Background: Atopic dermatitis (AD) is a chronically relapsing allergic skin inflammatory disease with a high incidence in the early childhood. Staphylococcus aureus colonization (S. aureus) is frequent in the skin of patients with AD and is one of the important environmental factors that develop or exacerbate this disorder. Objective: The aim of this study was to investigate the different clinical features of AD with S. aureus colonization and to seek its relation with the clinical features of AD. Method: We recruited 342 children with AD who visited the pediatric allergy clinic in Asan Medical Center from July 2003 to January 2007. They were divided into 2 groups based on the results of skin cultures: group 1 with no bacteria cultured and group 2 with S. aureus cultured. The clinical and laboratory data, such as SCORAD (SCORing Atopic Dermatitis), total eosinophil count (TEC), eosinophil fraction (%), serum total IgE, serum eosinophil cationic protein (ECP) and staphylococcal enterotoxin A and B -specific IgE levels, were evaluated and were compared between individual groups. Result: There was a statistical difference between groups 1 and 2 in TEC, eosinophil fraction (%), total IgE, serum ECP and SCORAD index. There was a significant difference in total IgE between the enterotoxin-negative and enterotoxin- positive groups. S. aureus colony counts were significantly correlated with total eosinophil count (r=0.259, P= 0.003), eosinophil (%) (r=0.196, P=0.009), and serum ECP (r= 0.212, P=0.035). Total IgE levels were significantly correlated with specific IgE levels to enterotoxins A and B (r= 0.335, P=0.012; r=0.393, P=0.002). S. aureus colonization and specific IgE levels to staphyloccal enterotoxins A were correlated with SCORAD index and total IgE levels. Conclusion Skin infections with S. aureus may be associated with pathogenesis of AD.
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