Jiménez-Córdoba I, Almendarez-Flores C, Correa-Bautista Y, Orozco-Martínez S, Huerta-López J

Language: Spanish
References: 16
Page: 152-159
PDF size: 487.51 Kb.

ABSTRACT

Introduction: Atopic dermatitis (AD) is a chronic inflammatory skin condition. In 1980 Hanifin and Rajka published the diagnosis criteria for atopic dermatitis that have been generally accepted by most allergists and dermatologists. Universally accepted criteria are: essential or “major” criteria and non-essential or “minor” criteria. The essential criteria are: personal or family history of atopy; pruritus and eczema. Atopic patients are recognized by their ability to produce large amounts of specific IgE antibodies to common substances, i.e. dust mites, pollens, molds, food and drugs. These antibodies can be detected by “prick”or RAST testing. The aim of this study was to identify the sensitization throught skin prick tests in the patients with atopic dermatitis criteria. Methods: This is a retrospective, descriptive and a transverse cohorte study. We revised all clinical records of patients with atopic dermatitis since January 1989 to December 1999 in the Allergic Department of the Pediatric National Institute of Mexico, DF. The variables studied were: gender, age, origin, diagnosis associates to AD, environmental indoors, sensitization to allergens and serum levels of IgE. Results: We revised 76 clinical records of patients with atopic dermatitis and skin prick tests. The median age was 7 years (range 0.8-14 years). 63/76 (67.8%) patients had a positive skin prick tests and 50/76 (65.8%) of these were male. 55/76 (72%) patients were from Mexico City, 12/76 (16%) patients were from The State of Mexico and the last 9/76 (12%) from others States. 5/18 patients less ‹ 1 year old had a positive skin prick tests, 2/5 to a dermatophagoides, 2/5 to cow’s milk protein and egg and 1 to a molds (alternaria). Since one year old, we observed predominant of positive dust-mite skin prick tests. Only 5 patients presented pure AD (8%) 4/5 patients dust-mite sensitization and 1 had negative skin prick test. 8/76 (12.6%) patients had AD asthma associated, 15/76 (23.8%) patients had AD allergic rhinitis associated and 24/76 (38.1%) patients had AD associated to with asthma and allergic rhinitis. Humidity and dust-mite were the two characteristic indoor environment with statistic significance that contributed to symtoms exacerbation and positive skin prick test (p ‹ 0.001). Discusion: In this study we found, that the 82.9% of the patients studied had a positive skin prick tests. In patients less than 5 years old, 5/30 patients had a diagnosis of AD and these patients had a sensitization to dermatophagoides before a year of age. We concluded that our patients presented sensitization to indoor allergens in the early life. Patients houses with AD presented two risk factors to sensitization to dust-mite: humidity and the presence of carpet and soft toy. 90.4% of the patients presented other allergic disease. The skin prick tests are important in pediatric patients, because they help to identify allergens that increase the risk factors to develop allergic airway disease so that measures be taken to prevent the atopic triada (AD, asthma and allergic rhinitis).

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