Background:
House dust mite allergens are associated with atopic dermatitis (ad).
Objectives:
The aim of our study was to verify if house dust mite allergen avoidance measures can improve the clinical manifestations of ad in children.
Methods:
Forty-one children (mean age 3.9 years) affected by ad associated with high total and/or specific ige serum levels ('extrinsic' ad) were recruited. clinical evaluation was performed utilizing the severity scoring of ad (scorad) index; dust was sampled from the children's beds and tested using an enzyme-linked immunosorbent assay. the study was planned in two parts. in the first part, a placebo-controlled trial of 2 months duration, mite allergen avoidance measures (encasing mattresses and pillows; a weekly hot wash of bedding; frequent vacuum cleaning of living room and bedroom; soft toys and carpets regularly cleaned or removed; no pets allowed) were recommended to group a patients, but not to group b. in the second part of the study, environmental avoidance measures were recommended to initial control group b patients also. one year after the start of the study the amounts of mite allergen in the home and clinical score of ad were measured in both groups.
Results:
At the end of the first part of the study, significant decreases in major allergens of dermatophagoides pteronyssinus (der p1) and d. farinae (der f1) load (from 393 to 94 ng m-2) and concentration (from 1.84 to 0.73 microg g-1 of dust) in children's beds were observed in treatment group a. at the same time, in this group the mean scorad index improved significantly (from 33 to 26; p = 0.022). after 12 months, when all patients had used allergen avoidance measures, der p1 + der f1 load, concentration and clinical score had improved, reaching similar values in both groups.
Conclusions:
Simple mite allergen avoidance measures should be recommended to families with children affected by extrinsic ad in order to control the clinical manifestations and prevent mite sensitization.