Introduction/Objective. The incidence of comorbidity of asthma and allergic rhinitis was one of the reasons for changing guidelines for the treatment of asthma and allergic rhinitis. The World Health Organization and Allergic Rhinitis and its Impact on Asthma group proposed the new diagnostic and therapeutic concept ??one airway, one disease.? Further, the presence of allergic rhinitis in children with asthma contributes significantly to low control of asthma; also, the treatment of allergic rhinitis in children with asthma has positive effects in terms of reducing the severity of asthma symptoms. The aim of this study was to determine the prevalence of allergic diseases among children in the Republic of Srpska, as well as to determine whether allergic rhinitis and eczema are more common in children with asthma. Methods. Our study was conducted as a cross-sectional study and included 3,000 children aged six to 15 years from 13 primary schools in the Republic of Srpska. The final data processing included 1,975 correctly completed questionnaires. Results. The prevalence of wheezing in the previous 12 months was 7.9%, of allergic rhinitis 12.7%, and of eczema 5%. Asthma was diagnosed by a doctor in 3.5% of the children, allergic rhinitis in 19.2%, and eczema was diagnosed in 14.5% of the children. Conclusion. Children with asthma had statistically significant higher prevalence of other alergic diseases compared to general population. Also, children with mild asthma had statistically significant risk to be undiagnosed. Undiagnosed asthma in comorbidity with other allergic diseases leads to poor asthma control in children.

Bearing in mind the results of the epidemiological studies, the logical question arises whether allergic rhinitis represents an earlier clinical manifestation of allergic airway disease or itself is causative for asthma. Comorbidity or one disease, the diagnosis of allergic rhinitis often precedes the development of asthma. Literature reports that 40-90% of asthmatics have symptoms of allergic rhinitis. The epidemiological evidence also suggests that allergic rhinitis and asthma radially presented one united airway disease with two-stage than two separate diseases. Symptoms of one disease often predominate and are unrecognized or hidden of another disease even if they exist. The epidemiology evidence of comorbidity of allergic rhinitis and asthma confirmed the new concept of the united airway diseases. Despite the evidence of the correlation between allergic rhinitis and asthma, there is some resistance in clinical practice in recognizing this link.

Cough variant asthma (CVA) was first described by Glauser. CVA was described as the isolated chronic cough as the only presenting symptom responsive to bronchodilator therapy. The authors now suggest that CVA is present with airway hyperresponsiveness, eosinophilic inflammation of central and peripheral airways and bronchodilator responsive coughing without typical manifestation of asthma such as wheezing or dyspnea. Pathologically, CVA shares common features such as eosinophilic inflammation and remodeling changes with classic asthma. Because of that, CVA is clinically considered as a variant type of asthma, a phase at the beginning of asthma pathogenesis or as a precursor of classic asthma. Nearly 30% of patients with CVA eventually develop intermittent wheezing, an average of 3-5 years. It is clinically very important to recognize CVA because long-term inhaled corticosteroids can significantly decrease the development of classic asthma in these patients.

Atopic dermatitis (AD) is one of the most common skin conditions in children and adolescents. This disease is characterized by acute and chronic lesions. Acute lesions can occur at any age and have a recurring character. Localization of acute lesions is a characteristic for a certain age of the child. Chronic lesions are present after the second year of life and characterized by pruritus and lichenification. Ichthyosis and xerosis are also characteristics of chronic lesions. The authors represent two hypotheses about pathophysiology of atopic dermatitis: "inside-out" hypothesis suggests that pathophysiological process is the result of an inflammatory response, while the "outside-inside" hypothesis suggests that changes of the epidermal barrier are responsible for the process in lesions in atopic dermatitis. There is no gold standard, clinical or laboratory, for the diagnosis of atopic dermatitis. The diagnosis should be based on anamnesis, clinical features and laboratory results. The therapeutic approach includes general and specific measures. General measures including topical moisturizers, bathing and bathing practices and wet-wrap therapy. Specific measures include topical corticosteroids and topical calcineurin inhibitors. Systemic immunosuppressant agents and phototherapy are a second-line treatment and used when the atopic dermatitis is not controlled. These patients must be treated by a dermatologist or pediatricians.

SAŽETAK: Naša studija je prva ovakva studija koja koristi internacionalnu metodologiju za određivanje prevalencije alergijskih oboljenja kod školske djece. Cilj ove studije bio je odrediti prevalenciju i geografske varijacije simptoma alergijskih oboljenja kod djece školskog uzrasta na teritoriji Republike Srpske. Istraživanje je provedeno u obliku studije presjeka i obuhvatalo je 3000 djece iz 13 osnovnih škola. Prevalencija simptoma alergijskih oboljenja određivala se putem upitnika Internacionalne studije za astmu i alergije kod djece (The International Study of Asthma and Allergies in Childhood-ISAAC). Prevalencija vizing u poslednjih 12 mjeseci u Republici Srpskoj bila je 7,95%, ekcema 5,01% i simptoma alergijskog rinokonjuktivitisa 12,71%. Simptomi astme najčešće su prisutni kod djece uzrasta od 8 do 10 godina. Prevalencija simptoma ekcema i alergijskog rinitisa ima tendenciju rasta do 9. odnosno 10. godine uzrasta djeteta, poslije čega se uočava pad učestalosti ovih simptoma. Rezultati multicentričnih studija pokazuju da su zemlje u razvoju, kao što je naša, u posebnom riziku za veću učestalost simptoma alergijskih oboljenja kod djece. Stoga je važno provoditi epidemiološke studije o prevalenciji ovih oboljenja, posebno imajući na umu uticaj ovih oboljenja na kvalitet života djece.