a diciembre de 2020. Existe una relación 2:1, con predominancia masculina. La edad de aparición es variable, desde el nacimiento hasta los 8 años. El prurito fue el mayor síntoma asociado. La topografía más común fue el tronco y las extremidades; y la morfología de manchas hipercrómicas. En la mayoría se observó máculas hiperpigmentadas o eritematosas con formación de ampollas (signo de Darier). Se obtuvo confirmación histológica en cuatro de los seis casos. Todos los pacientes presentaron mastocitosis cutánea, principalmente del subtipo urticaria pigmentosa. No se encontró manifestación sistémica secundaria a la mastocitosis. Este estudio ayuda a identificar la prevalencia y los hallazgos clínicos e histopatológicos en pacientes pediátricos con mastocitosis, la cual se debe sospechar en pacientes que presentan prurito y máculas hiperpigmentadas o eritematosas con signo de Darier en el tronco y las extremidades.
BackgroundThere are no previous studies published reporting allergen sensitizations in the population of most Central American countries, including Guatemala. There are many types of climates in different regions, with variable altitude, humidity, etc. The purpose of this study was to determine the most common allergen sensitizations in children with Allergic Rhinitis and Asthma in 4 different regions.MethodsThe study was performed on 461 children aged 5 to 15 years, from 4 different regions in Guatemala. A questionnaire was given to record information regarding family history of atopic disease and symptoms of Rhinitis and Asthma. The diagnosis was made in the presence of at least 3 symptoms of each disease. Scratch testing was performed using a commercially available device and a panel of 8 allergen extracts: Cypress Arizona, Dog, Cat, Dermatophagoides farinae and pteronyssinus, Cockroach Mix, Mold Mix and Bermuda grass.ResultsPatient average age was 8.3 years, 55% male and 45% female. Patient distribution by region was 35% from Huehuetenango, 29% Chiquimula, 18% Mazatenango and 18% Quetzaltenango. Family history of allergic rhinitis was present in 46% of patients, asthma in 51% and atopic dermatitis in 33%. The most common diagnosis was rhinitis in 86% of patients, 52% had asthma and 43%, both rhinitis and asthma. 98% had a positive Histamine Control and all a Negative Saline Control. 36% of patients had no allergy sensitization to allergens tested and 64% showed positive skin tests. The most frequent allergic sensitization was to Dermatophagoides pteronyssinus (44%) and farinae (43%), followed by Cockroach (28%). We also found less frequently, positive skin tests to grass (14%), Cat (14%), Mold (10%), Dog (8%) and Cypress (6%). The regions with higher dust mite sensitization were Quetzaltenango (51–55%) and Huehuetenango (45–51%).ConclusionsThe most common allergen sensitizations in children with allergic rhinitis and asthma in Guatemala are dust mites and cockroach. Family history of either rhinitis or asthma is present in a significant amount of patients (46–51%) with atopic disease and allergic sensitization, showing that it is an important risk factor in Guatemala. In 36% of patients in this study, allergic sensitization does not seem to contribute to their rhinitis and asthma symptoms.
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