The Severity of Atopic Dermatitis in Chidren and the Role of Hypersensitivity to Food Allergens in its Occurrence

Background: The SCORAD index is most often used to assess the severity of atopic dermatitis (AD). Hypersensitivity to food allergens is found in up to 60% of children with moderate to severe forms of the disorder and it is a significant cause of intensification of skin changes. Aim: The study was to assess the severity of AD and the presence of hypersensitivity to food allergen. Methods: The study comprised 114 children (56 boys and 58 girls) aged from 1.5 months to 14.9 years, with diagnosed AD according to Hanifin and Rajka’s criteria. The severity of the illness was assessed by the SCORAD index and the following were analysed to recognize hypersensitivity to food allergens: anamnesis data, total IgE antibodies, specific IgE antibodies and the results of the skin prick test (SPT) for food allergens. Results: 61.4% of children had a moderate form of the illness, the median SCORAD index was 28.5 points. There was a significant correlation with the total SCORAD index values for: spread (p< 0.0001), intensity (p<0.0001) and subjective signs (p<0.0001), as well as a correlation between the parameters: spread and intensity of changes (p < 0.0001); spread and subjective signs (p< 0.0001); intensity and subjective signs (p < 0.0001). Hypersensitivity to food allergens was found in 28% of children tested (history of hypersensitivity to food 47.5%, high total IgE antibodies 56.1%, SPT positive 32.4%, specific IgE antibodies to food allergens 28%), and the most frequent allergens responsible were cow’s milk, 12.3% and eggs in 5.3% children. Conclusion: The most common was the moderate form of illness, and hypersensitivity to food allergens was significantly present. By removal of the responsible allergen, we can contribute to a reduction in the intensity of changes.