Adult Atopic Dermatitis (AD): a role for Seafood ?

Take Home Message: Around 45% of adults with Atopic Dermatitis (AD) have sensitization to Seafood (Study from Malaysia)

Comments:
–Seafood as a cause for skin problems (Eczema, Urticaria) is deeply engrained in Asian culture
-The link between high sensitization to seafood should be compared with similar testing methods in the general population
-Indeed, sensitization to seafood does not mean that Seafood is the cause of AD…even less certain is if specific food avoidance will improve AD clinically, especially for some methods as IgG testing in blood samples (please click HERE to read more.
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Abstract:
Background: Seafood is an important source of nutrient in Asia. However, it is believed to cause or aggravate atopic dermatitis(AD). We aim to determine relevant seafood sensitization among adults with AD.
Method: One-hundred-and-thirty-two adults with AD were subjected to skin prick test (SPT) with seven common local seafood allergens (anchovy, tuna, mackerel, squid, shrimp, lobster and crab), house dust mites (HDM) and cockroach.
Results: The median age of study subjects was 32 years(17-77 years) with male:female of 1:3. The mean duration of AD was 16 years. Eighty-two patients(62.2%) had other atopic conditions. Using SCORAD, 44.7% had mild; 42.4% moderate and 12.9% severe disease. Eighty-six patients (65.2%) self-reported to have seafood allergy with the main symptoms of transient pruritus and erythema within 2 hours of ingestion. SPT revealed 50.8% of the patients were sensitized to at least one of the 7 seafood allergens. The relevant sensitization rate was 43.9%. Interestingly, 46% of those without history of seafood allergy developed at least one positive reaction in the SPT. Lobster, prawn and crab were the 3 most frequent sensitizing allergens. Nearly all patients(98.3%) who were sensitized to crustacean were also sensitized to HDM. There was no significant correlation between a positive SPT to seafood with age; age of onset of AD; duration; and severity of AD; and the presence of other atopic diatheses.
Conclusion: The relevant sensitization rate of local seafood among adults with AD was 43.9%. To confirm true seafood allergy, oral challenge test is the next step.

Reference: Regional Congress of Dermatology (RCD) 2016 – Singapore. RCD16-0039 Free Papers 1 (Eczemas, psoriasis) SEAFOOD SENSITIZATION IN ADULTS WITH ATOPIC DERMATITIS: A CROSS-SECTIONAL STUDY IN HOSPITAL KUALA LUMPUR, MALAYSIA H.L. Lee1, M.M. Tang2, A. Johar2 1, Taiping, Malaysia 2Kuala Lumpur Hospital, Dermatology, Kuala Lumpur, Malaysia