099 Palmar hyperlinearity patterns and fractional exhaled nitric oxide identify atopic eczema more effectively than filaggrin variant status

Hyperlinear palms are described as a feature of loss-of-function (LoF) variants in Filaggrin (FLG). Fractional exhaled nitric oxide (FeNO) is possibly marker for Th2 inflammation and elevated atopic eczema (AE). We explore the features participants (age <31 years) with AE Bangladeshi ethnicity from East London investigate which factors best distinguish them non-AE controls (no personal history disease participant/parents) cross-sectional study. Participants were recruited between May 2018 March 2020. Patterns palmar linearity categorised, FeNO recorded LoF FLG identified using targeted sequencing. These general demographics compared both groups. Firth’s logistic regression was used models Area Under Receiver Operator Characteristic (AUROC). Five hundred seventy seven cases available (507 71 controls). patterns noted. There at least one variant 39.3% 16.9% controls. Adjusted palm (AUROC 76.44%) performed better than status 68.04%) distinguishing In data subset 445 (n=132 too young testing), individual pattern well full dataset model had an AUROC 77.05%. Combination included 89.10%. The addition did not improve palm/FeNO model. demonstrate it possible that dosage expression (as ‘seen’ within ridged skin palm) more relevant factor just genotype development. AE-phenotypic association putative surrogate supports systemic immune activation thus need earlier treatments AE.