title: The natural history of atopic dermatitis and its association with Atopic March.
abstract: BACKGROUND
  Atopic dermatitis (AD) is the first manifestation of Atopic March. The natural history of AD and predictive factors for Atopic March have not been widely studied in Asia.
  
  
  OBJECTIVE
  To study the natural history and associated factors of disease remission and risk of respiratory allergy in Thai children with AD.
  
  
  METHODS
  Medical records of AD patients attending Allergy clinic at Siriraj hospital from 2004-2014 were reviewed. Patients were further followed-up to obtain current symptoms and treatment.
  
  
  RESULTS
  One hundred and two AD patients (60.8% female) were followed for 10.2±4.7 years. The median age at diagnosis was 1.5 (0.1-12.0) years. The most common allergen sensitization was Dermatophagoides pteronyssinus and Dermatophagoides farinae. Forty-four percent of patients had complete remission at the median age of 6.3 (2.0-15.0) years. Forty-seven percent of early AD patients (onset < 2 years) had concomitant food allergy which egg and cow's milk were leading causes. The remission rate of AD was higher in early AD than later onset AD (p=0.02). Allergic rhinitis (AR) and asthma were diagnosed in 61.8% and 29.4% of the patients at the median age of 4.6 and 3.8 years, respectively. Early AD and food allergies were significantly associated with early asthma (onset < 3years) (OR=10.80, p< 0.01 and OR=8.70, p=0.01).
  
  
  CONCLUSIONS
  Almost half of AD children had complete remission at school age with a better prognosis in early AD. At preschool age, two-thirds and one-third developed AR and asthma, respectively. Early AD and food allergy were risk factors of early asthma.
authors.affiliation: Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Sinjira
authors.initials: S
authors.lastname: Somanunt
authors.affiliation: Department of Pediatrics, Bhumibol Adulyadej Hospital, Royal Thai Air Force, Bangkok, Thailand.
authors.forename: Sasawan
authors.initials: S
authors.lastname: Chinratanapisit
authors.affiliation: Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Punchama
authors.initials: P
authors.lastname: Pacharn
authors.affiliation: Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Nualanong
authors.initials: N
authors.lastname: Visitsunthorn
authors.affiliation: Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Orathai
authors.initials: O
authors.lastname: Jirapongsananuruk
mesh_terms: D000293:Adolescent; D000485:Allergens / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003876:Dermatitis, Atopic / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D004781:Environmental Exposure; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D007114:Immunization; D007223:Infant; D053208:Kaplan-Meier Estimate; D008297:Male; D016017:Odds Ratio; D011159:Population Surveillance; D012307:Risk Factors; D012882:Skin Tests; D013785:Thailand / Q000453:epidemiology
chemical_list: D000485:Allergens