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Atopik Dermatitli Çocuk Hastalarda Besin Duyarlılığının Değerlendirilmesi

Year 2024, Volume: 26 Issue: 2, 194 - 200, 20.08.2024
https://doi.org/10.24938/kutfd.1466473

Abstract

Amaç: Atopik dermatit, gıda alerjilerinin gelişimi için önemli bir risk faktörü olarak kabul edilmektedir. Bu retrospektif çalışmada, atopik dermatitli pediatrik hastalardaki besin duyarlılığının deri prik testlerine göre değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntemler: Çalışmaya, hastanemiz Pediatrik Alerji Kliniğinde 1 Ocak 2023 ve 31 Ocak 2024 tarihleri arasında besin alerjenleriyle deri prik testleri uygulanan atopik dermatit tanılı çocuk hastalar dahil edilmiştir. Demografik veriler, atopik dermatit başlangıç yaşı, şiddeti, tedavileri ve eşlik eden atopik hastalıklar (astım, alerjik rinit) tıbbi kayıtlardan toplanmıştır. Deri prik testlerinin sonuçları retrospektif olarak değerlendirilmiştir.
Bulgular: Çalışmaya %64,2'si erkek ve ortalama yaşları 7 ay (Çeyrekler arası aralık [ÇAA]: 5-14) olan 229 hasta katıldı. Atopik dermatit başlangıç yaş ortancası 3 (ÇAA:2-6) aydı. Hastaların 12'sinde (%5,2) eşlik eden diğer alerjik hastalıklar mevcuttu. SCORAD'a (Atopik dermatit ağırlık ölçeği) göre atopik dermatit şiddeti hastaların %61,1'inde hafif, %29,3'ünde orta ve %9,6'sında şiddetliydi. Hastaların 73'ünde (%31,9), en sık yumurta (%28,4) ile olmak üzere besin alerjen duyarlılığı saptandı. Hastaların %10'unda (n=23) çoklu besin duyarlılığı saptandı. Duyarlılık saptanan hastalarda atopik dermatitin daha erken başladığı, toplam IgE ve eozinofil sayılarının daha yüksek olduğu ve orta-şiddetli atopik dermatitin daha sık olduğu görüldü (p<0.05). Çok değişkenli analizde, atopik dermatitin 3 aydan önce başlaması, orta-şiddetli atopik dermatit ve eozinofil sayısının >500/mm3 olması duyarlılık için risk faktörleri olarak belirlendi.
Sonuç: Pediatrik atopik dermatit hastalarının yaklaşık üçte birinde, en sık yumurta ile olmak üzere, en az bir gıda alerjenine karşı duyarlılık saptanmıştır. Atopik dermatit erken yaşlarda başlaması, yüksek eozinofil sayısı ve atopik dermatitin orta-şiddetli olması, besin alerjen duyarlılığı için daha yüksek risk oluşturur. Bu nedenle, gereksiz eliminasyon diyetlerinin önüne geçebilmek için bu grup hastaların özellikle çocuk alerji kliniklerine yönlendirilmesi çok önemlidir.

