CLINICAL AND IMMUNOLOGICAL CHARACTERISTICS OF ATOPIC DERMATITIS SEVERITY IN CHILDREN: THE ROLE OF TOTAL IGE, EOSINOPHILIA, AND POLYSENSITIZATION

Atopic dermatitis is a common chronic inflammatory skin disease in children, with considerable heterogeneity in clinical course and severity associated with immunological activity and patterns of allergen sensitization. The aim of this study was to evaluate the relationship between the clinical severity of atopic dermatitis and total immuno­globulin E (IgE), peripheral blood eosinophilia, and the extent of sensitization in children. The study included 200 children aged 3–18 years with a confirmed diagnosis of atopic dermatitis. Disease severity was assessed using the SCORAD index. Total serum IgE and peripheral blood eosinophil levels were determined, and patterns of allergic sensitization were evaluated. Total IgE levels above age-adjusted reference values were found in 76.0% of patients. Mean total IgE concentrations were 154.2±61.8 IU/ml in mild, 312.7±104.6 IU/ml in moderate, and 586.3±214.9 IU/ml in severe atopic dermatitis (p<0.001). Eosinophilia was detected in 68.5% of patients, while the mean eosinophil percentage increased from 4.9±1.8% in mild disease to 10.2±3.1% in severe disease (p<0.001). Total IgE was positively correlated with SCORAD (r=0.61), peripheral blood eosinophils were correlated with SCORAD (r=0.54), and total IgE was correlated with eosinophil levels (r=0.49; p<0.001). Molecular sensitization was detected in 91.0% of patients, while polysensitization was observed in 63.0%. These findings indicate that the integrated assessment of total IgE, peripheral blood eosinophilia, and the extent of sensitization together with SCORAD may provide a more compre­hensive characterization of the clinical and immunological phenotype of pediatric atopic dermatitis.