Perfil de sensibilização alergênica em crianças e adolescentes com dermatite atópica moderada e grave

Abstract

Atopic dermatitis (AD) is a chronic inflammatory skin disease that affects about 10-20% of children. In some cases, food allergens may act as a trigger and influence the severity of the dermatitis, however, the role of inhaled allergens in the pathogenesis of AD remains unclear. The present study evaluated children and adolescents with moderate to severe AD, treated at the Allergy and Immunology Pediatric Service of the Federal University of Uberlândia, to identify the allergen sensitization profile of these patients. This evaluation was performed through skin tests or serum specific IgE levels for food and inhaled allergens. The oral challenge test was performed in cases with specific indication. Was selected 60 patients with moderate to severe AD, with a median age of 61 months, and 62% female. The presence of allergic comorbidities occurred in 78% of patients and family history of atopy, 70%. The most of the sample had some sensitization (79%) to allergens tested, so that inhaled (70%) was more frequent than the food (25%). Of the positive tests for food, chicken egg was most frequently found (73%), while the positivity to at least one dust mites was observed in all patients with inhaled sensitization. Children with food sensitization were on average younger (37 months) than those with aeroallergen sensitivity (84 months). Only 15% had clinical reactivity to food confirmed by oral provocation tests. Therefore, the house dust mites are the most allergens involved in the sensitization of patients with moderate to severe atopic dermatitis, especially in older children and adolescents. Sensitization to food, especially the chicken egg, tends to occur mainly in infants with moderate to severe AD. The food allergy appears to be involved in a limited number of patients with AD, and that the suspicion becomes more evident in difficult to control cases, despite conventional treatment.