References

  • Mancuso JB, Lee SS, Paller AS, Ohya Y, Eichenfield LF. Management of severe atopic dermatitis in pediatric patients. J Allergy Clin Immunol Pract. 2021;9(4):1462-1471.
  • Ferreıra EO, Torres T, Gonçalo M, Mendes-Bastos P, Selores M, Fılıpe P. Update on atopic dermatitis. Acta Med Port. 2019;32(9):606-613.
  • Bergmann MM, Caubet JC, Boguniewicz M, Eigenmann PA. Evaluation of food allergy in patients with atopic dermatitis. J Allergy Clin Immunol Pract. 2013;1(1):22-28.
  • Aksu K, Arga M, Asilsoy S, et al. Diagnosis and management of atopic dermatitis: National Guideline 2018. 2018;16(2):1-95.
  • Eichenfield LF, Tom WL, Chamlin SL, et al. Guidelines of care for the management of atopic dermatitis: section 1. diagnosis and assessment of atopic dermatitis. J American Acad Dermatol. 2014;70(2):338-351.
  • Hanifin JM, Rajka G. Diagnostic features of atopicdermatitis. Acta Derm Venereol. 1980;60(92):44–47.
  • Papapostolou N, Xepapadaki P, Gregoriou S, Makris M. Atopic Dermatitis and food allergy: a complex ınterplay what we know and what we would like to learn. J Clin Med. 2022;11(14):4232.
  • Tham EH, Rajakulendran M, Lee BW, Van Bever HPS. Epicutaneous sensitization to food allergens in atopic dermatitis: What do we know? Pediatr Allergy Immunol. 2020 ;31(1):7-18.
  • Domínguez O, Plaza AM, Alvaro M. Relationship between atopic dermatitis and food allergy. Curr Pediatr Rev. 2020;16(2):115-122.
  • Smolkin YS, Masalskiy SS, Zaytseva GV, Smolkina OY. Аllergic sensitization in children with atopic dermatitis in the first 2 years of life according to the results of skin tests. Vopr Pitan. 2022;91(6):50-60.
  • Flohr C, Perkin M, Logan K, et al. Atopic dermatitis and disease severity are the main risk factors for food sensitization in exclusively breastfed infants. J Invest Dermatol 2014; 134(2):345-350.
  • Tran NLH, Ly NTM, Trinh HKT, Le MK, Vo NVT, Pham DL. Prediction of food sensitization in children with atopic dermatitis based on disease severity and epidermal layer ımpairment. Int Arch Allergy Immunol. 2024;185(1):43-55.
  • Atakul G, Çimen SS. The prevalence of sensitization to food allergens in children with atopic dermatitis. Allergol Immuno Pathol (Madr). 2023;51(3):85-90.
  • Lack G, Fox D, Northstone K, Golding J. Factors associated with the development of peanut allergy in childhood. N Engl J Med. 2003;348(11):977-985.
  • Emeksiz ZŞ, Cavkaytar Ö, Aksoy İ, Dallar Y, Soyer Ö. Food hypersensitivity in atopic dermatitis during ınfancy: skin prick testing for whom? Asthma Allergy Immunology. 2017;15:32-37.
  • Sicherer SH, Sampson HA. Food hypersensitivity and atopic dermatitis: patho physiology, epidemiology, diagnosis, and management. J Allergy Clin Immunol 1999;104 (3 Pt 2):114-122.
  • Tsakok T, Marrs T, Mohsin M, et al. Does atopic dermatitis cause food allergy? A systematic review. J Allergy Clin Immunol 2016;137(4):1071-1078.
  • Martin PE, Eckert JK, Koplin JJ, et al. Which infants with eczema are at risk of food allergy? Results from a population-based cohort. Clin Exp Allergy 2015;45(1):255-264.
  • Shoda T, Futamura M, Yang L, et al. Timing of eczema onset and risk of food allergy at 3 years of age: A hospital-based prospective birth cohort study. J Dermatol Sci. 2016;84(2): 144-148.
  • Gray CL, Levin ME, duToit G. Egg sensitization, allergy and component patterns in African children with atopic dermatitis. Pediatr Allergy Immunol. 2016;27(7):709‐715.
  • Külhaş Çelik İ, Civelek E, Büyüktiryaki B, et al. Food Sensitization Patterns of Infants with Food-Triggered Atopic Dermatitis. Turkish Journal of Pediatrics. 2020;14(5):396-401.
  • Weidinger S, Beck LA, Bieber T, Kabashima K, Irvine AD. Atopicdermatitis. Nat. Rev. Dis. Primers. 2018;4:1
  • Flohr C, Johansson SG, Wahlgren CF, Williams H. How atopic is atopic dermatitis? J. Allergy Clin Immunol. 2004;114:150–158.
  • Eller E, Kjaer H.F, Høst A, Andersen K.E, Bindslev-Jensen C. Food allergy and food sensitization in early child hood: Results from the DARC cohort. Allergy. 2009;64:1023–1029.
  • Hill DJ, Heine RG, Hosking CS. The diagnostic value of skin prick testing in children with food allergy. Pediatric Allergy Immunol. 2004;15:435–441.
  • Roduit C, Frei R, Depner M, et al. Phenotypes of atopic dermatitis depending on the timing of onset and progression in childhood. JAMA Pediatr 2017;171(7):655-662.
  • Flohr C, Perkin M, Logan K, et al. Atopic dermatitis and disease severity are the main risk factors for food sensitization in exclusively breast fed infants. J Invest Dermatol 2014; 134(2):345-350.
  • Werfel T, Ballmer-Weber B, Eigenmann PA, et al. Eczematous reactions to food in atopic eczema: position paper of the EAACI and GA2LEN. Allergy 2007;62(7):723-728.
  • Boyce JA, Assa’ad A, Burks AW, et al. Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel. J Allergy Clin Immunol 2010;126:S1-58.

