Tracing of atopic march among the Egyptian atopic dermatitis patients.

Background: Atopy is a personal or familial predisposition to produce IgE antibodies and become sensitized to environmental triggers. Atopy is thought to relate to AD, allergic rhinitis, and asthma. Aim and objectives: To examine the link between atopic dermatitis and other atopic conditions in Egyptian patients, focusing on disease onset, severity, the atopic march progression in relation to IgE levels and IgA status. Patients and methods: A prospective study with 70 Egyptian participants from Al-Azhar University's Allergy and Immunology Center examined two groups: 50 with atopic dermatitis and 20 healthy controls matched by age and sex. Atopic status was assessed via skin prick tests and IgE levels. All subjects underwent spirometry, serum IgA, CBC, liver and renal function tests, nasal and sinus CT scans, and chest imaging. Results: Patients with atopic dermatitis (AD) showed a significant rise in total IgE levels, with median values over twice those of controls, while IgA levels were lower. AD was the first atopic sign in 90% of cases, with bronchial asthma (BA) and allergic rhinitis (AR) as initial presentations in 2% and 8%. Severity was high in 72% of AD cases, versus 12% in BA and 16% in AR. Conclusion: This study shows a strong link between atopic diseases, high IgE, and IgA deficiency in Egyptian patients. IgA deficiency worsens disease severity. Atopic dermatitis starts the "atopic march,' leading to other atopic disorders.