1. Is it true that eczema related to sinus (resdung) and asthma?

Yes. Atopic eczema, allergic rhinitis and bronchial asthma are the classic triad of atopy. These 3 are the common presentation of an atopy/allergy, which I would call them the 3 musketeers of atopy, “all for one and one for all”, Besides, food allergies are also considered as one of the atopy.

Atopy is define as a personal or familial propensity to produce IgE antibodies and sensitization in response to environmental triggers. The development of atopic diseases is strongly influenced by both genetic and environmental factors. Interestingly, there are studies showed that Atopic eczema is a prerequisite for the development of allergic rhinitis, asthma and specific sensitization. It’s postulated that the impaired skin barrier function in atopic eczema promotes easy entry for pathogens, allergens and other environmental insults such as toxins, irritants, pollutants, which subsequently lead to multiple allergens sensitization. This serves as the tipping point for the gradual development of other atopic disease.

Numerous studies had shown that allergic disease occur in a time-based order, from atopic dermatitis and food allergy in infancy to gradual development into allergic rhinitis and bronchial asthma in childhood. This phenomenon is also known as the “atopic/ allergic march”. Initially, babies could start off with dry skin. Subsequently, they may develop atopic eczema during infancy. When weaning from breast milk takes place, food allergies may then present. Once they enter toddler age, they may develop allergy towards inhaled allergens and may manifest as asthma or allergic rhinitis.

2. None of parents having eczema, is it possible for the baby having eczema?

In accordance with the Malaysian Allergy Prevention (MAP) guideline 2014, the percentage of risk of allergy in offspring is based on family history of allergy.

Furthermore, the risk grade of allergy could be categorized as such:

• Low risk group - none of the family members with allergy, risk of development of allergic disease in a child is around 10-20%
• Medium risk group - one parent or one sibling with allergy, risk of development of allergic disease in a child is around20-40%
• High risk group - both parents or one parent & one sibling with allergy, risk of development of allergic disease in a child is around 60-80%

This article was contributed by Dr Goh Chun Hwee, Consultant Paediatrician at Pantai Hospital Ampang. To know more about where and when to see Dr Goh Chun Hwee at his clinic, click here.