Improvement in the management of atopic dermatitis (AD) influences the appearance of respiratory allergic diseases.The study included 176 children affected by atopic dermatitis (AD) and previously evaluated between 1993 and 2002 at the age of 9-16 months, who underwent a telephonic interview by means of a semi-structured, pre-formed questionnaire after a mean follow-up time of 8 years. According to the SCORAD (scoring atopic dermatitis), at first evaluation children had mild AD in 23% of cases, moderate in 62%, severe in 15%. AD disappeared in 92 cases (52%), asthma appeared in 30 (17%) and rhinoconjunctivitis in 48 (27%). The factors significantly related to the appearance of asthma were: sensitization to food allergens with sIgE > 2 KU/L (cow’s milk and hen’s egg; P < 0.05) or to inhalant allergens with sIgE > 0.35 KU/L (P < 0.05). Logistic regression analysis showed that inhalant sensitization was positively related to the occurrence of asthma (OR = 4.219). While AD showed similar rates of disappearance to those of a previously published study performed by the same investigators, the incidence of asthma was reduced, at the same follow-up time, from 29% to 15% (P = 0.002), and the incidence of rhinoconjunctivitis from 35% to 24% (P = 0.02). Integrated management of AD does not seem to influence its natural course. Nevertheless, the decrease in the percentage of children evolving towards respiratory allergic disease stresses the importance of early diagnosis and improvement in management carried out by specialist centers. The presence of allergic sensitization at one year of age might predict the development of respiratory allergy.
Editor’s comment: This study is further proof of the allergic march.
Ricci G, Patrizi A, Giannetti A et al. Does improvement management of atopic dermatitis influence the appearance of respiratory allergic diseases? A follow-up study. Clinical and Molecular Allergy 2010; 8(8).
source : Medical Journal Reviews WAO Provided by Widodo Judarwanto, pediatrician
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