Atopic dermatitis
AD was diagnosed prospectively at scheduled and acute care visits at age
0-6 years (prior to evaluation of our outcomes) according to Hanifin and
Rajka’s criteria14 capturing age of debut and age of
remission as previously detailed15,16. A diagnosis of
AD required the presence of 3 of 4 major criteria and at least 3 of 23
minor signs. The following 4 minor signs were excluded: keratoconus and
anterior sub-capsular cataracts, delayed blanch, and impaired
cell-mediated immunity. The severity of AD was scored using the Scoring
Atopic Dermatitis (SCORAD) index at scheduled and acute care
visits17, ranging from 0 to 83 points (excluding the
subjective components of pruritus and sleeplessness from the modified
SCORAD index). As we saw the children at acute care visits whenever they
had an AD flare-up, we were sure to capture the highest SCORAD value in
the course of their disease.
Aeroallergen sensitization
Assessment of sIgE levels in blood samples was done at age 6 and 12
years by an initial screening method (ImmunoCAP Phadiatop Infant™ and
ImmunoCAP Phadiatop™, Thermo Fisher Scientific, Uppsala,
Sweden)18 followed by analysis of individual allergen
sIgE levels in screening positive samples towards birch, grass, mugwort,
horse, dog, cat, house dust mites (D. pteronyssinus and D. farinae) and
molds (Penicillium notatum, Cladosporium herbarum, Aspergillus fumigatus
and Alternaria alternata). Sensitization was defined as values of sIgE ≥
0.35 kUA/L13.