Related Experiment Videos
Immediate contact reactions to cow's milk and egg in atopic children
A P Oranje1, R S Aarsen, P G Mulder
1Department of Dermatology and Venereology, Division of Paediatric Dermatology, Erasmus University, Rotterdam, The Netherlands.
Insights
Immediate skin reactions in children, like hives and rash, often linked to atopic dermatitis, can be triggered by food contact. The Skin Application Food Test (SAFT) effectively identifies these reactions, suggesting an immune response.
Area of Science:
- Pediatric Allergy and Immunology
- Dermatology
- Clinical Immunology
Background:
- Immediate contact urticaria and rash around the mouth are common in young children, often associated with atopic dermatitis.
- These symptoms suggest a food-induced immediate contact reaction, which can be irritative or immune-mediated.
- Food allergy diagnosis in children often relies on clinical history and specific tests.
Purpose of the Study:
- To evaluate the efficacy of the Skin Application Food Test (SAFT) in diagnosing immediate food-induced contact reactions in children.
- To investigate the role of immune-mediated mechanisms in these reactions.
- To assess the impact of food-to-skin contact on atopic dermatitis in affected children.
Main Methods:
- A cohort of 40 children aged 0-5 years with immediate contact urticaria and rash were studied.
- The Skin Application Food Test (SAFT), a direct skin contact test for up to 30 minutes, was used for re-inducing reactions.
- Results were correlated with IgE RAST (Radioallergosorbent test) and total IgE levels.
Main Results:
- The SAFT identified immediate contact urticaria within minutes in positive cases.
- SAFT results showed significant correlation with IgE RAST, supporting an immune-mediated mechanism.
- Food-to-skin contact exacerbated dermatitis in 52% of children with atopic dermatitis.
Conclusions:
- The SAFT is a valuable and 'physiological' diagnostic tool for immediate food-induced contact reactions in children.
- Immune-mediated mechanisms play a significant role in food allergy presenting as dermal reactions.
- Contact reactions to foods are important in the context of (dermal) food allergy and atopic dermatitis management.
Abstract:
Forty children (0-5 years old), presented with immediate contact urticaria, rash and often atopic dermatitis (n = 34). Redness or urticaria around the mouth appearing after consuming cow's milk or egg, were the major complaints in all. These symptoms suggested a food-induced immediate contact reaction, which can be immune-mediated or irritative. To reinduce this reaction, a skin provocation test, called SAFT, was performed. SAFT stands for Skin Application Food Test. This test is based on direct skin contact, during a maximum of 30 min with food in its 'ordinary consumptive state'. The SAFT can be regarded as a 'physiological' provocation patch test. If positive, contact urticaria develops most often within a few minutes. The results of SAFT and IgE RAST correlated significantly well. Total IgE values were not informative. The rapid onset of the SAFT reaction, induced by proteins, supported by RAST results, strongly indicates an immune-mediated mechanism. In 52% of the 34 patients with atopic dermatitis, dermatitis was exacerbated following food-to-skin contact. Immune-mediated contact reactions to foods play an important role in (dermal) food allergy.