Q I'm a parent in my 40s with an elementary school-age child who has atopic dermatitis and recently has been having a stuffy and runny nose. Is this related to atopic dermatitis?
A It is very common for children with atopic dermatitis to also have allergic rhinitis. This is called the atopic march, where the same allergic immune mechanism appears simultaneously or sequentially in the skin and nasal mucosa. Treating both atopy and rhinitis together improves management of both conditions.
Detailed Answer
Allergic rhinitis accompanies atopic dermatitis in about 30-50% of children. In the atopic march pattern, atopic dermatitis appears first (in infancy), followed sequentially by allergic rhinitis (in childhood) and asthma (in school age). The same IgE-mediated allergic immune mechanism appears across multiple organs.
Key to managing both conditions together: ①Remove common triggers — avoiding house dust mites and pollen helps both skin and rhinitis. ②Rhinitis treatment — suppressing rhinitis with antihistamines and nasal steroid sprays indirectly improves atopy by reducing scratch stimulation. ③Consider immunotherapy — if the sensitizing allergen is clear, allergen immunotherapy is effective for both conditions in the long run.
Korean Medicine Perspective
In Hyeongsang medicine, the co-occurring pattern of atopy and rhinitis is viewed as weakness of the lung (肺), spleen (脾), and stomach (胃). When lung qi is deficient, both the skin and nasal mucosa lack defensive capacity. Socheongryong-tang or Hwanggi-bangpung-tang to tonify lung qi and disperse wind-cold, plus strengthening spleen-stomach function to build the immune foundation — complex prescriptions that address both conditions simultaneously are effective.
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