| 1. |
- Peiser, M., et al.
(författare)
-
Allergic contact dermatitis: Epidemiology, molecular mechanisms, in vitro methods and regulatory aspects
- 2012
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Ingår i: Cellular and Molecular Life Sciences. - : Springer Science and Business Media LLC. - 1420-682X .- 1420-9071. ; 69:5, s. 763-781
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Forskningsöversikt (refereegranskat)abstract
- Contact allergies are complex diseases, and one of the important challenges for public health and immunology. The German 'Federal Institute for Risk Assessment' hosted an 'International Workshop on Contact Dermatitis'. The scope of the workshop was to discuss new discoveries and developments in the field of contact dermatitis. This included the epidemiology and molecular biology of contact allergy, as well as the development of new in vitro methods. Furthermore, it considered regulatory aspects aiming to reduce exposure to contact sensitisers. An estimated 15-20% of the general population suffers from contact allergy. Workplace exposure, age, sex, use of consumer products and genetic predispositions were identified as the most important risk factors. Research highlights included: advances in understanding of immune responses to contact sensitisers, the importance of autoxidation or enzyme-mediated oxidation for the activation of chemicals, the mechanisms through which hapten-protein conjugates are formed and the development of novel in vitro strategies for the identification of skin-sensitising chemicals. Dendritic cell cultures and structure-activity relationships are being developed to identify potential contact allergens. However, the local lymph node assay (LLNA) presently remains the validated method of choice for hazard identification and characterisation. At the workshop the use of the LLNA for regulatory purposes and for quantitative risk assessment was also discussed. © The Author(s) 2011.
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| 2. |
- Diepgen, T. L., et al.
(författare)
-
Hand eczema classification: a cross-sectional, multicentre study of the aetiology and morphology of hand eczema
- 2009
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Ingår i: British Journal of Dermatology. - : Oxford University Press (OUP). - 1365-2133 .- 0007-0963. ; 160:2, s. 353-358
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Tidskriftsartikel (refereegranskat)abstract
- Hand eczema is a long-lasting disease with a high prevalence in the background population. The disease has severe, negative effects on quality of life and sometimes on social status. Epidemiological studies have identified risk factors for onset and prognosis, but treatment of the disease is rarely evidence based, and a classification system for different subdiagnoses of hand eczema is not agreed upon. Randomized controlled trials investigating the treatment of hand eczema are called for. For this, as well as for clinical purposes, a generally accepted classification system for hand eczema is needed. The present study attempts to characterize subdiagnoses of hand eczema with respect to basic demographics, medical history and morphology. Clinical data from 416 patients with hand eczema from 10 European patch test clinics were assessed. A classification system for hand eczema is proposed. It is suggested that this classification be used in clinical work and in clinical trials.
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| 3. |
- Ruzicka, T, et al.
(författare)
-
Efficacy and safety of oral alitretinoin (9-cis retinoic acid) in patients with severe chronic hand eczema refractory to topical corticosteroids: results of a randomized, double-blind, placebo-controlled, multicentre trial
- 2008
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Ingår i: British Journal of Dermatology. - : Oxford University Press (OUP). - 1365-2133 .- 0007-0963. ; 158:4, s. 808-817
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Tidskriftsartikel (refereegranskat)abstract
- Background Patients with severe chronic hand eczema (CHE) refractory to topical corticosteroids currently have limited treatment options suited for chronic use, and few controlled clinical studies have investigated new therapies in this setting. Objectives To assess the efficacy and safety of oral alitretinoin (9-cis retinoic acid) taken at 10 mg or 30 mg once daily for up to 24 weeks, compared with placebo control, in the treatment of severe CHE refractory to topical corticosteroids. Methods A randomized, double-blind, placebo-controlled, prospective, multicentre trial was conducted in 111 dermatology outpatient clinics in Europe and Canada. A total of 1032 patients with severe refractory CHE were randomized in a 1 : 2 : 2 ratio to placebo, or 10 mg or 30 mg of oral alitretinoin once daily for up to 24 weeks. Safety was assessed for all patients during a follow-up period of 4 weeks, and responders were observed for relapse for 24 weeks after the end of therapy. The primary efficacy parameter was Physician Global Assessment of overall CHE severity, with response defined as clear or almost clear hands. Results Responses, defined as clear or almost clear hands, were achieved in up to 48% of patients treated with alitretinoin, compared with 17% for placebo (P < 0.001), with up to 75% median reduction in disease signs and symptoms. Treatment was well tolerated, with dose-dependent adverse effects comprising headache, mucocutaneous events, hyperlipidaemia, and decreased free thyroxine and thyroid-stimulating hormone. The median time to relapse, defined as recurrence of 75% of initial signs and symptoms, was 5.5-6.2 months in the absence of anti-eczema medication. Conclusions Alitretinoin given at well-tolerated doses induced clearing of CHE in a substantial proportion of patients with severe disease refractory to standard therapy.
