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      Prevalences of Allergic Disorders in Children with Terra Firma-Forme Dermatosis

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          Abstract

          Background:

          Terra firma-forme dermatosis (TFFD) is a clinical condition that may be defined as a dirty appearance of skin. Although it has been defined for many years, its clinical value is not well known.

          Objective:

          We aimed to determine the prevalence of allergic disorders (asthma, allergic rhinitis, and eczema) to investigate if this clinical condition is associated with allergic disorders in children with TFFD.

          Materials and Methods:

          A questionnaire descriptive of allergic disorders [International Study of Asthma and Allergies in Children (ISAAC)] was applied to all children diagnosed with TFFD at the pediatric clinics during a 6-month period specified for the study. The results were compared with the two ISAAC studies that have been previously conducted in our region.

          Results:

          The prevalence of TFFD among 1695 children examined at our outpatient clinic was found to be 3.18% ( n = 54). The youngest of the children was 6 months old and the oldest 13 years, with an average age of 6.08 ± 2.69 years. Our study group had significantly greater rates and intensities of lifetime wheezing, wheezing in the last 12 months (current wheezing), lifetime allergic rhinitis, allergic rhinitis in the last 12 months; and the rate of physician-diagnosed allergic rhinitis compared to the comparator groups ( P < 0.005).

          Conclusions:

          The results support the view that TFFD may be a sign of associated asthma and allergic rhinitis.

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          Most cited references18

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          Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines-2016 revision.

          Allergic rhinitis (AR) affects 10% to 40% of the population. It reduces quality of life and school and work performance and is a frequent reason for office visits in general practice. Medical costs are large, but avoidable costs associated with lost work productivity are even larger than those incurred by asthma. New evidence has accumulated since the last revision of the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines in 2010, prompting its update.
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            Worldwide variations in the prevalence of symptoms of atopic eczema in the International Study of Asthma and Allergies in Childhood.

            Little is known about the prevalence of atopic eczema outside Northern Europe. We sought to describe the magnitude and variation in the prevalence of atopic eczema symptoms throughout the world. A cross-sectional questionnaire survey was conducted on random samples of schoolchildren aged 6 to 7 years and 13 to 14 years from centers in 56 countries throughout the world. Those children with a positive response to being questioned about the presence of an itchy relapsing skin rash in the last 12 months that had affected their skin creases were considered to have atopic eczema. Children whose atopic eczema symptoms resulted in sleep disturbance for 1 or more nights per week were considered to have severe atopic eczema. Complete data was available for 256,410 children aged 6 to 7 years in 90 centers and 458,623 children aged 13 to 14 years in 153 centers. The prevalence range for symptoms of atopic eczema was from less than 2% in Iran to over 16% in Japan and Sweden in the 6 to 7 year age range and less than 1% in Albania to over 17% in Nigeria for the 13 to 14 year age range. Higher prevalences of atopic eczema symptoms were reported in Australasia and Northern Europe, and lower prevalences were reported in Eastern and Central Europe and Asia. Similar patterns were seen for symptoms of severe atopic eczema. Atopic eczema is a common health problem for children and adolescents throughout the world. Symptoms of atopic eczema exhibit wide variations in prevalence both within and between countries inhabited by similar ethnic groups, suggesting that environmental factors may be critical in determining disease expression. Studies that include objective skin examinations are required to confirm these findings.
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              A clinical index to define risk of asthma in young children with recurrent wheezing.

              Because most cases of asthma begin during the first years of life, identification of young children at high risk of developing the disease is an important public health priority. We used data from the Tucson Children's Respiratory Study to develop two indices for the prediction of asthma. A stringent index included frequent wheezing during the first 3 yr of life and either one major risk factor (parental history of asthma or eczema) or two of three minor risk factors (eosinophilia, wheezing without colds, and allergic rhinitis). A loose index required any wheezing during the first 3 yr of life plus the same combination of risk factors described previously. Children with a positive loose index were 2.6 to 5.5 times more likely to have active asthma between ages 6 and 13 than children with a negative loose index. Risk of having subsequent asthma increased to 4.3 to 9.8 times when a stringent index was used. We found that 59% of children with a positive loose index and 76% of those with a positive stringent index had active asthma in at least one survey during the school years. Over 95% of children with a negative stringent index never had active asthma between ages 6 and 13. We conclude that the subsequent development of asthma can be predicted with reasonable accuracy using simple, clinically based parameters.
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                Author and article information

                Journal
                Indian J Dermatol
                Indian J Dermatol
                IJD
                Indian Journal of Dermatology
                Wolters Kluwer - Medknow (India )
                0019-5154
                1998-3611
                Jan-Feb 2021
                : 66
                : 1
                : 49-54
                Affiliations
                [1] From the Department of Pediatrics, Pamukkale University Faculty of Medicine, Denizli, (The work was carried out at Denizli MediKlinik Hospital), Mugla, Turkey
                [1 ] Department of Pediatrics, Muğ la Sıtkı Koçman University Faculty of Medicine, Muğ la, Turkey
                [2 ] Department of Dermatology, Servergazi State Hospital, Denizli, Turkey
                Author notes
                Address for correspondence: Dr. Gürbüz Akçay, Department of Pediatric, Pamukkale University Faculty of Medicine, Pamukkale, Denizli, Turkey. E-mail: gurbuzakcay@ 123456hotmail.com
                Article
                IJD-66-49
                10.4103/ijd.IJD_324_19
                8061479
                33911293
                6d7ec595-a7c1-44dc-871c-2449cdb8e386
                Copyright: © 2021 Indian Journal of Dermatology

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : May 2019
                : February 2020
                Categories
                Original Article

                Dermatology
                allergic rhinitis,asthma,eczema,isaac,prevalence,terra firma-forme dermatosis
                Dermatology
                allergic rhinitis, asthma, eczema, isaac, prevalence, terra firma-forme dermatosis

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