Allergic march in children: Atopic dermatitis in Japanese children with bronchial asthma

Atopic diseases in children often develop in series and atopic dermatitis usually occurs first. To clarify the serial development of atopic dermatitis and bronchial asthma in atopic children in Japan, the present and/or past history of atopic dermatitis in patients with bronchial asthma was examined. Patients (n = 280) with bronchial asthma in five prefectures in Japan were examined at a mean (± SD) age of 8.2 (± 4.5) years and asked about prior and/or concurrent atopic dermatitis. The mean (± SD) age of the patients at the onset of bronchial asthma was 3.0 (± 2.3) years. There was a present or past history of atopic dermatitis in 54% of the patients, and 47 and 72% of those had developed atopic dermatitis within the first 6 and 12 months of life, respectively. In 86% of the patients with both bronchial asthma and atopic dermatitis, atopic dermatitis developed first. The mean (± SD) duration from the onset of atopic dermatitis to the time of examination was 7.3 (± 4.3) years, and atopic dermatitis had been cured in 49% of the patients within this period regardless of the therapy used. Patients with atopic dermatitis had a higher rate of atopic dermatitis in their families (43%) compared with those without atopic dermatitis (23%). These data show that half of the children with bronchial asthma first develop atopic dermatitis in early infancy and that it is relatively easily cured.