Skin prick test can identify eczematous infants at risk of asthma and allergic rhinitis.
BACKGROUND
Assessment of allergic sensitization is not routinely performed in infants and young children with eczema.


OBJECTIVE
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).


METHODS
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.


RESULTS
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.


CONCLUSIONS
In children with eczema within the first 2 years of life, SPT can provide valuable information on the risk of childhood asthma and AR.
Lowe
A J
AJ
Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Melbourne, Australia. lowe.adrian@gmail.com
Hosking
C S
CS
Bennett
C M
CM
Carlin
J B
JB
Abramson
M J
MJ
Hill
D J
DJ
Dharmage
S C
SC
D000367:Age Factors; D001249:Asthma / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D001315:Australia / Q000453:epidemiology; D002648:Child; D015331:Cohort Studies; D003876:Dermatitis, Atopic / Q000150:complications* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis* / Q000453:epidemiology; D007223:Infant; D007428:Intradermal Tests / Q000379:methods; D008297:Male; D016017:Odds Ratio; D012135:Respiratory Sounds / Q000175:diagnosis / Q000209:etiology; D006255:Rhinitis, Allergic, Seasonal / Q000175:diagnosis* / Q000209:etiology; D012307:Risk Factors; D012737:Sex Factors