Patterns of aeroallergen sensitization predicting risk for asthma in preschool children with atopic dermatitis

Objective: Atopic dermatitis (AD) is a chronic inflammatory skin disorder mostly affecting young children. Although several studies aimed to identify the risk factors for asthma in AD children, many aspects still need to be clarified. The aim of this study was to investigate the possible risk factors for asthma at school age in 99 children with early-onset and IgE-mediated AD. Methods: All children performed clinical evaluation and total and specific IgE assay for a panel of inhalant and food allergens at two different times (t(1) and t(2)) during preschool, and asthma diagnosis was assessed at one follow-up visit (t(3)) at school age. Results: At t(3), 39% of children had developed asthma. Of the variables compared, the sensitization to more than one class of inhalant allergens at t(2) (mean age = 30 months) was associated with asthma, with grass (OR = 3.24, p = 0.020) and cat sensitization (OR = 2.74, p = 0.043) as independent risk factors. Conclusions: The sensitization pattern of a child with early-onset AD, also within the first 2-3 years of life, can reflect his risk to develop asthma. Therefore, testing these children for the more common allergens during this time frame should be recommended to predict the evolution of atopic diseases.