EVALUATION OF FOOD SENSITIVITY IN CHILDREN WITH ATOPIC DERMATITIS

Year 2024, Volume: 26 Issue: 2, 194 - 200, 20.08.2024
https://doi.org/10.24938/kutfd.1466473

Abstract

Objective: Atopic dermatitis is considered an important risk factor for the development of food allergies. This retrospective study aimed to evaluate food sensitivity in pediatric patients with atopic dermatitis based on skin prick tests.
Material and Methods: The study included children diagnosed with atopic dermatitis who underwent skin prick tests with food allergens at our hospital’s Pediatric Allergy Clinic between January 1, 2023 and January 31, 2024. Demographic data, atopic dermatitis onset age, severity, treatments, and co-existing atopic diseases (asthma, allergic rhinitis) were collected from medical records. Skin prick test results were evaluated retrospectively.
Results: The study comprised 229 patients, predominantly male (64.2%) with a median age of 7 months (IQR:5-14). The median age at atopic dermatitis onset was 3 (IQR:2-6) months. Co-existing allergic diseases were present in 12 (5.2%) patients. Based on SCORing Atopic Dermatitis (SCORAD), atopic dermatitis severity was mild in 61.1%, moderate in 29.3%, and severe in 9.6% of patients. Food allergen sensitization was observed in 73 (31.9%) patients, predominantly to hen's egg (28.4%). Multiple food sensitivities occurred in 10% of patients (n=23). Patients with food sensitivityshowed earlier atopic dermatitis onset, higher total IgE and eosinophil counts, and more frequent moderate-severe atopic dermatitis (p<0.05). Multivariate analysis identified atopic dermatitis onset before 3 months, moderate-severe atopic dermatitis, and eosinophils >500/ mm3 as risk factors for sensitization.
Conclusion: Approximately one-third of pediatric atopic dermatitis patients exhibited sensitivity to at least one food allergen, most commonly hen’s egg. Early atopic dermatitis onset, elevated eosinophils, and moderate-severe atopic dermatitis pose a higher risk for sensitization. Hence, mitigating unnecessary elimination diets and prompt referral of these patients to pediatric allergy clinics is crucial.

