Risk factors for food sensitization in children with atopic dermatitis: a single-center cross-sectional study

WANG Dan, WU Xue-Ge, YAN Shi, ZHOU Tian-Tian, HUANG Ya-Jiao, LI Jie, LUO Xiao-Yan

Chinese Journal of Contemporary Pediatrics ›› 2022, Vol. 24 ›› Issue (8) : 887-893.

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Chinese Journal of Contemporary Pediatrics ›› 2022, Vol. 24 ›› Issue (8) : 887-893. DOI: 10.7499/j.issn.1008-8830.2202098
CLINICAL RESEARCH

Risk factors for food sensitization in children with atopic dermatitis: a single-center cross-sectional study

  • WANG Dan, WU Xue-Ge, YAN Shi, ZHOU Tian-Tian, HUANG Ya-Jiao, LI Jie, LUO Xiao-Yan
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Abstract

Objective To study the risk factors for food sensitization and the influence of food sensitization on quality of life and clinical signs in children with atopic dermatitis (AD). Methods A retrospective analysis was performed on the medical data of 241 children with AD, including demographic features, age of onset, severity of AD, quality of life, physical examination results, skin prick test (SPT) results, serum total IgE levels, and eosinophil count. According to the results of SPT, the children were divided into a food sensitization group (n=127) and a non-food sensitization group (n=114). The multivariate logistic regression analysis was used to identify the risk factors for food sensitization in children with AD. Results The prevalence rate of food sensitization was 52.7% (127/241) in the children with AD. The multivariate logistic regression analysis showed that birth in autumn or winter, age of onset of AD<12 months, severe AD, and total IgE>150 IU/mL were risk factors for food sensitization (P<0.05). Compared with the non-food sensitization group, the food sensitization group had a significantly poorer quality of life (P=0.008) and significantly higher prevalence rates of non-specific hand/foot dermatitis and palmar hyperlinearity (P<0.05). Compared with the single food sensitization group, the multiple food sensitization group had more severe AD and a significantly higher proportion of children with exclusive breastfeeding or total IgE>150 IU/mL (P<0.05). Conclusions The AD children born in autumn or winter, or those with early onset (<12 months), severe AD or total IgE>150 IU/mL have a higher risk of food sensitization. The AD children with food sensitization have a poorer quality of life and are more likely to develop non-specific hand/foot dermatitis and palmar hyperlinearity.

Key words

Atopic dermatitis / Food sensitization / Risk factor / Quality of life / Clinical sign / Child

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WANG Dan, WU Xue-Ge, YAN Shi, ZHOU Tian-Tian, HUANG Ya-Jiao, LI Jie, LUO Xiao-Yan. Risk factors for food sensitization in children with atopic dermatitis: a single-center cross-sectional study[J]. Chinese Journal of Contemporary Pediatrics. 2022, 24(8): 887-893 https://doi.org/10.7499/j.issn.1008-8830.2202098

