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dr Zorica Živković
when it comes to the most common diseases that affect children, adolescents, and adults, allergic diseases are certainly in lead. interestingly, the last couple of years their growth is noticeable, especially among the young, and the cause of that is, as it turned out, the age specificity appearing of this kind of disease and therefore “allergic march“. already in childhood is possible to notice the first manifestations in the form of eczema (atopic dermatitis) and allergic reactions to food that precede the development of respiratory allergies (allergic rhinitis and asthma).
on the occurrence and appearance of the symptoms of allergic diseases affect many factors, and genetics plays a significant role, but also the environment where the child grows up. of course, eventually successful prevention is possible, but in that case, is necessary to spot prenatal and postnatal factors of risk. allergies are manifesting in different ways from the most severe forms of anaphylactic reactions, nettle rash, angioedema, allergic rhinitis, allergic asthma, serum diseases, allergic vasculitis, atopic dermatitis, contact dermatitis, granulomatosis, up to wide spectrum of contact hypersensitivity and food allergies, medicines and venom insects.
what is “allergic march”?
“atopic (allergic) march” represents a series of allergic disorders, which start in childhood as eczema (atopic dermatitis ad) and food allergies and then become allergic rhinitis (AR) and asthma. when it comes to children that have one of the allergic diseases, 20-30% of kids age 4-7 have asthma, 5-10% eczema (atopic dermatitis) and 2-5% food allergies. it’s important to know that until age 7 almost every child prone to atopy shows some of the symptoms and signs of allergic disease, so it’s easy to react on time.
study about the allergic disease in children was done in our country-research was conducted in 5 regional centers with different demographics and sociological characteristics and it included about 14 000 kids of 2 age groups, 6-7 years and 13-14 years old. altogether in Serbia from asthma suffer 5,91%, from allergic rhinitis 11,46% and eczema 14,27% of kids.
eczema and food allergies
no matter who the patient is, eczema or atopic dermatitis (AD) and food allergies most common appear and manifest at the same time, actually, food allergy is one of the main factors of risk for eczema developing. almost 35 % of kids with eczema have a positive test (specific IgE) to some food allergen and commonly on proteins in cow’s milk. kids allergic to cow milk at an early age, more frequently manifest signs of bronchial hyperactivity at school age.
to protect ourselves from the external effects of microorganisms or aside allergens, it is a very important role of surface skin layer (epidermis). if the epidermis is damaged entrance of pathogens, allergens, toxins irritants and different species of pollutants is quite easy and thus the first step is made in eczema appearing.
the studies show that eczema representations vary from country to country and ranges from 0,3 to 20,5 %. in our area frequency of eczema in pre-school age, kids are from 9,5 to 17,2% and at school-age kids from 9,1 to 16,2%. in 45% of kids with eczema first symptoms of the disease are manifested in the first months of life, in 60% of kids during the first year of life and even in 85% of patients at age 5 at the latest. less than 50% of patients with eczema have a complete resolution of the disease until age 7 and a total of 60% until the period of adolescence that indicates the clinical course of the disease. mentioned studies show that eczema is one of the main risks of asthma development in later life. early beginning of the disease and severe clinical picture, elevation of serum IgE, positive in vivo and in vitro allegro test increase probability to eczema progress into allergic rhinitis and asthma.
what can you do as a parent for your child?
advice for parents whose children have dry, irritated skin prone to allergies and infections can be easily found in all our international publications and media and not only for the professional public. if you as a parent are prone to allergies yourself, you will recognize the symptoms at your children at an early age, so you will be prepared for taking advice about prevention of allergy development. early prevention is the most important, so even before the symptoms appear and accompanying complications begin. as already mentioned, eczema is manifested clinically by the 6th month of a child’s life in almost half of cases.
early prevention involves, first and foremost, the removal of relevant allergens from food, air, and the environment, and special attention should be paid to contacting the skin with potential allergens and harmful agents in clothing and generally fabrics. at a young age, children’s skin is tender, sensitive and immature, but the skin of children with the atopic constitution is similar to that in the later period. pay attention to the choice of hygienic and cosmetic skincare products and necessarily to the choice of the fabric for baby’s or children’s clothes. it’s important to choose lighter cotton clothing of natural composition to reduce the factor of risk. clothing made of wool, synthetic materials, synthetic and dark colors is simply not suitable for the toddler’s skin. if the baby’s skin is already irritated, the labels, tags, stitches, and cuts on the inside will additionally harm her, and this should be kept in mind when it comes to choosing the right clothing for children of any age.