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| 4. |
- Uter, W., et al.
(författare)
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The epidemic of methylisothiazolinone contact allergy in Europe : follow-up on changing exposures
- 2020
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Ingår i: Journal of the European Academy of Dermatology and Venereology. - : Wiley. - 0926-9959 .- 1468-3083. ; 34:2, s. 333-339
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Tidskriftsartikel (refereegranskat)abstract
- Background: Methylisothiazolinone (MI) has caused an unprecedented epidemic of contact allergy in Europe and elsewhere. Subsequently, regulatory action has been taken, at least in Europe, aiming at reducing risk of MI sensitization. Objective: To follow-up on the prevalence of contact allergy to MI in consecutively patch tested patients and assess the spectrum of products containing MI or methylchloroisothiazolinone (MCI)/MI in patients positive to MI which elicited current allergic contact dermatitis. Methods: A cross-sectional survey was performed in 2016 and 2017, including all adult patients patch tested with the baseline series (including MI 0.2% aq.) between 1 May and 31 October at 14 centres in 11 European countries. Patients with positive reactions (+ to +++) to MI were further examined regarding history, clinical characteristics and eliciting products, which were categorized into 34 types and 4 classes (leave-on, rinse-off, household, occupational). The results were compared with the reference year 2015. Results: A total of 317 patients, n = 202 of 4278 tested in 2016 (4.72%) and n = 115 of 3879 tested in 2017 (2.96%), had positive reactions to MI; the previous result from 2015 was 5.97% (P < 0.0001). The share of currently relevant contact allergy among all positive reactions declined significantly as well (P = 0.0032). Concerning product classes, a relative decline of leave-on and a relative increase of rinse-off and household products was noted. Conclusion: The prevalence of MI contact allergy decreased by 50% from 2015 to 2017. As a consequence of regulation, the share of cosmetics products (leave-on in particular) eliciting allergic contact dermatitis is decreasing. The chosen method of analysing causative products in sensitized patients has proven useful to monitor effects of intervention.
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| 5. |
- Stalder, J-F, et al.
(författare)
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Patient-Oriented SCORAD (PO-SCORAD): a new self-assessment scale in atopic dermatitis validated in Europe.
- 2011
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Ingår i: Allergy. - : Wiley. - 1398-9995 .- 0105-4538. ; 66, s. 1114-1121
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Tidskriftsartikel (refereegranskat)abstract
- To cite this article: Stalder J-F, Barbarot S, Wollenberg A, Holm EA, De Raeve L, Seidenari S, Oranje A, Deleuran M, Cambazard F, Svensson A, Simon D, Benfeldt E, Reunala T, Mazereeuv J, Boralevi F, Kunz B, Misery L, Mortz CG, Darsow U, Gelmetti C, Diepgen T, Ring J, Moehrenschlager M, Gieler U, Taïeb A, for the PO-SCORAD Investigators Group. Patient-Oriented SCORAD (PO-SCORAD): a new self-assessment scale in atopic dermatitis validated in Europe. Allergy 2011; DOI: 10.1111/j.1398-9995.2011.02577.x. ABSTRACT: Background: Patient-oriented medicine is an emerging concept, encouraged by the World Health Organization, to greater involvement of the patient in the management of chronic diseases. The Patient-Oriented SCORing Atopic Dermatitis (PO-SCORAD) index is a self-assessment score allowing the patient to comprehensively evaluate the actual course of atopic dermatitis (AD), using subjective and objective criteria derived mainly from the SCORAD, a validated AD severity clinical assessment tool. Objectives: To validate the PO-SCORAD index in a large European population of patients exhibiting all forms of AD severity by assessing its correlation with the SCORAD index. Patients/methods: Four hundred and seventy-one patients (185 adults, 286 children) consulting for AD in hospitals from 9 European countries were recruited. The investigators and the patients used the SCORAD and PO-SCORAD scales, respectively, to assess AD severity at inclusion (D0) and 28 ± 7 days later (D28). Results: Patient-Oriented SCORing Atopic Dermatitis and SCORAD scores were significantly correlated at D0 [r = 0.67 (95% CI: 0.62; 0.72), P < 0.0001]. Consistency was confirmed at D28, with a stronger linear correlation between both scales [r = 0.79 (95% CI: 0.75; 0.83), P < 0.0001]. Absolute changes from baseline in SCORAD and PO-SCORAD scores were also significantly correlated [r= 0.71 (95% CI: 0.64; 0.76), P < 0.0001]. Although no specific intervention was investigated, AD improved over the study, with a decrease of PO-SCORAD and SCORAD scores from D0 to D28 by -19.19% and -24.39%, respectively. The consistency of the correlations was similar in the adult and children groups. Conclusions: This study validated the use of PO-SCORAD to self-assess AD severity and demonstrated its good correlation with SCORAD.
