We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
JAMA Pediatrics Patient Page |

Atopic Diseases in Children FREE

Megan A. Moreno, MD, MSEd, MPH
JAMA Pediatr. 2016;170(1):96. doi:10.1001/jamapediatrics.2015.3886.
Text Size: A A A
Published online

Atopic diseases are a group of diseases linked by a shared underlying problem with the immune system. The main feature is the development of a particular immunoglobulin (IgE) directed against allergens that are usually harmless. Childhood atopic disease includes atopic dermatitis, allergic rhinitis, asthma, and food allergy. This month’s JAMA Pediatrics includes 2 articles about atopic disease.

Atopic dermatitis, also called eczema, is a chronic, relapsing inflammatory disease of the skin that leads to itching and risks for skin infection. It is the most common skin disease in children: about 10% to 20% of children in the United States and Western Europe have atopic dermatitis. Skin treatment typically includes moisturizers and anti-inflammatory treatments such as steroid creams.

Allergic rhinitis is caused by allergic inflammation in the nose and throat after being exposed to an allergen. Symptoms include runny nose (rhinorrhea), stuffy nose (nasal congestion), itching, and sneezing. Itchy or watery eyes can also be symptoms. For some patients, the symptoms are seasonal; for others, the symptoms are year round. Treatment often consists of trying to reduce exposure to the allergen and using medicines such as nasal steroids, oral antihistamines, or decongestants.

Asthma is a disorder that includes airway obstruction that is reversible, lungs that are much more sensitive to allergens and irritants, and chronic airway inflammation. Symptoms include wheezing and difficulty breathing. Treatment often includes medicines that are inhaled as well as taken by mouth to open the airways and reduce inflammation.

Food allergies are common in children. The most common are nut and egg allergies. Some food allergies commonly resolve in later childhood, and others do not. Treatment involves being prepared in case of accidental exposure and avoiding that food.

Because the illnesses involved in atopic disease are linked by common causes, the “atopic march” refers to the common problem that children who have one of these illnesses are at significant risk for developing another at some point during childhood. For example, about 75% of children with atopic dermatitis will develop allergic rhinitis and more than 50% will develop asthma. There are 2 important factors in which children are at risk for atopic disease:

  • Genetics: Genetics play a large role in developing atopic diseases; these underlying genetic risks then react to a trigger in the environment to cause the atopic illness. A family history of atopic diseases is a risk factor for children to develop these conditions.

  • Environment: Even though genetics are important in risks for disease, exposure to environmental agents, or “triggers,” is important in atopic disease.

The “hygiene hypothesis” is that a more hygienic environment and fewer childhood infections may be an important reason why there are increases in atopic disease. According to this theory, too much hygiene or early avoidance of possible things that can cause an allergic reaction increase risks of atopic disease. We know that early exposure to peanuts, for example, can reduce the risk of developing a peanut allergy. Other studies have found that more exposure to viral infections, such as through daycare or school, was protective for atopic disease.

If your child has been diagnosed with one atopic disease, talk with your pediatrician about ways to prevent the atopic march.


The JAMA Pediatrics Patient Page is a public service of JAMA Pediatrics. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your child’s medical condition, JAMA Pediatrics suggests that you consult your child’s physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections