Open Access, Peer-reviewed
pISSN 2288-0402
eISSN 2288-0410
    Allergy Asthma Respir Dis. 2016 Jul;4(4):290-295. Korean.
    Published online Jul 31, 2016.
    https://doi.org/10.4168/aard.2016.4.4.290
    © 2016 The Korean Academy of Pediatric Allergy and Respiratory Disease; The Korean Academy of Asthma, Allergy and Clinical Immunology
    Original Article

    Sensitization in children with atopic dermatitis: a single center study

    Ari Song,1,* Ji Young Lee,1,2,* Hea-kyoung Yang,1,2 Minji Kim,1,2 Kangmo Ahn,1,2 Sang-il Lee,2 and Jihyun Kim1,2
      • 1Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
      • 2Environmental Health Center for Atopic Diseases, Samsung Medical Center, Seoul, Korea.
    • Correspondence to: Jihyun Kim. Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea. Tel: +82-2-3410-3539, Fax: +82-2-3410-0805, Email: jhlovechild@gmail.com

      *These authors contributed equally to this study and should be considered co-first authors.
    Received February 23, 2016; Revised May 19, 2016; Accepted May 25, 2016.

    This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/).

    Abstract

    Purpose

    There are few recent data regarding allergic sensitization of atopic dermatitis (AD) in Korea. The aim of this study was to investigate patterns of sensitization according to age and gender in children with AD.

    Methods

    This retrospective study included 4,661 children with AD from 1998 to 2014. The serum specific IgE (sIgE) levels to egg white (EW), cow's milk (CM), peanut, wheat, soybean, buckwheat, tree nuts, crustaceans, meat, and house dust mites (HDMs) were reviewed. AD was categorized into the extrinsic (ADe) and intrinsic type (ADi) according to the presence or absence of sensitization. The proportion of patients with sIgE to EW or CM greater than the previously reported diagnostic decision point (DDP) was determined.

    Results

    A total of 4,661 children (2,843 boys and 1,818 girls) were collected. We identified 1,857 of 2,663 children (69.7%) with the ADe type and 806 of 2,663 children (30.3%) with the ADi type. The sensitization rates increased with age (P<0.001). EW (59.3%) was the most commonly sensitized food, followed by CM (46.6%), peanut (32.2%), wheat (31.5%), soybean (28.1%), and buckwheat (23.7%). The most commonly sensitized food groups were tree nuts (56.7%) and crustaceans (28.3%). The rate of sensitization to HDMs was 40.1%. In addition, 11.1% and 7.5% of children had levels of sIgE to EW and CM, respectively, higher than the DDP.

    Conclusion

    The incidence of ADe among children with AD was 69.7% and increased with age. The most commonly sensitized food allergen was EW, followed by CM and peanut.

    Keywords
    Atopic dermatitis; Sensitization; Diagnostic decision point; Child

    Figures

    Fig. 1
    Proportion of extrinsic and intrinsic type atopic dermatitis. ADe, extrinsic type atopic dermatitis; ADi, intrinsic type atopic dermatitis.

    Fig. 2
    Patterns of sensitization to foods or house dust mites in children with extrinsic type atopic dermatitis according to their ages. Out of 1,857 children with extrinsic type atopic dermatitis, 1,545 were younger than 3 years, 251 were between the ages of 3–6 years, and 61 between the ages 7–12 years. ***P<0.001.

    Fig. 3
    Sensitization rates to common food and inhalant allergens in children with atopic dermatitis according to their ages. Df, Dermatophagoides farinae; Dp, Dermatophagoides pteronyssinus; HDMs, house dust mites. ***P<0.001.

    Fig. 4
    The proportion of patients with specific IgE to egg white and cow's milk greater than the diagnostic decision points (DDPs). The DDPs were applied based on the previously reported specific IgE levels as follows: egg white-specific IgE levels of 28.1 kU/L (<2 years of age); egg white-specific IgE levels of 22.9 kU/L (≥2 years of age); cow's milk-specific IgE levels of 31.4 kU/L (<2 years of age); and cow's milk-specific IgE levels of 10.1 kU/L (≥2 years of age). *P<0.05.

    Tables

    Table 1
    Clinical characteristics of the subjects (n=4,661)

    Table 2
    Sensitization rates to common food and inhalant allergens in children with atopic dermatitis

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    MeSH Terms
    Arachis
    Child*
    Dermatitis, Atopic*
    Egg White
    Fagopyrum
    Humans
    Immunoglobulin E
    Incidence
    Korea
    Meat
    Milk
    Nuts
    Pyroglyphidae
    Retrospective Studies
    Soybeans
    Trees
    Triticum
    Metrics
    Share
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