RISK FACTORS FOR THE SEVERITY OF ATOPIC DERMATITIS MANIFESTATIONS IN CHILDREN

Authors

  • Sergei N. Belugin International Sakharov Environmental Institute, Belarusian State University
  • Olga S. Belugina Belarusian State Medical University
  • Ekaterina A. Lisowenko Belarusian State Medical University
  • Irina N. Belugina Belarusian State Medical University
  • Ellada I. Aliyeva Belarusian State Medical University

Keywords:

atopic dermatitis, children, severity, breast feeding, risk factors

Abstract

The aim of this study was to identify possible associations of certain somatic, atopic and environmental factors (obtained from medical history) with the severity of atopic dermatitis (AD) measured by the SCORAD index in children undergoing inpatient and outpatient treatment in Minsk. Using a cross-sectional approach, data from 42 patients with a confirmed diagnosis of AD aged 3 to 18 years were analyzed. In each case, AD severity was assessed by the SCORAD 
index. AD severity in children was directly associated with a short duration of breastfeeding (one-way ANOVA, p < 0,001), a predisposition to allergic reactions (Student’s t-test, p = 0,022), allergic rhinitis (p < 0,001) and reactions to non‑food allergens (p < 0,001). A moderate correlation was found between the SCORAD index and birth weight in boys (r = −0,46, p = 0,043, n = 19), as well as birth length (r = −0,54, p = 0,016, n = 19). In children with AD, the SCORAD 
score was directly related to the frequency of certain clinical morphological skin manifestations (erythema, edema, oozing, pruritus, lichenification, scaling) and inversely related to remission duration. Reaction to non‑food allergens or a tendency to pustular eruptions were associated with edematous lesions, oozing at eruption sites, excoriations, skin dryness and scaling. Oozing at eruption sites was associated with the absence of breastfeeding or its short duration. The 
observed protective role of breastfeeding in reducing AD severity and the worsening of AD manifestations associated with adverse environmental factors (nonfood allergens, pustular infection) suggest the need for individualized control of risk factors during patient follow‑up to optimize treatment and prevent AD exacerbations.

Author Biographies

  • Sergei N. Belugin, International Sakharov Environmental Institute, Belarusian State University

    PhD (medicine), docent; associate professor at the department of environmental medicine and radiobiology

  • Olga S. Belugina, Belarusian State Medical University

    senior lecturer at the department of dermatology, venereology and cosmetology – including courses for continuing professional development and retraining

  • Ekaterina A. Lisowenko, Belarusian State Medical University

    intern doctor at the department of dermatology, venereology and cosmetology – including courses  for continuing professional development and retraining

  • Irina N. Belugina, Belarusian State Medical University

    PhD (medicine), docent; associate professor at the department of dermatology, venereology and cosmetology – including courses for continuing professional development and 
    retraining

  • Ellada I. Aliyeva, Belarusian State Medical University

    intern doctor at the department of dermatology, venereology and cosmetology – including courses for continuing professional development and retraining

