Skin Prick Testing in a Portuguese Pediatric Population: A Multicenter Cross-Sectional Study of Clinical and Allergen
Manuel Lima Ferreira1, João Nogueira Oliveira2, Mariana Pinto3
1Pediatrics Department. Unidade Local de Saúde Tâmega e Sousa. Penafiel. Portugal.
Insights
This study reveals high rates of polysensitization to allergens like house dust mites in Portuguese children with allergic diseases. Sensitization patterns show significant regional and age-related variations, highlighting the need for personalized diagnostic approaches.
Area of Science:
- Pediatric Allergy and Immunology
- Clinical Medicine
- Epidemiology
Background:
- Allergic diseases are prevalent in children and adolescents, often linked to inhalant allergen sensitization.
- Limited recent data exists on sensitization profiles in Portugal, especially concerning regional and demographic factors.
- This study addresses the scarcity of information on pediatric allergen sensitization in Portugal.
Purpose of the Study:
- To characterize the clinical and allergen sensitization profiles of children and adolescents with allergic diseases in Portugal.
- To investigate regional and demographic variability in allergen sensitization patterns.
- To provide updated data for diagnostic and management strategies in pediatric allergic diseases.
Main Methods:
- A multicenter, retrospective, cross-sectional study was conducted across 14 Portuguese hospitals.
- Included were 3456 children and adolescents (<18 years) diagnosed with allergic diseases and positive skin prick tests.
- Data collected included demographics, clinical information, and environmental factors, with skin prick tests following EAACI guidelines.
Main Results:
- Allergic rhinitis (78.1%) and asthma (54.5%) were most common; 43.1% had both. High sensitization rates were observed for Dermatophagoides pteronyssinus (84.3%) and Dermatophagoides farinae (74.3%).
- Polysensitization affected 58.4% of patients. Sensitization patterns varied significantly by age and geographic location (coastal vs. inland).
- Migrant children exhibited lower sensitization rates despite similar disease prevalence.
Conclusions:
- This is the first multicenter study detailing pediatric allergen sensitization patterns in Portugal.
- High polysensitization rates and regional variability emphasize the need for tailored diagnostic strategies.
- Skin prick testing remains a crucial tool for initial assessment of pediatric allergic diseases.
Introduction:
Allergic diseases, particularly allergic rhinitis and asthma are highly prevalent among children and adolescents and frequently associated with sensitization to inhalant allergens. However, recent data on sensitization profiles in the Portuguese pediatric population are scarce, especially regarding regional and demographic variability. In this context, we aimed to characterize the clinical and allergen sensitization profiles of children and adolescents with allergic diseases in Portugal, through a multicenter approach.
Methods:
We conducted a retrospective, cross-sectional study across 14 Portuguese hospitals between January 2021 and June 2023. Children and adolescents (< 18 years) with a clinical diagnosis of allergic diseases and at least one positive skin prick test to inhalant allergens were included. Demographic, clinical, and environmental data were collected from electronic medical records. Skin prick tests followed European Academy of Allergy & Clinical Immunology recommendations. Statistical analysis was performed using IBM® SPSS® Statistics version 29.
Results:
A total of 3456 patients were included (60.5% male; median age 10 years). Allergic rhinitis (78.1%) and asthma (54.5%) were the most common diagnoses and 43.1% presented with both conditions. Sensitization was most frequent to Dermatophagoides pteronyssinus (84.3%) and Dermatophagoides farinae (74.3%), followed by Lepidoglyphus destructor (57.8%), grass pollens (60.4%), and Blomia tropicalis (23.5%). Polysensitization occurred in 58.4% of patients. Sensitization patterns varied with age. Geographic differences were noted: house dust mites sensitization predominated in coastal regions, whereas sensitization to pollens, molds, and animal epithelia was more frequent inland. Migrant children (14.2%) showed lower sensitization rates to most allergens, despite a comparable disease burden.
Conclusion:
To the best of our knowledge, this is the first multicenter study to describe pediatric allergen sensitization patterns in Portugal. The high rates of polysensitization and the regional variability underscore the importance of tailored diagnostic strategies. Skin prick test remains a key tool in the initial assessment of allergic diseases.
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