Food Sensitization and Food Allergy in Atopic Dermatitis

Öz

Atopic dermatitis is the most common chronic inflammatory skin disease of childhood and foods are among the factors that exacerbate eczema. In this study, we aimed to investigate the frequency of food sensitization and food allergies in atopic dermatitis and their association with diseaseseverity. The data of 236 patients aged between 0 -18 years who were diagnosed as atopic dermatitis between 2015-2018 at our Pediatric Allergy and Immunology Department were retrospectively examined. The food sensitization was positive in 68 (31%) patients and the most sensitized foods were egg (20%), cow’s milk (11.8 %) and peanut (4.5%). A total of 147 oral food challenges were performed on 133 patients and 41 (30.8%) patients were diagnosed as food allergy (36 (27%) milk, 4 (3%) egg, 1 (0.8%) pumpkin seed).  Patients were divided into two groups according to disease severity as mild (Group 1) and moderate-severe (Group 2) atopic dermatitis. There were no differences between the groups in terms of age of onset, gender, parental atopy, IgE level, eosinophil count and inhalan allergen sensitization. Food sensitization and food allergy were respectively 20%, 8% in group 1 and 34%, 21% in group 2. Both food sensitization and food allergy were significantly higher in group 2 (p=0.039, p= 0.041, respectively). Approximately one third of patients with atopic dermatitis are accompanied by food allergies and moderate-severe atopic dermatitis comprises higher risk. Food allergy diagnosis should be confirmed by oral food challenges, which is the gold standard diagnostic test and unnecessary food eliminations should be avoided.

Anahtar Kelimeler

• atopic dematitis,food allergy

Atopik Dermatitte Besin Duyarlanması ve Besin Alerjisi

Öz

Atopik dermatit çocukluk çağının en sık görülen kronik inflamatuar cilt hastalığı olup, besinler egzemayı alevlendiren faktörler arasında yerini almaktadır. Bu çalışmada atopik dermatitli hastalarda besin duyarlanması ve besin alerjisi sıklığını araştırmak ve bunların atopik dermatit şiddeti ile ilişkisinin incelenmesi amaçlanmıştır. Üniversitemiz Çocuk İmmunolojisi ve Alerji Hastalıkları Bilim Dalı’nda2015-2018 yılları arasında atopik dermatit tanısı konulan 0-18 yaş arasındaki 236 hastanın verileri sonuçları retrospektif olarak incelendi. Besin alerjen duyarlanması68 (%31) hastada pozitif olup duyarlanma saptanan ilk üç besin sırasıyla yumurta (%20), inek sütü (%11,8) ve yer fıstığı (%4,5) idi. Yüz otuz üç hastaya toplam 147 besin yükleme testi yapıldı. Besin yükleme testi ile 36 (%27) hastada inek sütü, 4 (%3) hastada yumurta alerjisi gösterildi. Kabak çekirdeği ile anafilaksi öyküsü ve deri prik testi pozitifliği olan 1 (%0,8) hasta ile birlikte toplam 41 (% 30,8) hastada besin alerjisi tanısı konuldu. Hastalar hastalık şiddetine göre hafif (grup 1) ve orta-ağır(grup 2) şiddette atopik dermatit olarak iki gruba ayrılarak karşılaştırıldığında; şikayet başlangıç yaşı, cinsiyet, ailede atopi öyküsü, IgE düzeyi, eozinofil sayısı ve inhalan alerjen duyarlanması açısından iki grup arasında fark saptanmadı.  Besin alerjen duyarlanması ve besin alerjisi grup 1’de sırasıyla %20, %8; grup 2’de %34, %21 olup, grup 2’de anlamlı olarak yüksek saptandı (sırasıyla p=0.039, p= 0.041).  Atopik dermatitli hastaların yaklaşık üçte birinde besin alerjisi eşlik etmektedir. Özellikle orta-ağır atopik dermatitli hastalar bu açıdan riskli gruptadır. Besin alerjisi tanısı altın standart tanı testi olan besin yükleme testi ile doğrulanmalı, gereksiz besin eliminasyonundan kaçınılmalıdır

Anahtar Kelimeler

• atopik dermatit,besin alerjisi,çocuk

Kaynakça

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