SKIN SENSITIZATION IN ASTHMATIC-CHILDREN LESS-THAN 36 MONTHS OF AGE

Background: Atopy is reported to play an insignificant role in wheezin g during infancy in contrast to later childhood. For this reason skin testing may not be included in a workup of wheezing infants. Objective /Method: In order to evaluate the degree and evolution of skin sensiti zation to allergens in infants with asthma, we have retrospectively an alyzed the skin test results from 40 referred asthmatic children less than 36 months of age, who had had more than three wheezing episodes a nd whose symptoms improved on treatment with beta-agonist and anti-inf lammatory agents. Results: Skin sensitization (epicutaneous) to common indoor and outdoor aeroallergens and foods were demonstrated in 23 (5 8%) of these patients. Asthmatic children with the onset before 12 mon ths of age and duration of less than 12 months were sensitive predomin antly to foods. Those with later onset asthmas and longer duration dev eloped sensitivity first to indoor and then to outdoor allergens. The most common food, indoor, and outdoor allergens were egg, dust mite, a nd pollens, respectively. Six of these patients had repeat skin tests later. Two demonstrated a decrease in skin sensitivities to foods, one gained a new sensitivity to grass, while three remained unsensitized. Conclusion: Skin sensitization to allergens was common in selected as thmatic infants and evolves in the order of exposures: foods, indoor a llergens, and outdoor allergens. Repeat skin tests showed changing ski n test patterns in some patients.