Case Control Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Pediatr. Aug 8, 2016; 5(3): 288-292
Published online Aug 8, 2016. doi: 10.5409/wjcp.v5.i3.288
Skin disease and thyroid autoimmunity in atopic South Italian children
Marcella Pedullà, Vincenzo Fierro, Pierluigi Marzuillo, Francesco Capuano, Emanuele Miraglia del Giudice, Eleonora Ruocco
Marcella Pedullà, Vincenzo Fierro, Pierluigi Marzuillo, Francesco Capuano, Emanuele Miraglia del Giudice, Department of Woman, Child and General and Specialized Surgery, Seconda Università degli Studi di Napoli, 80138 Napoli, Italy
Eleonora Ruocco, Department of Dermatology, Seconda Università degli Studi di Napoli, 80138 Napoli, Italy
Author contributions: Pedullà M drafted the manuscript; Pedullà M, Fierro V and Marzuillo P participated in the conception and the design of the study; Pedullà M and Capuano F examined the patients, collected anthropometric data; Miraglia del Giudice E and Ruocco E supervised the design and execution of the study.
Institutional review board statement: An informed consent was obtained from the parents and the children all enrolled after the nature of the investigation was explained and in accordance with the approved protocol from the Institutional Review Board at the Second University of Naples.
Informed consent statement: An informed consent was obtained from the parents and the children all enrolled after the nature of the investigation was explained.
Conflict-of-interest statement: Nothing to declare.
Data sharing statement: We agree with data sharing.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Pierluigi Marzuillo, MD, Department of Woman, Child and General and Specialized Surgery, Seconda Università degli Studi di Napoli, Via L. De Crecchio n° 2, 80138 Napoli, Italy. pierluigi.marzuillo@gmail.com
Telephone: +39-081-5665420
Received: January 26, 2016
Peer-review started: January 26, 2016
First decision: March 23, 2016
Revised: April 8, 2016
Accepted: May 7, 2016
Article in press: May 9, 2016
Published online: August 8, 2016
Abstract

AIM: To verify the prevalence of thyroid autoimmunity (TA) and the possible association between atopy and TA in children affected by skin disease.

METHODS: Three hundred and twenty-four children consecutively referred due to skin disease symptoms to our Pediatric Department were enrolled. One hundred and eighty-seven were diagnosed with atopic dermatitis (AD), 95 with acute urticaria, 40 with chronic urticaria (CU), and 2 with alopecia areata (AA). According to the work-up for atopy, the children were divided into two groups: Atopics and non-atopics. TA was diagnosed by serum thyroid peroxidase autoantibodies and/or thyroglobulin autoantibodies levels more than twice normal values over a period of two months by immunoassay.

RESULTS: In all children with skin disease, a significant prevalence of TA in atopics compared with non-atopics (13.67% vs 2.67%, P = 0.0016) and a significant association between TA and atopy (OR = 5.76, 95%CI: 1.71-19.35) were observed. These findings were confirmed as significant in children with AD: TA in atopics was 11.5%, while TA in non-atopics was 2.7% (P = 0.03, OR = 4.68, 95%CI: 1.02-21.38). In addition, atopics with CU showed a significantly higher prevalence of TA (26.9%), but none of the non-atopics showed CU (P = 0.0326). On the other hand, atopics with AA showed a 100% (2 out of 2) prevalence of TA, compared with none of the non-atopics.

CONCLUSION: In children with skin disease, atopy seems to be associated with an increased risk of TA.

Keywords: Skin disease, Thyroid autoimmunity, Atopic dermatitis, Children

Core tip: We observed a significant association between atopy and thyroid autoimmunity (TA) in atopic children with skin disease. This association was confirmed in atopic children affected by atopic dermatitis. The key message from our study for pediatricians is that clinicians should always evaluate thyroid peroxidase and thyroglobulin autoantibodies in atopic children with skin disease, as these children could also have TA.