Atopic March (Allergic March)

Atopic march, also called allergic march, is the way allergies appear from infancy and progress through childhood.

While this march can occur at any time, studies show that allergies tend to occur and progress in order from skin; atopic dermatitis (eczema) then to food allergies in infancy, and finally allergic asthma or nasal allergies in childhood.

The common trend of evidence points toward the relationship between the severity and the age of onset of eczema, increases the risk of developing the remaining atopic conditions along the march.

The cause of the atopic march is not completely understood but is thought to have several genetic and environmental factors that could lead to its development and progression.

Some common ideas with experts suggest that a defective skin barrier may provide the pathway for allergens and other pathogens to invade the body. For example, an infant with severe eczema, and a broken skin barrier may take in foreign particles easier and trigger an immune response that will eventually lead to a food allergy the next time they encounter that same kind of particle.

Broken skin barriers are also more susceptible to pathogens like staphylococcus, which may cause irritation and itching resulting in a possible immune response, and widespread inflammation.

More studies still need to be done for ways to prevent or stop the process.  Ideas like controlling allergen exposure, maintaining a good skin barrier and immunotherapy are good starting points but may not be a fool proof method of preventing future steps down the atopic highway. Some even suggest that a controlled environment during infancy will be the best method but that is not always the easiest task.   The best choice would to be seen by an allergist who can properly assess genetic and environmental risk. Being able to identify these risks early may lead to a better treatment plan or preventable options.

Yang L, Fu J, Zhou Y. Research progress in atopic march. Front Immunol. 2020;11:1907. doi:10.3389/fimmu.2020.01907

Zheng T. The atopic march: progression from atopic dermatitis to allergic rhinitis and asthma. J Clin Cell Immunol. 2014;05(02). doi:10.4172/2155-9899.1000202

Hill DA, Spergel JM. The atopic march. Ann Allergy Asthma Immunol. 2018; 120, 131-137. Available from: http://www.annallergy.org/article/S1081-1206(17)31258-9/pdf. Accessed February 28, 2018.

Bantz SK, Zhu Z, Zheng T. The atopic march: Progression from atopic dermatitis to allergic rhinitis and asthma. J Clin Cell Immunol. 21 Nov 2014; 5(2), 202. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4240310/. Accessed February 28, 2018.