Cross Allergic Reactions in Infants and Toddlers with Atopic Dermatitis More Severe

The course of atopic dermatitis in children with cross sensitization is more severe, according to new findings. Researchers performed allergological diagnostics on 69 children with atopic dermatitis who were less than three years of age. They found cross sensitization in 26 percent of children, with sensitization to tree pollen and fruits as well as grass pollen and vegetables being the most frequent types of cross allergy. Family history was positive with regard to atopy, with significantly higher rates in children from the study group than those in the control group, while a statistically higher prevalence of allergic rhinitis and bronchial asthma, as well as co-existence of sensitization to house dust mite and animal dander, were revealed in the study group, as well. The researchers concluded that the role of pollen-food allergy syndrome in children up to three years old with atopic dermatitis and sensitization to plant pollen should be taken into account in the pathogenesis of the disease. These patients may also require more frequent treatment with systemic steroids.

—Adv Med Sci. 2013 Oct 30: 1-7.

Topical Calcineurin Use Declines in Younger Patients with Atopic Dermatitis

Use of topical calcineurin inhibitors has dropped off significantly in children younger than two years of age, ever since the FDA took regulatory action in 2005. Researchers assessed medical claims for diagnoses consistent with an indication for a TCI in Medicaid patients from 2001 to 2009, and assessed prescriptions for evidence of first-line atopic dermatitis therapy use before TCI initiation. They noted a substantial decrease in the rate of TCI, particularly in patients younger than two years of age, with use of tacrolimus falling from 36.7 percent to 22.5 percent, and pimecrolimus use dropping from 47 percent to 33.7 percent, after regulatory actions. In addition, previous use of topical corticosteroids increased by seven percent for both TCIs from the pre- to post-regulatory period. However, after regulatory actions, there was only a small increase in the proportion of tacrolimus or pimecrolimus users with an atopic dermatitis or eczema diagnosis before drug initiation, and high strength use of tacrolimus was unchanged.

—Pediatrics. 2013 Nov;132(5):e1327-32.