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ORIGINAL ARTICLE |
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| Year : 2006 | Volume
: 51
| Issue : 1 | Page : 33-35 |
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| Atopic dermatitis and ABO blood group |
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Dwijendra Nath Gangopadhyay, Biswanath Naskar, Alok Kumar Roy
Department of Dermatology and Venereology, N.R.S. Medical College, Kolkata, West Bengal, India
Correspondence Address:
Dwijendra Nath Gangopadhyay
Department of Dermatology and Venereology, N.R.S. Medical College, Kolkata, West Bengal
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0019-5154.25186
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BACKGROUND: Atopic dermatitis is a chronic recurrent genetically determined skin disease affecting all age groups. PURPOSES: To study epidemiological and environmental factors, clinical patterns and the relationship of atopic dermatitis with ABO blood group system. METHODS: In 30 atopic dermatitis patients blood group distribution was compared with the distribution in 1500 relative donors of the blood bank of the same institute. FINDINGS: There were 18 males (60%) and 12 females (40%). Family and personal history of atopy were observed in 21 (70%(and 19 cases (63.3%) respectively. CONCLUSIONS: Blood group O subjects were significantly less in the study population in comparison to control. LIMITATION: Hospital based study with small sample size; hence the result cannot be generalized.
Keywords: Atopic dermatitis, Environmental factors, ABO blood group
How to cite this article:
Gangopadhyay DN, Naskar B, Roy A. Atopic dermatitis and ABO blood group. Indian J Dermatol 2006;51:33-5 |
| Introduction | |  |
Atopic dermatitis (AD) is a, chronically relapsing disease in the abnormally reacting skin of atopic individuals which is frequently associated with increased serum IgE level and a personal or family history of AD, allergic rhinitis and/or asthma. There is no single distinguishing feature of AD or a diagnostic laboratory test, so the diagnosis is based on constellations features. Although the etiology of AD is unknown, the disease is probably multifactorial with the interactions between genetic and environmental factors.[1] It has been reported that the prevalence of AD has been on the rise for the last three decades.[2],[3] AD is variable from place to place as the environment plays a major role in its etiopathogenesis. AD is less severe in India than in western countries. In the present study, we evaluated the relation ship between atopic dermatitis and the ABO blood group, a segment only occasionally cited in the literature.[4],[5]
| Materials and Methods | | |
Thirty patients of atopic dermatitis diagnosed according to the criteria of Hanifin and Rajka[6] were enrolled from the patients attending the Dermatology OPD of NRS Medical College, Kolkata over a period of 1 year. In every patient, detailed history was noted including age, age at onset, mode of onset, family and personal history of atopy, seasonal variation, food habits and associated diseases, if any. A thorough clinical examination was carried out.
Blood samples were collected by venepuncture from each subject and tested for ABO blood group with corresponding antisera. ABO blood group distribution was elicited among the relative blood donors to the blood bank of the same institute and considered as control. The data were tabulated, analyzed and compared with the data from other studies.
| Results | | |
Out of the 30 patients, 18 (60%) were male and 12 (40%) female. In this study youngest patient was six months and oldest one was 65 years old. The age and sex distributions are shown in [Table - 1].
The age at onset of disease was six to nine months in two (6.7%) cases, one and half years in one case, 3-10 years in 6 cases (20%), 11-20 years in 7 (23.3%) and 4 cases (13.3%) were between 31-50 years and in four cases (13.3%) it is above 51 years [Table - 2].
The onset was insidious in 13 (43.3%) patients, subacute in 11 (36.7%) cases and in 6 (20%) patients it was acute.
Personal history of atopy was observed in 19 (63.3%) cases. Ten (33.3%) patients suffered from asthma, 9 (30%) cases had allergic rhinits and 4 cases were observed in varying combination of urticaria and asthma.
Family history of atopy was present in 21 (70%) patients. History of urticaria was found in 5 (16.7%) cases, asthma in 10 (33.3%) cases, allergic rhinitis in 6 (20%) cases. Food intolerance to eggs, erabs, prawn, milk and brinjal was noted in 14 (46.7%) patients and 16 (53.33%) cases gave history of intolerance to clothing mainly woolen and synthetic garments. The condition aggravated during winter in 12 (40%) cases, 8 (26.7%) cases in summer and in 5 (16.7%) patients exacerbations occurred in rainy seasons.
A history of mild to moderate degree of photosensitivity was noted in 4 cases (13.3%), 5 (16.7%) patients gave definite history of aggravation of the disease following emotional upset.
The frequently affected sites were flexors of the elbow in 21 (70%) cases, posterior aspects of knee, face, front of the ankle - 14 (46.7%) cases each, nape of the neck in 10 (33.3%) and abdomen in 5 (16.7%) cases.
Bacterial infection was a common associated feature in 60% cases, fungal and viral (herpes simplex, herpes zoster) infections in 33.3% each and scabies was associated in 23.3% of patients. White dermographism and xerosis were seen in 26 (86.7%) cases each, cheilitis was found in 10 (33.4%) patients, palmoplantar keratoderma was noted in 8 (26.7%), pityriasis alba in 6 (20%), follicular hyperkeratosis in 4 (13.4%) and ichthyosis vulgaris was found in 3 (10.8%) cases. Nipple eczema and alopecia areata were found in 2 cases (6.7%) and vitiligo was noted in one case. No case with hyperlinear palm was seen in our study and no other congenital or systemic disease of importance was associated with any of the cases studied.
Distribution of blood groups amongst 30 patients of atopic dermatitis and in 1500 individuals who are relative donors of the patients admitted in the same hospital and considered as control are shown in [Table - 3].
