ATOPIC-DERMATITIS - INCIDENCE, PRESENTATION AND MANAGEMENT PROBLEMS AS SEEN IN ARAR, NORTHERN SAUDI-ARABIA

Objective: To study the incidence, presentation and management problem s of patients with atopic dermatitis as seen in Arar Central Hospital and compare them with other studies elsewhere. Design: 5-year (January 1991 - December 1995) retrospective study of patients' data as collec ted from their files. Setting: Arar Central Hospital, Arar, Northern S audi Arabia. Subjects: 1,015 new cases of atopic dermatitis. Results: The overall annual incidence rate of atopic dermatitis was 203 per 100 ,000 base population. The incidence rate has increased over the last 5 years from 146 per 100,000 in 1991 to 302 per 100,000 in 1995. Sevent y percent of new patients with atopic dermatitis were below 2 years, w ith a median age of 4 months in infants, 6 years in older children and 23 years in young adults. The male to female ratio was 1.1 to 1, with a positive family history of atopy (asthma, allergic rhinitis and ato pic dermatitis) elicited in 35% of patients. Eighty of the patients we re Saudis. One hundred and sixty six (63%) of 264 infants with the dis order, available for reevaluation after 3 years were free of symptoms of the disease. In older children and adults the disease was punctuate d by frequent flare-ups and long periods of resolution. Bacteria skin infection, commonly due to staphylococcus aureus was the most common c omplication. No case of eczema vaccinatum or herpeticum was encountere d. Varicella infection ran a more prolonged course in some of our pati ents with atopic dermatitis. Follow-up of patients was associated with a high default rate, probably related to the frustrations with the di sorder and an elusive search for a cure. Conclusion: As compared to st udies in Europe. the first symptoms of atopic dermatitis in infants, o ccur a little later (8-12 weeks compared to 6-8 weeks), otherwise, the presentation and course were similar. The study illustrates the incre asing incidence of atopic dermatitis in the population studied. There is therefore, a need for increased awareness and understanding by the general public.