What Is the Atopic March?
The atopic march is the development of atopic dermatitis (AD) in infancy and subsequent allergic rhinitis and asthma in later childhood. This means that patients who experience atopic dermatitis (eczema) as an infant have a greater chance of developing allergies and asthma as children and adults. Symptoms of eczema, such as cracks in the skin, often set off a chain of allergic diseases. Some patients with eczema/atopic dermatitis have food sensitivities, and certain foods may worsen their eczema. About half of patients with severe atopic dermatitis have the disease due to gene mutations including filaggrin.
The prevalence of atopic dermatitis is increasing in the U.S. leading to an increase of allergic diseases. There is also evidence of a reverse sequence, so patients with asthma in childhood are likely to develop atopic dermatitis in adulthood. A study documented in the journal of clinical and cellular immunology suggested that childhood eczema, especially in association with childhood rhinitis, is strongly associated with atopic asthma in middle-aged adults that is often still symptomatic. While some argue that there isn’t a causal relationship between eczema and other allergic diseases, recent studies suggest that the immune system of children with eczema reacts more strongly to irritants than usual.
Eczema can appear as soon as 6 weeks after birth. Patients with moderate to severe eczema may be at risk of developing food allergies, particularly peanut and egg. Because of this risk of developing a food allergy, it is critical to see an allergist for allergy testing as early as possible to intervene. When a child’s eczema is under good control, their skin is better at preventing food allergens from getting in. If you have a child showing symptoms of an allergy or eczema, we suggest visiting a Board Certified Allergist. An allergist will examine the skin and perform an allergy test to confirm the condition. Once a diagnosis is made, you will be able to control the atopic march with a personalized treatment plan.
The Importance of the Epidermal Barrier
Restoring the skin barrier as soon as eczema develops is the best way to stop the atopic march. Your skin forms a barrier, known as the epidermal barrier, keeping moisture in and external allergens out. Many NYC allergists recommend the soak and seal treatment. This involves thoroughly moisturizing the skin in a warm bath, then trapping the moisture in with a moisturizing ointment.
Most physicians and allergists prescribe topical steroids to combat atopic dermatitis. You can also discuss using certain anti-itch creams to soothe your symptoms. The allergists at NY Allergy & Sinus Centers provide fast eczema, asthma, and allergy relief. We accept most insurance plans and can accommodate same-day appointments. However, for allergy testing appointments, we ask that you refrain from taking antihistamines for at least 48 hours. Book your appointment online or call (212) 686-4448 to see the allergists who care.
Meet the Physician Collaborator
Dr. Neha Sirohi is a physician specializing in both Pediatric and Adult Allergy & Immunology. She is Board Certified by the American Board of Pediatrics and board eligible for the American Board of Allergy and Immunology. You can schedule an appointment with Dr. Sirohi by booking online or visiting one of our six allergy centers in NYC.