Atopic Dermatitis and Food Allergy: A Paediatric Approach

Atopic dermatitis and food allergy are common conditions of childhood that are closely linked. 30% of children with moderate to severe eczema suffer from food allergy and can present with different types of reactions: immediate or IgE-mediated reactions, delayed or non-IgEmediated eczematous flares, or a combination of the two. A detailed history is very important when approaching such patients. The presence of IgE-mediated symptoms warrants investigation and management requires avoidance of the culprit allergen, an emergency care plan and appropriate follow up. Non-IgE-mediated reactions can be more difficult to diagnose, and investigations are more difficult to interpret. Topical treatment is paramount in all patients with atopic dermatitis, while food elimination diets remain the mainstay of the management of food allergy, and should be done under specialist supervision. In this review, we discuss the current understanding of atopic dermatitis and food allergy, the role of investigations and management of paediatric patients with both conditions. We propose an algorithm that can be used by paediatricians when dealing with children with food allergy and atopic dermatitis.