Food Sensitivity in Children Diagnosed with Atopic Dermatitis in the First 2 Years: How Many of These Patients Are Truly Allergic?

Objectives: In this study, it was aimed to examine food sensitivity in patients with atopic dermatitis (AD) and to investigate the frequency of food allergy in patients with food sensitivity.
Methods: Patients aged 0–2 years who were followed up with the diagnosis of AD were included in the study. The characteristics of demographic and clinical and laboratory findings of the patients were recorded retrospectively. Patients were classified as mild, moderate, and severe using the SCORing AD index according to the severity of AD. The presence of food sensitivity was evaluated by skin prick test and serum-specific immunoglobulin (Ig)E results. Food allergy was diagnosed by oral food challenge (OFC) test.
Results: Of the 72 patients included in the study, 62.5% (n=45) were male, and the mean age was 9±4.8 months. When the disease severity was evaluated, it was mild in 40 patients (55.6%); moderate/severe AD was present in 32 patients (44.4%). The frequency of moderate/severe AD was higher in patients who were younger (p=0.01), whose symptoms started in the first 6 months (p=0.03), who had a family history of allergic disease (p=0.001), who breastfed for <6 months (p=0.01), who had a higher median serum total IgE level, and a higher percentage of serum eosinophils (p=0.005 and p=0.01, respectively). Food sensitivity in 45.8% of patients; food allergy was detected in 41.7% of them. The most common sensitivities and allergies were eggs white/yolk and cow’s milk, respectively. The rate of food sensitivity was found to be higher in male gender (p=0.03) and breastfed patients (p=0.03), whereas it was similar in patients with mild and moderate/severe AD.
Conclusion: In the investigation of food sensitivity in patients with AD, it is important to evaluate other demographic and clinical characteristics such as gender and breastfeeding, apart from the severity of disease. The OFC test should be performed to confirm the food allergy in patients with food sensitivity before the recommendation of an elimination diet.

Ýlk 2 Yaþta Atopik Dermatit Tanýsý Alan Çocuklarda Besin Duyarlýlýðý: Ne Kadarý Alerjik?

Amaç: Bu çalýþmada atopik dermatit (AD) tanýsý olan hastalarda besin duyarlýlýðý ve duyarlýlýk saptanan hastalarda besin alerjisi sýklýðýnýn araþtýrýlmasý amaçlanmýþtýr.
Metod: Çalýþmaya AD tanýsý ile izlenen 0-2 yaþ arasý hastalar dahil edildi. Hastalarýn demografik ve klinik özellikleri ile laboratuvar bulgularý geriye dönük olarak kayýt edildi. Hastalar AD þiddetine göre SCORAD (SCORing Atopic Dermatitis) indeksi kullanýlarak hafif, orta ve aðýr olarak sýnýflandýrýldý. Besin duyarlýlýðý varlýðý deri prik ve serum spesifik (sp)Immunglobulin (Ig) E sonuçlarý ile deðerlendirildi. Besin alerjisi tanýsý oral besin yükleme testi ile konuldu.
Bulgular: Çalýþmaya dahil edilen 72 hastanýn %62,5’i (n=45) erkek, yaþ ortalamasý 9 ± 4,8 ay idi. Hastalýk þiddeti deðerlendirildiðinde 40 hastada (%55,6) hafif; 32 hastada (%44,4) orta/aðýr þiddette AD mevcuttu. Daha küçük yaþta olan (p=0,01), semptomlarý ilk 6 ayda baþlayan (p=0,03), ailesinde alerjik hastalýk öyküsü olan (p=0,001), daha kýsa süre anne sütü alan (p=0,01), ortanca serum total IgE düzeyi ve serum eozinofil yüzdesi daha yüksek saptanan (sýrasý ile p=0,005, p=0,01) hastalarda orta/aðýr þiddette AD sýklýðý daha fazla saptandý. Hastalarýn %45,8’inde besin duyarlýlýðý; %41,7’sinde besin alerjisi saptandý. En sýk duyarlýlýk ve alerji saptanan besinler yumurta beyazý/sarýsý ve inek sütü idi. Erkek cinsiyette olan (p=0,03) ve anne sütü alan hastalarda (p=0,03) besin duyarlýlýðý oraný daha yüksek iken, hafif ve orta/aðýr þiddette AD’li hastalarda benzer oranda idi.
Sonuç: Atopik dermatit tanýlý hastalarda besin duyarlýlýðýnýn araþtýrýlmasýnda hastalýk þiddeti dýþýnda cinsiyet, anne sütü alýmý gibi diðer demografik ve klinik özelliklerin birlikte deðerlendirilmesi önemlidir. Besin duyarlýlýðý saptanan atopik dermatit tanýlý hastalarda besin eliminasyonu önerilmeden önce mutlaka besin yükleme testi yapýlmalýdýr. (SETB-2023-08-133)