References

  1. Eichenfield LF, Tom WL, Chamlin SL, Feldman SR, Hanifin JM, et al. Guidelines of care for the management of atopic dermatitis: section 1. Diagnosis and assessment of atopic dermatitis. Journal of the American of Academy of Dermatology. 2014; 70 (2): 338-351. DOI: 10.1016/j.jaad.2013.10.010
  2. Mohn CH, Blix HS, Halvorsen JA, Nafstad P, Morton V, et al. Incidence trends of atopic dermatitis in infancy and early childhood in a nationwide prescription registry study in Norway. JAMA Netw. Open. 2018; 1(7): e184145. DOI: 10.1001/jamanetworkopen.2018.4145
  3. Asher MI, Montefort S, Bjorksten B, Lai CKW, Strachan DP, et al. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC Phases One and Three repeat multicountry cross-sectional surveys. Lancet. 2006; 368(9537):733-743. DOI: 10.1016/S0140-6736(06)69283-0
  4. Kramer MS, Chalmers B, Hodnett ED, Sevkovskaya Z, Dzikovich I., et al. Promotion of Breastfeeding Intervention Trial (PROBIT): a randomized trial in the Republic of Belarus. PROBIT Study Group (Promotion of Breastfeeding Intervention Trial). JAMA. 2001; 285(4), 413-420. https://doi.org/10.1001/jama.285.4.413
  5. Thomsen SF, Ulrik CS, Kyvik KO, Hjelmborg Jv, Skadhauge LR, et al. Importance of genetic factors in the etiology of atopic dermatitis: a twin study. Allergy Asthma Proc. 2007; 28: 535-539. DOI: 10.2500/aap2007.28.3041
  6. Weidinger S, Illig T, Baurecht H, Irvine AD, Rodriguez E, et al. Loss-of-function variations within the filaggringene predispose for atopic dermatitis with allergic sensitizations. J Allergy Clin Immunol. 2006; 118: 214-219. DOI: 10.1016/j.jaci.2006.05.004
  7. Kathuria P, Silverberg JI. Association of pollution and climate with atopic eczema in US children. Pediatr. Allergy Immunol. 2016; 27: 478–485. DOI: 10.1111/pai.12543
  8. Belugina IN, Yagovdik NZ, Belugina OS, Belugin SN. Outdoor environment, ozone, radionuclide-associated aerosols and incidences of infantile eczema in Minsk, Belarus. J Eur Acad Dermatol Venereol. 2018; 32: 1977-1985 DOI: 10.1111/jdv.15063
  9. Belugina I, Yagovdik N, Belugina O, Belugin S. The impact of meteorological factors on the incidence of infantile atopic dermatitis. Int J Dermatol. 2024; 63(12):e405-e414. DOI: 10.1111/ijd.17404
  10. Hanifin JM, Rajka G. Diagnostic features of atopic dermatitis. Acta Derm Venereol.1980; 92(Suppl): 44–47. https://doi.org/10.2340/00015555924447
  11. ISAAC. The International Study of Asthma and Allergies in Childhood manual [Internet].Auckland(NZ):Münster;1993.54p. https://isaac.auckland.ac.nz/phases/phaseone /phaseonemanual
  12. Severity scoring of atopic dermatitis: the SCORAD index. Consensus Report of the European Task Force Atopic Dermatitis. Dermatology (Basel). 1993; 186(1): 23–31. DOI: 10.1159/000247298
  13. Zhang Z, Li H, Zhang H, Cheng R, Li M, et al. Factors associated with persistence of early-onset atopic dermatitis up to the age of 12 years: a prospective cohort study in China. Eur J Dermatol. 2021; 31(3):403-408. DOI: 10.1684/ejd.2021.4045.
  14. Simpson EL, De Benedetto A, Boguniewicz M, Ong PY, Lussier S, et al. Phenotypic and Endotypic Determinants of Atopic Dermatitis Severity From the Atopic Dermatitis Research Network (ADRN) Registry. Allergy Clin Immunol Pract. 2023; 11(8):2504-2515. DOI: 10.1016/j.jaip.2023.04.052.
  15. Fotopoulou M, Iordanidou M, Vasileiou E, Trypsianis G, Chatzimichael A, et al. A short period of breastfeeding in infancy, excessive house cleaning, absence of older sibling, and passive smoking are related to more severe atopic dermatitis in children. E.Eur J Dermatol. 2018; 28(1):56-63. DOI: 10.1684/ejd.2017.3165.
  16. Olesen AB, Ellingsen AR, Olesen H, Juul S, Thestrup-Pedersen K. Atopic dermatitis and birth factors: historical follow up by record linkage. BMJ 1997; 314:1003–1008. DOI: 10.1136/bmj.314.7086.1003
  17. Egeberg A, Andersen YM, Gislason G, Skov L, Thyssen JP. Neonatal risk factors of atopic dermatitis in Denmark- results from a nationwide register based study. Pediatr Allergy Immunol. 2016; 27:368–374. DOI: 10.1111/pai.12560

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Published

2026-01-12

Issue

No. 4 (2025): ЖУРНАЛ БЕЛОРУССКОГО ГОСУДАРСТВЕННОГО УНИВЕРСИТЕТА ЭКОЛОГИЯ

Section

Medical Ecology

How to Cite

[1]
Belugin, S. et al. 2026. RISK FACTORS FOR THE SEVERITY OF ATOPIC DERMATITIS MANIFESTATIONS IN CHILDREN. Journal of the Belarusian State University. Ecology. 4 (Jan. 2026), 35–41.