Ozanli Ismail, Uluc Nezihe Nefise, Iskender Nagehan, Akin Taha Yasin, Varli Yusuf Ziya, Balci Sibel, Simsek Isil Eser, Aydogan Metin
From the Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey and.
Department of Biostatistics and Medical Informatics, Basic Medical Sciences, Kocaeli University, Kocaeli, Turkey.
Allergy Asthma Proc. 2025 Sep 1;46(5):e137-e143. doi: 10.2500/aap.2025.46.250054.
Data on the frequency of food sensitivity (FS) and food allergy (FA) in patients with atopic dermatitis (AD) differ among studies. The aim of this study was to determine the frequency of FS and FA in different AD phenotypes according to the age of onset and severity of AD. In addition, we aimed to investigate the risk of FA in these patients. Patients diagnosed with AD between 2022 and 2024 were included in the study. All patients with AD admitted during this period were analyzed for the coexistence of FA and FS. The study included 257 children with AD. Of these patients, 147 of 257 were girls (57.2%). The median (interquartile range [IQR]) age of onset of AD was 6 months (2.5-30 months). By the age of AD onset, FS and FA were present in 60.3% and 32.5%, respectively, in patients with moderate-to-severe AD, with disease onset between ages 0 and 3 months. Among the patients with disease onset between ages 4 and 11 months, the corresponding rates in moderate-to-severe cases were 59.6% for FS and 17.4% for FA. FS was present in 39.3% of moderate-to-severe cases with AD onset age after 12 months, but none had FA. Being in the moderate-to-severe category for AD increased the risk of FA 14-16 times compared with the mild AD group. FS is significantly more prevalent than FA in patients with AD. In children in whom FS test results are positive, the diagnosis of AD-FA coexistence should not be made without performing an elimination diet and oral food challenge test. This approach will help prevent unnecessary food elimination.
关于特应性皮炎（AD）患者食物敏感（FS）和食物过敏（FA）发生率的数据在不同研究中存在差异。本研究的目的是根据AD的发病年龄和严重程度确定不同AD表型中FS和FA的发生率。此外，我们旨在调查这些患者发生FA的风险。2022年至2024年间诊断为AD的患者纳入本研究。对在此期间收治的所有AD患者分析FA和FS的共存情况。该研究纳入了257例AD患儿。其中，257例中有147例为女孩（57.2%）。AD的发病年龄中位数（四分位间距[IQR]）为6个月（2.5 - 30个月）。在0至3个月发病的中重度AD患者中，到AD发病时，FS和FA的发生率分别为60.3%和32.5%。在4至11个月发病的患者中，中重度病例中FS和FA的相应发生率分别为59.6%和17.4%。AD发病年龄在12个月以后的中重度病例中，FS发生率为39.3%，但无人发生FA。与轻度AD组相比，中重度AD患者发生FA的风险增加14 - 16倍。在AD患者中，FS的发生率显著高于FA。对于FS检测结果呈阳性的儿童，在未进行排除饮食和口服食物激发试验的情况下，不应诊断为AD - FA共存。这种方法将有助于防止不必要的食物排除。
