, which define the terms 'dermatitis' and 'flexural'. When assessed during a survey of skin disease in primary schoolchildren, there was excellent agreement between a trained nurse and a dermatologist with regard to the presence or absence of this sign in 73 consecutive children, with perfect agreement in 71 children (97%), and a chance corrected agreement index (kappa statistic) of 0.90 (95% confidence interval [CI] 0.77-0.99). Agreement between two nurses on 114 consecutive schoolchildren was not quite as good, with perfect agreement in 102 children (90%), and a kappa value of 0.51 (95% CI 0.26-0.77). The protocol is easy to perform, does not require children to undress, takes < 1 min to carry out, and is highly acceptable to children and staff. This protocol may be useful in standardizing the assessment of atopic dermatitis in population studies of children.

London-born black Caribbean children are at increased risk of atopic dermatitis.

BACKGROUND: Previous reports suggest that atopic dermatitis is more common in black Caribbean children born in the United Kingdom than in white children. It is unclear whether these differences are caused by selection bias or variations in the use of the word "eczema" in the groups studied. OBJECTIVE: Our objective was to explore ethnic group differences in the prevalence of atopic dermatitis in London schoolchildren. METHODS: A cross-sectional prevalence survey of 693 junior school children in three schools was performed. Atopic dermatitis was defined in three ways: (1) by a dermatologist, (2) by visible flexural dermatitis as recorded by an independent observer, and (3) by a history of flexural dermatitis according to the child's parents. RESULTS: The prevalence of atopic dermatitis according to examination by a dermatologist was 16.3% in black Caribbean children and 8.7% in white children. This increased risk was present for different methods of defining of a atopic dermatitis and persisted after adjustment for potential confounders. CONCLUSION: London-born black Caribbean children appear to be at an increased risk of having atopic dermatitis.

London-born black Caribbean children are at increased risk of atopic dermatitis

BACKGROUND: Previous reports suggest that atopic dermatitis is more common in black Caribbean children born in the United Kingdom than in white children. It is unclear whether these differences are caused by selection bias or variations in the use of the word "eczema" in the groups studied. OBJECTIVE: Our objective was to explore ethnic group differences in the prevalence of atopic dermatitis in London schoolchildren. METHOD: A cross-sectional prevalence survey of 693 junior school children in three schools was performed. Atopic dermatitis was defined in three ways: (1) by a dermatologist, (2) by visible flexural dermatitis as recorded by an independent observer, and (3) by a history of flexural dermatitis according to the child's parents. RESULTS: The prevalence of atopic dermatitis according to examination by a dermatologist was 16.3 percent in black Caribbean children and 8.7 percent in white children. This increased risk was present for different methods of defining of atopic dermatitis and persisted after adjustment for potential confounders. CONCLUSION: London-born black Caribbean children appear to be at an increased risk of having atopic dermatitis. (AU)

Skin care in atopic eczema.

1. Eczema impairs the quality of life of both sufferers and carers. 2. Emollients play a major part in the skin care of eczema. 3. Care needs to be taken to ensure correct strength and dose of topical steroids when used. 4. All practitioners need to be aware of the range conventional and complementary therapies on offer to eczema sufferers.