Atopic dermatitis: clinical phenotypes, persistence and comorbidity

Abstract

Background. Atopic dermatitis is the most common skin disease among children. Its natural history is heterogeneous with a difference in age of manifestation, localization of lesions, severity, sensitization profiles, presence of comorbid atopic conditions, and longitudinal trajectories of disease progression. The study aimed to assess the impact of factors such as the onset of the disease, atopic family history, presence of concomitant allergic pathology, duration of breastfeeding on the course of the disease and the development of respiratory allergies, and the impact of environmental factors that aggravate the disease. Materials and methods. Children with atopic dermatitis (n = 88) were included in the study from September 2020 to April 2021 in Kyiv, Ukraine. Symptoms of respiratory allergy in the history of patients have been documented as comorbidity. Results. Total of 88 patients at the time of examination presented with manifestations of atopic dermatitis in the form of a rash, dry skin, scaling, itching, lichenization. The disease severity was significantly related to the age of onset: children with early phenotype had more severe disease (OR = 16.261; 2.056–127.911). There was no statistically significant association of early phenotype of atopic dermatitis with the development of concomitant allergic diseases (OR = 1.813; 0.415–7.916). A severe course was observed in the group of children with atopic family history (OR = 2.750; 1.123–6.735). Children with severe atopic dermatitis had a high risk of concomitant respiratory allergy (OR = 5.604; 1.863–16.863). The duration of breastfeeding did not impact the severity of atopic dermatitis (OR = 0.778; 0.119–5.100) and the risk of concomitant atopic diseases (OR = 1.417; 0.444–4.521). The course of atopic dermatitis was influenced by seasonality in 76 children (86.4 %): the condition of the skin deteriorated in the winter. Contact with the animal was associated with exacerbation of atopic dermatitis in 4 (4.5 %) children, food ingestion — in 20 children (25 %), pollen trees and grasses caused exacerbation in 5 children (5.7 %). Conclusions. Children with a severe phenotype of atopic dermatitis are at risk of developing respiratory allergies. Patients with atopic dermatitis who develop symptoms at the age of under 2 years, as well as those with an atopic family history, are at high risk of developing a severe disease phenotype.

Effectiveness of allergen-specific immunotherapy in children with bronchial asthma sensitized to house dust mites

“…), так і фіксованих (ендотелій, епітелій, фібро бласти та інші елементи, що можуть бути визнані іму нокомпетентними) [4]. Їх ступінь участі визначається видом антигену, шляхом надходження в організм, крат ністю та тривалістю його впливу на клітиннотканинні структури бронхолегеневої системи [5].…”

“…Саме тут починає діяти алергенспецифічна іму нотерапія (АСІТ) як єдиний спосіб лікування, який може змінити природний перебіг алергічної астми, зменшуючи частоту та тяжкість симптомів і прогресу вання риніту до БА [3]. Ефективна АСІТ індукує чис ленні імуноопосередковані механізми, які послідовно активуються, що призводить до алергенспецифічної толерантності, може змінювати як ранню, так і пізню гіперреактивність дихальних шляхів, допомагає досяг ти контролю/ремісії алергічного захворювання та за побігає новій сенсибілізації [5,6].…”

House dust mite sensitivity in atopic children with Dectin-1 rs7309123 polymorphism

“…Atopic dermatitis (AD), the most common skin disease in infants and children, is a complex disease with a multifactorial aetiology, including genetic and environmental factors [1]. Children with AD are at risk of developing respiratory allergies.…”

“…Children with AD are at risk of developing respiratory allergies. This risk may be higher for children who develop percutaneous sensitization to house dust mite (HDM) allergens [1]. The relationship between the amount of HDM on the skin and in patients' homes and the severity of AD has long been known [2].…”