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| 6. |
- Bruynzeel, DP, et al.
(författare)
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Monitoring the European standard series in 10 centres 1996-2000
- 2005
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 53:3, s. 146-149
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Tidskriftsartikel (refereegranskat)abstract
- A 5-year retrospective study of the frequency of sensitization to the 25 allergens of the European standard series (ESS) was conducted in 10 centres in 8 European countries. Included were the results of 26 210 patients. The range in sensitivities differed moderately between the centres. Combining results of different centres and drawing conclusions on incidences can be done only with great care. The information on the ranking of the allergens and their sensitization incidence in the clinics are useful for decisions on the future composition of the standard series. The ESS is still a valid screening tool, and no substances should be deleted.
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| 7. |
- Bruze, M., et al.
(författare)
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Validation of a questionnaire algorithm based on repeated open application testing with the constituents of fragrance mix I
- 2020
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Ingår i: British Journal of Dermatology. - : Oxford University Press (OUP). - 0007-0963 .- 1365-2133. ; 182:4, s. 955-964
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Tidskriftsartikel (refereegranskat)abstract
- Background: In a European study on contact allergy in the general population, it was hypothesized that the combination of contact allergy to a fragrance together with a history indicating dermatitis at exposure, and thereafter subsequent avoidance of scented products, implied a diagnosis of allergic contact dermatitis. Objectives: The primary aim of this study was to validate this hypothesis and algorithm. The secondary aim was to investigate whether there was any association between the outcome of the repeated open application test (ROAT) and the patch test reactivity. Methods: In total, 109 patients with and without contact allergy to fragrance mix (FM) I were recruited. Volunteers from six European dermatology clinics participated in the study including a patch test and a ROAT. Results: Positive ROAT reactions were noted in 26 of the 44 volunteers with contact allergy to FM I. None of the volunteers reacted to the vehicle (P < 0·001). More individuals with a positive algorithm had positive ROATs than those with a negative algorithm. However, the difference was not statistically significant. The lower the patch test concentration eliciting a positive test reaction, the more likely a positive ROAT and the more likely that the positive ROAT appeared early during the investigative period. Conclusions: The algorithm used in this study was not substantiated in this ROAT set-up. The stronger the patch test reactivity the more likely was a positive ROAT and the more likely it was that the positive ROAT appeared early during the application period. What's already known about this topic?. To the best of our knowledge, a scientifically designed and conducted repeated open application test (ROAT) has never been performed before to validate a diagnosis of allergic contact dermatitis partly based on a questionnaire. What does this study add?. This is the largest controlled, randomized and blinded ROAT performed to date. Higher patch test reactivity to fragrance mix I indicated a greater likelihood of a positive ROAT. What are the clinical implications of this work?. Further refinement of the questions is required in order to diagnose allergic contact dermatitis from fragrances based on a questionnaire.
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| 8. |
- Cazzaniga, S., et al.
