Factor associated with food allergy among preschool children with atopic dermatitis, and resolution of atopic dermatitis
Supaluk Tangvalelerd,1 Kantima Kanchanapoomi,1 Prapasri Kulalert,2 Punchama Pacharn,1 Orathai Jirapongsananuruk,1 Nualanong Visitsunthorn,1 Rattanavalai Nitiyarom,3 Wanee Wisuthsarewong,3 Witchaya Srisuwatchari1
Affiliations:
1 Division of Allergy and Clinical Immunology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
2 Department of Clinical Epidemiology, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand
3 Division of Dermatology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Abstract
Background: Food allergy (FA) has been reported in one-third of children with moderate-to-severe atopic dermatitis (AD).
Objectives: To identify factor associated with food allergy among preschool children with AD, and to compare AD resolution between preschool children with and without FA.
Methods: A cross-sectional study using database registry and questionnaire interview was conducted at Siriraj Hospital (Bangkok, Thailand) during 2022, and physician-diagnosed AD children aged ≤ 6 years were enrolled.
Results: A total of 110 children (60.9% male, median age: 2.3 years) were included. Of those, 53 and 57 children had AD with and without FA, respectively. Very early-onset AD (≤ 3 months) and moderate-to-severe AD at onset were reported in 43.9% and 26.3% of AD without FA, and in 35.8% and 45.3% of AD with FA, respectively. The most commonly reported FAs were hen’s egg, cow’s milk, and wheat. Moderate-to-severe AD at onset was found significant associated with FA (aOR: 2.50; p = 0.037). Thirty-one (28.2%) patients experienced completed resolution of AD by 5 years of age. Of those, 19 had AD without FA, and 12 had AD with FA (p = 0.213). The median age at AD resolution was 18 months and 22.5 months in the without and with FA groups, respectively. AD with FA showed a strong trend toward a significantly longer duration to achieving AD resolution after adjusting for onset and severity of AD (aHR: 0.46, p = 0.050).
Conclusion: Preschool AD children with FA were found to have significantly greater AD severity at AD onset and a longer duration to AD resolution compared to AD children without FA.
Key words: atopic dermatitis, food allergy, risk factor, preschool children, resolution