Atopic dermatitis and asthma-clinical interconnections

Abstract

Introduction. Atopic diseases, such as atopic dermatitis, allergic rhinitis, and asthma have become more prevalent in recent decades, now affecting about 20% of the population in developed countries. The term “atopic march” describes the typical progression of these conditions, starting with atopic dermatitis (AD) in infants and often leading to allergic rhinitis and asthma in children. The purpose: To perform a literature review about clinical interconnection between AD and asthma and about the possibility of progression from AD to asthma and vice-versa. Material and methods: A literature search was performed, using key words “atopic dermatitis, asthma, atopic diseases, atopic march”. We used PubMed database and selected articles published in 2012-2024. During search system identified 715 articles. After selection of most relevant ones published in English, we analyzed 20. Results. AD significantly increases the risk of developing asthma, as evidenced by higher odds ratios in children with AD compared to those without, according to several longitudinal studies. Children with AD who have specific IgE antibodies to common environmental allergens, typically identified by age 2 to 4, are more likely to progress to allergic rhinitis and asthma than those with non-IgE mediated AD. Therefore, extrinsic AD is a more precise indicator of the initial risk for developing other atopic conditions. The key risk factors for the progression and persistence of asthma include early onset of AD, IgE sensitization, and its severity. Approximately 70% of patients with severe AD develop asthma, compared to 20-30% of those with mild AD, and about 8% of the general population. Conclusions. The development of these diseases and their progression is significantly influenced by genetic and environmental factors. It’s very important to identify patients at risk from an early age and to provide a window for early therapeutical strategies.