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Characteristics and prognosis of childhood atopic dermatitis: a multicenter study in Turkey
Hasan Yuksel1, Demet Can, Ismail Reisli
1Department of Pediatric Allergy and Pulmonology, Celal Bayar University Medical Faculty, Manisa, Turkey. hyukselefe@hotmail.com
Insights
Not all childhood atopic dermatitis (AD) cases show allergic sensitization. However, children with high immunoglobulin E (IgE) levels and positive skin prick tests are more likely to develop other allergic diseases.
Area of Science:
- Pediatric Allergy and Immunology
- Dermatology
- Clinical Immunology
Background:
- Childhood atopic dermatitis (AD) is often considered the initial manifestation of the atopic march.
- Nonatopic AD cases may not follow the typical atopic march progression.
- Understanding AD characteristics in childhood is crucial for prognosis.
Purpose of the Study:
- To determine the clinical characteristics of childhood atopic dermatitis in Turkey.
- To investigate the prognosis of childhood atopic dermatitis.
- To identify factors associated with the development of additional allergic diseases in children with AD.
Main Methods:
- Retrospective analysis of 531 children with AD from 11 regions in Turkey.
- Data collected included age at diagnosis, serum immunoglobulin E (IgE) levels, and allergen skin prick test (SPT) results.
- Clinical data on coexisting or developing allergic diseases and follow-up duration were recorded.
Main Results:
- The mean age at diagnosis was 37.8 months, with a mean IgE level of 318.3 IU/ml.
- Allergen SPT was positive in 47% of children; 46.6% had additional allergic diseases at some point.
- Higher IgE levels, positive SPT, and a family history of allergies were significantly associated with increased risk of additional allergic diseases.
Conclusions:
- Allergic sensitization is not universal in childhood atopic dermatitis.
- While not as high as anticipated, additional allergic diseases are more common in children with atopic sensitization, indicated by elevated IgE and positive SPT.
- These findings highlight the importance of assessing for atopic sensitization in children diagnosed with AD.
Background:
Childhood atopic dermatitis (AD) is classically accepted as initial finding of atopic march; however, nonatopic cases do not follow this course. The aim of this study was to determine the characteristics and prognosis of AD in childhood in Turkey.
Methods:
The study included 531 children with AD that presented to pediatric allergy departments in 11 different regions of Turkey. Age at diagnosis, total serum and inhalant-specific immunoglobulin E (IgE) levels and allergen skin prick test results were recorded retrospectively. Clinical characteristics like additional allergic diseases at presentation or during follow-up were recorded as well as duration of follow-up.
Results:
Mean age at diagnosis was 37.8 +/- 36.2 months. Mean IgE level was 318.3 +/- 677.8 IU/ml (median 100 IU/ml). Skin prick tests yielded positive results in 47% of children. At presentation, 31.6% of children reported additional allergic disease, while 11.7% developed allergic disease during follow-up. Among all, 46.6% had additional allergic disease at any point. IgE levels were significantly higher in children with additional allergic diseases (p = 0.001). Allergen skin prick test positivity and family history of allergic diseases increased the risk of additional allergic diseases significantly (OR = 3.90, 95% CI = 2.3-6.6 and OR = 1.89, 95% CI = 1.3-2.8, respectively).
Conclusions:
Allergic sensitization is not present in all cases of AD. Coexistence of additional allergic diseases is not as high as expected but more common in children who have been demonstrated to have atopic sensitization with high IgE levels and allergen skin prick test positivity.
