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

Diagnosis and Dietary Management of Food Allergy in Patients With Atopic Dermatitis

Diagnosis and management of patients with atopic dermatitis suspected of food allergy should follow established international guidelines.[44–46] Skin testing and/or sIgE should be performed in patients with a history compatible with an immediate IgE-mediated reaction to the suspected allergen(s). In addition, selected food skin testing/sIgE can be considered in patients with moderate-to-severe atopic dermatitis under the age of five unresponsive to topical treatments and other skincare treatments. Atopy patch testing has been studied to evaluate foods responsible for atopic dermatitis flare-ups in children with atopic dermatitis.[47,48] Although promising, they are not standardized and not suggested in routine diagnosis of food allergy in patients with atopic dermatitis. DBPCFC may be necessary in some instances to confirm food allergy; many patients with atopic dermatitis present with asymptomatic sensitization and these challenges may help guide which allergens may be clinically relevant. Finally, an elimination diet trial based on results of conclusive food challenges may be indicated, on the basis of evidence that this may reduce the severity of atopic dermatitis in these patients.[49] Unselected elimination diets are not recommended because of possibility of loss of tolerance to introduced foods[50,51] and can be associated with other complications such as nutritional risks and growth restriction.[49,52,53]