Prevalence of cutaneous hypersensitivity to Aspergillus fumigatus in patients with asthma in the central part of Karnataka and its impact on asthma severity

Introduction: Severe asthma is particularly linked to atopic conditions, especially to mold allergens like Aspergillus fumigatus. Allergic bronchopulmonary aspergillosis is an immunological lung disorder, with initial phase of hypersensitivity to Aspergillus (AH). This study aimed to assess Aspergillus sensitization among asthmatic patients through cutaneous hypersensitivity testing at our tertiary care center in central Karnataka. Material and methods: This hospital-based cross-sectional study included 100 asthmatic patients attending the outpatient department at SS Institute of Medical Sciences, Davangere, Karnataka, from 2022 to 2024. Patients with acute exacerbations, COPD, bronchiectasis, recent antihistamine use, or pregnancy were excluded; asthma was diagnosed as per GINA guidelines using clinical history and spirometry. Results: In our study we found that the prevalence rate of AH is 22% in asthma patients diagnosed by skin prick test (SPT). The most common symptom among the patients with AH was cough (100%), shortness of breath (95.5%) and wheeze (86.4%). Patient’s with AH had more severe asthma (p<0.001), cough (p=0.04), shortness of breath (p<0.001), wheeze (p=0.017) and night awakenings (p = 0.003) compared to patients without AH, which were statistically significant. Conclusion: Cutaneous hypersensitivity to Aspergillus fumigatus was found in 22% of asthmatics. Early detection and targeted management strategies for patients sensitized to Aspergillus fumigatus can potentially improve disease outcomes.