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The burden of atopic dermatitis (AD), a chronic, relapsing inflammatory skin disease, increases with disease severity and is associated with multiple flares per year over many years. We characterized the real-world burden of disease, including flares, in patients with AD enrolled in MEASURE-AD from Latin America. Patients (aged ≥12 years) with physician-confirmed AD receiving or eligible for systemic therapy were enrolled in MEASURE-AD between December 2019 and June 2020. Patient characteristics, treatments and outcomes were recorded during a single office visit. Primary outcome measures included worst itch within the past 24 h (Worst Pruritus Numerical Rating Scale [WP-NRS]) and quality of life (QoL; Dermatology Life Quality Index [DLQI] and cDLQI). Among secondary outcomes, the frequency and duration of disease flares within the last 6 months were assessed. Herein result from the Latin American (Brazil, Mexico and Argentina) population (N=180; adults (≥18 years), n=157; adolescents, n=23). Analyses were based on observed data; only descriptive statistics were presented. The mean (SD) age was 33.8 (17.0) years, 52.2% were males and all patients were receiving AD treatment, including 65.6% receiving systemic therapy alone or in combination. Severe pruritus (WP-NRS ≥7) was reported by 54.4% of patients (adults, 57.3%; adolescents, 34.8%). A very or extremely large effect on QoL (DLQI or cDLQI ≥11) was reported among 50.0% of patients ≥16 years and 42.9% of patients 12–15 years. Over the previous 6 months, 0, 1–2, 3–4, 5–6 and >6 flares were reported by 8.3%, 27.2%, 31.1%, 11.7% and 15.6% of patients, respectively. On average, flares lasted 15.2 days (adults, 15.9 days; adolescents, 11.1 days). Although all patients received treatment and two-thirds received systemic therapies, severity scores and impact on QoL and itch were extremely high, suggesting that AD is not adequately controlled in all patients. [ABSTRACT FROM AUTHOR]

Studies suggest that children who start solid foods early are at risk for developing food allergies. Herein, we evaluated the effects of the introduction of peanuts to the diets of children on emerging peanut allergies. Children with allergic rhinitis and asthma were enrolled in the present study and evaluated in four stages. In the first stage, a clinical history was completed for all participants. In the second stage, skin tests were conducted to detect the sensitization to peanuts. In the third stage, the parents were interviewed about the peanut-eating habits of their children. In the fourth stage, children with a convincing history of allergy or a positive peanut skin test result were subjected to an open oral food challenge (OOFC). Three hundred children in four groups were included, 58.2% of the subjects were male, and the mean age was 7.3±3.9 years. The median age of first exposure to peanuts in patients with peanut allergies was greater than that in children without peanut allergies (2 years versus 1 year; p=0.009). The multivariate analysis, including only those children subjected to the OOFC, revealed that the consumption of peanuts after the age of ≥2 years is a risk factor for developing a peanut allergy (odds ratio=8.0, 95% confidence interval 1.3-50.0, p=0.026). The results of the present study showed that the late introduction of peanuts to children increases the risk of developing a peanut allergy. [ABSTRACT FROM AUTHOR]

The clinical behavior of asthma varies with age at onset. This study was undertaken to identify associated markers of adult-onset allergic asthma (age ≥20 years).This cross-sectional study compared two groups: 58 patients with asthma onset at ≥20 years and 66 with onset at ≥20 years. They were compared depending on results of clinical history, and body mass index (BMI), aeroallergen sensitization, total serum IgE, eosinophil count, asthma control test, and asthma severity level.Ages at first asthma episode were 10.0 ± 6.6 and 33.4 ± 10.5 (p<0.001) in the <20 and ≥20 group, respectively. BMI was higher in adult asthmatic subjects (29.8 versus 27.1, P=0.017), but BMI ≥30 kg/m(2) was not associated with asthma onset in ≥20 years (odds ratio [OR] = 1.56, 95% confidence interval [CI] 0.759 to 3.211; p= 0.227). After multivariate analysis, allergic rhinitis and IgE ≥150 IU/mL were negatively correlated with asthma onset in ≥20 years old (OR adjusted [ORa] = 0.255, 95% CI 0.078 to 0.837, P= 0.024, and ORa =0.385, 95% CI 0.175 to 0.849, p= 0.018, respectively).Adult-onset allergic asthma was not different from early-onset asthma. [ABSTRACT FROM AUTHOR]

Background: Sensitization to allergens in atopic dermatitis patients is a risk factor for developing asthma and allergic rhinitis in the future, as well as an aggravating factor in the course of the disease. Recent studies have attributed the activity of the proteases of some antigens to cause a grater defect in the epithelial barrier and a more severe disease. Objectives: To know the sensitization to allergens pattern in children with atopic dermatitis attended at Allergology Service of University Hospital of UANL, Mexico, and to know if these children have higher sensitization to antigens with proteolytic activity. Material and method: A retrospective study was done reviewing the skin prick test reports done in our service to children ranging from 5 months to 1 6 years old, diagnosed with atopic dermatitis during a period of 2 years, from January 2012 to January 2014. The frequency of sensitization to aeroallergens and food were analyzed as well as the weal size (≥6mm) on the skin in response to each particular allergen in the case of food skin prick test. Results: Reports of skin tests of 66 children, 30 boys and 36 girls, were included; 37 of children were sensitized to more than one allergen, 18/66 had asthma and/or allergic rhinitis, 40/66 60% skin prick tests were positive to high activity protease aeroallergens (Dermatophagoides pteronyssinus/Dermatophagoides farinae). Regarding food, sensitization was seen in 38 children; fruits and vegetables were the two most common foods. Only seven children had skin prick weal bigger than 6 mm, mainly to egg, fish and cow's milk. Conclusion: Children with atopic dermatitis are often sensitized to high protease activity aeroallergens, polysensitization is very common and the association with airway allergy is seen early in life. Sensitization to food is also common in these patients, but only a small percentage showed a response large enough to be associated with disease severity. [ABSTRACT FROM AUTHOR]

