Proactive Treatment Decreased Serum IgE Titer Significantly in Patients with Severe Atopic Dermatitis (AD)

RATIONALE: Elevation of total serum IgE is frequently seen among patients with severe atopic dermatitis, but the effect of intensive treatment towards IgE is not much investigated. The objective of this study is to reveal the relationship between the remission level of the skin inflammation in the long term and the total serum IgE in children with severe AD. METHODS: Of the patients with severe AD who admitted to our division in 2004-2006, forty seven patients whose IgE levels at first presentation were above 100 IU/ml and were reevaluated at least one more time after 1-2 years were enrolled. In all patients, Scoring Atopic Dermatitis (SCORAD) and detailed photo documentation were taken. Patients were advised to use topical corticosteroids proactively and no one received any additional systemic treatment. RESULTS: The mean (range) age and total serum IgE was 4.3 yrs (0-14) and 6,920 IU/ml (160-47,100). All patients once could enter remission state successfully with in-hospital treatment. By the clinical course of AD after discharge, patients were divided into 3 groups; remission-maintenance group (SCORAD < 20), partial remission group (SCORAD: 20-40) and deteriorated group (SCORAD > 40). The difference from baseline in the SCORAD and IgE were not statistically significant between those 3 groups. IgE had been increasing in all groups before start of the in-hospital treatment, but IgE of remission group were significantly decreased after 6 months compared with other groups (p < 0.001). CONCLUSIONS: Adequate proactive treatment to keep good skin condition could contribute to decrease total serum IgE in severe childhood AD.