(författare)
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Development of a clinical score system for the diagnosis of photoallergic contact dermatitis using a consensus process: item selection and reliability
- 2015
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Ingår i: Journal of the European Academy of Dermatology and Venereology. - : Wiley. - 1468-3083 .- 0926-9959. ; 29:7, s. 1376-1381
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Tidskriftsartikel (refereegranskat)abstract
- Background: Photoallergic contact dermatitis (PACD) is an uncommon condition, and there is a lack of validated criteria for its diagnosis. Objective: To identify a set of relevant criteria to be considered when suspecting a diagnosis of PACD and to assess the reproducibility of these criteria. Methods: This was a diagnostic item selection and reliability study performed between July 2012 and October 2012. A panel of seven recognized experts was invited to consecutive rounds of a Delphi survey and to a conclusive face-to-face meeting with the aim of obtaining an agreement on criteria for the diagnosis of PACD. The panel was also provided with a series of 16 reports of suspected PACDs to be classified according to a five-point likelihood scale. Identified criteria with the weights attributed by experts were used to develop a score system for the diagnosis of PACD. Consensus was measured by calculating the Intraclass Correlation Coefficient (ICC). The performance of the score system was evaluated in terms of overall classification accuracy. Results: Seven criteria were identified by experts as relevant for the diagnosis of PACD. The criteria were related to the type of skin lesions, accompanying symptoms, skin area involved, general medical history, modality of exposure to the culprit substance, history of exposure to the sun or other light sources and photopatch test results. Experts reached a moderate agreement on PACD cases classification, with ICC=0.69 (95% Confidence Interval, CI, 0.50-0.86). The score system enabled discrimination of probable and definite PACD cases from possible and unlikely or excluded ones, with a nearly perfect agreement being observed between the score system classification and judgment by experts. Conclusion: A diagnostic score was proposed. The score should receive a comprehensive validation on a larger series of cases and with multiple evaluators.
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| 9. |
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| 10. |
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| 11. |
- Diepgen, TL, et al.
(författare)
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Mercaptobenzothiazole or the mercapto-mix: which should be in the standard series?
- 2006
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 55:1, s. 36-38
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Tidskriftsartikel (refereegranskat)abstract
- Mercaptobenzothiazole (MBT) compounds are well known contact allergens. To detect rubber allergic patients we use both MBT (2% in petrolatum) and a mercapto-mix with 4 constituents of 0.5% each in our standard series. In this article the EECDRG presents data of in total 32 475 consecutive tested patients attending the respective contact dermatitis clinics from 11 centres in Europe to determine if the mix and MBT detected the same allergic patients. We found 327 patients positive to the mix or MBT, or to both. 261 were positive to the mix and 254 to MBT. MBT was negative in 73 patients who were positive to the mix. If the mix had not been in the standard series, on average 22% of patients allergic to a mercapto-compound would have been missed, for MBT this would have been on average 20%. All clinics would have missed a significant number of positive reactions if both compounds had not been tested. We conclude, that both the mercapto mix and MBT are required in the standard series.
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| 12. |
- Diepgen, T, et al.
(författare)
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Therapie von handekzemen. Was können wir von publizierten klinischen Studien lernen?
- 2005
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Ingår i: Hautarzt. - : Springer Science and Business Media LLC. - 0017-8470. ; 56:3, s. 224-231
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Tidskriftsartikel (refereegranskat)abstract
- Abstract in German Handekzeme sind sehr häufig, können verschiedene Ursachen haben und trotz einer Vielzahl von Behandlungsoptionen, die von topischen Kortikosteroiden über Phototherapie bis zur oralen Gabe von Ciclosporin und Retinoiden reichen, eine therapeutische Herausforderung darstellen. In den führenden Literaturdatenbanken (ldquorCochraneldquo, ldquorMEDLINEldquo, ldquorEmbaseldquo, ldquorPascalldquo, ldquorJicst-Eplusldquo, ldquorAmedldquo) wurden systematisch publizierte Studien zur Therapie des Handekzems recherchiert und nach Qualitätskriterien bewertet. Zusätzlich wurden vier führende medizinische Zeitschriften (BMJ, JAMA, Lancet, NEJM) und 17 dermatologische Zeitschriften ab 1977 per Hand durchsucht. Eingeschlossen wurden alle Studien, die sich auf alle möglichen Varianten von ärztlich diagnostizierten Handekzemen bezogen. Dabei konnten von insgesamt 100 klinischen Untersuchungen 31 als randomisierte klinische Studien (RCT) identifiziert werden. Diese RCTs weisen teilweise erhebliche methodische Mängel auf und untersuchen sehr unterschiedliche Therapieoptionen. Es besteht ein großer Bedarf an guten RCTs zur Therapie des Handekzems, wobei nicht nur neue, sondern auch etablierte Therapieoptionen untersucht werden sollten und die verschiedenen Handekzemtypen Berücksichtigung finden müssen.
