Does a 'reverse' atopic march exist?
The classical description of the atopic march usually refers to the progression from atopic dermatitis towards asthma, but this pathway has been questioned. We assessed in a prospective observation the possible onset of atopic dermatitis in children with asthma alone at baseline, and evaluated retrospectively their characteristics. Seven hundred and forty-five children (360 male, 6-9 years of age) with asthma alone, without food allergy or atopic dermatitis, were followed-up with regular visits for 9 years. 692 children completed the 9-year observation, and 20% of them were found to have developed atopic dermatitis at 9 years. Comparing retrospectively the children who developed AD with the remaining, no significant difference existed at baseline concerning the demographic characteristics and family history. There was a significantly higher proportion ( chi2 = 0.01) of subjects with single sensitization to mites and a significantly lower proportion of polysensitized subjects ( chi2 = 0.01) within the children who developed AD. Sensitization to foods appeared in 9% of children who developed AD and in 3.8% in the other children (NS). According to these observations, the development of a particular allergic disease does not necessarily follow the classical paradigm of the atopic march.
Barberio
G
G
Department of Pediatrics, Allergy Unit, University of Messina, Italy.
Pajno
G B
GB
Vita
D
D
Caminiti
L
L
Canonica
G W
GW
Passalacqua
G
G
D001249:Asthma / Q000276:immunology* / Q000503:physiopathology; D002648:Child; D003876:Dermatitis, Atopic / Q000276:immunology* / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D005512:Food Hypersensitivity / Q000276:immunology / Q000503:physiopathology; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012189:Retrospective Studies