The frequency of common skin conditions in preschool-age children in Australia - Atopic dermatitis

Objective: To determine the prevalence and severity of atopic dermatitis in a stratified cross-section of preschool-age children examined throughout V ictoria, Australia. Design: A cross-sectional skin survey using a selected cluster sample of th e various centers throughout Victoria. Setting: The study population included Victorian children attending child-c are centers, preschools, and Maternal and Child Health Centres, with the re ference population being Australian children aged 5 years and younger. Participants: Of 1634 potential participants, 1116 children (68.3%) were ex amined. Intervention: A dermatologist performed a total skin examination, including head and neck, limbs, and trunk, on all children. The diaper area was exam ined in children younger than 12 months. Main Outcome Measure: All parents were administered a questionnaire to elic it demographic information, history of skin conditions, and family history of skin problems or related diseases. The examiner recorded the presence, s ite, and severity of atopic dermatitis for calculation of age- and sex-spec ific prevalence rates. Results: The age- and sex-adjusted point prevalence was 30.8% (95% confiden ce interval [CI], 28.0%-33.5%). Most children (63.7%) were classified as ha ving minimal or mild disease. Only 5.8% of children with atopic dermatitis did not have face or flexural involvement. Of the 237 children with atopic dermatitis and information available, 209 used 1 or more products to treat their condition. Conclusions: Atopic dermatitis is common, decreasing in prevalence after th e first 3 years of life. Most children have mild disease requiring little i f any treatment, and much could be prevented with simple measures. Educatio nal programs directed at those caring for preschoolage children that provid e information on simple preventive measures, where practical, and sources o f advice for treatment, if necessary, could substantially reduce the morbid ity of this condition in predisposed children.