FLORENCE, ITALY — A case-control study conducted in Greece lends support to the theory that a “superclean” environment during infancy and early childhood may predispose children to atopic dermatitis.
Penny Emmanouil, M.D., and associates in the department of dermatology at Pentelis Children's Hospital in Athens, Greece, studied home hygiene, standards of living, exposure to infections, and vaccination rates among 150 children aged 28 days to 3 years who were seen for atopic dermatitis (AD) symptoms at an outpatient clinic.
These results were compared with data from a group of 150 children aged 35 days to 3 years who had no atopic symptoms during the same period.
Findings were released at the 13th Congress of the European Academy of Dermatology and Venereology.
A strong association was found between superclean environments and the presence of AD. The cleaner the household and the higher the family standard of living, the more likely it was that children had AD.
Significant differences were seen in the two groups of children. For instance, nearly half of children with AD had their own bedrooms, while those without AD symptoms tended to share living space with parents and siblings. Those with AD were more likely to live in larger, cleaner, more well-to-do households with fewer children.
No relationships were seen between vaccinations or infections and AD.
More work must be done to tease out risk factors that may be responsible for the development of AD in early childhood, Dr. Emmanouil said.
However, she hypothesized that exposure to microbes might be restricted in those households that practice meticulous hygiene
“As a result, the immune system in infancy and early childhood is restricted, and the switch from the TH2- to TH1-mediated immune response is impaired,” she said.