Atopic Dermatitis linked to asthma??

My 26 month old son has had a rash around his mouth for several weeks now. I took him to the doctor and she said it was atopic dermatitis and that children who present with this often get asthma. I am very concerned. My son had RSV at 6 months and has had pneumonia twice since. He is a very active and is otherwise a healthy little boy. I was just begining to think he was outgrowing these illnesses and getting stronger when the doctor mentioned asthma. How likely is it that this rash could be linked to asthma? Is there anything I can do to prevent him from getting asthma or more respiratory illnesses. Please answer, very worried.

[National Jewish Health]

In general, in young children, atopic dermatitis a major risk factor for persistent asthma; those with moderate to severe disease are very likely to develop airways allergic disease.  We recommend optimal management of atopic dermatitis, but we do not know if this helps reduce the risk or severity of subsequent asthma.  To learn more please read our atopic dermatitis information by copying and pasting this address

http://www.nationaljewish.org/disease-info/diseases/allergy/about/conditions/eczema.aspx

into the address window of your internet browser.
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Authors
Full Name Galli, Elena. Gianni, Simona. Auricchio, Giovanni. Brunetti, Ercole.
Mancino, Giorgio. Rossi, Paolo.
Institution Research Center, AFaR, S. Pietro Hospital, Fatebenefratelli, Roma,
Italy. galli.***@****
Title Atopic dermatitis and asthma.
Source Allergy & Asthma Proceedings. 28(5):540-3, 2007 Sep-Oct.
Abstract Atopic dermatitis (AD), a chronic inflammatory skin disease, frequently associated with respiratory allergy, is one of the most common skin disorders observed in children.  The prevalence of AD and other allergic diseases is increasing in industrialized countries, representing a major burden on health care cost.  AD has been proposed as an "entry point" for subsequent allergic diseases, suggesting the possibility that effective management of AD could prevent the development of respiratory allergy or at least reduce the severity of asthma and allergic rhinitis.  AD and asthma share a common genetic and pathogenic basis, and several longitudinal studies provided evidence for the atopic march from AD to allergic rhinitis and asthma.  However, because only a few prospective studies starting at children's births and having a sufficiently long follow-up have been developed, little is known about the natural course of AD and the potential succession of atopic phenotypes in childhood.  Finally, recent genetic and epidemiological data raised the question whether AD may either develop to asthma or be part of a syndrome consisting of both diseases.
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To learn more please read our asthma information by copying and pasting this address

http://www.nationaljewish.org/disease-info/diseases/asthma/index.aspx

into the address window of your internet browser.

Because infants with atopic dermatitis are likely to develop food and aeroallergen sensitization, I would recommend your son be followed by his doctor for the development of these, and then avoiding allergic foods and also eliminating allergens in homes to which the young child is sensitized.  The biggest predictor for subsequent asthma persistence and severity in toddlers with recurrent cough and wheeze is allergic sensitization to indoor allergens with higher levels of exposure in the home.  The hygiene hypothesis suggests that the absence of infection exposure at a critical point in immune system development leads to a greater risk for the later development of atopic disease.  We don’t know if the infection exposure helps once the atopic dermatitis and/or asthma are in play; indeed, the same microbial exposures, which are suspected to be protective at a critical point in immune system development, can aggravate allergic inflammation and worsen ongoing atopic disease.  Often children who have had respiratory syntactical virus (RSV) go on to develop asthma.  To learn more please read our allergy information by copying and pasting this address

http://www.nationaljewish.org/disease-info/diseases/allergy/about/index.aspx

into the address window of your internet browser.