Atopic Dermatitis and its Relation to Food Allergy

François Graham; Philippe A. Eigenmann


Curr Opin Allergy Clin Immunol. 2020;20(3):305-310. 

In This Article


Atopic dermatitis is frequent disorder of childhood which poses a strong risk factor for the development of food allergy. A large amount of evidence in recent years supports epicutaneous sensitization to food allergens via defective skin barrier in atopic dermatitis. Genetic factors, skin microbiome dysbiosis, as well as innate immunity dysregulation are all implicated in the pathogenesis of atopic dermatitis, and play a role in transcutaneous sensitization. Food allergy may be present in approximately one-third of patients with moderate-to-severe atopic dermatitis, and dietary evictions may be warranted in such patients. However, this requires a careful evaluation by specialists to confirm causality between foods and atopic dermatitis exacerbation as unnecessary dietary evictions may lead to loss of tolerance to allergenic foods and nutritional deficiencies. Strategies to prevent food allergy in high-risk patients with atopic dermatitis are currently being investigated, with promising results from early introduction of allergenic foods. Further studies are required to precise the optimal strategy and timing of introduction and whether this may be applicable to other allergenic foods. Ultimately, further studies on the pathophysiology of atopic dermatitis and its role in the development of food allergy will help to define better therapeutic targets for both the primary prevention and treatment of food allergy.