Prevention of eczema

Abstract

In a prospective study of the development of reaginic allergy, infants of allergic parents were either subjected to an allergen-avoidance regimen from birth for six months or managed conventionally. The group on the allergen-avoidance regimen had less eczema at six months and one year than did the control group at six months. They also had a lower mean serum-total-IgE level at six weeks.

PIP: The incidence of reaginic allergy in the general population in Britain and America is about 20%. The allergy is known to be familial, either resulting from a primary overaction of the IgE-producing mechanism or from an overstimulus of a normal immunity mechanism. It has been suggested that in early infancy, vulnerability to sensitization is a transient phenomenon. To determine this, a prospective study was conducted on the development of allergy in a group of 62 infants born to allergic parents, some following a simple allergen-avoidance regimen (breastfeeding) and the rest following a conventional management. The infants were seen at the ages of 6 weeks, 3, 6, and 12 months. Atopic eczema was classified in 4 grades according to a criteria. Prick skin tests and blood analysis for IgG, IgM, and IgA were performed. 49 infants completed the study, 23 of whom successfully followed the allergen-avoidance regimen. 19 infants fed cow's milk comprised the nonregimen group. A further 7 infants were dropped from the analysis because of dietary lapses. There was no significant difference between the mean serum IgA levels of the regimen and nonregimen groups. The regiment group had significantly less eczema at 6 months (p0.010) and at (p=0.017). Comparison of parental eczema between the 2 groups showed no significant differences. Mean serum IgE levels of infants diagnosed as having eczema were greater at all ages than those who did not have eczema, significantly so at 3 months and 1 year. This study shows that changes in environmental factors can reduce the incidence of atopic eczema in an "at-risk" group. An ongoing study is being done on the group of infants in this study for the development of other allergy, as severe asthama in childhood is often preceded by eczema in infancy.