Evaluation of clinical and laboratory findings in patients with atopic dermatitis

Evaluation of Clinical and Laboratory Findings in Patients with Atopic Dermatitis Objective: Atopic dermatitis is a chronic, itchy inflammatory skin disease. It is seen at a rate of 10-20% in childhood. The prevalence of food allergy in children has been reported as 33-63% in various studies. In our study, it was aimed to reveal the demographic and clinical characteristics of children with atopic dermatitis who applied to our clinic, to determine their complaints at presentation, accompanying additional symptoms, and to examine laboratory parameters, skin prick test, patch test results and food sensitivities Material and Method: 564 patients who applied to the Pediatric Allergy Outpatient Clinic between January 2016 and January 2019 and were diagnosed with atopic dermatitis according to the Hanifin-Rajka criteria were included in the study. The demographic and clinical characteristics of the patients and their laboratory data (serum eosinophils, serum total IgE, IgA, IgG, IgM levels, skin prick test, patch test) were retrospectively analyzed. Patients with and without allergen sensitivity were grouped according to the skin prick test. SPSS (Statistical Package for Social Sciences) Windows 22.0 program was used for statistical analysis. Results: Of the 564 patients included in the study with the diagnosis of atopic dermatitis, 343 (60.8%) were male. 329 (58.3%) of the patients were diagnosed with atopic dermatitis in the first 12 months. The mean age at presentation was 15.34 ± 13.33 months. The most common complaint was rash (56%), the second most common was rash and itching (24.2%). We found that respiratory system symptoms were most frequently accompanied by skin findings at a rate of 20.2%. There was a family history of allergic disease in 58.7% of the patients. Sensitivity to at least one allergen according to the skin prick test was detected in 138 (35.1%) patients. The most common sensitivity was found in foods, with egg (21.3%) in the first place and milk (12.2%) in the second place. Serum total IgE and eosinophil levels were higher in patients with positive skin prick test (p<0.001). According to the skin prick test result of the patients who applied at the first 1 year of age, food allergen sensitivity was higher than inhalant sensitivity (p <0.001). Eosinophils were elevated in 82 (61.2%) of 134 patients with positive skin prick test. Although immunoglobulin A, G and M levels were found to be lower in the first 1 year of age compared to advancing ages, this situation was not associated with food sensitivity (p>0.05). Tolerance developed in 67.4% of our 123 patients. It was found that tolerance developed 4.3 times more in women than in men (OR 4.33, 95% CI, 1:58-11.86, p=0.004). Conclusion: Atopic dermatitis is an important cause of morbidity in childhood due to its increasing prevalence in recent years and being a chronic disease. In our study, food sensitivity was found to be higher than inhaled sensitivity in the first 1 year according to the skin prick test. In patients with food sensitivity, serum eosinophil elevation is significant and can be used as a marker. Patch testing may be an option for diagnosis in patients with clinically suspected food allergy and negative skin test and allergen-specific IgE levels. The results of our study are similar to the results of studies conducted both in our country and in other countries. Recognition of the disease, correct orientation of patients and early appropriate treatment have an important effect on the prognosis of the disease.