Table of Content

Archive

Spring 2004, Vol. 12 No. 1

H.K. Dermatol. Venereol. Bull. (2004) 12, 6-11


Original Article

'Measuring' eczema in children: what actually are we measuring?

EKL Hon 韓錦倫, TF Leung 梁廷勳, TF Fok 霍泰輝

Abstract
The disease activity and severity of atopic dermatitis (AD) may be measured clinically and biochemically. There are at least thirteen clinical scoring systems for the assessment of disease severity in AD. Each system has its problems with inter-observer and intra-observer variability. They focus on the various symptoms and signs of this chronically relapsing disease. There are also various non-specific biochemical markers of disease severity. The markers for type 1 T helper (Th1) lymphocyte-mediated immunity, usually associated with infective process, are depressed in AD and their levels may be altered with eczema treatment whereas Th2 markers are associated with allergic inflammation and may be elevated in AD. Interleukin-18, a pleiomorphic marker, plays important roles in both Th1 and Th2 immunity. Cutaneous T cell-attracting chemokine (CTACK), on the other hand, is a skin-specific chemoattractant cytokine which may correlate with AD severity and obviate the issue of observer reliability. We share our experience in some of these markers and discuss the potential clinical significance of their measurement.