Clinical features and risk factors of IgE-independent aтopic dermatitis in children

Abstract

Relevance. Atopic dermatitis (AD) is an inflammatory disease characterized by a chronic course with periods of remissions and exacerbations. IgE-independent atopic dermatitis is a medical and social problem of our time, since the disease manifests itself most often in childhood and is one of the most frequent forms of dermatoses among the pediatric population. The prevalence of atopic dermatitis among children is up to 20 %, among adults - 2-8 %. Recently, there has been a significant increase in atopic diseases worldwide. The aim: to study specific features of IgE-independent atopic dermatitis in children living in a metropolis. Materials and Methods. A prospective cohort study was conducted, which included 451 children aged 5 to 14 years with a diagnosis of AD who applied for outpatient care at the Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology for the period 2020-2021. All parents (guardians) have given voluntary informed consent to the participation of children in the study and the publication of personal data. Examination of patients included general clinical methods, assessment of the SCORAD index and laboratory allergological examination (total and 73 specific IgE in blood serum with the most common food and aeroallergens). In 103 (22.8 %) children (57 (55.3 %) boys and 46 (44.7 %) girls), the results of the allergological analysis did not confirm concomitant allergic sensitization. Atopic dermatitis in these children was defined as IgE-independent. Results and Discussion. Predictors of the development of IgE-independent AD were hereditary predisposition [odds ratio (OR) 2.42; 95 % confidence interval (CI) 1.12-5.25], artificial feeding [OR 4.04; 95 % CI 1.46-11.20], comorbidities [OR 1.42; 95 % CI 0.57-3.52], late onset [OR 1.67; 95 % CI 0.81-3.41]. According to the SCORAD index, the majority of patients (75.7 %) had a moderate degree of AD and no seasonality. Features of skin rashes corresponded to the age periods of the course of AD: erythematous-squamous forms with lichenification foci prevailed. For the first time, the features of IgE-independent atopic dermatitis in children were shown. The role of risk factors for the development of IgE-independent atopic dermatitis in children has been shown for the first time. Conclusion. IgE-independent type of AD can be diagnosed in every fifth child with AD. The study of risk factors will allow predicting the development of this type of disease.