Atopic Triad

What is the atopic triad?

To ensure that we are all talking about the same thing in our allergy community and beyond, we have put together an explanation on atopy and atopic triad in the context of allergic disease.  We may use these terms periodically in the content we publish on Zestfull. 

The atopic triad (sometimes known as the atopic dermatitis triad) is defined by Medical News Today as “the tendency of asthma, eczema and allergies to occur together.” 

Atopic triad

A triad is a group of three things that are closely related to each other, while atopy is defined by Allergy Insider as “the genetic disposition to develop allergic diseases such as allergic rhinitis, asthma and atopic dermatitis.” The word atopy was coined in 1923 by the American allergists A. F. Coca and R. A. Cooke1Hill DA, Spergel JM. The atopic march: Critical evidence and clinical relevance [published correction appears in Ann Allergy Asthma Immunol. 2018 Mar 9;:]. Ann Allergy Asthma Immunol. 2018;120(2):131-137. doi:10.1016/j.anai.2017.10.037, derived from the Greek word ‘atopia’ meaning different or out of place. It was originally proposed as a term to cover asthma and allergic rhinitis but in 1933 atopic dermatitis (also known as eczema) was added to the group because it so commonly occurred with asthma and allergic rhinitis2Spergel JM, Paller AS, Atopic dermatitis and the atopic march. Journal of Allergy and Clinical Immunology. 2003:112(6):Supplement 118-S127. doi:10.1016/j.jaci.2003.09.033. (Spergel et al, 2003) 

Together, the three conditions form the atopic triad, with eczema often appearing in an individual before the symptoms of asthma and allergic rhinitis start to develop.

The connection to the atopic march

The atopic march is a term to describe “the progression from atopic dermatitis during infancy to asthma and allergic rhinitis in later childhood.”3 Tran MM, Lefebvre DL, Dharma C, Dai D, Lou WYW, Subbarao P, Becker AB, Mandhane PJ, Turvey SE, Sears MR, and the Canadian Healthy Infant Longitudinal Development Study investigators. Predicting the atopic march: Results from the Canadian Healthy Infant Longitudinal Development Study. Journal of Allergy and Clinical Immunology. 2018; 114(2): 601-607. doi:10.1016/j.jaci.2017.08.024 Simply put, when a child is diagnosed with eczema they may be at the start of a march towards food allergies, asthma and finally allergic rhinitis (environmental allergies), the other allergic diseases that make up the atopic triad. The atopic march may lead to the development of one of the other allergic diseases, all of them, or may not in fact progress at all. 

If you are looking for a glossary of terms about food allergies, asthma, and eczema please refer to Allergy Insider

You can also listen to our podcast, The Itch, to learn more about these conditions. Episode 2 of The Itch Podcast, where Dr. Gupta walks you through each stage.

This page was medically reviewed by Dr. Payel Gupta.