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| 13. |
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| 14. |
- Larsen, F S, et al.
(författare)
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The occurrence of atopic dermatitis in Greenland
- 2005
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Ingår i: Acta Dermato-Venereologica. - : Medical Journals Sweden AB. - 1651-2057 .- 0001-5555. ; 85:2, s. 140-143
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Tidskriftsartikel (refereegranskat)abstract
- Until recently there was no information available on the prevalence of atopic dermatitis in Greenland. Our objective was to determine the prevalence of atopic dermatitis in younger schoolchildren in Greenland. In the autumn of 2000 we used our previously elaborated questionnaire in a cross-sectional study of 954 schoolchildren aged 7 - 8 years, who lived in five Greenlandic towns. The findings were compared to data on atopic dermatitis from Denmark. The response rate was 65% ( 622). The lifetime prevalence of atopic dermatitis was calculated to be 14.0% (95% confidence interval 11.3 - 16.7) using our standard score criteria with an absolute lower limit estimate of 4.5%. Taking the response rate of 65% into consideration this study indicates that in 2000 the lifetime prevalence of atopic dermatitis among younger schoolchildren in Greenland was in the range of 10 - 15%.
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| 15. |
- Naldi, L., et al.
(författare)
-
Comparators, study duration, outcome measures and sponsorship in therapeutic trials of psoriasis: update of the EDEN Psoriasis Survey 2001-2006
- 2010
-
Ingår i: British Journal of Dermatology. - : Oxford University Press (OUP). - 1365-2133 .- 0007-0963. ; 162:2, s. 384-389
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Tidskriftsartikel (refereegranskat)abstract
- Background Several new therapeutic options for psoriasis have been tested in clinical trials in recent years. Choice of comparator, study duration and outcome measures are critical for interpreting application of trial results to clinical practice. Objectives We examined whether these trial aspects have changed substantially in recent years in comparison with the past. Methods A systematic search and evaluation of all randomized controlled trials (RCTs) for psoriasis published from January 2001 up to December 2006 in 14 leading medical and dermatological journals, compared with those published from 1977 to 2000. Results There were 140 RCTs of psoriasis in the period 2001-2006 and 249 in the period 1977-2000. The proportion of placebo-controlled studies increased from 44.6% to 69.3%. The median study duration increased from 7 weeks to 12 weeks. The proportion of studies adopting the Psoriasis Area and Severity Index score as an outcome increased from 30.6% to 57.7%, while the number of studies incorporating a quality of life measure increased from only one (0.4%) to 12 studies (7.7%). The proportion of studies sponsored by pharmaceutical companies increased from 61.0% to 73.7%. Conclusions Despite the increased number of new options, the number of head-to-head comparative trials has decreased and most trials focus on short-term effects, probably reflecting the increased influence of industrial sponsorship on the research agenda.
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| 16. |
- Ofenloch, R, et al.
(författare)
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Colophony as marker for fragrance allergy in the general European population.
- 2015
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Ingår i: British Journal of Dermatology. - : Oxford University Press (OUP). - 1365-2133 .- 0007-0963.
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Colophony is not used as a fragrance ingredient. However, colophony is a well-established marker of fragrance contact allergy(2-4) . Colophony was therefore included as a fragrance allergy marker in our recent paper in BJD on contact allergy in the general population (prevalence 1.0%; 95%-CI 0.6%-1.3%)(5) . When including colophony as a fragrance marker in the article on fragrance contact allergy(1) together with fragrance mix I (FM I) in the True test containing an evernia prunastri (oak moss) with a high content of atranol and chloratranol or fragrance mix II (FM II) or any of the individual materials in either FM I or FM II or Myroxylon pereirae (MP) or sesquiterpene lactones, some information in table 5 of this article(1) change slightly according to the numbers given here: This article is protected by copyright. All rights reserved.
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| 17. |
- Svensson, A., et al.
