Bone Health in Patients With Atopic Dermatitis

The goal of this study is to objectively evaluate bone health and contributing factors in children with AD. This will be compared with existing normative data. Such an objective prospective study, directly looking at bone health in children has not yet been done. This will be done using bone densitometry (DXA) and high-resolution peripheral quantitative computed tomography (HR-pQCT) for the accurate and precise measurement of bone health status. HR-pQCT is a cutting-edge technology available at only at a few academic centers in the United States that is used to measure bone strength with minimal doses of radiation. In addition, blood and urine metabolic parameters related to bone health will be analyzed, and data will be correlated with eczema severity. The results from this study will allow us to design large-scale, multi-institutional studies on bone health in this population and ultimately to guide decision making in children who may be at risk specifically regarding treatment recommendations and supportive care.

The specific aims of this project are:

• To determine bone mineral density (BMD) and cortical and trabecular bone strength in children with atopic dermatitis, using DXA and to compare this with normative data.
• HR-pQCT data will be compared with current known data from other diseases
• To correlate bone mineral density with eczema severity using Eczema area and severity index (EASI) and Scoring atopic dermatitis (SCORAD) scores.
• To determine if bone mineral density in children with atopic dermatitis correlates with bone age and bone-health specific serum markers.

Inclusion criteria

• Children 5 to 17 years of age with a diagnosis of moderate to severe atopic dermatitis as made by a dermatologist
• Duration of atopic dermatitis symptoms for a minimum of 6 months
• Ability to cooperate with DXA and HR-pQCT procedure

Exclusion criteria

• Those without a confirmed diagnosis of moderate to severe atopic dermatitis
• Presence of concurrent disease that may also affect bone health, including rickets or other vitamin D deficiency, thyroid disease, renal disease, Paget's disease, osteogenesis imperfecta, inflammatory bowel disease, and other chronic inflammatory diseases
• Current use of medications that may affect bone health, including bisphosphonate, Forteo, Tymlos, denosumab, thiazide, heparin, medroxyprogesterone acetate, cyclosporine, and oral tacrolimus. However, medications that are used for atopic dermatitis treatment are allowed
• Pregnant or breast feeding females
• Inability to cooperate with the blood draw