Tropical endemic limbo-conjunctivitis (TELC) and allergic management: a preliminary study in Togolese children

To study the impact of certain allergens on the manifestations of tropical endemic limbo-conjunctivitis (TELC) in Togolese children. This is a 3-year prospective study of 36 Togolese children with acute recurrences of TELC after 1 to 5 months of remission. Skin prick tests were conducted with five perennial respiratory allergens (dust mites, paper mites, roaches, dog and cat, grass pollen) and three food allergens (egg, peanut, shrimp). The reactions were compared to a negative control (saline solution) and a positive control (histamine or codeine sulfate). Length of remissions between acute exacerbations before and after allergy testing were noted. Thirty-five children were polysensitive. Individual allergens were: dust mites (83.3%), followed by cockroach (72.2%), shrimp (61.1%), peanuts (55.6%), eggs (44.4%), the cat and/or dog dander (38.9%), and grass pollen (22.2%). The rate of remission prior to allergy testing was 77.8% within 2 months after treatment of an exacerbation; with allergy management, 55.5% of patients experienced remission beyond 1 year. The literature reports that TELC is caused by multiple antigens. The clear predominance of respiratory and food allergens may lead to a new pathway for managing TELC in Togolese children. Allergy testing is of great importance for patients with frequent acute exacerbations of TELC.