Abstract
Food allergy can result in life-threatening anaphylaxis. Atopic dermatitis (AD) causes intense itching and impaired quality of life. Previous studies have shown that patients with classical early-onset AD tend to develop food allergy and that 10% of adults with food allergies have concomitant AD. However, it is not known whether late-onset food allergy leads to adult-onset AD, a recently recognized disease entity. Using an initial cohort of one-million subjects, this study retrospectively followed-up 2851 patients with food allergy (age > 12 years) for 14 years and compared them with 11,404 matched controls. While 2.8% (81) of the 2851 food allergy patients developed AD, only 2.0% (227) of the 11,404 controls developed AD. Multivariate regression analysis showed that food allergy patients were more likely to develop AD (adjusted hazard ratio = 2.49, p < 0.0001). Controls had a 1.99% risk of developing AD, while food allergy patients had a significantly higher risk (7.18% and 3.46% for patients with ≥3 and <3 food allergy claims, respectively) of developing adult-onset AD. This is the first study to describe the chronological and dose-dependent associations between food allergy in adolescence and the development of adult-onset AD.
Highlights
Atopic dermatitis (AD) is a common allergic disease affecting approximately 10% of the population
The presence of food allergy was associated with a higher risk of developing congestive heart failure, chronic pulmonary disease, rheumatoid disease, and renal disease
We investigated the cumulative incidence of AD in these patients after several years of follow-up, using the log-rank test with a Kaplan–Meier analysis (Figure 2)
Summary
Atopic dermatitis (AD) is a common allergic disease affecting approximately 10% of the population. AD is usually associated with other allergic diseases, including allergic rhinitis and asthma. The disease pathogenesis is multifactorial, and includes the presence of an abnormal skin barrier and aberrant immune responses. Following increasing reports of an adult-onset form of the disease, adult-onset AD has recently been recognized as a distinct disease entity, characterized by late disease onset and lesions affecting exposed areas, such as the face and hands. As with adult-onset asthma [1,2], it is believed that adult-onset AD is associated more strongly with environmental factors than the classic AD [3]. AD in adults was recently reported to be associated with obesity, hypertension, and prediabetes [4], all of which are significant cardiovascular risk factors
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