The common manifestations of atopic dermatitis (AD) appear sequentially with involvement of the cheeks in infancy, flexural extremities in childhood, and hands in adulthood. Although less common clinical manifestations are well described, they have not been the subject of epidemiologic studies to describe their prevalence in specific age groups. This observational, cross-sectional, comparative study included 131 children younger than 18 of both sexes with AD who attended the clinics of the Dermatology Department of the National Institute of Pediatrics in Mexico City. Patients were examined to determine the presence of infrequent clinical manifestations of AD during infancy, preschool and school age, and adolescence and stratified according to sex, age, and number of clinical signs. A chi-square test was used to detect differences according to age and sex. Logistic regression analysis was also performed. The main findings according to age were genital dermatitis and papular-lichenoid dermatitis variant in infants; atopic feet, prurigo-like, nummular pattern, and erythroderma in preschool and school-aged children; and eyelid eczema and nipple dermatitis in adolescents. The risk of development of nipple dermatitis and eyelid eczema increased with age, and the development of genital dermatitis decreased with age. The knowledge of the prevalence of less common clinical manifestations of AD according to age in different populations might be helpful in diagnosing incipient cases of AD. [ABSTRACT FROM AUTHOR]

Background: Several international guidelines on immunotherapy exist, but they only apply partially in Mexico. The Mexican guideline of immunotherapy dates from 1998. Objectives: To establish clinical recommendations and suggestions for Allergy residents and specialists for skin testing and allergen immunotherapy based on evidence and Mexican expert opinion, according to the GRADE system. Methods: The guidelines were developed following the methodology of a guideline for clinical practice starting with the formulation of clinical questions, in the context of Mexican environmental conditions and morbidity, with the participation of allergists from all regions of the country. External validation was obtained. Its development followed three steps: 1. formulation of 24 clinical questions. 2. Search for consensus on the answers among members of the Regional chapters of both Mexican Colleges of Allergists (CMICA and COMPEDIA) during regional meetings. 3. Literature search for articles related to the questions and grading of its quality according to GRADE. Results: Based on the regional consensus, 116 articles and the safety, patient acceptance/ comfort and cost clinical recommendations and suggestions were developed on basic aspects of skin testing, subcutaneous and sublingual immunotherapy (patient preparation, vial preparation and application schedules) and the treatment of eventual adverse reactions. Conclusions: A clinical guideline was developed respecting particular methodology, validated by CMICA and COMPEDIA for its implementation among Mexican allergists. Several aspects deserve further study to improve scientific evidence. [ABSTRACT FROM AUTHOR]

Background: Atopic dermatitis is an ever more frequent disease in children; its etiology is unknown, although a genetic predisposition along with environment factors could be the origin. Objective: To determine the prevalence of atopic dermatitis among school-children and the main associated risk factors. Patients and methods: A randomized, stratified and conglomerated sample of 6 to 12 year-old school-children was obtained. Their parents answered the main ISAAC questionnaire, to which some variables were added, such as family and hereditary history, tobaccosmoking exposure and nutritional condition according to the body mass index as associated risk factors. Results: We found a prevalence of 3% for atopic dermatitis, and the presence of dermatitis symptoms during the last twelve months was found in 6.8% of the cases. Multivariate analysis demonstrated an elevated risk for atopic dermatitis in children of mothers with any type of allergic disease (OR 2.75, CI 95% 1.09 to 6.92, p = 0.031). Conclusions: The frequency of atopic dermatitis as well as that of the symptoms was low, similar to previous reports conducted in Mexico. Maternal atopy was the only factor associated with atopic dermatitis. [ABSTRACT FROM AUTHOR]

Background: Atopic dermatitis is a frequent chronic dermatosis in children. Objective: To determine the prevalence of atopic dermatitis in a pediatric population from Morelia, Michoacan. Participants and methods: An observational, descriptive and comparative study was done to estimate the prevalence and underdiagnosis of atopic dermatitis in children and teenagers from Morelia, Michoacan (n = 9578). This study had a sensitivity of 0.87 and a specificity of 0.92. Results: A prevalence of 10.1% and 5.4% was found in children from 6 to 10 years old and teenagers from 11 to 16 years old. The diagnosis was done in only 20% of all cases. The high underdiagnosis suggests taking emergent actions of preventive medicine. Conclusions: The prevalence of atopic dermatitis in pediatric population from Morelia is similar of that reported in the United States and less than of Mexico City. [ABSTRACT FROM AUTHOR]

Summary We undertook an association analysis between the ile50val, glu375ala, cys406arg, and ser761pro polymorphisms of the IL-4Rα gene and atopic asthma, total IgE levels and IL-4 serum levels in a population from western Mexico. We found that the ser761pro polymorphism was monomorphic for ser761, while there was no association between any of the other polymorphisms and the three phenotypes analysed. [ABSTRACT FROM AUTHOR]

Investigates the influence of birth, siblings and maternal factors in atopic dermatitis (AD) in Mexico City, Mexico. Correlations between early infections and sibship size; Significance of postmaturity on the risk of developing AD; Impact of the disease on first-born children.