Effect of atopic dermatitis on the natural course of food allergy in infants and young children

PURPOSE: There have been studies showing that food allergy plays a role in the pathogenesis of atopic dermatitis. However, there have been few studies about the effect of atopic dermatitis on remission of food allergy. Thus, this study aimed to evaluate the difference in remission according to the presence of atopic dermatitis in infants and young children with milk or egg allergy. METHODS: A retrospective study was performed on 109 infants and young children with IgE-mediated food allergy in a tertiary hospital. They divided into food allergy with atopic dermatitis (FA with AD) and without atopic dermatitis (FA without AD). RESULTS: In the milk allergy group, initial milk-specific IgE levels were 21.16±27.98 kU(A)/L and 11.36±22.88 kU(A)/L, respectively, in FA with AD and FA without AD under 12 months of age. The remission rates of milk allergy at 36 months of age were 64.9% and 90.0%, respectively, in FA with AD and FA without AD. In the egg allergy groups, initial egg-specific IgE levels were 34.48±36.72 kU(A)/L and 15.66±28.60 kU(A)/L, respectively, in FA with AD and FA without AD under 12 months of age. The remission rates of egg allergy at 36 months of age were 61.2% and 90.0% in children with FA with AD and FA without AD. CONCLUSION: Atopic dermatitis may play an important role in the natural history of food allergy in infants. Different strategies are needed for the management of food allergy in young children with atopic dermatitis.

Characteristics of airborne pollen in Incheon and Seoul (2015–2016)

BACKGROUND: Pollen allergens are one of the main contributors to the development and/or aggravation of allergic rhinitis, allergic conjunctivitis, and asthma. OBJECTIVE: An examination of the airborne pollen in residential areas should be conducted to aid the diagnosis and treatment of allergic diseases. METHODS: Airborne pollen samples were collected from 2 sites in Incheon and 2 in Seoul from 2015 to 2016. RESULTS: The highest monthly concentration of airborne pollen was observed in May and September each year. Pollen from 32 families and 50 genera was identified over the 2 years; of these, Pinus spp. showed the highest pollen concentration (41.6%), followed by Quercus spp. (25.3%), and Humulus spp. (15.3%), the latter of which had the highest concentration among weed pollen. The total pollen concentration was significantly higher in Incheon than in Seoul (p = 0.001 in 2015, p < 0.001 in 2016) and higher in 2016 than in 2015. The concentrations of pollen from weed species (Cupressaceae, Humulus spp., Artemisia spp., Ambrosia spp., and Chenopodiaceae) and grass species (Gramineae) were significantly higher (p < 0.001) than those from tree species. Pollen was distributed from February to November. The first pollen identified in both regions in each year was Alnus spp. Overall, the total concentration of Quercus spp., Betula spp., Humulus spp., Artemisia spp., Ambrosia spp., and Chenopodiaceae pollen increased significantly over the 2 years. CONCLUSION: Region-specific differences exist in the pollen of major allergenic plants. Continuous monitoring of pollen is thus essential for management of pollen-related allergic disorders in each region.

Erratum: Acknowledgments Addition. Validation of “quality-of-life questionnaire in Korean children with allergic rhinitis” in middle school students

In this paper, acknowledgments section for grant support was omitted unintentionally.

Family quality of life among families of children with atopic dermatitis

BACKGROUND: Atopic dermatitis (AD) may cause emotional distress and impairs the quality of life (QoL) in children and their families. OBJECTIVE: We examined family QoL of children with AD and explored associated factors such as disease severity and psychosocial factors among parents of children with AD. METHODS: Study participants were 78 children (1 month to 16 years old) diagnosed with AD and their parents visiting an outpatient clinic of the Department of Pediatrics in Inha University Hospital. Data were collected using structured questionnaires and medical record review. Parents completed the Dermatitis Family Impact questionnaire (DFI), the Positive Affect and Negative Affect Schedule, the Satisfaction with Life Scale, and the Korean Parenting Stress Index. For children aged below 6-year-old, parents were asked to complete the Infants' Dermatologic Quality of Life. SCOring Atopic Dermatitis (SCORAD), Children's Dermatology Life Quality Index, and the Pediatric Quality of Life Inventory version 4.0 Generic Core Scale were also completed. RESULTS: The mean age of parents and children were 37.4 ± 5.3 years and 65.1 ± 45.7 months, respectively. Among them, 87.2% of parents were mothers and 60.3% of children were boys. The mean score of DFI was 11.2 ± 6.0. The mean SCORAD score was 28.3 ± 16.1. Family who experienced strong negative emotionality had a 3.8 times higher probability of experiencing a lower QoL than parents who did not (odds ratio [OR], 3.82; p = 0.041). Family of children with higher severity of AD had a 6.6 times (OR, 6.55; p = 0.018) higher probability of experiencing a low family QoL than their less-severe counterparts. Families of girls with AD had a lower QoL (OR, 8.40; p = 0.003) than families of boys. CONCLUSION: Family QoL among parents of children with AD was low and associated with parent’s psychosocial characteristics as well as disease severity of the children. Considering parental involvement in AD management for children, emotional support for parents can be helpful in long journey of disease management.

