Role of sensitization and multimorbidity in atopic dermatitis in children

Macharadze D.Sh.

G.N. Gabrichevsky Moscow Research Institute of Epidemiology and Microbiology, Rospotrebnadzor, Moscow, Russia

Some patients with atopic dermatitis have sensitization to food and aeroallergens and/or an increase in the level of total IgE in the blood serum. The classification of atopic dermatitis into IgE- and non-IgE-dependent types has long been known to clinicians. Recent studies show that the level of total IgE is increased with certain phenotypes of atopic dermatitis. Most often these are patients with unique subtypes, having a severe course of the disease from an early age, combined with allergic asthma and/or food allergy. Sensitization is also one of the risk factors leading to "atopic march" and atopic multimorbidity, which is explained by a defect in the barrier function of the epidermis and the facilitation of the penetration of allergens and infectious agents into the skin. In children with moderate and severe atopic dermatitis, food allergies are common (but it is unlikely that food allergy is a direct cause of the development of atopic dermatitis), although researchers also consider the role of other aeroallergens (house dust, fungal and pollen mites) in the immunopathogenesis of the disease. The severity of the disease and the risk of multimorbidity, including bronchial asthma and allergic rhinitis, are closely related to the early debut of persistent atopic dermatitis. According to the latest data, 50-90% of children with atopic dermatitis do not have a direct chronology of the "atopic march" type, when they develop asthma and rhinitis in the future.