Extreme dietary measures in the management of atopic dermatitis in childhood

Of 63 children with severe atopic dermatitis who were treated with a diet eliminating all but 6 foods for a 6-week period, 9 (14%) abandoned the diet, 21 (33%) completed the diet but did not benefit, and in 33 (52%) there was significant benefit. However, the outcome at 12 months was the same regardless of the response to the diet because of the tendency for dermatitis to markedly improve in all three groups. Of 37 children with exceptionally severe atopic dermatitis treated with an antigen avoidance regimen comprising hospitalization, exclusive feeding with an elemental formula for a median duration of 30 days, and measures to reduce exposure to pet animal and dust mite antigens at home, 10 (27%) either failed to respond to the regimen or relapsed within 12 months, and sustained improvement was seen in 27 (73%) patients. A few-food diet or a strict anti avoidance regimen may be associated with improvement of atopic eczema where conventional treatments have failed.