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US Pharm. 2007;32(4):10.
Allergic diseases are important causes of
morbidity in the United States. The National Ambulatory Medical Care Survey
reported that allergic rhinitis, asthma, and contact dermatitis or eczema were
among the 15 most common diagnoses made in patients 11 to 20 years old. In
addition, injections of allergenic extracts were the most commonly prescribed
drug in those age 11 to 14 years and the second most common in those 15 to 20
years old. The number of visits to office-based dermatologists was 33.8
million, and the number of visits to office-based physicians for skin rash was
11.5 million.
According to the 2005 National Health Interview
Survey, 11% of children younger than 18 years suffered from hay fever in the
past 12 months, 12% from respiratory allergies, and 13% from other allergies.
Non-Hispanic white children (13%) were more likely to have had respiratory
allergies than non-Hispanic black children (10%) or Hispanic children (9%).
Children living in the South (15%) were more likely to have had respiratory
allergies than those living in the Midwest (11%), Northeast (10%), or West
(9%). Children in fair or poor health (34%) were more than three times as
likely to have had respiratory allergies as children in excellent health.
The determination of whether a clinical syndrome
may have an allergic etiology was studied by the use of allergy skin tests.
Introducing an allergen into the skin of an allergic individual resulted in a
cutaneous inflammatory reaction within 10 to 20 minutes. The National Health
and Nutrition Examination Survey (NHANES) studied skin-test reactivity on a
national sample of a noninstitutionalized population. Each participant was
skin tested against eight allergens: house dust, alternaria, cat, dog, mixed
giant and short ragweed, oak, perennial rye grass, and Bermuda grass.
The prevalence rate of skin-test reactivity to at
least one allergen was 20.2%. Among individual allergens, ragweed and rye
grass had the highest individual rates of reactivity, with about 10% of the
population reacting to each one. The prevalence rate of skin-test reactivity
was higher in males (22.2%) than in females (18.4%). The prevalence rate was
higher in blacks (23.2%) than in whites (19.5%), but the difference was not
significant. Peak reactivity to at least one allergen occurred in people ages
18 to 24 years. The peak reactivities were 33.3% for males and 25.2% for
females.
The graph shows that non-Hispanic black females 17
years and younger had the highest prevalence of allergic skin conditions,
followed by their male counterparts and non-Hispanic white males. The
prevalence of allergic skin conditions varied between boys and girls depending
on race. Among non-Hispanic whites, the prevalence of allergic skin conditions
was higher among girls four years or younger, but the prevalence rates
reversed among children 5 to 17 years old; girls had a higher prevalence rate
than boys in the same age group. Among the non-Hispanic blacks, however, the
girls had a higher rate of prevalence than that of their male counterparts
across all the age groups for children.
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