PREDICTION OF FOOD SENSITISATION IN CHILDREN WITH ATOPIC DERMATITIS
BASED ON DISEASE SEVERITY AND EPIDERMAL LAYER IMPAIRMENT
Background: Atopic dermatitis (AD) is characterised by
epidermal barrier impairment, associated with food allergen (FA)
sensitisation and AD severity. However, no clinical guidance has been
established for evaluations of food sensitisation (FS) in AD patients.
This study investigated how AD severity and epidermal barrier impairment
are associated with FS, and factors that can predict FS in children with
AD. Methods: This cross-sectional study included 100 children
(12–60 months) diagnosed with AD. AD severity was determined using the
Scoring Atopic Dermatitis (SCORAD) index. FS was evaluated by measuring
serum specific IgE antibodies against 31 FAs using an immunoblotting
method. Epidermal barrier impairment was assessed by measuring
transepidermal water loss (TEWL) and stratum corneum hydration (SCH)
levels. Results: 90% of participants were sensitised to at
least one tested FA, with cow’s milk, egg white, beef, almond, egg yolk,
and peanut being the most common. Children with moderate-severe AD had
lower SCH levels than those with mild AD. Children with AD who were
sensitised to > 10 FAs had significantly higher TEWL and
lower SCH levels, compared with those sensitised to 1–4 FAs and 5–10
FAs. The SCORAD score and SCH level in lesional skin provided moderately
predictive value for sensitisation to FAs in children with AD.
Conclusion: FS is common in children with AD and closely
associate with AD severity as well as epidermal barrier impairment.
Evaluations of FS should be considered for children with moderate to
severe AD and/or low SCH levels.