Atopic Triad (atopic march)

What is the atopic triad ( atopic march )?

Atopic Triad is termed when eczema, allergies, and asthma occur together in a child, it is also called the atopic march. Often, eczema is diagnosed first, followed by allergies, and then asthma.

How common are Eczema, Allergies, and Asthma in children

Eczema, allergies, and asthma are common in children, and these conditions tend to be passed along from parent to child (are inherited). These conditions often occur when the body’s disease-fighting system (immune system) responds to certain harmless substances as though they were harmful germs (allergic reaction).

These substances could be things that your child breathes in, touches, or eats. The immune system creates proteins (antibodies) to fight the germs, which causes your child’s symptoms.

In other cases, symptoms may be the result of your child’s immune system attacking tissues in his or her own body (autoimmune reaction).

Symptoms of these conditions can affect your child’s skin, ears, nose, throat, stomach, or lungs. You can help reduce your child’s symptoms and avoid flare-ups by taking certain actions at home and at school.

Eczema

Eczema, also called atopic dermatitis, is a skin disorder that causes inflammation of the skin. Symptoms of eczema may include:

• Dry, scaly skin.
• Red rash.
• Itchiness. This may occur before or along with a rash, and it is often very intense. Itchiness can lead to scratching, which sometimes results in skin infections or thickening of the skin.

What are common Allergies in Children

Common allergic reactions that are part of the atopic triad include allergies to:

• Certain foods.
• Environmental allergens, such as:
  • Dust.
  • Pollen.
  • Air pollutants.
  • Animal dander.
  • Mold.

Symptoms of a mild food allergy may include:

• A stuffy nose (nasal congestion).
• Tingling in the mouth.
• Itchy, red rash.
• Nausea or vomiting.
• Diarrhea.

Symptoms of a severe food allergy may include:

• Swelling of the lips, face, and tongue.
• Swelling of the back of the mouth and throat.
• Wheezing.
• A hoarse voice.
• Itchy, red, swollen areas of skin (hives).
• Dizziness or light-headedness.
• Fainting.
• Trouble breathing, speaking, or swallowing.
• Chest tightness.
• Rapid heartbeat.

Symptoms of environmental allergies may include:

• A runny nose.
• Nasal congestion.
• A feeling of mucus going down the back of the throat (postnasal drip).
• Sneezing.
• Itchy, watery eyes.
• Itchy mouth, throat, and ears.
• Sore throat.
• Cough.
• Headache.
• Frequent ear infections.

Asthma

Asthma is a reversible condition in which the airways tighten and narrow in response to certain triggers or allergens. Symptoms of asthma may include:

• Coughing, which often gets worse at night or in the early morning. Severe coughing may occur with a common cold.
• Chest tightness.
• Wheezing.
• Difficulty breathing or shortness of breath.
• Difficulty talking in complete sentences during an asthma flare.
• Lower respiratory infections, like bronchitis or pneumonia, that keep coming back (recurring).
• Poor exercise tolerance.

What causes these conditions to develop?

Eczema, allergies, and asthma each tend to be inherited. They may develop from a combination of:

• Your child’s genes.
• Your child breathing in allergens in the air.
• Your child getting sick with certain infections at a very young age.

Eczema is often worse during the winter months due to frequent exposure to heated air. It may also be worse during times of ongoing stress.

What are the treatment options for these conditions?

An early diagnosis can help your child manage symptoms. It is important to get your child tested for allergies and asthma, especially if your child has eczema. Follow specific instructions from your child’s health care provider about managing and treating your child’s conditions.

Eczema treatment may include:

• Controlling your child’s itchiness by using over-the-counter anti-itch creams or medicines, as told by your child’s health care provider.
• Preventing scratching. It can be difficult to keep very young children from scratching, especially at night when itchiness tends to be worse.
  • Your child’s health care provider may recommend having your child wear mittens or socks on his or her hands at night and when itchiness is worst. This helps prevent skin damage and possible infection.
• Bathing your child in water that is warm, not hot. If possible, avoid bathing your child every day.
• Keeping the skin moisturized by using over-the-counter thick cream or ointment immediately after bathing.
• Avoiding allergens and things that irritate the skin, such as fragrances.
• Helping your child maintain low levels of stress.

Allergy treatment may include:

• Avoiding allergens.
• Medicines to block an allergic reaction and inflammation. These may include:
  • Antihistamines.
  • Nasal spray.
  • Steroids.
  • Respiratory inhalers.
  • Epinephrine.
  • Leukotriene receptor antagonists.
• Having your child get allergy shots (immunotherapy) to decrease or eliminate allergies over time.

Asthma treatment includes:

Making an asthma action plan with your child’s health care provider. An asthma action plan includes information about:

• Identifying and avoiding asthma triggers.
• Taking medicines as directed by your child’s health care provider. Medicines may include:
  • Controller medicines. These help prevent asthma symptoms from occurring. They are usually taken every day.
  • Fast-acting reliever or rescue medicines. These quickly relieve asthma symptoms. They are used as needed and they provide short-term relief.

What changes can I make to help manage my child’s conditions?

• Teach your child about his or her condition. Make sure that your child knows what he or she is allergic to.
• Help your child avoid allergens and things that trigger or worsen symptoms.
• Follow your child’s treatment plan if he or she has an asthma or allergy emergency.
• Keep all follow-up visits as told by your child’s health care provider. This is important.
• Make sure that anyone who cares for your child knows about your child’s triggers and knows how to treat your child in case of emergency. This may include teachers, school administrators, child care providers, family members, and friends.
  • Make sure that people at your child’s school know to help your child avoid allergens and things that irritate or worsen symptoms.
  • Give instructions to your child’s school for what to do if your child needs emergency treatment.
  • Make sure that your child always has medicines available at school.