Seasonal variation and monthly patterns of skin symptoms in Korean children with atopic eczema/dermatitis syndrome

Abstract

Background: There have been controversies about the seasonality in aggravation of atopic eczema/dermatitis syndrome (AEDS) symptoms, although understanding the seasonal patterns of AEDS symptoms is an important step in preventing exacerbation through proactive management. Objective: The aim of this study was to evaluate whether there are seasonal variations or monthly patterns of symptoms in children with AEDS. Methods: A total of 590 children with AEDS (median age, 21 months) were enrolled and were followed up for at least 1 year between August 2012 and March 2015. Daily symptom scores that described the extent of itching, sleep disturbance, erythema, dryness, oozing, and edema were recorded on a scale of 0 to 4. The baseline score for each patient was defined as the 20th percentile of each individual's total score. The symptom score difference of each patient was expressed relative to the baseline level. The seasonal or monthly variation in symptom score differences was analyzed through generalized estimating equation analysis. Results: Based on the AEDS symptom records from 87,879 person-days, the mean symptom score difference from baseline in patients with AEDS increased significantly in spring, autumn, and winter relative to the reference season (summer): by 0.62 (95% confidence interval [CI], 0.44-0.81) in spring, by 0.45 (95% CI, 0.24-0.67) in winter, and by 0.18 (95% CI, 0.02-0.36) in autumn. The mean symptom score difference from baseline increased significantly in January, February, March, April, May, June, October, November, and December relative to the reference month of August. Conclusion: Skin symptoms in children with AEDS were worse in spring, winter, and autumn than in summer. In terms of monthly patterns, the skin symptoms were the worst in April.