Abstract:
Atopic dermatitis (AD) is one of the main risk factors for infants in the development of food allergy. Oral immunotherapy (OIT) in early childhood has been found to be highly effective and safe in preschoolers with and without AD, especially in young infants. Delays in initiation of OIT in infants and children due to uncontrolled AD risk expansion of the number of foods children develop allergy to through unnecessary avoidance of multiple foods. Parents and caregivers may attribute eczema flares to OIT doses, which physicians usually ascribe to non-food triggers such as weather changes, psychological stress, and infection. There is a lack of published literature confirming OIT as a trigger of AD flares, and the degree to which OIT may be associated with AD flares needs to be further studied. We describe 8 case scenarios with varying degrees of AD flare before and during OIT. We propose management algorithms for children with preexisting concurrent AD and food allergy who are being considered for starting OIT and children with AD flares during OIT. Optimizing AD control strategies and providing adequate AD care education before starting OIT can reduce confusion for both parents and allergists if rashes arise during OIT, thus improving adherence to OIT.
摘要:
特应性皮炎(AD)是婴幼儿食物过敏发展的主要风险身分之一。儿童早期的口服免疫疗法(OIT)已被证明对患有和不患有AD的学龄前儿童非常有效和安全。尤其是在年轻的婴儿。由于不受控制的AD而导致的婴儿和儿童中OIT开始的延迟有增加儿童通过不必要地避免多种食物而发展过敏的食物数量的风险。父母和照顾者可能将湿疹耀斑归因于OIT剂量,医生通常将其归因于非食物触发因素,例如天气变化,心理压力,和感染。缺乏已发表的文献证实OIT是AD耀斑的触发因素,OIT可能与AD耀斑相关的程度需要进一步研究。我们描述了在OIT之前和期间具有不同程度的AD耀斑的八种情况。我们为正在考虑开始OIT的先前存在并发AD和食物过敏的儿童提出管理算法,以及OIT期间患有AD耀斑的儿童。如果OIT期间出现皮疹,优化AD控制策略并在开始OIT之前提供足够的AD护理教育可以减少父母和过敏症患者的困惑。从而提高对OIT的依从性。