Features of sensitization to food allergens in children with congenital ichthyosis

BACKGROUND: Congenital ichthyosis is a heterogeneous group of rare genetic skin diseases characterized by generalized keratinization disorders and epidermal barrier dysfunction. Among the various forms of ichthyosis, Netherton syndrome has been described as having the highest risk of developing allergies. However, the characteristics of sensitization and clinical manifestations of allergic diseases in other forms of congenital ichthyosis have not been studied.

AIM: To study the pattern of food sensitization in children with different forms of congenital ichthyosis.

METHODS: A retrospective analysis of the medical records of 43 children with congenital ichthyosis was conducted, in whom the levels of specific immunoglobulin E to food allergens were studied. The children were divided into 2 groups. Group I included 13 children with Netherton syndrome; the group II consisted of 30 children with other forms of ichthyosis. Children in group II were divided into subgroups: IIA (n = 17) with the autosomal recessive form of ichthyosis and IIB (n = 12) with the keratinopathic form of ichthyosis. One child with vulgar ichthyosis was also included in the study. The comparison group consisted of 40 children, comparable in age, without skin diseases and allergies. In groups I and II, allergological anamnesis and total immunoglobulin E levels were assessed. In all three groups, specific immunoglobulin E levels to 5 allergens were assessed. In children with Netherton syndrome, the level of antibodies to 10 allergens was additionally assessed.

RESULTS: The frequency of detection of elevated total immunoglobulin E levels in patients with Netherton syndrome in group I was significantly higher than in children in group II. Total immunoglobulin E levels exceeding 1000 IU/mL were also more common in group I. Sensitization to food allergens was detected in all children in group I and in 72.2 % of patients in group II, and was more common in children with the autosomal recessive form of ichthyosis. Sensitization to chicken egg white was detected in all children in group I and in 20.0 % of children in group II. Children with Netherton syndrome were also more often sensitized to cow’s milk proteins and other allergens compared to children with non-syndromic forms. In children with Netherton syndrome, specific immunoglobulin E levels were more often distributed from the low to moderately high class.

CONCLUSIONS: The data obtained during the study made it possible to estimate the frequency of sensitization to major food allergens in pediatric patients with various forms of congenital ichthyosis — in particular, such a rare disease as Netherton syndrome.