Abstract
OBJECTIVE—To define the evolution of prepubertal growth in atopic dermatitis and the factors influencing that growth pattern. METHODS—Height and height velocity over two years, weight, triceps and subscapular skin fold thickness, and bone age were assessed in 80 prepubertal patients with atopic dermatitis and a control group of 71 healthy prepubertal school children. RESULTS—Height standard deviation scores (SDS) and height velocity SDS did not differ between patients and controls, and were not influenced by body surface area affected by atopic dermatitis, topical glucocorticoid potency, or coexisting asthma. However, height SDS (r = −0.37) and height velocity SDS (r = −0.31) correlated inversely to age in patients but not in controls. A greater proportion (z = 2.84) of patients than controls had year 2 height velocity SDS less than −1.96. Patients had a mean delay in bone age of 0.22 years and 0.41 years at the beginning of year 1 and year 2 of the study, respectively. The delay in bone age correlated positively with age (r = 0.39) and duration of atopic dermatitis (r = 0.39), and negatively with height SDS (r = −0.51) and height velocity SDS (r = −0.38). CONCLUSIONS—Prepubertal children with atopic dermatitis are not short compared with controls. However, as they approach the teenage years their height velocity decreases, the proportion of children with extremely low height velocity increases, and the delay in bone age increases. These features are consistent with the pattern of growth seen in people with constitutional growth delay.
Full Text
The Full Text of this article is available as a PDF (102.4 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Balfour-Lynn L. Growth and childhood asthma. Arch Dis Child. 1986 Nov;61(11):1049–1055. doi: 10.1136/adc.61.11.1049. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bode H. H. Dwarfism following long-term topical corticosteroid therapy. JAMA. 1980 Aug 22;244(8):813–814. [PubMed] [Google Scholar]
- Cole T. J., Freeman J. V., Preece M. A. Body mass index reference curves for the UK, 1990. Arch Dis Child. 1995 Jul;73(1):25–29. doi: 10.1136/adc.73.1.25. [DOI] [PMC free article] [PubMed] [Google Scholar]
- David T. J. Dietary treatment of atopic eczema. Arch Dis Child. 1989 Oct;64(10):1506–1509. doi: 10.1136/adc.64.10.1506. [DOI] [PMC free article] [PubMed] [Google Scholar]
- David T. J., Ferguson A. P., Newton R. W. Nocturnal growth hormone release in children with short stature and atopic dermatitis. Acta Derm Venereol. 1991;71(3):229–231. [PubMed] [Google Scholar]
- Ferguson A. C., Murray A. B., Tze W. J. Short stature and delayed skeletal maturation in children with allergic disease. J Allergy Clin Immunol. 1982 May;69(5):461–466. doi: 10.1016/0091-6749(82)90122-1. [DOI] [PubMed] [Google Scholar]
- Hauspie R., Susanne C., Alexander F. Maturational delay and temporal growth retardation in asthmatic boys. J Allergy Clin Immunol. 1977 Mar;59(3):200–206. doi: 10.1016/0091-6749(77)90150-6. [DOI] [PubMed] [Google Scholar]
- Kristmundsdottir F., David T. J. Growth impairment in children with atopic eczema. J R Soc Med. 1987 Jan;80(1):9–12. doi: 10.1177/014107688708000106. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Martin A. J., Landau L. I., Phelan P. D. The effect on growth of childhood asthma. Acta Paediatr Scand. 1981 Sep;70(5):683–688. doi: 10.1111/j.1651-2227.1981.tb05768.x. [DOI] [PubMed] [Google Scholar]
- Massarano A. A., Hollis S., Devlin J., David T. J. Growth in atopic eczema. Arch Dis Child. 1993 May;68(5):677–679. doi: 10.1136/adc.68.5.677. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Patel L., Clayton P. E., Addison G. M., Price D. A., David T. J. Adrenal function following topical steroid treatment in children with atopic dermatitis. Br J Dermatol. 1995 Jun;132(6):950–955. doi: 10.1111/j.1365-2133.1995.tb16954.x. [DOI] [PubMed] [Google Scholar]
- Patel L., Clayton P. E., Jenney M. E., Ferguson J. E., David T. J. Adult height in patients with childhood onset atopic dermatitis. Arch Dis Child. 1997 Jun;76(6):505–508. doi: 10.1136/adc.76.6.505. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pike M. G., Chang C. L., Atherton D. J., Carpenter R. G., Preece M. A. Growth in atopic eczema: a controlled study by questionnaire. Arch Dis Child. 1989 Nov;64(11):1566–1569. doi: 10.1136/adc.64.11.1566. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Prader A. Delayed adolescence. Clin Endocrinol Metab. 1975 Mar;4(1):143–155. doi: 10.1016/s0300-595x(75)80037-5. [DOI] [PubMed] [Google Scholar]
- Priftis K., Milner A. D., Conway E., Honour J. W. Adrenal function in asthma. Arch Dis Child. 1990 Aug;65(8):838–840. doi: 10.1136/adc.65.8.838. [DOI] [PMC free article] [PubMed] [Google Scholar]
- REICHLING G. H., KLIGMAN A. M. Alternate-day corticosteroid therapy. Arch Dermatol. 1961 Jun;83:980–983. doi: 10.1001/archderm.1961.01580120092023. [DOI] [PubMed] [Google Scholar]
- Shalet S. M. Treatment of constitutional delay in growth and puberty (CDGP). Clin Endocrinol (Oxf) 1989 Jul;31(1):81–86. doi: 10.1111/j.1365-2265.1989.tb00456.x. [DOI] [PubMed] [Google Scholar]
- Smith J. M. Long term steroid treatment in asthmatic children. Ann Allergy. 1965 Oct;23(10):492–496. [PubMed] [Google Scholar]
- Tanner J. M., Whitehouse R. H., Takaishi M. Standards from birth to maturity for height, weight, height velocity, and weight velocity: British children, 1965. I. Arch Dis Child. 1966 Oct;41(219):454–471. doi: 10.1136/adc.41.219.454. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Turpeinen M., Salo O. P., Leisti S. Effect of percutaneous absorption of hydrocortisone on adrenocortical responsiveness in infants with severe skin disease. Br J Dermatol. 1986 Oct;115(4):475–484. doi: 10.1111/j.1365-2133.1986.tb06242.x. [DOI] [PubMed] [Google Scholar]
- Vermeer B. J., Heremans G. F. A case of growth retardation and cushing's syndrome due to excessive application of betamethasone-17-valerate ointment. Dermatologica. 1974;149(5):299–304. doi: 10.1159/000251537. [DOI] [PubMed] [Google Scholar]
- Wahlgren C. F. Pathophysiology of itching in urticaria and atopic dermatitis. Allergy. 1992 Apr;47(2 Pt 1):65–75. doi: 10.1111/j.1398-9995.1992.tb05091.x. [DOI] [PubMed] [Google Scholar]