Asthma linked to atopic dermatitis persistence

Asthma is associated with rash persistence in children with atopic dermatitis (AD), US researchers report.

The team, from the University of Pennsylvania in Philadelphia, also found that increased frequency of wheezing among children with asthma and AD is associated with increased rash persistence.

"Our findings add to the current literature on the natural history of atopic dermatitis and can be used to counsel patients," comment Jackie Garrett et al in the Annals of Allergy, Asthma and Immunology.

"On the basis of our findings, those with asthma and frequent wheezing will be more likely to have a rash over time and be more likely to require the use of topical medications to alleviate their rash," they say.

The researchers studied data on 2104 children, aged a mean of 7 years, from the Pediatric Eczema Elective Registry who were assessed for asthma, wheeze frequency, and AD skin symptoms at enrolment and after 3 years.

Overall, 1041 children had diagnosed asthma at enrolment and 934 had the condition at follow up. At enrolment, 76.3% had experienced one or more episodes of wheezing in the previous 6 months, and this proportion increased to 88.7% at follow up.

At enrolment and follow up, children with a diagnosis of asthma were 30% and 40%, respectively, less likely to have been rash free over the preceding 6 months than those without a history of asthma.

Furthermore, an increased frequency of wheezing episodes was associated with a reduced likelihood for being rash free over the previous 6 months.

For example, compared with children without asthma, those with asthma and four to 12 wheezing episodes in the previous 6 months at enrolment were 33% less likely to be rash free, while children with more than 12 episodes of wheezing were 43% less likely to be rash free.

Garrett and team conclude: "Our data suggest that the presence of asthma correlates with poorer AD disease control (ie, more likely to have persistent rash). In addition, the frequency of wheeze in asthmatic patients also correlates with the persistence of rash."

They add: "Future studies are needed in this area."

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