Journal List > Allergy Asthma Respir Dis > v.4(1) > 1059201

Choi, Hwang, Hwang, and Kim: Significance of Malassezia-specific IgE in children with dermatitis involving the head and neck

Abstract

Purpose

Even though Malassezia yeast may play an important role in the exacerbation of atopic dermatitis (AD), only a few studies of Malassezia infection have been conducted in children with AD. Thus, we compared each of clinical findings, including the severity of head and neck dermatitis and laboratory results depending on specific IgE against Malassezia furfur.

Methods

This cross-sectional study was carried out on 121 children aged 3 months to 18 years between April and July of 2014. Retrospective data was collected using the medical records, and patients were divided into 2 groups according to the presence of Malassezia sensitization.

Results

Specific IgE against Malassezia (group 1) was observed in 28 of all patients (23.1%). Group 1 children were at an older age (9.1±6.9 vs. 2.1±3.7, P<0.001). Group 1 children had a higher SCORing Atopic Dermatitis (SCORAD) index (46.4±21.0 ng/mL vs. 37.2±13.4 ng/mL, P=0.001), and total IgE (1,324.2±1,166.0 IU/mL vs. 209.5±532.5 IU/mL, P<0.001) compared to group 2 children (Malassezia-). In the group 1, the correlation between the Malassezia-specific IgE and 25-hydroxyvitamin D3 was negatively weak (r=–0.106) and not statistically significant (P=0.246). Furthermore, Malassezia-specific IgE and the SCORAD index (r=0.281, P=0.002) or total IgE (r=0.380, P<0.001) were positively correlated.

Conclusion

The results of this study suggest that specific IgE against M. furfur may be helpful in assessing the severity of prepubertal children and early adolescents with AD involving the head and neck.

Figures and Tables

Fig. 1

The distribution of patients according to Malassezia furfur-specific IgE antibodies.

aard-4-31-g001
Fig. 2

Correlations of the level of 25-(OH)D (A), SCORAD index (B), and total IgE (C) to Malassezia furfur-specific IgE antibodies. P-value was applied by Pearson correlation. 25-(OH)D, 25-hydroxy vitamin D; sIgE, specific IgE; SCORAD, SCORing Atopic Dermatitis; ImmunoCAP (Phadia AB, Uppsala, Sweden).

aard-4-31-g002
Table 1

The clinical characteristics of the two groups classified according to the presence of specific Malassezia IgE

aard-4-31-i001
Variable Malassezia+
(n = 28)
Malassezia-
(n = 93)
P-value
Male sex 21 (75.0) 58 (62.4) 0.218
Age (yr) 9.1 ± 6.9 2.1 ± 3.7 < 0.001
Vaginal delivery 20 (71.4) 63 (67.7) 0.822
SCORAD index 46.4 ± 21.0 37.2 ± 13.4 0.001
Severity 0.171
 Mild 0 (0) 1 (1.1) 0.582
 Moderate 12 (42.9) 57 (61.3) 0.084
 Severe 16 (57.1) 35 (37.6) 0.067
Other allergic disease (+) 21 (75.0) 39 (41.9) 0.002
Bronchial asthma 2 (7.1) 9 (9.7) 0.683
Allergic rhinitis 17 (60.7) 24 (25.8) 0.001
Allergic conjunctiviitis 1 (3.6) 2 (2.2) 0.672

Values are presented as number (%) and mean±standard deviation.

SCORAD, SCORing Atopic Dermatitis.

Table 2

The laboratory findings of the two groups classified according to the presence of specific Malassezia IgE

aard-4-31-i002
Variable Malassezia+
(n = 28)
Malassezia-
(n = 93)
P-value
25-(OH)D3 (ng/mL) 17.9 ± 10.4 24.0 ± 13.9 0.127
Vitamin D status 0.092
Sufficient (≥ 30) 5 (17.9) 29 (31.2) 0.169
 Insufficient (20-29.9) 5 (17.9) 26 (28.0) 0.283
 Deficient (< 20) 18 (64.3) 38 (40.9) 0.029
Total IgE (IU/mL) 1,324.2 ± 1,166.0 209.5 ± 532.5 < 0.001
ECP (µg/L) 26.2 ± 38.0 18.2 ± 23.4 0.240
Total eosinophil count (/µL) 726.7 ± 689.5 658.3 ± 461.4 0.077

Values are presented as mean±standard deviation or number (%).

25-(OH)D3, 25-hydroxyvitamin D3; ECP, eosinophiccationic protein.

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