Atopic Dermatitis and Asthma: Parallels in the Evolution of Treatment

Eichenfield, Lawrence F.; Hanifin, Jon M.; Beck, Lisa A.; Lemanske, Robert F.; Sampson, Hugh A.; Weiss, Scott T.; Leung, Donald Y.M.

doi:10.1542/peds.111.3.608

Cited by 169 publications

(123 citation statements)

References 54 publications

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“…1 Children with AD are more likely to develop other atopic conditions, including food allergy, than children who have no history of the disease. [2][3][4] Previous clinical studies have documented greatly varying estimates of the rate of IgE-mediated food allergy in AD patients, ranging from 15% to 40%. The most commonly cited range is 30% to 40%, all in tertiary care centers, reflecting more severely affected patients.…”

Section: What This Study Addsmentioning

confidence: 99%

Food Allergy in Infants With Atopic Dermatitis: Limitations of Food-Specific IgE Measurements

et al. 2015

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BACKGROUND AND OBJECTIVES: Children with atopic dermatitis (AD) have a higher risk for development of food allergies. The objective of this study was to examine incidence of food allergy development in infants with AD and the predictive value of food-antigen-specific immunoglobulin E measurements.METHODS: This trial examined the long-term safety and efficacy of pimecrolimus cream 1% in .1000 infants (3-18 months) with mild-to-severe AD without a history of food allergy. Food allergy development was followed throughout a 36-month randomized double-blind phase followed by an open-label (OL) phase up to 33 months. Additionally, sIgE for cow's milk, egg white, peanut, wheat, seafood mix, and soybean was measured by ImmunoCAP at baseline, end of the double-blind phase, and end of OL phase.RESULTS: By the end of the OL phase, 15.9% of infants with AD developed at least 1 food allergy; allergy to peanut was most common (6.6%), followed by cow's milk (4.3%) and egg white (3.9%). Seafood, soybean, and wheat allergies were rare. Levels of sIgE for milk, egg, and peanut increased with severity of AD, as determined by Investigator's Global Assessment score. We assigned sIgE decision points for the 6 foods and tested their ability to predict definite food allergy in this population. Positive predictive values for published and newly developed sIgE decision points were low (,0.6 for all values tested). CONCLUSIONS:In a large cohort of infants at risk for development of food allergy, sIgE levels were not clinically useful for predicting food allergy development. WHAT'S KNOWN ON THIS SUBJECT:Food allergies are often thought to be a common trigger in atopic dermatitis (AD). Serum immunoglobulin E is frequently used to assess food sensitization and clinical allergy, but few studies have assessed it longitudinally in infants and children with AD. WHAT THIS STUDY ADDS:In a large infant population with mild to moderate AD, 15.9% of patients developed food allergy during the study. Serum immunoglobulin E decision points had low positive predictive values, indicating that they are of limited use in this population.

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Section: What This Study Addsmentioning

confidence: 99%

Food Allergy in Infants With Atopic Dermatitis: Limitations of Food-Specific IgE Measurements

et al. 2015

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“…Among children up to 4 years of age, the incidence of asthma has increased 160%, and the incidence of atopic dermatitis has increased twofold to threefold. 1 The incidence of peanut allergy has also doubled in the past decade. 2 Thus, atopic diseases increasingly are a problem for clinicians who provide health care to children.…”

Section: Introductionmentioning

confidence: 99%

Effects of Early Nutritional Interventions on the Development of Atopic Disease in Infants and Children: The Role of Maternal Dietary Restriction, Breastfeeding, Timing of Introduction of Complementary Foods, and Hydrolyzed Formulas

Greer¹,

Sicherer²,

Burks³

2008

Pediatrics

984

708

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“…In addition, small family size, increased income, education, migration from rural to urban environments, and increased use of antibiotics may also be associated with the rise in AD. 5,6 While the pathogenesis of AD remains unclear, genetic and environmental factors have been suggested among many potential ones. Large-scale epidemiological studies are needed to identify potential AD-aggravating environmental factors.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Atopic Dermatitis in Korean Children Based on Data From the 2008-2011 Korean National Health and Nutrition Examination Survey

Lee

Han

Kim

et al. 2016

Allergy Asthma Immunol Res

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This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.Population-based studies of atopic dermatitis (AD) in Korean children are lacking. Thus, the purpose of this study was to determine the prevalence, geographic distribution, and risk factors of AD in the Korean pediatric population. We examined AD prevalence using data from the 2008-2011 Korea National Health and Nutrition Examination Survey (KNHANES), which was a cross-sectional survey of 8,947 children up to age 18 throughout the country. Overall, 13.50% of children reported a diagnosis of AD. The age-standardized prevalence ranged from 9.13% to 17.67% between cities and provinces, with the highest prevalence -observed in many of the larger cities at low latitudes, as well as Jeju-do. After adjusting for confounders, high economic status was found to be a significant factor for predicting increased prevalence of AD, with an odds ratio of 1.35 (95% confidence interval of 1.02-1.79, P=0.0034). Urban living (odds ratio 1.24, 95% confidence interval of 1.00-1.53, P=0.0526) was also associated with a higher prevalence of AD. In this first large scale, nationwide study in Korean children, we found that the overall prevalence of AD depends on age, household income, and geographic distribution.

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Atopic Dermatitis and Asthma: Parallels in the Evolution of Treatment

Cited by 169 publications

References 54 publications

Food Allergy in Infants With Atopic Dermatitis: Limitations of Food-Specific IgE Measurements

Food Allergy in Infants With Atopic Dermatitis: Limitations of Food-Specific IgE Measurements

Effects of Early Nutritional Interventions on the Development of Atopic Disease in Infants and Children: The Role of Maternal Dietary Restriction, Breastfeeding, Timing of Introduction of Complementary Foods, and Hydrolyzed Formulas

Prevalence of Atopic Dermatitis in Korean Children Based on Data From the 2008-2011 Korean National Health and Nutrition Examination Survey

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