Clinical presentation and biophysical parameters of patients with atopic dermatitis in Lagos, Nigeria

Background The increasing prevalence of atopic dermatitis (AD) in Nigeria is possibly due to awareness and urbanization. AD, a common, chronic inflammatory dermatosis with hereditary predispositions and environmental triggers, shows abnormal skin biophysical parameters and characteristic clinical features. We aimed to document clinical and biophysical features of Nigerian AD patients and disease severity. Patients and methods Of the 150 patients diagnosed with AD by dermatologists in two tertiary hospitals in Lagos, we obtained baseline data on demographics, clinical features and disease severity using the EASI score with an interviewer-administered questionnaire for 140 patients. Skin pH, hydration levels, and transepidermal water loss (TEWL) measured using Courage and Khazaka multiprobe adapter-6 were analyzed using SPSS, version 24. Results The mean age was 24.5±19.8 years, with a female-to-male ratio of 1.7:1.57.9% were over 6 years old at AD onset and allergic conjunctivitis was more associated with atopy than allergic rhinitis or asthma (61.4 : 50 : 16.4). Identified risk factors were breast-milk substitutes (90%) and egg consumption (89.3%); heat was most identified trigger. Dennie–Morgan folds, palmar hyperlinearity, and periorbital darkening were most common clinical features in 86.4, 83.6, and 43.6%, respectively. Using EASI, 49.3% : 30% : 7.1% had mild : moderate : severe disease, respectively. Means of hydration levels on chin and forearm were 56.7±18.5 and 40.0±20.7; skin pH 6.5±2.1 and 5.5±0.4; and TEWL 32.4 [24.5–52.2] and 18.8 [13.7–34.8], respectively. Conclusion AD occurs at older ages in Nigerian patients, mostly associated with allergic conjunctivitis. Dennie–Morgan folds, periorbital hyperpigmentation and palmar hyperlinearity are common clinical features. Patients have mild to moderate disease. Elevated skin pH and TEWL were noted on the face.