The Turkish Journal of Pediatrics 2023 , Vol 65 , Num 2
The risk factors for food allergy in infants with atopic dermatitis
Zülfikar Akelma 1-2 ,Seda Şirin Köse 1 ,Serap Özmen 1-3
1 Pediatric Allergy and Immunology Clinic, Dr. Sami Ulus Maternity and Children’s Research and Training Hospital, Ankara
2 Division of Pediatric Allergy and Immunology, Ankara Yıldırım Beyazıt University, Ankara
3 Division of Pediatric Allergy and Immunology, Health Sciences University, Ankara, Türkiye
DOI : 10.24953/turkjped.2022.656 Background. There is a lack of information about which risk factors accompany food allergy (FA) in infants with atopic dermatitis (AD). We hypothesized that we would be able to predict FA through risk factors in infants with AD.

Methods. This prospective descriptive cross-sectional study was performed with infants aged 1-12 months with newly diagnosed AD. The SCORing Atopic Dermatitis (SCORAD) and Eczema Area and Severity Index (EASI), Infants` Dermatitis Quality Of Life (IDQOL), and Family Dermatological Life Quality (FDLQ) index scores were calculated at first admission. We developed a new tool, Sites of Eczema (SoE), to score sites of eczema on the body.

Results. A total of 279 infants with AD were included. FA was found in 166 (59.5%) infants with AD, of whom 112 had single and 54 had multiple FAs. The SCORAD index, EASI scores, IDQOL1, IDQOL2, and FDQL, and SoE scores were higher in the subgroup with FA compared to that without FA (p<0.001). In the multivariate regression model, eosinophil count (odds ratio [OR]=1.00, 95% confidence interval: [CI, 1.00-1.00]; p=0.008), serum total IgE level (OR=1.02, 95% CI: [1.00-1.03]; p=0.002), pruritus score (OR=0.87, 95% CI: [0.77-0.97]; p=0.019), SCORAD index (OR=1.04, 95% CI: [1.01-1.08]; p=0.008), FDQL index (OR=1.09, 95% CI: [1.01-1.18]; p=0.014), and SoE score (OR=1.48, 95% CI: [1.00-2.19]; p=0.046) were identified as the highest risk factors for FA in infants with AD.

Conclusions. Serum total IgE levels, eosinophil counts and ratio, SCORAD index and EASI scores, IDQOL and FDLQ index, pruritus and sleep disturbance scores, and SoE scores were identified as risk factors for FA in infants with AD in this study. The SoE score is an important risk factor for FA in infants with AD. We recommend that the risk factors for FA in patients with AD guide the management of these patients. Keywords : children, Eczema Area and Severity Index (EASI), Family Dermatological Life of Quality (FDLQ), Infants` Dermatitis Quality Of Life (IDQOL), SCORing Atopic Dermatitis (SCORAD), Sites of Eczema (SoE), total serum IgE

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