Dermatophagoides in childhood asthma. Allergy to dermatophagoides associates more severe childhood asthma with a potential role for acaricides.

OBJECTIVE: To evaluate hypersensitivity to Dermatophagoides pteronyssinus (D. pteronyssinus) and Dermatophagoides farinae (D. farinae) in pediatric patients with asthma, and the use of acaricides. METHODS: This is a randomized controlled trial in 82 asthmatic children. They were recruited and evaluated for severity and chronicity according to the Global Initiative for Asthma Guidelines. The study was carried out in the Pediatric Allergy Clinic, Al Noor Hospital, Khalifa Branch, Abu Dhabi, United Arab Emirates between September 2008 and June 2010. Skin prick test (SPT) was performed including D. pteronyssinus and D. farinae, and for those who were sensitive to one, or the other. The therapeutic value of acaricides was evaluated by assessing the severity of asthma before and after their use. RESULTS: Approximately 81.7% of asthmatics were sensitive to house dust mites (HDM). Hypersensitivity was associated with the more severe and persistent asthma (p=0.029). The manifested severity of asthma was not HDM species-specific. There was a linear association between response of children to acaricides and increasing severity of asthma. CONCLUSION: Hypersensitivity to HDM is an important factor for persistent and severe forms of asthma. Acaricides can help control childhood asthma, and we recommend SPT as part of the routine work-up of patients with asthma to determine HDM sensitive patients that can benefit from acaricides use.

House dust mites in pediatric atopic dermatitis.

OBJECTIVE: To evaluate hypersensitivity to Dermatophagoides pteronyssinus (D. pteronyssinus) and D. farinae in pediatric patients with atopic dermatitis (AD), and to assess the therapeutic value of using acaricides with other environmental anti house dust mites (HDM) measures. METHODS: Ninety-eight children with AD were chosen randomly from the Pediatric Allergy Clinic in Al-Noor Hospital, Khalifa branch, Abu Dhabi, United Arab Emirates during the period between January 2008 to January 2009 and were evaluated for severity and chronicity. They were subjected to skin prick test (SPT) including D. pteronyssinus and D. farinae antigens and were also assessed for the therapeutic value of acaricides and environmental anti HDM measures. RESULTS: We found that 74.5% of patients were sensitive to one or both strains of HDM. A highly significant association was found between the severity of the symptoms of AD and its persistence with hypersensitivity to HDM (p=0.001). Acaricides and environmental anti HDM measures can improve patients with mild AD. CONCLUSION: Hypersensitivity to HDM is an important factor for the more acute, more chronic, and more severe AD. Anti HDM measures including the use of acaricides can help control mild AD. We recommend SPT as a part of the work up of patients with AD. The HDM sensitive patients can benefit from anti HDM measures.