Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology · 2026
Phenotypes of atopic dermatitis in Polish children-Latent class analysis of cross-sectional questionnaire-based study.
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Dumycz Karolina, Zygadło Joanna, Panczyk Mariusz, Kulus Marek, Sokolowska Milena, Feleszko Wojciech
Аннотация
BACKGROUND: Atopic dermatitis (AD) is a common chronic inflammatory skin disease with a heterogeneous clinical course. Distinct phenotypes show differences in age at onset, severity, and allergic profile; however, evidence from Central and Eastern Europe remains limited.
METHODS: An anonymous online questionnaire distributed via social media targeted parents of children <18 years of age with physician-diagnosed AD. The data included demographics, environmental exposures, AD history, proxy Patient-Oriented Eczema Measure (POEM) scores, comorbidities, and self-reported sensitizations. Children were stratified by age (<6 vs. ≥6 years). Latent class analysis (LCA) was used to identify phenotypes in age groups using age of onset, current severity, recent exacerbations, viral skin infections, and sensitization type.
RESULTS: A total of 435 children were included in this analysis (mean age, 3.92 years; 59.8% male). AD onset before 6 months occurred in 67.1% of patients. In children <6 years (n = 359), three phenotypes were identified: "early-onset, moderate-severe with co-sensitization" (n = 100, 27.9%), with highest frequency of food allergy; "early-onset, mild with food sensitization" (n = 195, 54.3%), and "later-onset, mild with aeroallergen sensitization" (n = 64, 17.8%). In children ≥6 years (n = 76), two phenotypes emerged: "early-onset with co-sensitization" (n = 53, 69.7%), which displayed higher frequency of atopic comorbidities, and "later-onset with aeroallergen sensitization" (n = 23, 30.3%). The classes showed clear separation based on selected features.
CONCLUSIONS: Distinct, clinically relevant AD phenotypes were identified in children, which were in line with phenotypes reported in previous longitudinal studies, although based on cross-sectional data. These findings underscore AD heterogeneity and support the utility of pragmatic, region-specific surveys for phenotype identification outside longitudinal cohorts.
METHODS: An anonymous online questionnaire distributed via social media targeted parents of children <18 years of age with physician-diagnosed AD. The data included demographics, environmental exposures, AD history, proxy Patient-Oriented Eczema Measure (POEM) scores, comorbidities, and self-reported sensitizations. Children were stratified by age (<6 vs. ≥6 years). Latent class analysis (LCA) was used to identify phenotypes in age groups using age of onset, current severity, recent exacerbations, viral skin infections, and sensitization type.
RESULTS: A total of 435 children were included in this analysis (mean age, 3.92 years; 59.8% male). AD onset before 6 months occurred in 67.1% of patients. In children <6 years (n = 359), three phenotypes were identified: "early-onset, moderate-severe with co-sensitization" (n = 100, 27.9%), with highest frequency of food allergy; "early-onset, mild with food sensitization" (n = 195, 54.3%), and "later-onset, mild with aeroallergen sensitization" (n = 64, 17.8%). In children ≥6 years (n = 76), two phenotypes emerged: "early-onset with co-sensitization" (n = 53, 69.7%), which displayed higher frequency of atopic comorbidities, and "later-onset with aeroallergen sensitization" (n = 23, 30.3%). The classes showed clear separation based on selected features.
CONCLUSIONS: Distinct, clinically relevant AD phenotypes were identified in children, which were in line with phenotypes reported in previous longitudinal studies, although based on cross-sectional data. These findings underscore AD heterogeneity and support the utility of pragmatic, region-specific surveys for phenotype identification outside longitudinal cohorts.