Use of specific IgE in assessing the relevance of fungal and dust mite allergens to atopic dermatitis: A comparison with asthmatic and nonasthmatic control subjects

Background: Although allergens have been implicated as aggravating factors in atopic dermatitis (AD), there is little epidemiologic data on the signif icance of specific IgE. Objective: We sought to compare sensitization to dust mite and fungi betwee n patients with AD and asthmatic and nonasthmatic control subjects. Methods: Total IgE and specific IgE to Dermatophagoides pteronyssinus, Alte rnaria alternata, Aspergillus fumigatus, Candida albicans, Malassezia furfu r, and Trichophyton rubrum were measured in 73 patients with moderate to se vere AD. Total IgE and IgE specific for D pteronyssinus, A alternata, and M furfur were also measured in sera from 156 asthmatic and 212 nonasthmatic control subjects. Results: Positive correlations were found between total IgE and IgE antibod ies specific for each of the antigens, IgE specific for M furfur was observ ed more frequently in adults compared with children with AD (P < .01), AD s era had higher levels of total IgE and a higher prevalence of positive sera to D pteronyssinus (95% vs 42% and 17% for subjects with AD, asthmatic sub jects, and nonasthmatic subjects, respectively), M furfur (53% vs 1% and 0. 5%), and A alternata (49% vs 29% and 18%). Among the sera from subjects all ergic to mites, the contribution of IgE specific for D pteronyssinus to the total IgE levels was similar regardless of the clinical status. Conclusions: Our results demonstrate that moderate-to-severe AD is strongly associated with sensitization to dust mite and M furfur (odds ratios, 45.6 and 132 vs pooled control sera). These results suggest that both environme ntal allergens and colonizing fungi contribute to the severity of disease, which is consistent with the view that mite avoidance and antifungal treatm ent can be beneficial in the treatment of these patients.