Skin health survey on atopic dermatitis among Japanese children: The Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study

Chikana Kawaguchi; Maki Ozawa; Takanori Hidaka; Keiko Murakami; Mami Ishikuro; Fumihiko Ueno; Aoi Noda; Tomomi Onuma; Genki Shinoda; Masatsugu Orui; Taku Obara; Yumiko Ito; Takashi Kakinuma; Kazuhiro Kudoh; Hiroaki Ozawa; Satoshi Nakagawa; Masato Mizuashi; Ryoko Omori; Masatoshi Deguchi; Yumi Kanbayashi; Masayuki Asano; Toshiya Takahashi; Muneo Tanita; Masahiro Hara; Kenshi Yamasaki; Takayoshi Tadaki; Hiromi Suzuki; Katsuko Kikuchi; Kenichiro Tsuchiyama; Takenobu Ohashi; Shu Sasai; Motoko Honda; Taku Fujimura; Sadanori Furudate; Yoshiko Kagimoto; Maki Kawamura; Nobuko Tabata; Rika Chikama; Hiromi Komatsu; Yota Sato; Kayo Tanita; Yutaka Kimura; Shino Yusa; Hitoshi Terui; Hisayuki Tono; Yusuke Muto; Shinichi Kuriyama; Masayuki Yamamoto; Setsuya Aiba

doi:10.1016/j.alit.2024.09.008

Skin health survey on atopic dermatitis among Japanese children: The Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study

Allergol Int. 2024 Oct 18:S1323-8930(24)00116-3. doi: 10.1016/j.alit.2024.09.008. Online ahead of print.

Authors

Chikana Kawaguchi¹, Maki Ozawa², Takanori Hidaka³, Keiko Murakami⁴, Mami Ishikuro⁵, Fumihiko Ueno⁶, Aoi Noda⁷, Tomomi Onuma⁶, Genki Shinoda⁵, Masatsugu Orui⁵, Taku Obara⁷, Yumiko Ito⁸, Takashi Kakinuma⁹, Kazuhiro Kudoh¹⁰, Hiroaki Ozawa¹¹, Satoshi Nakagawa¹², Masato Mizuashi¹³, Ryoko Omori⁸, Masatoshi Deguchi¹⁴, Yumi Kanbayashi⁸, Masayuki Asano¹⁵, Toshiya Takahashi⁸, Muneo Tanita¹⁶, Masahiro Hara¹⁷, Kenshi Yamasaki⁸, Takayoshi Tadaki¹⁸, Hiromi Suzuki¹⁹, Katsuko Kikuchi²⁰, Kenichiro Tsuchiyama²¹, Takenobu Ohashi²², Shu Sasai²³, Motoko Honda²⁴, Taku Fujimura⁸, Sadanori Furudate²⁵, Yoshiko Kagimoto²⁶, Maki Kawamura²⁷, Nobuko Tabata²⁸, Rika Chikama²⁹, Hiromi Komatsu³⁰, Yota Sato³¹, Kayo Tanita⁸, Yutaka Kimura³², Shino Yusa³³, Hitoshi Terui⁸, Hisayuki Tono¹⁵, Yusuke Muto³⁴, Shinichi Kuriyama³⁵, Masayuki Yamamoto⁶, Setsuya Aiba³⁶

