Article

Skin prick test can identify eczematous infants at risk of asthma and allergic rhinitis.

Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Melbourne, Australia.
Clinical & Experimental Allergy (impact factor: 5.03). 12/2007; 37(11):1624-31. DOI:10.1111/j.1365-2222.2007.02822.x pp.1624-31
Source: PubMed

ABSTRACT Assessment of allergic sensitization is not routinely performed in infants and young children with eczema.
To determine whether infants who have atopic eczema (with sensitization) are at a greater risk of developing asthma and allergic rhinitis (AR) than those with non-atopic eczema (without concurrent sensitization).
The presence of eczema was prospectively documented until 2 years of age in a birth cohort of 620 infants with a family history of atopic disease. Sensitization status was determined by skin prick tests (SPTs) at 6, 12, and 24 months using six common allergens. Interviews were conducted at 6 and 7 years to determine the presence of asthma and AR.
Within the first 2 years of life, 28.7% of the 443 children who could be classified had atopic eczema: 20.5% had non-atopic eczema, 19.0% were asymptomatic but sensitized and 31.8% were asymptomatic and not sensitized. When compared with children with non-atopic eczema in the first 2 years of life, children with atopic eczema had a substantially greater risk of asthma [odds ratio (OR)=3.52, 95% confidence interval=1.88-6.59] and AR (OR=2.91, 1.48-5.71). The increased risk of asthma was even greater if the infant had a large SPT (OR=4.61, 2.34-9.09) indicative of food allergy. There was no strong evidence that children with non-atopic eczema had an increased risk of asthma or AR compared with asymptomatic children.
In children with eczema within the first 2 years of life, SPT can provide valuable information on the risk of childhood asthma and AR.

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Keywords

2 years
 
24 months
 
7 years
 
allergic rhinitis
 
allergic sensitization
 
asthma [odds ratio
 
asymptomatic children
 
atopic disease
 
concurrent sensitization
 
first 2 years
 
food allergy
 
greater risk
 
increased risk
 
large SPT
 
non-atopic eczema
 
Sensitization status
 
skin prick tests
 
SPTs
 
strong evidence
 
young children