ABSTRACT
BACKGROUND: Long-term, prospective studies investigating the prevalence, serum IgE and the natural history of atopic dermatitis (AD) in a community are lacking. METHODS: In a Japanese community, the skin of primary school children and junior high school students was examined and a questionnaire was given to their parents; their serum total IgE, and house dust mite (HDM)- and Japanese cedar pollen (JCP)-specific IgE levels were also assessed once a year for 9 years. RESULTS: The median AD prevalence in all students (492 in 1998 and 380 in 2004) was 7.6% (6.1-10.4%). The prevalence and the area of skin eruptions of AD decreased with growth. Serum total and HDM-specific IgE levels were high in AD patients, and significant differences were noted for both levels between children with and without later remission of skin eruptions at the time of primary school entry. IgE level increases were noted in the following order: healthy skin < dry skin < AD. In children presenting only with dry skin without atopic disorders, such as AD, asthma and allergic rhinitis, levels of total HDM- and JCP-specific IgE were significantly higher than in children with healthy skin. CONCLUSIONS: The infantile IgE level serves as a prognostic index, and sensitization to inhalant allergens may be easily established in individuals with clinically dry skin, even when AD is not present, and this may lead to the development of atopic disorders.
Subject(s)
Asthma/epidemiology , Dermatitis, Atopic/epidemiology , Immunoglobulin E/blood , Rhinitis, Allergic, Seasonal/epidemiology , Adolescent , Allergens/immunology , Animals , Asthma/immunology , Child , Dermatitis, Atopic/immunology , Dermatitis, Atopic/pathology , Follow-Up Studies , Humans , Japan/epidemiology , Pollen/immunology , Prevalence , Pyroglyphidae/immunology , Rhinitis, Allergic, Seasonal/immunology , Skin/pathology , Surveys and QuestionnairesABSTRACT
A 46-year-old man, with a history of atopic dermatitis and bronchial asthma, underwent surgery for an inguinal hernia. Forty-three minutes subsequent to spinal anesthesia, the patient complained suddenly of dyspnea with wheezing. Blood pressure decreased and skin eruption was observed on his chest. Postoperative laboratory tests revealed high IgE concentration, and a skin test confirmed an allergy to latex. The patient's allergic reaction was easily overlooked because of his history of bronchial asthma and the possibility that the hypotension was caused by the high spinal anesthesia. Latex allergy should be considered in any suspicious case presenting with these symptoms during surgery. After recovery, a skin test should be used to confirm the allergy to avoid repeated allergic episodes.