Validation of "quality-of-life questionnaire in Korean children with allergic rhinitis" in middle school students

PURPOSE: The quality of life questionnaire in Korean children with allergic rhinitis (QoL-KCAR) was developed to assess the quality of life in Korean children aged 6–12 years old with allergic rhinitis. The aim of this study was to validate the QoL-KCAR in Korean middle school students with allergic rhinitis. METHODS: A survey with questionnaire and skin prick test was performed on 277 middle school students. The students were classified into 3 groups: allergic-rhinitis (AR), non-allergic rhinitis (non-AR), and controls. AR was defined who had nasal symptoms within 12 months and positive response to skin test. Non-AR group was composed of students with nasal symptoms but had negative response to skin test. The rest who had no symptoms of rhinitis and negative response to skin test were classed as control group. QoL-KCAR has 10 questions with 5-point scales for response options. RESULTS: There were significant differences in the answer scores among the 3 groups (P<0.05). Total answer score is 20.9±10.2, 17.3±8.8, 4.4±5.6 in the AR, non-AR group, and control groups, respectively. It showed significant differences in all items between the AR and control groups, and 4 questions between the AR and non-AR groups. There were significant differences in total score and each score of 8 questions between before and after education in AR group. CONCLUSION: QoL-KCAR questionnaire can be useful for assessing quality-of-life in the Korean students aged 12 to 15 years old with allergic rhinitis as well as children aged 6 to 12 years old.

Fractional exhaled nitric oxide in Korean children with allergic rhinitis

PURPOSE: Fractional exhaled nitric oxide (FeNO) is useful for the diagnosis of allergic rhinitis (AR) as well as bronchial asthma (BA). However, FeNO may differ according to race, age, and other determinants. There have been few studies about FeNO in Korean children with AR. The aims of this study were to evaluate the value of FeNO in AR and to compare FeNO, and determinants of FeNO levels between AR, BA, and combined AR and BA. METHODS: This study included 647 children aged 5 to 17. The children were classified into 5 groups after performing the skin test, FeNO measurement, the pulmonary function test, and the methacholine challenge test: those with nonallergic rhinitis (NAR), those with AR, those with BA, and those with combined AR and BA, and healthy controls,. RESULTS: The values of FEV1 (forced expiratory volume in one second) %predicted were 94.4%+/-12.6%, 93.8%+/-20.7%, 90.0%+/-17.4% in AR, BA, and combined AR and BA, respectively. The values of FeNO in AR (32.3+/-25.0 ppb), BA (31.1+/-20.5 ppb), and combined AR and BA (34.5+/-30.4 ppb) were significantly higher compared to those of NAR (16.8+/-13.5 ppb) and controls (15.9+/-12.5 ppb). There was no significant difference in FeNO among AR, BA, and combined AR and BA. FeNO was significantly higher in patients with > or =4 positive results (36.6+/-29.2 ppb) than in those with <4 positive skin test results (27.6+/-20.7 ppb). When the receiver operating characteristic curve analysis for prediction of AR showed 0.756 of area under the curve, the cutoff level of FeNO was 16 ppb. CONCLUSION: In this study, children with AR had increased levels of FeNO. It is suggested that AR may have eosinophilic bronchial inflammation without BHR or clinical asthma.

Clinical features of allergic rhinitis in Korean children

PURPOSE: The characteristics of allergic rhinitis can be different among countries and areas because causative allergens and aggravating factors depend on the living environment. However, there have been few studies on the clinical feature of Korean children with allergic rhinitis, as well as on clinical characteristics in different age groups. The aim of this study was to investigate the clinical characteristics of Korean children with allergic rhinitis. METHODS: The medical records of children under 12 years of age who had rhinitis symptoms were analyzed in terms of clinical symptoms and positive allergens. Subjects were classified into 2 groups: those with allergic rhinitis (AR group) and nonallergic rhinitis (NAR group). Both groups were subdivided into 3 categories: the 1-4 years, 5-8 years, and 9-12 age groups. RESULTS: Among 516 children, 397 (76.94%) belonged to the AR group and 119 (23.06%) belonged to the NAR group. The male to female ratios were 2:1 in both groups. There were significant differences in sneezing and itching between the AR and NAR groups across different age subgroups. There were significant differences in nasal obstruction between the AR and NAR groups in the 9-12 age group. The incidence of AR was 77.8 % in chronic sinusitis patients. Sensitized allergens were house dust mites, animal hair, pollen, and mold in decreasing order in the AR group. Children who were sensitized to animal hair more frequently had sneezing than those who were not. CONCLUSION: Sneezing and itching strongly suggest allergic rhinitis in Korean children. Clinical characteristics of allergic rhinitis in Korean children would helpful in early diagnosis and adequate treatment of disease.

Prevalence and allergens of allergic rhinitis in children and adolescents in Gwangju

PURPOSE: Allergic rhinitis (AR) is one of the most common childhood diseases in Korea. In this study, we aimed to investigate the prevalence and allergens of childhood AR in Gwangju. METHODS: From April 2013 to September 2013 in Gwangju, skin prick test and questionnaire survey were performed targeting 2,330 children in total (350 kindergartners, 930 elementary school students, 589 middle school students, and 461 high school students). RESULTS: The overall prevalence of AR was 23.5% (female 21.3%, male 26.1%). According to age groups, prevalence of AR was 14.9% (female 10.7%, male 19.8%) in kindergartners, 24.5% (female 18.8%, male 29.4%) in elementary school students, 23.3% (female 18.1%, male 27.6%) in middle school students, 26.2% (female 27.7%, male 23.2%) in high school students. The most common allergen was Dermatophagoides pteronyssinus (79.7%), followed by Dermatophagoides farina (72.2%), birch (14.0%), alder (12.0%), Japanese hop (9.2%), Alternaria (8.9%), cat fur (7.2%), Japanese cedar (6.9%), ryegrass (6.6%), willow (6.0%), pine (5.4%), oak (4.9%), mugwort (4.3%), orchard grass (4.0%), sheep fescue (3.7%), fat hen (3.4%), ragweed (3.4%), and maple (3.4%). CONCLUSION: This research figures out the prevalence and the detailed allergens of AR in Gwangju children. We suggest that more vegetation data of Japanese cedar should be surveyed in recent future.