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Ravnborg N, Ambikaibalan D, Agnihotri G, Price S, Rastogi S, Patel KR, Singam V, Andersen Y, Halling AS, Silverberg JI, Egeberg A, Thyssen JP. Prevalence of asthma in patients with atopic dermatitis: A systematic review and meta-analysis. J Am Acad Dermatol 2020; 84:471-478. [PMID: 32112994 DOI: 10.1016/j.jaad.2020.02.055] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 02/07/2020] [Accepted: 02/14/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND It is well established that asthma is common in patients with atopic dermatitis (AD). OBJECTIVES We performed a systematic review and meta-analysis to determine the prevalence of asthma and respiratory symptoms in individuals with AD as well as the association between AD and asthma. METHODS At least 2 authors independently searched the medical databases PubMed, EMBASE, LILACS, and SCOPUS for all English-language studies with data on asthma prevalence among patients with AD or the association between AD and asthma. Pooled odds ratios with 95% confidence intervals (CIs) and pooled proportions were estimated with random-effects models. The Newcastle-Ottawa scale was used to assess study quality. RESULTS The search yielded 39,503 articles. Of these, 213 studies were included in a quantitative analysis. The overall pooled prevalence of asthma was 25.7% (95% CI, 23.7-27.7) in patients with AD and 8.1% (95% CI, 7.0-9.4) among reference individuals. There was a significant association between AD and asthma when compared with reference individuals (odds ratio, 3.03; 95% CI, 2.64-3.47). LIMITATIONS The definitions of AD and asthma differed across the included studies and varied from self-report to physician diagnosed. CONCLUSIONS Asthma is a common comorbidity of AD. Physicians should be cognizant of this relationship and address asthma symptoms in their patients.
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Affiliation(s)
- Nanna Ravnborg
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; Copenhagen Research Group for Inflammatory Skin (CORGIS), Hellerup, Denmark
| | - Danni Ambikaibalan
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; Copenhagen Research Group for Inflammatory Skin (CORGIS), Hellerup, Denmark
| | | | - Shmuel Price
- Midwestern University Chicago College of Osteopathic Medicine, Illinois
| | - Supriya Rastogi
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Kevin R Patel
- Rosalind Franklin University of Medicine and Science, North Chicago, Illinois
| | - Vivek Singam
- University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
| | - Yuki Andersen
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; Copenhagen Research Group for Inflammatory Skin (CORGIS), Hellerup, Denmark
| | - Anne-Sofie Halling
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; Copenhagen Research Group for Inflammatory Skin (CORGIS), Hellerup, Denmark
| | - Jonathan I Silverberg
- Northwestern University Feinberg School of Medicine, Chicago, Illinois; Northwestern Medicine Multidisciplinary Eczema Center, Chicago, Illinois
| | - Alexander Egeberg
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; Copenhagen Research Group for Inflammatory Skin (CORGIS), Hellerup, Denmark
| | - Jacob P Thyssen
- Department of Dermatology and Venereology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.
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Ibrahim NK, Alghamdi AA, Almehmadi MM, Alzahrani AA, Turkistani AK, Alghamdi K. Allergy and related clinical symptoms among medical students and interns. Pak J Med Sci 2019; 35:1060-1065. [PMID: 31372143 PMCID: PMC6659050 DOI: 10.12669/pjms.35.4.1281] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Revised: 04/24/2019] [Accepted: 04/29/2019] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVES To determine the prevalence, types, clinical presentations, triggers, and predictors of allergic disorders among medical students and interns at King Abdulaziz University (KAU), Jeddah, Saudi Arabia. METHODS A cross-sectional design was used for this study in which 600 medical students and interns were selected by a multistage stratified random sampling. A validated, confidential, self-administered questionnaire was used during 2016 / 2017. It asked about the previous diagnosis of allergic disorders, associated factors, types, clinical symptoms and the triggering allergenic. Descriptive & inferential statistics were done and logistic regression analysis was conducted. RESULTS The overall prevalence of diagnosed allergic disorder(s) among the participants was 36.2%.The commonest types of allergy were skin (33.8%) followed by respiratory (29.5%) presentations. The most frequently reported allergenic triggers were the house dust (45.6%) and smoke (30.4%). The first allergy predictor was family history of allergic disorders (aOR= 4.35, 95 % CI: 2.96-6.39), followed by female gender. Regarding the outcome of allergy on students' life, 16.1% occasionally missed classes, and 28.6% had sleep disturbance during allergic attacks. CONCLUSION Allergy represents an important problem among medical students and interns. Family history and female gender were the predictors of allergy. Skin and respiratory allergies were the most common types. House dust and smoke were the commonest allergenic triggers. Detection of allergens and management of cases of allergy among medical students and interns are needed. Education and conduction of awareness campaigns about allergy are needed.
