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J Allergy Clin Immunol. 2008 Jan;121(1):141-147.e4. Epub 2007 Nov 5.

The role of atopic sensitization in flexural eczema: findings from the International Study of Asthma and Allergies in Childhood Phase Two.

Collaborators (151)

Björkstén B, Brunekreef B, Cookson W, von Mutius E, Strachan D, Weiland SK, Büchele G, Kleiner A, Rzehak P, Weinmayr G, Weiland SK, Priftanji A, Shkurti A, Simenati J, Grabocka E, Shyti K, Agolli S, Gurakuqi A, Stein RT, Urrutia de Pereira M, Jones MH, Pitrez PM, Cooper PJ, Chico M, Chen YZ, Zhong NS, Lei C, Wong G, Riikjärv M-, Annus T, Annesi-Maesano I, Gotua M, Rukhadze M, Abramidze T, Kvachadze I, Karsanidze L, Kiladze M, Dolidze N, Leupold W, Keil U, von Mutius E, Weiland SK, von Mutius E, Keil U, Weiland S, Arthur P, Addo-Yobo E, Gratziou C, Priftis C, Papadopoulou A, Katsardis C, Tsanakas J, Hartziagorou E, Kirvassilis F, Clausen M, Shah JR, Mathur RS, Khubchandani RP, Mantri S, Forastiere F, Di Domenicantonio R, De Sario M, Sammarro S, Pistelli R, Serra MG, Corbo G, Perucci CA, Svabe V, Sebre D, Casno G, Novikova I, Bagrade L, Brunekreef B, Schram D, Doekes G, Jansen-van Vliet PH, Janssen NA, Aarts FJ, de Meer G, Crane J, Wickens K, Barry D, Nystad W, Bolle R, Lund E, El-Sharif N, Nemery B, Barghuthy F, Abu Huij S, Qlebo M, Batlles Garrido J, Rubi Ruiz T, Bonillo Perales A, Gonzalez Jiménez Y, Aguirre Rodriguez J, Momblan de Cabo J, Losilla Maldonado A, Daza Torres M, Garcia-Macos L, Martinez Torres A, Guillén Pérez JJ, Piñana López A, Castejon Robles S, Garcia Hernandez G, Martinez Gimeno A, Moro Rodríguez AL, Luna Paredes C, Gonzalez Gil I, Suarez-Varela MM, Llopis González A, Escirbano Montaner A, Tallon Guerola M, Bråbäck L, Kjellman M, Nilsson L, Mai X-, Bråbäck L, Sandin A, Saraçlar Y, Kuyucu S, Tuncer A, Saçkesen C, Sumbuloğlu V, Geyik P, Kocabaş C, Strachan D, Kaur B, Aït-Khaled N, Anderson HR, Asher I, Beasley R, Björkstén B, Brunekreef B, Cookson W, Crane J, Ellwood P, Foliaki S, Keil U, Lai C, Mallol J, Mitchell E, Montefort S, von Mutius E, Odhiambo J, Pearce N, Robertson C, Shah J, Stewart A, Strachan D, Weiland SK, Williams H.

Abstract

BACKGROUND:

The association between allergic sensitization and eczema has been debated for years.

OBJECTIVE:

We sought to determine and compare the strength of the association between allergen skin sensitization and eczema in both developing and industrialized countries.

METHODS:

Twenty-eight thousand five hundred ninety-one randomly selected 8- to 12-year-old schoolchildren in 20 countries were physically examined for flexural eczema and received skin prick testing to Dermatophagoides pteronyssinus, Dermatophagoides farinae, cat hair, Alternaria tenuis, mixed tree and grass pollen, and allergens of local relevance.

RESULTS:

The age- and sex-adjusted odds ratios (ORs) for a positive association between flexural eczema and atopy ranged between 0.74 (95% CI, 0.31-1.81) and 4.53 (95% CI, 1.72-11.93), with a significantly stronger association in affluent compared with nonaffluent countries (combined age- and sex-adjusted OR(affluent) = 2.69 [95% CI, 2.31-3.13] and OR(nonaffluent) = 1.17 [95% CI, 0.81-1.70]). The combined population attributable fraction for atopy in flexural eczema was 27.9% for affluent and 1.2% for nonaffluent-country centers. Correlating gross national per-capita income with either ORs or population attributable fractions for atopy in flexural eczema confirmed a highly significant positive association (P = .006 and P < .001, respectively).

CONCLUSIONS:

The association between atopy and flexural eczema is weak and more variable than previously suggested, and the strength of this association is positively linked to gross national income.

[PubMed - indexed for MEDLINE]
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