Resumen
Introducción. La sensibilización a alérgenos observada en la dermatitis atópica aumenta el riesgo del niño a padecer de rinitis alérgica y asma. Estudios recientes indican que entre mayor actividad de proteasas haya en los alérgenos a los que se está sensibilizado hay un mayor defecto en la barrera cutánea y una mayor gravedad de la enfermedad.
Métodos. Revisamos los reportes de las pruebas cutáneas por “prick” realizadas en nuestro servicio a niños de 5 meses a 16 años de edad, con diagnóstico de dermatitis atópica, durante el periodo de enero de 2012 a enero de 2014. Evaluamos la frecuencia de sensibilización a aeroalérgenos y alimentos, así como el tamaño de la roncha en la respuesta cutánea para cada alérgeno en particular.
Resultados. Se incluyeron los reportes de pruebas cutáneas de 66 niños, 30 hombres y 36 mujeres. Cuarenta y seis pacientes (69%) estaban sensibilizados a aeroalérgenos y 38 (58%) a alimentos. Los ácaros del polvo de casa (Dermatophagoides pteronyssinus/Dermatophagoides farinae) fueron los alérgenos con mayor frecuencia de respuesta positiva en las pruebas cutáneas. De los niños con sensibilización a alimentos, solo los niños sensibilizados a la leche de vaca, el huevo y al pescado tuvieron una roncha mayor de 6 mm de diámetro.
Conclusión. En los niños con dermatitis atópica es común la sensibilización a aeroalérgenos con un alta actividad de proteasas y la polisensibilización es muy común. La sensibilización a alimentos es común en estos pacientes, pero solo un pequeño porcentaje de ellos muestra respuestas cutáneas lo suficientemente grandes para relacionarlas con gravedad de la enfermedad.
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