D1.176 - Prognostic Evaluation of the Allergic March in Patients with Atopic Dermatitis

Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by intense pruritus, xerosis, and eczematous skin lesions with a typical distribution pattern. It represents the first step of the allergic march. In this study, we aimed to evaluate the persistence of AD, the development of allergic rhinitis and asthma, and the factors influencing these outcomes in patients who were previously followed in our center with a diagnosis of AD with onset before 36 months of age and who were currently between 10 and 14 years old.

MATERIALS AND METHODS: Patients who were diagnosed with AD within the first 36 months of life and followed and treated in the pediatric allergy department of our center, and who were between 10 and 14 years of age during the study period, were included. Disease severity (SCORAD index) and food sensitization status were obtained from medical records. Families were contacted by telephone and the ISAAC questionnaire was administered. The control group consisted of age-matched patients without a previous diagnosis of AD who presented to the pediatric outpatient clinic. The ISAAC questionnaire was administered to families who provided consent during their outpatient visits.

A total of 180 patients (65.6% male) who had been followed for AD before the age of 3 years and had a current median age of 12.21 years (IQR 11.48–12.88) were included. Persistence of eczema was reported by 24.4% of families. Among patients with previously documented food sensitization by skin prick testing (SPT) (n=69), 20.3% (n=14) reported ongoing eczema, compared to 27% (n=30) of those without food sensitization (n=111) (p=0.31). There was no significant difference in AD persistence between patients with mild-to-moderate AD according to initial SCORAD (23%) and those with severe AD (28.9%) at ages 10–14 (p=0.42). Ever wheezing was reported in 45.6% (n=82) of patients, and 25% (n=45) had physician-diagnosed asthma. The rates of ever wheezing and physician-diagnosed asthma were significantly higher than in the control group (p=0.013 and p=0.005, respectively). No significant difference was observed between groups regarding physician-diagnosed allergic rhinitis (p=0.104).

In this study, the long-term clinical course of children diagnosed with AD in early childhood was evaluated during adolescence. AD was found to persist into adolescence in a proportion of patients, and allergic airway diseases developed more frequently compared to controls. Therefore, long-term and close follow-up of these patients is important.