Using family atopy scores to identify the risk of atopic dermatitis in infants
Abstract
Background Atopic dermatitis is the first manifestation of
allergic disease in early life. Early interventions may prevent the
development of allergy disease. Allergy trace cards have been
used to identify the level of allergic risk, based on family atopy
scores. Because environmental factors may also influence the
development of atopic dermatitis, the usefulness of the allergy
trace card needs to be reevaluated.
Objective To compare the incidence of atopic dermatitis in
infants aged 0-4 months with total family atopy scores of > 0 to
those with scores of 0.
Methods We conducted this cohort study from June 1, 2012 to
December 31, 2012 at Sanglah Hospital, Denpasar. Family atopy
score was tabulated from all pregnant woman in the Obstetric
Outpatient Clinic and the Maternity Room. Subjects were divided
into two groups based on their total family atopy score: those with
scores > 0 and those with scores of 0. The appearance of atopic
dermatitis symptoms in the infants were evaluated until they
reached 4 months of age. The incidence of atopic dermatitis in
two groups was compared using Chi-square test.
Results The incidence of atopic dermatitis in this study was 10.9%.
The group with total family atopy scores of 0 had a significantly
higher incidence of atopic dermatitis than the group with scores
> 0 (adjusted RR 22.5; 95%CI 8.8 to 57.0; P = 0.001).
Conclusion The incidence of atopic dermatitis is higher in
infants with total family atopy score > 0 and this group has a 22.5
times higher risk of atopic dermatitis compared to infants with
total family atopy score of 0. Allergy trace cards are relevant in
differentiating the risk of atopy with regards to development of
atopic dermatitis. We suggest that family atopy scores be evaluated
during antenatal care in order to limit the development of atopic
dermatitis in infants.
References
Wahn U. The Allergic march. World Allergy Organization (serial online). 2004; [cited 2010 March 31]; [about 8 screens]. Available from: http://www.worldallergy.org/professional/allergic_diseases_center/allergic_march/
Moore MM, Rifas-Shiman SL, Rich-Edwards JW, Kleinman KP, Camargo CA, Gold DR, et al. Perinatal predictors of atopic dermatitis occuring in the first six months of life. Pediatrics. 2004;113:468-74.
Illi S, von Mutius E, Lau S, Nickel R, Gruber C, NiggemannB, et al. The natural course of atopic dermatitis from birth to age 7 years and the association with asthma. J Allergy Clin Immunol. 2004;113:925-31.
Gustafsson D, Sjoberg O, Foucard T. Development of allergies and asthma in infants and young children with atopic dermatitis--a prospective follow-up to 7 years of age. Allergy. 2000;55:240-5.
Bergmann RL, Edenharter G, Bergmann KE, Foster J, Bauer CP, Wahn V, et al. Atopic dermatitis in early infancy predicts allergic airway disease at 5 years. Clin Exp Allergy. 1998;28:965-70.
Harsono A. Pencegahan primer penyakit alergi. In: Arief S, Saharso D, Hamidi E, editors. Naskah lengkap continuing education ilmu kesehatan anak XXXV kapita selekta ilmu kesehatan anak IV, hot topics in pediatrics. Surabaya: Balai Penerbit FK Unair; 2005. p.23-8.
Pediatric allergy immunology working group of Indonesian pediatric society. Kartu deteksi dini risiko alergi. Jakarta; 2010.
Halkjaer LB, Loland L, Buchvald FF, Agner T, Skov L, Strand M, et al. Development of atopic dermatitis during the first 3 years of life: the Copenhagen prospective on asthma in childhood cohort study in high-risk children. Arch Dermatol. 2006;142:561-5.
Hanifin JM, Rajka G. Diagnostic features of atopic dermatitis. Acta Derm Venereol Suppl (Stockh). 1980;92:44-7.
Sybilski AJ, Doboszynska A, Samolinski B. Prediction of atopy in the first year of life using cord blood IgE levels and family history. Eur J Med Res. 2009;14:227-32.
Wahn U, Mutius EV. The development of atopic phenotypes: genetic and enviromental determinants. In: Cooke JR editor. Nutrition support for infants and children at risk. Switzerland: Nestec Ltd; 2007. p. 1-3.
Yi O, Kwon HJ, Kim H, Ha M, Hong SJ, Leem JH, et al. Effect of environmental tobacco smoke on atopic dermatitis among children in Korea. Environ Res. 2012;113:40-5.
Shinohara M, Saito H, Matsumoto K. Different timings of prenatal or postnatal tobacco smoke exposure have different effects on the development of atopic eczema/dermatits syndrome (AEDS) during infancy. J Allergy Clin Immunol. 2012;129:23-8.
Wang IJ, Hsieh WS, Wu KY, Guo YL, Hwang YH, Jee SH, et al. Effect of gestational smoke exposure on atopic dermatitis in the offspring. Pediatr Allergic Immunol. 2008;19:580-6.
Endaryanto A. Trace card for early allergy detection. Proceedings of the Symposium for Doctors; 2009 February 7; Tretes, Jawa Timur. p.2-5.
Thomas IN, Myalil JM. How significant is family history in atopic dermatitis? A study on the role of family history in atopic dermatitis in children in Ajman United Arab Emirates. Egyptian Dermatol Online J. 2010;6:1-6.
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
Accepted 2017-02-01
Published 2014-12-30
