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ISRN Pediatrics
Volume 2012 (2012), Article ID 408769, 6 pages
http://dx.doi.org/10.5402/2012/408769
Research Article

Cow’s Milk Allergy Is a Major Contributor in Recurrent Perianal Dermatitis of Infants

1Department of Pediatrics, Faculty of Medicine, Ain Shams University, Abbassia, Cairo 11566, Egypt
2Department of Clinical Pathology, Faculty of Medicine, Ain Shams University, Abbassia, Cairo 11566, Egypt

Received 12 May 2012; Accepted 1 August 2012

Academic Editors: S. C. Aronoff and S. K. Patole

Copyright © 2012 Mostafa Abdel-Aziz El-Hodhod et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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.