References

  • Mancuso JB, Lee SS, Paller AS, Ohya Y, Eichenfield LF. Management of severe atopic dermatitis in pediatric patients. J Allergy Clin Immunol Pract. 2021;9(4):1462-1471.
  • Ferreıra EO, Torres T, Gonçalo M, Mendes-Bastos P, Selores M, Fılıpe P. Update on atopic dermatitis. Acta Med Port. 2019;32(9):606-613.
  • Bergmann MM, Caubet JC, Boguniewicz M, Eigenmann PA. Evaluation of food allergy in patients with atopic dermatitis. J Allergy Clin Immunol Pract. 2013;1(1):22-28.
  • Aksu K, Arga M, Asilsoy S, et al. Diagnosis and management of atopic dermatitis: National Guideline 2018. 2018;16(2):1-95.
  • Eichenfield LF, Tom WL, Chamlin SL, et al. Guidelines of care for the management of atopic dermatitis: section 1. diagnosis and assessment of atopic dermatitis. J American Acad Dermatol. 2014;70(2):338-351.
  • Hanifin JM, Rajka G. Diagnostic features of atopicdermatitis. Acta Derm Venereol. 1980;60(92):44–47.
  • Papapostolou N, Xepapadaki P, Gregoriou S, Makris M. Atopic Dermatitis and food allergy: a complex ınterplay what we know and what we would like to learn. J Clin Med. 2022;11(14):4232.
  • Tham EH, Rajakulendran M, Lee BW, Van Bever HPS. Epicutaneous sensitization to food allergens in atopic dermatitis: What do we know? Pediatr Allergy Immunol. 2020 ;31(1):7-18.
  • Domínguez O, Plaza AM, Alvaro M. Relationship between atopic dermatitis and food allergy. Curr Pediatr Rev. 2020;16(2):115-122.
  • Smolkin YS, Masalskiy SS, Zaytseva GV, Smolkina OY. Аllergic sensitization in children with atopic dermatitis in the first 2 years of life according to the results of skin tests. Vopr Pitan. 2022;91(6):50-60.
  • Flohr C, Perkin M, Logan K, et al. Atopic dermatitis and disease severity are the main risk factors for food sensitization in exclusively breastfed infants. J Invest Dermatol 2014; 134(2):345-350.
  • Tran NLH, Ly NTM, Trinh HKT, Le MK, Vo NVT, Pham DL. Prediction of food sensitization in children with atopic dermatitis based on disease severity and epidermal layer ımpairment. Int Arch Allergy Immunol. 2024;185(1):43-55.
  • Atakul G, Çimen SS. The prevalence of sensitization to food allergens in children with atopic dermatitis. Allergol Immuno Pathol (Madr). 2023;51(3):85-90.
  • Lack G, Fox D, Northstone K, Golding J. Factors associated with the development of peanut allergy in childhood. N Engl J Med. 2003;348(11):977-985.
  • Emeksiz ZŞ, Cavkaytar Ö, Aksoy İ, Dallar Y, Soyer Ö. Food hypersensitivity in atopic dermatitis during ınfancy: skin prick testing for whom? Asthma Allergy Immunology. 2017;15:32-37.
  • Sicherer SH, Sampson HA. Food hypersensitivity and atopic dermatitis: patho physiology, epidemiology, diagnosis, and management. J Allergy Clin Immunol 1999;104 (3 Pt 2):114-122.
  • Tsakok T, Marrs T, Mohsin M, et al. Does atopic dermatitis cause food allergy? A systematic review. J Allergy Clin Immunol 2016;137(4):1071-1078.
  • Martin PE, Eckert JK, Koplin JJ, et al. Which infants with eczema are at risk of food allergy? Results from a population-based cohort. Clin Exp Allergy 2015;45(1):255-264.
  • Shoda T, Futamura M, Yang L, et al. Timing of eczema onset and risk of food allergy at 3 years of age: A hospital-based prospective birth cohort study. J Dermatol Sci. 2016;84(2): 144-148.
  • Gray CL, Levin ME, duToit G. Egg sensitization, allergy and component patterns in African children with atopic dermatitis. Pediatr Allergy Immunol. 2016;27(7):709‐715.
  • Külhaş Çelik İ, Civelek E, Büyüktiryaki B, et al. Food Sensitization Patterns of Infants with Food-Triggered Atopic Dermatitis. Turkish Journal of Pediatrics. 2020;14(5):396-401.
  • Weidinger S, Beck LA, Bieber T, Kabashima K, Irvine AD. Atopicdermatitis. Nat. Rev. Dis. Primers. 2018;4:1
  • Flohr C, Johansson SG, Wahlgren CF, Williams H. How atopic is atopic dermatitis? J. Allergy Clin Immunol. 2004;114:150–158.
  • Eller E, Kjaer H.F, Høst A, Andersen K.E, Bindslev-Jensen C. Food allergy and food sensitization in early child hood: Results from the DARC cohort. Allergy. 2009;64:1023–1029.
  • Hill DJ, Heine RG, Hosking CS. The diagnostic value of skin prick testing in children with food allergy. Pediatric Allergy Immunol. 2004;15:435–441.
  • Roduit C, Frei R, Depner M, et al. Phenotypes of atopic dermatitis depending on the timing of onset and progression in childhood. JAMA Pediatr 2017;171(7):655-662.
  • Flohr C, Perkin M, Logan K, et al. Atopic dermatitis and disease severity are the main risk factors for food sensitization in exclusively breast fed infants. J Invest Dermatol 2014; 134(2):345-350.
  • Werfel T, Ballmer-Weber B, Eigenmann PA, et al. Eczematous reactions to food in atopic eczema: position paper of the EAACI and GA2LEN. Allergy 2007;62(7):723-728.
  • Boyce JA, Assa’ad A, Burks AW, et al. Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel. J Allergy Clin Immunol 2010;126:S1-58.
There are 29 citations in total.