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Affiliation(s)
- Nahla Khamis Ibrahim
- Nahla Khamis Ibrahim, Professor at Community Medicine Department, King Abdulaziz University, Jeddah, Saudi Arabia; Professor at Epidemiology Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Abeer Ali Alghamdi
- Abeer Ali Alghamdi, Medical Intern, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mayar Majed Almehmadi
- Mayar Majed Almehmadi, Medical Intern, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Asraa Khairallah Turkistani
- Asraa Khairallah Turkistani, Demonstrator of Family and Community Medicine, Umm Al Qura University, Mecca, Saudi Arabia
| | - Khalid Alghamdi
- Khalid Alghamdi, Resident, King Abdulaziz University, Jeddah, Saudi Arabia
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Thong BYH, Arulanandam S, Tan SC, Tan TC, Chan GYL, Tan JWL, Yeow MCW, Tang CY, Hou J, Leong KP. Shellfish/crustacean oral allergy syndrome among national service pre-enlistees in Singapore. Asia Pac Allergy 2018; 8:e18. [PMID: 29732294 PMCID: PMC5931925 DOI: 10.5415/apallergy.2018.8.e18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Accepted: 04/08/2018] [Indexed: 02/04/2023] Open
Abstract
Background All Singaporean males undergo medical screening prior to compulsory military service. A history of possible food allergy may require referral to a specialist Allergy clinic to ensure that special dietary needs can be taken into account during field training and deployment. Objective To study the pattern of food allergy among pre-enlistees who were referred to a specialist allergy clinic to work up suspected food allergy. Methods Retrospective study of all pre-enlistees registered in the Clinical Immunology/Allergy New Case Registry referred to the Allergy Clinic from 1 August 2015 to 31 May 2016 for suspected food allergy. Results One hundred twenty pre-enlistees reporting food allergy symptoms other than rash alone were referred to the Allergy Clinic during the study period. Of these, 77 (64.2%) had food allergy. Among those with food allergy, mean age was 19.1 ± 1.5 years. They comprised predominantly Chinese (66.2%) and Malays (20.8%). The most commonly reported foods were shellfish/crustaceans (78%), peanut (15.6%), and egg (6.5%). Self-limiting oral allergy syndrome, OAS (itchy lips and throat with/without lip angioedema) was the most common manifestation (n = 33, 42.9%) followed by anaphylaxis (n = 23, 29.9%). Majority of OAS was from shellfish/crustacean (90.6%); of which shrimp (30.3%), crab (15.2%), and lobster (3.0%) were the most common. Mild childhood asthma (69.7%), allergic rhinitis (6.3%), and eczema (6.1%) were the most common atopic conditions among individuals with shellfish/crustacean OAS. This pattern was similar for shellfish/crustacean anaphylaxis. Skin prick tests were most commonly positive for shrimp (OAS 87.1% vs. anaphylaxis 100%), crab (OAS 95.8% vs. 90.9%), and lobster (OAS 91.7% vs. 63.6%). Conclusion OAS to shellfish/crustaceans was more common than anaphylaxis among this study population of young males referred for food allergy symptoms other than rash alone.