References

1 Drucker AM, Wang AR, Li WQ, et al. The burden of atopic dermatitis: summary of a report for the national eczema association[J]. J Invest Dermatol, 2017, 137(1): 26-30. PMID: 27616422. DOI: 10.1016/j.jid.2016.07.012.
2 Bylund S, Kobyletzki LB, Svalstedt M, et al. Prevalence and incidence of atopic dermatitis: a systematic review[J]. Acta Derm Venereol, 2020, 100(12): adv00160. PMID: 32412646. DOI: 10.2340/00015555-3510.
3 Yuenyongviwat A, Koosakulchai V, Treepaiboon Y, et al. Risk factors of food sensitization in young children with atopic dermatitis[J]. Asian Pac J Allergy Immunol, 2021. Epub ahead of print. PMID: 33386793. DOI: 10.12932/AP-250820-0946.
4 Robison RG, Singh AM. Controversies in allergy: food testing and dietary avoidance in atopic dermatitis[J]. J Allergy Clin Immunol Pract, 2019, 7(1): 35-39. PMID: 30501976. PMCID: PMC6312729. DOI: 10.1016/j.jaip.2018.11.006.
5 中国医师协会皮肤科医师分会儿童皮肤病专业委员会, 中华医学会皮肤性病学分会儿童学组, 中华医学会儿科学分会皮肤性病学组. 儿童特应性皮炎相关食物过敏诊断与管理专家共识[J]. 中华皮肤科杂志, 2019, 52(10): 711-716. DOI: 10.35541/cjd.20190586.
6 Tham EH, Rajakulendran M, Lee BW, et al. Epicutaneous sensitization to food allergens in atopic dermatitis: what do we know?[J]. Pediatr Allergy Immunol, 2020, 31(1): 7-18. PMID: 31541586. DOI: 10.1111/pai.13127.
7 Tran MM, Lefebvre DL, Dharma C, et al. Predicting the atopic march: results from the Canadian Healthy Infant Longitudinal Development Study[J]. J Allergy Clin Immunol, 2018, 141(2): 601-607.e8. PMID: 29153857. DOI: 10.1016/j.jaci.2017.08.024.
8 Hill DJ, Hosking CS, de Benedictis FM, et al. Confirmation of the association between high levels of immunoglobulin E food sensitization and eczema in infancy: an international study[J]. Clin Exp Allergy, 2008, 38(1): 161-168. PMID: 18028467. DOI: 10.1111/j.1365-2222.2007.02861.x.
9 Boccardi D, D'Auria E, Turati F, et al. Disease severity and quality of life in children with atopic dermatitis: PO-SCORAD in clinical practice[J]. Minerva Pediatr, 2017, 69(5): 373-380. PMID: 26200523. DOI: 10.23736/S0026-4946.16.04294-8.
10 Fukuie T, Yasuoka R, Fujiyama T, et al. Palmar hyperlinearity in early childhood atopic dermatitis is associated with filaggrin mutation and sensitization to egg[J]. Pediatr Dermatol, 2019, 36(2): 213-218. PMID: 30810250. DOI: 10.1111/pde.13752.
11 Brar KK, Calatroni A, Berdyshev E, et al. Hyperlinear palms as a clinical finding in peanut allergy[J]. J Allergy Clin Immunol Pract, 2020, 8(8): 2823-2825. PMID: 32376483. PMCID: PMC7483281. DOI: 10.1016/j.jaip.2020.04.056.
12 De D, Kanwar AJ, Handa S. Comparative efficacy of Hanifin and Rajka's criteria and the UK working party's diagnostic criteria in diagnosis of atopic dermatitis in a hospital setting in North India[J]. J Eur Acad Dermatol Venereol, 2006, 20(7): 853-859. PMID: 16898910. DOI:10.1111/j.1468-3083.2006.01664.x.
13 Peters RL, Krawiec M, Koplin JJ, et al. Update on food allergy[J]. Pediatr Allergy Immunol, 2021, 32(4): 647-657. PMID: 33370488. PMCID: PMC8247869. DOI: 10.1111/pai.13443.
14 Schmitt J, Langan S, Deckert S, et al. Assessment of clinical signs of atopic dermatitis: a systematic review and recommendation[J]. J Allergy Clin Immunol, 2013, 132(6): 1337-1347. PMID: 24035157. DOI: 10.1016/j.jaci.2013.07.008.
15 Silverberg JI, Lei D, Yousaf M, et al. Comparison of patient-oriented eczema measure and patient-oriented scoring atopic dermatitis vs eczema area and severity index and other measures of atopic dermatitis: a validation study[J]. Ann Allergy Asthma Immunol, 2020, 125(1): 78-83. PMID: 32199977. DOI: 10.1016/j.anai.2020.03.006.
16 Thomas KS, Apfelbacher CA, Chalmers JR, et al. Recommended core outcome instruments for health-related quality of life, long-term control and itch intensity in atopic eczema trials: results of the HOME VII consensus meeting[J]. Br J Dermatol, 2021, 185(1): 139-146. PMID: 33393074. PMCID: PMC8359383. DOI: 10.1111/bjd.19751.
17 Matsui T, Tanaka K, Yamashita H, et al. Food allergy is linked to season of birth, sun exposure, and vitamin D deficiency[J]. Allergol Int, 2019, 68(2): 172-177. PMID: 30670337. DOI: 10.1016/j.alit.2018.12.003.
18 Liu X, Arguelles L, Zhou Y, et al. Longitudinal trajectory of vitamin D status from birth to early childhood in the development of food sensitization[J]. Pediatr Res, 2013, 74(3): 321-326. PMID: 23797532. PMCID: PMC3773018. DOI: 10.1038/pr.2013.110.
19 Ng JC, Yew YW. Effect of vitamin D serum levels and supplementation on atopic dermatitis: a systematic review and meta-analysis[J]. Am J Clin Dermatol, 2022, 23(3): 267-275. PMID: 35246808. DOI: 10.1007/s40257-022-00677-0.
20 Umar M, Sastry KS, Al Ali F, et al. Vitamin D and the pathophysiology of inflammatory skin diseases[J]. Skin Pharmacol Physiol, 2018, 31(2): 74-86. PMID: 29306952. DOI: 10.1159/000485132.
21 Tokura Y. Extrinsic and intrinsic types of atopic dermatitis[J]. J Dermatol Sci, 2010, 58(1): 1-7. PMID: 20207111. DOI: 10.1016/j.jdermsci.2010.02.008.
22 Hu Y, Liu S, Liu P, et al. Clinical relevance of eosinophils, basophils, serum total IgE level, allergen-specific IgE, and clinical features in atopic dermatitis[J]. J Clin Lab Anal, 2020, 34(6): e23214. PMID: 32068307. PMCID: PMC7307373. DOI: 10.1002/jcla.23214.
23 Martin MJ, Estravís M, García-Sánchez A, et al. Genetics and epigenetics of atopic dermatitis: an updated systematic review[J]. Genes (Basel), 2020, 11(4): 442. PMID: 32325630. PMCID: PMC7231115. DOI: 10.3390/genes11040442.
24 Brough HA, Nadeau KC, Sindher SB, et al. Epicutaneous sensitization in the development of food allergy: what is the evidence and how can this be prevented?[J]. Allergy, 2020, 75(9): 2185-2205. PMID: 32249942. PMCID: PMC7494573. DOI: 10.1111/all.14304.
25 Eigenmann PA, Beyer K, Lack G, et al. Are avoidance diets still warranted in children with atopic dermatitis?[J]. Pediatr Allergy Immunol, 2020, 31(1): 19-26. PMID: 31273833. DOI: 10.1111/pai.13104.
26 Jiao L, Su CW, Cao T, et al. Maternal influences and intervention strategies on the development of food allergy in offspring[J]. Front Immunol, 2022, 13: 817062. PMID: 35281070. PMCID: PMC8904425. DOI: 10.3389/fimmu.2022.817062.
27 Bradshaw LE, Haines RH, Thomas KS, et al. Clinical examination for hyperlinear palms to determine filaggrin genotype: a diagnostic test accuracy study[J]. Clin Exp Allergy, 2021, 51(11): 1421-1428. PMID: 34608691. DOI: 10.1111/cea.14025.
28 Mustonen N, Siljander H, Niemel? O, et al. Allergy-related symptoms are poorly predicted by IgE and skin prick testing in early life[J]. Int Arch Allergy Immunol, 2021, 182(7): 574-584. PMID: 33550294. DOI: 10.1159/000512109.
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