Details

Primary Language English
Subjects Health Services and Systems (Other)
Journal Section Özgün Araştırma
Authors

Şule Büyük Yaytokgil 0000-0002-9393-7497

Emine Vezir 0000-0002-0639-7358

Publication Date August 20, 2024
Submission Date April 7, 2024
Acceptance Date May 24, 2024
Published in Issue Year 2024 Volume: 26 Issue: 2

Cite

APA Büyük Yaytokgil, Ş., & Vezir, E. (2024). EVALUATION OF FOOD SENSITIVITY IN CHILDREN WITH ATOPIC DERMATITIS. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi, 26(2), 194-200. https://doi.org/10.24938/kutfd.1466473
AMA Büyük Yaytokgil Ş, Vezir E. EVALUATION OF FOOD SENSITIVITY IN CHILDREN WITH ATOPIC DERMATITIS. Kırıkkale Uni Med J. August 2024;26(2):194-200. doi:10.24938/kutfd.1466473
Chicago Büyük Yaytokgil, Şule, and Emine Vezir. “EVALUATION OF FOOD SENSITIVITY IN CHILDREN WITH ATOPIC DERMATITIS”. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi 26, no. 2 (August 2024): 194-200. https://doi.org/10.24938/kutfd.1466473.
EndNote Büyük Yaytokgil Ş, Vezir E (August 1, 2024) EVALUATION OF FOOD SENSITIVITY IN CHILDREN WITH ATOPIC DERMATITIS. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi 26 2 194–200.
IEEE Ş. Büyük Yaytokgil and E. Vezir, “EVALUATION OF FOOD SENSITIVITY IN CHILDREN WITH ATOPIC DERMATITIS”, Kırıkkale Uni Med J, vol. 26, no. 2, pp. 194–200, 2024, doi: 10.24938/kutfd.1466473.
ISNAD Büyük Yaytokgil, Şule - Vezir, Emine. “EVALUATION OF FOOD SENSITIVITY IN CHILDREN WITH ATOPIC DERMATITIS”. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi 26/2 (August 2024), 194-200. https://doi.org/10.24938/kutfd.1466473.
JAMA Büyük Yaytokgil Ş, Vezir E. EVALUATION OF FOOD SENSITIVITY IN CHILDREN WITH ATOPIC DERMATITIS. Kırıkkale Uni Med J. 2024;26:194–200.
MLA Büyük Yaytokgil, Şule and Emine Vezir. “EVALUATION OF FOOD SENSITIVITY IN CHILDREN WITH ATOPIC DERMATITIS”. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi, vol. 26, no. 2, 2024, pp. 194-00, doi:10.24938/kutfd.1466473.
Vancouver Büyük Yaytokgil Ş, Vezir E. EVALUATION OF FOOD SENSITIVITY IN CHILDREN WITH ATOPIC DERMATITIS. Kırıkkale Uni Med J. 2024;26(2):194-200.

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