(författare)
-
Prevalence of skin disease in a population-based sample of adults from five European countries
- 2018
-
Ingår i: British Journal of Dermatology. - : Oxford University Press (OUP). - 0007-0963. ; 178:5, s. 1111-1118
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Tidskriftsartikel (refereegranskat)abstract
- Background: There is a lack of prevalence data on skin diseases in the general adult population; most studies have been carried out in small, national or consecutive clinical samples. Objectives: To determine the prevalence of common skin disease in the general European population and to assess differences in the characteristics of treatment between countries. Methods: A random sample consisting of 12 377 participants aged 18-74 years was drawn from the general population of five European countries (Germany, Italy, the Netherlands, Portugal and Sweden). This was a cross-sectional study and all participants were interviewed using a standardized questionnaire that assessed the occurrence of 10 common skin diseases during lifetime, past year and past month. If a skin disease was reported, we additionally assessed who performed the diagnosis and treatment, and whether drugs had been prescribed. Results: The most common skin disease was warts (41·3%), followed by acne (19·2%) and contact dermatitis (15·0%). In general, women were more often affected by skin diseases compared with men; only skin cancer had a slightly higher prevalence in men. The prevalence of skin diseases in northern countries (Germany, the Netherlands and Sweden) was generally higher than in the southern countries (Italy and Portugal). In the Netherlands the treatment of skin diseases was less often performed by a dermatologist compared with the other countries. Conclusions: The prevalence estimates reported in this study are derived from a representative sample of the general population. Data assessment was performed comprehensively across countries, thus country-specific prevalence estimates are comparable.
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| 18. |
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| 19. |
- Wilkinson, JD, et al.
(författare)
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Monitoring levels of preservative sensitivity in Europe - A 10-year overview (1991-2000)
- 2002
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873. ; 46:4, s. 207-210
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Tidskriftsartikel (refereegranskat)abstract
- A 10-year multicentre analysis of the frequency of sensitivity to common preservatives collected in 16 centres in 11 countries has shown stable but persisting high levels of sensitivity to formaldehyde and 5-chloro-2-methyl-4-isothiazolin-3-one + 2-methyl-4-isothiazolin-3-one (MCI/MI). It has also revealed a significant increase in the level of reactivity to methyldibromoglutaronitrile (MDBGN) from 0.7% in 1991 to 3.5% in 2000. The current high level of sensitivity to MDBGN requires an urgent safety re-evaluation and risk assessment update along with consideration of immediate lowering of use concentrations, especially in leave-on products.
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| 20. |
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| 21. |
- Wolkerstorfer, A., et al.
(författare)
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Natural course of sensitization to cow's milk and hen's egg in childhood atopic dermatitis : ETAC™ study group
- 2002
-
Ingår i: Clinical and Experimental Allergy. - : Wiley. - 0954-7894 .- 1365-2222. ; 32:1, s. 70-73
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Tidskriftsartikel (refereegranskat)abstract
- Background: Sensitization to food allergens has been implicated in the pathogenesis of atopic diseases, in particular atopic dermatitis (AD). The aim of the present paper is to investigate the natural course of sensitization to egg and to cow's milk and its relationship with the severity of AD. Methods: The placebo intention-to-treat population of the ETAC™ (Early Treatment of the Atopic Child) study consisted of 397 children with AD aged 12-24 months (mean ± SD: 17.2 ± 4.1 months) who were followed for 18 months. All children were examined for objective SCORing Atopic Dermatitis (SCORAD) and specific IgE amongst other, to egg and to cow's milk at inclusion and after 3, 12 and 18 months. Fifteen patients were excluded from this analysis due to major protocol violations thus leaving 382 patients in the analysed population. Results: Sensitization to egg and to cow's milk was more common in atopic children with severe AD at all time-points. At inclusion, children sensitized to both egg and to cow's milk had the most severe AD (Kruskall-Wallis test P = 0.007). The degree of sensitization expressed in RAST classes was significantly related to the severity of AD. Furthermore, children sensitized to egg or to cow's milk at inclusion had a higher risk of persistence of AD (84% and 67%, respectively, vs. 57% in those not sensitized) and a higher objective SCORAD after 18 months follow-up. Conclusion: We found an association between severity of AD and sensitization to egg or to cow's milk. Moreover, sensitization to egg, and to a lesser extent cow's milk, indicates a worse outcome of AD in terms of persistence and severity of the disease.
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