Association between environmental allergen sensitization with severity of atopic dermatitis in children and young adult at Dr. Sardjito General Hospital, Yogyakarta

Abstract

The important role of aeroallergens and food allergens as the most common environmental allergens in exacerbation
of atopic dermatitis (AD) iswell known. Sensitization is an essential processwhich correlateswith clinicalmanifestation
of AD. The study of AD in Indonesia, especially in Yogyakarta, has not been reported, yet. The aim of study is to
evaluate the association between sensitization of environmental allergens with clinical severity of AD in children and
young adult at Dr. Sardjito General Hospital, Yogyakarta. An analytic observational cross sectional study was
performed on 33 children and young adult with AD. The severity of disease was determined by SCORing Atopic
Dermatitis (SCORAD). Assessment of sensitization was performed using specific IgE serum, atopy patch test, and
prick test. Data were analyzed using chi-square or Fisher exact test and prevalence ratio (PR) with significance
value of p<0.05 and 95%confidence interval (CI). The results showed that specific IgE positivity was associated
with severity of AD. Percentage of specific IgE positivity to house dust mite was significantly higher in subject with
moderate/severe AD compared to those of mild AD (p=0.049; PR 1.13; 95% CI 1.01-1.59). The result was also
similar for cat dander (p=0.041; PR 1.1; 95%CI 1.09-4.98), cow’s milk (p=0.038; PR 1.21; 95% CI 1.02-2.2),
and egg white (p=0.027; PR 1.23; 95% CI 1.15-2.97). Whereas specific IgE positivity to fish allergen was not
statistically different in subject with moderate/severe AD compared to those with mild AD (p=0.061; PR 0.8; 95%
CI 0.76-2.8). According to atopy patch test and prick test result, no association was found between allergen
sensitization and severity of AD. If allmethodswere combined to increase the sensitivity of sensitizationmeasurement,
then the association was found for all allergens. It could be concluded that environmental allergens sensitization is
associated with severity of AD in children and young adult at Dr. Sardjito General Hospital, Yogyakarta.
Key words: atopic dermatitis-disease severity-sensitization-aeroallergen-food allergen