%0 Journal Article
%T Cow＊s Milk Allergy Is a Major Contributor in Recurrent Perianal Dermatitis of Infants
%A Mostafa Abdel-Aziz El-Hodhod
%A Ahmad Mohamed Hamdy
%A Marwa Talaat El-Deeb
%A Mohamed O. Elmaraghy
%J ISRN Pediatrics
%D 2012
%R 10.5402/2012/408769
%X Background. Recurrent perianal inflammation has great etiologic diversity. A possible cause is cow＊s milk allergy (CMA). The aim was to assess the magnitude of this cause. Subjects and Methods. This follow up clinical study was carried out on 63 infants with perianal dermatitis of more than 3 weeks with history of recurrence. Definitive diagnosis was made for each infant through medical history taking, clinical examination and investigations including stool analysis and culture, stool pH and reducing substances, perianal swab for different cultures and staining for Candida albicans. Complete blood count and quantitative determination of cow＊s milk-specific serum IgE concentration were done for all patients. CMA was confirmed through an open withdrawal-rechallenge procedure. Serum immunoglobulins and CD markers as well as gastrointestinal endoscopies were done for some patients. Results. Causes of perianal dermatitis included CMA (47.6%), bacterial dermatitis (17.46%), moniliasis (15.87%), enterobiasis (9.52%) and lactose intolerance (9.5%). Predictors of CMA included presence of bloody and/or mucoid stool, other atopic manifestations, anal fissures, or recurrent vomiting. Conclusion. We can conclude that cow＊s milk allergy is a common cause of recurrent perianal dermatitis. Mucoid or bloody stool, anal fissures or ulcers, vomiting and atopic manifestations can predict this etiology. 1. Introduction Perianal dermatitis is probably the most common cutaneous disorder of the genitoanal area [1]. Diaper dermatitis is observed most frequently in infants at 9每12 months of age [2]. It has a multifactorial etiology and high chronicity [3, 4]. Its prevalence is not greatly different between genders or among races [5]. Signs of diaper dermatitis including erosions have been noted as early as the first 4 days of life [6每8]. There have been only a few studies on the etiology and causative factors in anal eczema [9每11]. The patient＊s diet may be a factor in the development of diaper dermatitis [12]. Breastfed infants are less likely to develop moderate to severe diaper dermatitis relative to formula-fed infants [2, 13]. Adverse reactions to cow＊s milk are frequent (2每7%) in the first year of life and may include cutaneous (50每60%), gastrointestinal (50每60%), or respiratory (20每30%) affection [14]. Streptococcal perianal infections were reported as a frequent cause of such a recurrent condition [15]. The aim of this work was to find out the different causes of recurrent perianal dermatitis with focus on the magnitude of cow＊s milk allergy and the possible clinical or
%U http://www.hindawi.com/journals/isrn.pediatrics/2012/408769/