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Early Intervention Key for Young Patients With Skin Conditions

Posted: August 22, 2012

Early intervention for young patients with skin conditions is important in reducing the risk for developing potentially serious medical conditions such as asthma and diabetes, recent studies have shown.

According to research presented at American Academy of Dermatology’s Summer Academy Meeting by Lawrence F. Eichenfield, MD, FAAD—a board-certified pediatric dermatologist, chief, division of pediatric and adolescent dermatology and professor of pediatrics and medicine—atopic dermatitis is linked to increased incidence of asthma, hay fever and food allergies (10–15% of children in Western nations will develop atopic dermatitis in the first few years of life).

“It is important to note that these common pediatric skin conditions can be managed effectively, which is why parents should consult a board-certified dermatologist at the first sign of a problem,” Eichenfield said. 

Small genetic mutations in proteins present in the epidermis, the outermost layer of the skin, create a fundamental problem in how the epidermis can function. These small mutations are very common in people with dry skin, leading researchers to believe that the mutations are responsible for dry skin and can subsequently lead to eczema. These small mutations are associated with much higher rates of asthma and peanut allergies. Research suggests peanut allergies may be caused by contact with the skin rather than by eating foods containing peanuts.

Atopic dermatitis, the most common form of eczema marked by chronic itchy rashes and skin inflammation, is also now linked to certain mental health disorders. Higher rates of attention deficit hyperactivity disorder (ADHD) was found in children with atopic dermatitis with more severe cases of this skin condition associated with a higher chance of developing ADHD. While the reason for this association is unknown, researchers are questioning whether ADHD may be caused by the sleep disturbances common in children with atopic dermatitis.

Psoriasis is another chronic skin condition marked by thick, red, itchy scaly patches, affecting an estimated 7.5 million Americans. There is strong data showing psoriasis is associated with an increased risk of diabetes, cardiovascular disease and higher rates of obesity in adults. Investigators are finding data which suggest apparent cardiovascular disease risk factors in patients with psoriasis which began during adolescence. Data currently shows higher obesity rates in children with psoriasis, as well as diabetes, lipid abnormalities, and hypertension.

A 100-patient, case-controlled pediatric study comparing medical conditions which can occur in conjunction with psoriasis in children to those without psoriasis found that 50% of psoriasis patients were overweight or obese compared to 32% of children who did not have psoriasis. Another study found that a greater number of children with psoriasis had abnormal liver function tests or fasting glucose or lipid levels. Specifically, 45% of psoriasis patients had at least one of these risk factors of cardiovascular disease compared to less than one-third of patients without psoriasis.

Eichenfield stressed that future research should examine the impact of inflammation over time and whether obesity is causing higher rates of psoriasis or if they are occurring together. In addition, he advised that children with psoriasis should be assessed for cardiovascular risk factors in order to try to decrease these risks in adulthood.