Allergy Asthma Respir Dis.  2016 Jul;4(4):290-295. 10.4168/aard.2016.4.4.290.

Sensitization in children with atopic dermatitis: a single center study

• Song A
• Lee JY
• Yang HK
• Kim M
• Ahn K
• Lee SI
• Kim J

• KMID: 2346759
• DOI: http://doi.org/10.4168/aard.2016.4.4.290

Abstract

PURPOSE
There are few recent data regarding allergic sensitization of atopic dermatitis (AD) in Korea. The aim of this study was to investigate patterns of sensitization according to age and gender in children with AD.
METHODS
This retrospective study included 4,661 children with AD from 1998 to 2014. The serum specific IgE (sIgE) levels to egg white (EW), cow's milk (CM), peanut, wheat, soybean, buckwheat, tree nuts, crustaceans, meat, and house dust mites (HDMs) were reviewed. AD was categorized into the extrinsic (ADe) and intrinsic type (ADi) according to the presence or absence of sensitization. The proportion of patients with sIgE to EW or CM greater than the previously reported diagnostic decision point (DDP) was determined.
RESULTS
A total of 4,661 children (2,843 boys and 1,818 girls) were collected. We identified 1,857 of 2,663 children (69.7%) with the ADe type and 806 of 2,663 children (30.3%) with the ADi type. The sensitization rates increased with age (P<0.001). EW (59.3%) was the most commonly sensitized food, followed by CM (46.6%), peanut (32.2%), wheat (31.5%), soybean (28.1%), and buckwheat (23.7%). The most commonly sensitized food groups were tree nuts (56.7%) and crustaceans (28.3%). The rate of sensitization to HDMs was 40.1%. In addition, 11.1% and 7.5% of children had levels of sIgE to EW and CM, respectively, higher than the DDP.
CONCLUSION
The incidence of ADe among children with AD was 69.7% and increased with age. The most commonly sensitized food allergen was EW, followed by CM and peanut.

Keyword

Atopic dermatitis; Sensitization; Diagnostic decision point; Child

MeSH Terms

Arachis
Child*
Dermatitis, Atopic*
Egg White
Fagopyrum
Humans
Immunoglobulin E
Incidence
Korea
Meat
Milk
Nuts
Pyroglyphidae
Retrospective Studies
Soybeans
Trees
Triticum
Immunoglobulin E

Figure

• 

  Fig. 1 Proportion of extrinsic and intrinsic type atopic dermatitis. ADe, extrinsic type atopic dermatitis; ADi, intrinsic type atopic dermatitis.

• 

  Fig. 2 Patterns of sensitization to foods or house dust mites in children with extrinsic type atopic dermatitis according to their ages. Out of 1,857 children with extrinsic type atopic dermatitis, 1,545 were younger than 3 years, 251 were between the ages of 3–6 years, and 61 between the ages 7–12 years. ***P<0.001.

• 

  Fig. 3 Sensitization rates to common food and inhalant allergens in children with atopic dermatitis according to their ages. Df, Dermatophagoides farinae; Dp, Dermatophagoides pteronyssinus; HDMs, house dust mites. ***P<0.001.

• 

  Fig. 4 The proportion of patients with specific IgE to egg white and cow's milk greater than the diagnostic decision points (DDPs). The DDPs were applied based on the previously reported specific IgE levels as follows: egg white-specific IgE levels of 28.1 kU/L (<2 years of age); egg white-specific IgE levels of 22.9 kU/L (≥2 years of age); cow's milk-specific IgE levels of 31.4 kU/L (<2 years of age); and cow's milk-specific IgE levels of 10.1 kU/L (≥2 years of age). *P<0.05.

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