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Affiliation(s)
- Bernard Yu-Hor Thong
- Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore 308433
| | | | - Sze-Chin Tan
- Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore 308433
| | - Teck-Choon Tan
- Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore 308433
| | - Grace Yin-Lai Chan
- Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore 308433
| | - Justina Wei-Lyn Tan
- Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore 308433
| | | | - Chwee-Ying Tang
- Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore 308433
| | - Jinfeng Hou
- Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore 308433
| | - Khai-Pang Leong
- Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore 308433
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Yang MS, Lee SP, Kwon YJ, Lee SM. Dog and Cat Allergies and Allergen Avoidance Measures in Korean Adult Pet Owners Who Participated in a Pet Exhibition. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2018; 10:155-164. [PMID: 29411556 PMCID: PMC5809764 DOI: 10.4168/aair.2018.10.2.155] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 12/02/2017] [Accepted: 12/06/2017] [Indexed: 01/12/2023]
Abstract
Purpose This study evaluated dog and cat allergies and their association with allergen avoidance measures in Korean adults. Methods The study population consisted of 537 adults who currently kept dogs or cats and participated in a pet exhibition in Korea. The subjects were asked to complete questionnaires regarding pet ownership, allergen avoidance, and allergy symptoms, and underwent skin prick tests. They were considered to have a dog or cat allergy if they suffered from one or more of allergy symptoms during contact with their pets. Results In total, 103 of 407 dog owners (25.3%) and 45 of 130 cat owners (34.6%) had a dog or cat allergy, respectively. Dog owners kept 1.3±1.5 dogs; this number did not differ according to the presence of dog allergy. Dog owners with a dog allergy had owned their dogs longer than those without (88.0±72.0 vs 67.5±72.7 months, P<0.05). Cat owners kept 2.1±3.6 cats; this number did not differ according to the presence of cat allergy, nor did the duration of cat ownership. Cat owners with a cat allergy had facial contact and slept with their cats less frequently (8.6±11.9 vs 18.3±27.0 times/day, P<0.01; 71.1% vs 81.2%, P<0.05); however, they had their cats shaved and beds cleaned less frequently than those without (1.8±3.3 vs 3.2±4.4 times/year, P<0.05; 1.5±1.5 vs 3.9±6.0 times/month, P<0.01). Conclusions Cat owners with a cat allergy tried to minimize contact with their cats, but efforts to avoid indoor cat allergens were lower than those without. In comparison, dog owners with a dog allergy had kept their dogs for longer time than those without; however, current contact with their dogs and allergen avoidance measures did not differ between the 2 groups.
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Affiliation(s)
- Min Suk Yang
- Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
| | - Sang Pyo Lee
- Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Young Jae Kwon
- Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Sang Min Lee
- Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
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Macedo PFAD, Bianchini EMG. Myofunctional orofacial examination: comparative analysis in young adults with and without complaints. Codas 2014; 26:464-70. [PMID: 25590908 DOI: 10.1590/2317-1782/20142014015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Accepted: 09/03/2014] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To verify myofunctional orofacial characteristics in young adults and to compare data on individuals with and without myofunctional complaints, aiming to identify the main myofunctional problems and differentiating them from characteristics that are common for this population, as well as to list items for myofunctional evaluation in this population. METHODS Cross-sectional study with 85 adult participants, aged between 19 and 39 years, selected through consecutive sampling at the Department of Speech, Language and Hearing Sciences of Universidade Veiga de Almeida. The participants were divided into two groups: G1 (comprising 50 individuals referred for orofacial myofunctional disorders) and G2 (comprising 35 volunteers without complaints). Descriptive evaluation of craniofacial structures of hard and soft tissues, kinesiology and mandible range of motion and functional patterns of breathing, chewing, and swallowing was applied. Three expert Speech-Language pathologists assessed all participants. Statistical analysis was done using χ2-test, Student's t-test, or Mann-Whitney test. The reliability level was 99%. RESULTS A predominance of Angle Class I pattern of occlusions for G2 (p<0.0001) was found. G1 showed (p<0.0001) mandible movements with deviations and joint noises, amplitude reduction in lateral and protrusive movements, unilateral chewing, nonexpected muscle contraction, temporomandibular joint noises, swallowing with excessive contraction of the orbicularis oris muscle, loud noise, and residues (p=0.006). CONCLUSION The main myofunctional orofacial alterations in young adults with complaints refer to changes of the mandibular movements and patterns of chewing or of swallowing, reflecting the main items of the clinical evaluation. Many items of assessment and characterization do not differ between the groups, and these should be analyzed regarding their relevance.
