The clinical and laboratory findings of infants with atopic dermatitis during diagnosis and follow-up.

Summary: Background. Atopic dermatitis is a chronic disease that affects patient and parents life worsely. What time will the patient go into remission is not known. Therefore, clinical and laboratory indicators that can indicate remission are needed. Materials and Methods. The study was conducted in Izmir Health Sciences University, Tepecik Training and Research Hospital. The clinical and laboratory data of patients between January 2014 and December 2019 were scanned from the patient records and the hospital data system. Results. 102 patients with a median age of 8 (min 2- max 24) months were included in the study. The median age of onset of the symptoms was 3 (min 1-max 21) months. The patients most frequently (85.2%) presented with eczema and lesions were most common (60.7%) in the extremities. Most of the patients (56.9%) had mild dermatitis. In the 6th month, 26.5% who continued follow-up had clinical improvement. Food allergy was present in 33.3% of the patients. The most common food allergen was egg (52.9%). Food allergy was associated with the severity of atopic dermatitis (p = 0.033), and the symptoms started earlier (p = 0.002). There is no relationship between the severity of atopic dermatitis and gender, family history, presence of additional atopic disease, response to treatment, total IgE and eosinophil count (p > 0.05); however, it was determined that the symptoms started earlier in patients with moderate/severe atopic dermatitis (p = 0.002). Conclusions. Food allergy is more common in the early-onset and moderate/severe atopic dermatitis. Accurate diagnosis of food allergy is necessary to increase the success of treatment and to prevent unnecessary diets.

Factors effecting natural course of egg allergy.

Summary: Background. There is limited data about the natural course of egg allergy in the literature. We aimed to analyze the factors that can affect the tolerance or persistence of egg allergy. Methods. A total number of 126 IgE- mediated egg allergic patient who had data about tolerance gaining were included in the study. Demographic and laboratory data were recorded retrospectively. Kaplan-Meier curves was used for estimation of resolution and the factors related to resolution by Cox regression model. Results. Among 126 patients 81 (64.2%) had gained tolerance with a median survival time of 48 months (min 12- max 121). Tolerance was gained in 22.2% (28) of these patients in the first 2 years, in 46.8% (49) 2-6 years, 3.1% (4) between 7-12 years. In univariate analysis, no history of anaphylaxis (at initiation or during OFC) (Hazard ratio 2.193; 95%CI 1.309-3.674, p = 0.003), baseline sIgE level less than 8.2 (Hazard ratio 11.292; 95%CI 2.766-46.090, p = 0.001) and baseline egg SPT less than 11 mm (Hazard ratio 2.906; 95%CI 1.424-5.930, p = 0.003) were found to be related to earlier resolution of egg allergy. In multivariate analysis only anaphylaxis was significantly related to later resolution (Hazard ratio: 6.547; 95%CI 15.80-27.434, p = 0.01). Conclusions. Higher levels of egg sIgE, skin prick test induration and anaphylaxis at onset or during oral food challenge, can give hint about persistence of egg allergy.