Department of Pediatric Allergy and Pulmonology, Celal Bayar University Medical Faculty, Manisa, Turkey.
Int Arch Allergy Immunol. 2010;152(4):362-7. doi: 10.1159/000288289. Epub 2010 Mar 3.
Childhood atopic dermatitis (AD) is classically accepted as initial finding of atopic march; however, nonatopic cases do not follow this course. The aim of this study was to determine the characteristics and prognosis of AD in childhood in Turkey.
The study included 531 children with AD that presented to pediatric allergy departments in 11 different regions of Turkey. Age at diagnosis, total serum and inhalant-specific immunoglobulin E (IgE) levels and allergen skin prick test results were recorded retrospectively. Clinical characteristics like additional allergic diseases at presentation or during follow-up were recorded as well as duration of follow-up.
Mean age at diagnosis was 37.8 +/- 36.2 months. Mean IgE level was 318.3 +/- 677.8 IU/ml (median 100 IU/ml). Skin prick tests yielded positive results in 47% of children. At presentation, 31.6% of children reported additional allergic disease, while 11.7% developed allergic disease during follow-up. Among all, 46.6% had additional allergic disease at any point. IgE levels were significantly higher in children with additional allergic diseases (p = 0.001). Allergen skin prick test positivity and family history of allergic diseases increased the risk of additional allergic diseases significantly (OR = 3.90, 95% CI = 2.3-6.6 and OR = 1.89, 95% CI = 1.3-2.8, respectively).
Allergic sensitization is not present in all cases of AD. Coexistence of additional allergic diseases is not as high as expected but more common in children who have been demonstrated to have atopic sensitization with high IgE levels and allergen skin prick test positivity.
儿童特应性皮炎（AD）通常被认为是特应性进行曲的初始表现；然而，非特应性病例并不遵循这一过程。本研究旨在确定土耳其儿童 AD 的特征和预后。
该研究纳入了 531 名在土耳其 11 个不同地区儿科过敏科就诊的 AD 患儿。回顾性记录了诊断时的年龄、总血清和吸入性特异性免疫球蛋白 E（IgE）水平以及过敏原皮肤点刺试验结果。记录了就诊时或随访期间出现的其他过敏性疾病的临床特征以及随访时间。
诊断时的平均年龄为 37.8±36.2 个月。平均 IgE 水平为 318.3±677.8 IU/ml（中位数 100 IU/ml）。47%的儿童皮肤点刺试验结果阳性。就诊时，31.6%的儿童报告有其他过敏性疾病，11.7%的儿童在随访期间出现过敏性疾病。所有儿童中，46.6%在任何时候都有其他过敏性疾病。有其他过敏性疾病的儿童 IgE 水平显著更高（p=0.001）。过敏原皮肤点刺试验阳性和过敏性疾病家族史显著增加发生其他过敏性疾病的风险（OR=3.90，95%CI=2.3-6.6 和 OR=1.89，95%CI=1.3-2.8）。
并非所有 AD 病例均存在过敏敏化。合并其他过敏性疾病的发生率并不如预期的那么高，但在 IgE 水平高且过敏原皮肤点刺试验阳性的已证实存在特应性致敏的儿童中更为常见。
