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Bronchial hyperresponsiveness in children with atopic dermatitis
S P Salob1, A Laverty, D J Atherton
1Department of Dermatology, Hospitals for Sick Children, London, England.
Insights
Children with atopic dermatitis often show bronchial hyperresponsiveness, a condition affecting airways. This heightened airway sensitivity is present even in those without diagnosed asthma, indicating a significant link.
Area of Science:
- Pediatric Allergy and Immunology
- Dermatology
- Pulmonology
Background:
- Atopic dermatitis is a common allergic skin condition in children.
- Bronchial hyperresponsiveness is a key feature of asthma.
- The relationship between atopic dermatitis and airway hyperresponsiveness requires further investigation.
Purpose of the Study:
- To assess bronchial hyperresponsiveness in children with atopic dermatitis.
- To compare airway responsiveness in children with atopic dermatitis and asthma versus those with atopic dermatitis alone.
- To investigate the association between atopic dermatitis and bronchial hyperresponsiveness in the absence of asthma symptoms.
Main Methods:
- Histamine provocation tests were used to measure bronchial responsiveness.
- Participants included children aged 7-15 years with atopic dermatitis.
- Groups comprised children with diagnosed asthma and those without asthma symptoms, plus a control group.
Main Results:
- All but one child with atopic dermatitis and asthma exhibited bronchial hyperresponsiveness.
- A significant majority (18/22) of children with atopic dermatitis alone also showed bronchial hyperresponsiveness.
- Bronchial hyperresponsiveness was significantly more severe in asthmatic subjects compared to non-asthmatic subjects with atopic dermatitis.
Conclusions:
- Atopic dermatitis is strongly associated with bronchial hyperresponsiveness in children.
- Bronchial hyperresponsiveness can be present in children with atopic dermatitis even without a history of asthma.
- Findings suggest a shared underlying mechanism or predisposition linking atopic dermatitis and airway hyperreactivity.
Abstract:
Using histamine provocation tests, bronchial responsiveness was measured in 43 children with atopic dermatitis, aged 7 to 15 years, who had attended pediatric dermatology clinics within the past 5 years. The children were divided into two groups, one group of 21 children in whom asthma had been previously diagnosed and in whom symptoms of asthma had occurred in the preceding year, and the other comprising 22 children who denied any such symptoms. Bronchial hyperresponsiveness (as defined by a 20% fall in forced expiratory volume in 1 second at a provoking dose of histamine of 7.8 mumol or less [PD20]) was demonstrated in all but 1 of the children with atopic dermatitis and asthma, in 18 of the 22 children with atopic dermatitis alone, but in only 3 of a control group of 18 children without atopic dermatitis or asthma. The asthmatic subjects (median PD20 = 0.22 mumol) had more severe bronchial hyperresponsiveness than the nonasthmatic subjects (median PD20 = 2.10 mumol). This study confirms the strong association between atopic dermatitis and bronchial hyperresponsiveness, even in the absence of overt asthmatic symptoms.