You can watch this in Youtube here: Addressing the Atopic March
It was pleasure for me to give a talk on the Allergic March. Essentially the allergic march describes how children first starts off with eczema which is closely related to food allergy and then the development of allergic rhinitis and asthma.
Everyone always ask me, why do I focus so much on eczema (atopic dermatitis) so much? The reason is that eczema is the spark that ignites the progression of allergic diseases. If allergic rhinitis or food allergy is the first step, you can bet that I will be talking a lot on that specific topic instead.
I spoke about how the eczematous skin can cause the development of food allergy. And so to prevent food allergy you have to introduce foods early. I also spoke about why you should not use skin care products that contain food proteins, as doing so will cause food sensitization and food allergy.
I also introduced the concept of the United Airway Disease in which Allergic Rhinitis and Asthma are closely linked. If a child’s allergic rhinitis is not controlled the nasal congestion will force them to breathe through the mouth. This constant mouth breathing can cause facial and dental maldevelopment with crooked teeth, receding jaw and narrow cheeks.
It turns out that mouth breathing also will cause increased risk for the development of Asthma as found out through the Nagahama Study. Thus it is important to evaluate a person with Allergic Rhinitis for Asthma and vice versa.
My co-speaker Prof David Price as I discussed about how patients are getting misinformation from the internet and developing “steroid phobia”. This “steroid phobia” can affect the proper management of patients with eczema, allergic rhinitis and asthma. I want to now explain that steroids, is neither good nor bad. It is simply a tool and it is a very helpful tool to help treat and manage allergic diseases. The key is maintaining proper follow-up and following the doctor’s instructions on use. I mentioned how sometimes patient may be seeking clarification from their doctors and a simple reassurance is all that is needed. Sometimes patients need time to digest the information that you have given. I have previously written on asthma and inhaled steroids growth concerns.
The point I want to make is that use of steroids done properly by a trained doctor is safe. In asthma, the inhaled steroids keep your disease under control and if you do not use your inhaled medications out of fear, the severe asthma attack will necessitate oral or IV steroids use for rescue. That rescue dose is much higher than what you would have received if you took your inhaled steroid medication and kept the asthma under control.
There is a treatment of allergic rhinitis and asthma called allergen specific immunotherapy. This treatment is a disease modifying therapy which alters your immune system’s allergic response. This treatment has shown to be effective, safe, reduces medication use and also has long term benefits.