Affiliations

¹ Department of Molecular Epidemiology, Graduate School of Medicine, Tohoku University, Miyagi, Japan.
² Department of Dermatology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Toshoguekimae Dermatology Clinic, Miyagi, Japan.
³ Department of Dermatology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Tohoku Medical Megabank Organization, Tohoku University, Miyagi, Japan.
⁴ Tohoku Medical Megabank Organization, Tohoku University, Miyagi, Japan. Electronic address: [email protected].
⁵ Department of Molecular Epidemiology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Tohoku Medical Megabank Organization, Tohoku University, Miyagi, Japan.
⁶ Tohoku Medical Megabank Organization, Tohoku University, Miyagi, Japan.
⁷ Department of Molecular Epidemiology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Tohoku Medical Megabank Organization, Tohoku University, Miyagi, Japan; Department of Pharmaceutical Sciences, Tohoku University Hospital, Miyagi, Japan.
⁸ Department of Dermatology, Graduate School of Medicine, Tohoku University, Miyagi, Japan.
⁹ Sendai Aoba Dermatology Clinic, Miyagi, Japan.
¹⁰ Division of Dermatology, Katta General Hospital, Miyagi, Japan.
¹¹ Toshoguekimae Dermatology Clinic, Miyagi, Japan.
¹² Kitayobancho Nakagawa Dermatology Clinic, Miyagi, Japan.
¹³ Department of Dermatology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Rifu Dermatology Allergy Clinic, Miyagi, Japan.
¹⁴ Department of Dermatology, Shiogama City Hospital, Miyagi, Japan.
¹⁵ Department of Dermatology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Nanohana Dermatology Clinic, Iwate, Japan.
¹⁶ Department of Dermatology, Tohoku Rosai Hospital, Miyagi, Japan.
¹⁷ Izumi-chuo Hifuka Clinic, Miyagi, Japan.
¹⁸ Minami Sendai Hifuka Clinic, Miyagi, Japan.
¹⁹ Department of Dermatology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Arai Ekimae Suzuki Clinic, Miyagi, Japan.
²⁰ Department of Dermatology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Sendai Taihaku Dermatology Clinic, Miyagi, Japan.
²¹ Department of Dermatology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Natori Tsuchiyama Dermatology Clinic, Miyagi, Japan.
²² Familia Clinic Oroshimachi, Miyagi, Japan.
²³ Asuto-Nagamachi Dermatologic Clinic, Miyagi, Japan.
²⁴ Ichibancho Minami Shinryoujo Akane Clinic, Miyagi, Japan.
²⁵ Department of Dermatology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Division of Dermatology, Osaki Citizen Hospital, Miyagi, Japan.
²⁶ Nami Dermatology Clinic, Miyagi, Japan.
²⁷ Kawamura Dermatology Office, Miyagi, Japan.
²⁸ Division of Dermatology, Japanese Red Cross Sendai Hospital, Miyagi, Japan.
²⁹ Chikama Rika Dermatology Clinic, Miyagi, Japan.
³⁰ Ciel Dermatology Clinic, Miyagi, Japan.
³¹ Department of Dermatology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Division of Dermatology, Japanese Red Cross Ishinomaki Hospital, Miyagi, Japan.
³² Department of Dermatology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Kimura Dermatology Clinic, Miyagi, Japan.
³³ Department of Dermatology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Tagajo Ekimae Hifuka, Miyagi, Japan.
³⁴ Department of Dermatology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Department of Dermatology, South Miyagi Medical Centre, Miyagi, Japan.
³⁵ Department of Molecular Epidemiology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Tohoku Medical Megabank Organization, Tohoku University, Miyagi, Japan; Department of Disaster Public Health, International Research Institute of Disaster Science, Tohoku University, Miyagi, Japan.
³⁶ Department of Dermatology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Matsuda Hospital, Miyagi, Japan.

PMID: 39426877
DOI: 10.1016/j.alit.2024.09.008

Abstract

Background: Precise skin phenotypic data are indispensable in accurately diagnosing atopic dermatitis (AD). Therefore, this study examined the interobserver concordance for AD and non-AD diagnoses between two dermatologists. AD prevalence determined by the self-reported physician diagnoses and the diagnoses determined from the United Kingdom (UK) diagnostic criteria were compared with the diagnoses made by the two dermatologists, using data from a skin health survey.

Methods: This study included 1,638 children that participated in the skin health survey, which was part of the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. AD was assessed using dermatologist assessments, self-reported physician diagnoses, and the UK diagnostic criteria. The concordance for diagnoses was evaluated using kappa. The sensitivity and specificity of the self-reported physician diagnoses and the UK diagnostic criteria were calculated by comparing them with the two dermatologists' diagnoses.

Results: Among the 1,638 children, 393 (24.0 %), 194 (11.9 %), and 597 (37.2 %) were diagnosed with AD by the two dermatologists, physicians, and the UK diagnostic criteria, respectively. The kappa (95 % CI) of the interobserver concordance for AD or non-AD diagnoses between the two dermatologists was 0.78 (0.75-0.81). The sensitivity and specificity of the self-reported physician diagnoses were 26.7 % and 94.1 %, respectively. The sensitivity and specificity of the UK diagnostic criteria were 85.0 % and 82.4 %, respectively.

Conclusions: Interobserver concordance for AD or non-AD diagnoses between the two dermatologists was substantial. Self-reported physician diagnoses exhibited low sensitivity that potentially indicated underdiagnosis of AD, whereas the UK diagnostic criteria might overdiagnose AD.

Keywords: Atopic dermatitis; Children; Dermatologists; Diagnosis; Japan.