[Table - 3] shows that the blood group B was the highest prevalent among the patients with 14 (46.7%) subjects belonging to this group, while among controls, 585 (29%) belonged to same group. It was followed by group A with 10 (33.3%) patients and 315 (21%) controls. Four (13.3%) patients and 480 (32%) controls had group O while 2 (6.7%) patients and 120 (8%) controls were of group AB.
On c2 testing in the distribution of different blod groups between patients and controls, it was found that blood group O was significantly less among aptients than among controls ( P <0.05). The distribution of other groups was similar in the two groups of persons.
| Discussion | | |
Atopic dermatitis, a genetically determined disorder with multifactorial inheritance, is characterized by recurrent chronically relapsing skin disease that most likely occurs from an immunologic dysregulation. But the epidemiological studies and increasing prevalence of the disease point towards an important role of environment in determining disease expression.[7] Recently many experienced persons have reported an increased incidence of AD in the West due to greater atmospheric pollution and exposure to chemicals for a long period.[2] As the present study was hospital-bssed, the exact incidence of AD in population could not be determined. Among other causes of increased prevalence of AD are urbanization, increased awareness, nuclear families and better case detection. ADS has been found to start at a yound age with 60% having the onset of disease in the first year of life and 85% by 5 years of age8. In the present study, only 2 (6.7%) patients gave history of onset at an age below 1 year. In the a study from northern part of India, 85% of patients have developed the disease by 1 year of age and only 2.68% devloped it after 6 years of age.[9] The higher age at onset in our study may be due to ignorance of the patients or other parents as most of the patients attending our hospital come from rural area and their educational status is low.
In our study, male patients (60%) are affected slightly greater than females (40%) which is in similar to other reports.[10] Itching was present in all patients of our study. Facial involvement is common in infantile stage. Flexors of limbs were more frequently involved than the extensors, which corroborates with findings of other studies.[9]
Of the various associated disease, ichthyosis vulgaris, follicular hyperkeratosis was commonly associated with AD. The AD is known to exacerbate during winter[11] probably due to dryness, while some patients exacerbate in summer because of the hot humid weather leading to hyperhidrosis, itch and secondary skin infectioins.[12] In our study, majority of the patients had aggravation during winter, a few (17%) of them had exacerbation and bacterial infection in the summer. IN our study, 21 cases (70%) had family history of atopy and personal history had 19 (63.3%) patients, which was similar of findings in other study.[13]
We found less number of patients of atopic dermatitis with blood group O. It may be that presence of blood group A or B antigen manifests atopic dermatitis in susceptible individual. Literature search elicited dubious results of different studies. While some studies show preponderance of group A, some show group O, still others have failed to find any difference in the distribution of different blood groups. [14],[15],[16],[17] However, most of the studies involved small number of patients. Studies involving large number of patients are advocated to settle the issue.
| References | | |
| 1. | Bradley M, Kockum I, Soderhall C, et al . Characterization by phenotype of families with atopic dermatitis. Acta Derm Venereol 2000;80: 106-10.  |
| 2. | Ninan TK, Russell G. Respiratory symptoms and atopy in Aberdeen school children: evidence from two surveys 25 years apart. Br Med J 1992;304: 873-5. [PUBMED] |
| 3. | Williams HC. Is the prevalence of atopic dermatitis increasing? Clin Exp Dermatol 1992;17: 385-91. [PUBMED] |
| 4. | Landsteiner K, 1990: Blood group and diseases cited by Mollison, 1972;80: 27-35. |
| 5. | Aird I, Bentall H; Mebigan JA, Roberts JAF. The correlation between ABO blood group and allergic disorders. Br Med J 1954;2: 315. |
| 6. | Leicht S, Hanggi M. Atopic dermatitis: How to incroporate advances in management. Posatgrad Med J 2001;109: 119-27. [PUBMED] |
| 7. | Williams HC. Epidemiology of atopic dermatitis (Review). Clin Exp Dermatol 2000;25: 522-9. [PUBMED] [FULLTEXT] |
| 8. | Rajka G, Langeland T. Grading of the severity of atopic dermatitis. Acta Derm Venereol (Stockh) 1989;144(Suppl):13-4. |
| 9. | Dhar S, Kanwar AJ. Epidemiology and clinical pattern of atopic dermatitis in North Indian Pediatric population. Pediatr Dermatol 1998;15:347-51. [PUBMED] [FULLTEXT] |
| 10. | Purdy JM. The long-term prognosis of infantile eczema. Br Med J 1953;1:1366. |
| 11. | Nagaraja, Kanwar AJ, Dhar S, et al . Frequency and significance of minor clinical features in various age-related sub-groups of atopic dermatitis in children. Pediatr Dermatol 1997;42:9-13. |
| 12. | Rajka G. Atopic eczema-correlation of environmental factors with frequency. Int J Dermatol 1986;25:301-4. [PUBMED] |
| 13. | Hanifin JM, Rajka G. Diagnostic features of atopic dermatitis. Acta Derm Venereol (Stockh) 1980;92(Suppl): 44-7. |
| 14. | EI-Mehairy MM, EI-Tarabishi N. The correlation between ABO blood group and allergic disorders. Ann. Allergy 1966;27: 366-8. |
| 15. | Nordelli L cited by Mourant AE. ABO blood group and skin diseases. 1928;130-45. |
| 16. | Gupta SR, Gupta MC. Blood group and skin diseases. Indian J Dermatol 1966;11: 49-50. |
| 17. | MacSween MP, Syme UA. ABO blood and skin diseases. Br J Dermatol 1965;77: 30-4. [PUBMED] |
Tables
[Table - 1], [Table - 2], [Table - 3] |
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