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Kim DH, Li K, Seo SJ, Jo SJ, Yim HW, Kim CM, Kim KH, Kim DW, Kim MB, Kim JW, Ro YS, Park YL, Park CW, Lee SC, Cho SH. Quality of life and disease severity are correlated in patients with atopic dermatitis. J Korean Med Sci 2012; 27:1327-32. [PMID: 23166413 PMCID: PMC3492666 DOI: 10.3346/jkms.2012.27.11.1327] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2011] [Accepted: 08/27/2012] [Indexed: 11/20/2022] Open
Abstract
Quantification of quality of life (QOL) related to disease severity is important in patients with atopic dermatitis (AD), because the assessment provides additional information to the traditional objective clinical scoring systems. To document the impact of AD on QOL for both children and adults as well as to quantify the relationship with disease severity, QOL assessments were performed over a 6-month period on 415 patients with AD. A questionnaire derived from the Infants' Dermatitis Quality of Life Index (IDQOL), the Children's Dermatology Life Quality Index (CDLQI) and the Dermatology Life Quality Index (DLQI) was used to determine the QOL for 71 infants, 197 children and 147 adults, respectively. To measure AD severity, both the Rajka & Langeland scoring system and the Scoring of Atopic Dermatitis (SCORAD) index were used. The mean scores were as follows: 7.7 ± 5.5 for IDQOL, 6.6 ± 6.3 for CDLQI, and 10.7 ± 7.9 for DLQI. In conclusion, these QOL scores are correlated with AD severity scores as estimated by the Rajka & Langeland severity score and the SCORAD. The outcome of the QOL instruments in this study demonstrates that atopic dermatitis of both children and adults affects their QOL.
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Affiliation(s)
- Dong Ha Kim
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Kapsok Li
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Seong Jun Seo
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Sun Jin Jo
- Department of Preventive Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Hyeon Woo Yim
- Department of Preventive Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Churl Min Kim
- Department of Family Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Kyu Han Kim
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
| | - Do Won Kim
- Department of Dermatology, Kyungpook National University College of Medicine, Daegu, Korea
| | - Moon-Bum Kim
- Department of Dermatology, Pusan National University College of Medicine, Busan, Korea
| | - Jin Woo Kim
- Department of Dermatology, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Young Suck Ro
- Department of Dermatology, Hanyang University College of Medicine, Seoul, Korea
| | - Young Lip Park
- Department of Dermatology, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Chun Wook Park
- Department of Dermatology, Hallym University College of Medicine, Seoul, Korea
| | - Seung-Chul Lee
- Department of Dermatology, Chonnam National University College of Medicine, Gwangju, Korea
| | - Sang Hyun Cho
- Department of Dermatology, The Catholic University of Korea College of Medicine, Seoul, Korea
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Rönmark EP, Ekerljung L, Lötvall J, Wennergren G, Rönmark E, Torén K, Lundbäck B. Eczema among adults: prevalence, risk factors and relation to airway diseases. Results from a large-scale population survey in Sweden. Br J Dermatol 2012; 166:1301-8. [PMID: 22372948 DOI: 10.1111/j.1365-2133.2012.10904.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND In contrast to asthma and rhinitis, few studies among adults investigating the prevalence and risk factors of eczema have been published. OBJECTIVES To investigate the prevalence and risk factors of eczema among adults in West Sweden. A further aim was to study the associations between asthma, rhinitis and eczema. METHODS A questionnaire on respiratory health was mailed in 2008 to 30,000 randomly selected subjects in West Sweden aged 16-75 years; 62% responded. The questionnaire included questions about eczema, respiratory symptoms and diseases and their possible determinants. A subgroup of 669 subjects underwent skin prick testing against common airborne allergens. RESULTS 'Eczema ever' was reported by 40·7% and 'current eczema' by 11·5%. Both conditions were significantly more common among women. The prevalence decreased with increasing age. The coexistence of both asthma and rhinitis with eczema was common. The main risk factors were family history of allergy and asthma. The dominant environmental risk factor was occupational exposure to gas, dust or fumes. Smoking increased the risk. Eczema was associated with urbanization, while growing up on a farm was associated with a decreased risk. Added one by one to the multivariate model, asthma, allergic rhinitis and any positive skin prick test were associated with eczema. CONCLUSIONS Eczema among adults is a common disease with more women than men having and having had eczema. Eczema is associated with other atopic diseases and with airway symptoms. Hereditary factors and exposure to gas, dust and fumes are associated with eczema.
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Affiliation(s)
- E P Rönmark
- Krefting Research Centre, Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Box 424, SE-405 30 Gothenburg, Sweden.
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Current world literature. Curr Opin Pediatr 2011; 23:700-7. [PMID: 22068136 DOI: 10.1097/mop.0b013e32834dda34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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