Behavioral characteristics in 3- to 12- month-old infant with atopic dermatitis: a case–control study Atopic dermatitis (AD) is a chronic, recurrent skin disorder which is observed most frequently among patients with a personal or family history of atopic diseases (1). Pruritus, inflammation, crusted lesions, and lichenification are typical characteristics of AD patients. AD may begin at any year but it is estimated that 65% of patients develop AD in the first year of life (2–5). The prevalence of AD has been steadily increasing since World War 2 and in most countries it affects more than 10% of the children (6). The exact cause of AD is unknown (1, 4) but there is general agreement that both, immunologic and psychologic factors are important in AD patho- genesis and should therefore be taken into account (1, 5, 7). Important dermatologists of the past associated the AD with neuropsychic factors, as is evidenced by the use of the term neurodermatitis in 19th century (1). The most disturbing symptom of AD is itching and it is said that itch in AD is more than the result of an inherently lowered threshold; it is better consid- ered as an innate perception of mild mechanical stimulation as itch and not as touch. It has been described as the itch that erupts when scratched rather than an eruption that itches (8, 9). Some Pourpak Z, Sedighipour L, Firooz A, Afrooz A, Ghobari B, Kaze- mnejad A, Bemanian MH, Afrooz GA. Behavioral characteristics in 3- to 12-month-old infant with atopic dermatitis: a case–control study. Pediatr Allergy Immunol 2007: 18: 339–345. Ó 2007 The Authors Journal compilation Ó 2007 Blackwell Munksgaard There have been reports that refer to the personality of the patients with atopic dermatitis (AD) especially adult patients but there are few studies regarding the behavioral characteristics in AD infants. The aim of this study was to compare behavioral characteristics of 30 AD infants (3– 12 months old) with 40 controls. The infants with the definite diagnosis of AD (according to Hanifin and Rajka criteria) referring to children medical center were included in this study. For assessing behavioral characteristics we used revised version of Infant Behavior Questionnaire for measuring 11 scales of behavioral characteristics (Fear, Perceptual Sensitivity, Distress to Limitations, Sadness, High Pleasure, Low plea- sure, Approach, Rate of Recovery from Distress, Soothability, Smiling and Laugher, and Duration of Orienting). Questionnaires were filled out by the physicians with the cooperation of the parents. The AD group showed significantly higher scores in Perceptual Sensitivity, Soothability, and High Pleasure compared with control group (p ¼ 0.000). In other characteristics no significant difference were noticed between atopic and non-patients. For eight characteristics, scores of atopic infants were similar healthy infants, but they tend to show more pleasure when subjected to an intense, novel or incongruity stimuli compared with healthy infants. Theoretically, higher scores in Percep- tual Sensitivity, Soothability, and High Pleasure are concordant with the pervious studies about adrenomedullary system over activity. Zahra Pourpak 1 , Leyla Sedighipour 1 , Alireza Firooz 2 , Azadeh Afrooz 1 , Bagher Ghobari 3 , Anoushiravan Kazemnejad 4 , Mohamad Hassan Bemanian 1 , Gholam Ali Afrooz 3 1 Department of Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, IR Iran, 2 Center for Research & Training in Skin Diseases & Leprosy, Tehran University of Medical Sciences, Tehran, IR Iran, 3 Faculty of Psychology, Tehran University of Medical Sciences, Tehran, IR Iran, 4 Department of Statistics, Faculty of Medical Sciences, Tarbiat Modarres University, Tehran, IR Iran Key words: atopic dermatitis; infants; infant behavior Zahra Pourpak, Department of Immunology, Asthma and Allergy Research Institute, Children Medical Center, No. 62, Gharib St., Keshavarz Blv, P.O. BOX: 14185–863, Tehran, IR, Iran Tel.:+98 21 66919587 Fax:+98 21 66428995 E-mail: zpourpak@hbi.ir, zpourpak@sina.tums.ac.ir, lsedighy@student.tums.ac.ir Accepted 13 January 2007 Pediatr Allergy Immunol 2007: 18: 339–345 DOI: 10.1111/j.1399-3038.2007.00534.x Ó 2007 The Authors Journal compilation Ó 2007 Blackwell Munksgaard PEDIATRIC ALLERGY AND IMMUNOLOGY 339