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Food Sensitivity in Children Diagnosed with Atopic Dermatitis in The First 2 Years: How Many of These Patients Are
Sevgi Sipahi Cimen1, Belgin Usta Guc2, Lida Bulbul3
1Division of Pediatric Allergy and Immunology, Department of Pediatrics, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye.
Insights
Food sensitivity affects nearly half of young children with atopic dermatitis (AD). Cow's milk and egg allergies are common, and oral food challenge tests are crucial for diagnosis.
Area of Science:
- Pediatric Allergy and Immunology
- Dermatology
- Clinical Nutrition
Background:
- Atopic dermatitis (AD) is a common chronic inflammatory skin condition in infants and young children.
- Food sensitivity and allergy are frequently associated with AD, impacting disease management and quality of life.
Purpose of the Study:
- To determine the prevalence of food sensitivity in young children diagnosed with atopic dermatitis.
- To investigate the frequency of confirmed food allergy among those with identified food sensitivity.
Main Methods:
- Retrospective analysis of demographic, clinical, and laboratory data from 72 children (0-2 years) with AD.
- Food sensitivity assessed via skin prick tests and serum-specific immunoglobulin E (IgE).
- Food allergy diagnosed using oral food challenge (OFC) tests.
Main Results:
- Food sensitivity was present in 45.8% of patients, with confirmed food allergy in 41.7%.
- Egg white/yolk and cow's milk were the most frequent sensitivities and allergies.
- Moderate/severe AD was more common in younger infants, those with early symptom onset, family history of allergy, shorter breastfeeding duration, and higher IgE/eosinophil levels.
Conclusions:
- Food sensitivity in AD patients is influenced by factors beyond disease severity, including gender and breastfeeding history.
- Oral food challenge (OFC) is essential for confirming food allergies before implementing dietary restrictions.
Objectives:
In this study, it was aimed to examine food sensitivity in patients with atopic dermatitis (AD) and to investigate the frequency of food allergy in patients with food sensitivity.
Methods:
Patients aged 0-2 years who were followed up with the diagnosis of AD were included in the study. The characteristics of demographic and clinical and laboratory findings of the patients were recorded retrospectively. Patients were classified as mild, moderate, and severe using the SCORing AD index according to the severity of AD. The presence of food sensitivity was evaluated by skin prick test and serum-specific immunoglobulin (Ig)E results. Food allergy was diagnosed by oral food challenge (OFC) test.
Results:
Of the 72 patients included in the study, 62.5% (n=45) were male, and the mean age was 9±4.8 months. When the disease severity was evaluated, it was mild in 40 patients (55.6%); moderate/severe AD was present in 32 patients (44.4%). The frequency of moderate/severe AD was higher in patients who were younger (p=0.01), whose symptoms started in the first 6 months (p=0.03), who had a family history of allergic disease (p=0.001), who breastfed for <6 months (p=0.01), who had a higher median serum total IgE level, and a higher percentage of serum eosinophils (p=0.005 and p=0.01, respectively). Food sensitivity in 45.8% of patients; food allergy was detected in 41.7% of them. The most common sensitivities and allergies were eggs white/yolk and cow's milk, respectively. The rate of food sensitivity was found to be higher in male gender (p=0.03) and breastfed patients (p=0.03), whereas it was similar in patients with mild and moderate/severe AD.
Conclusion:
In the investigation of food sensitivity in patients with AD, it is important to evaluate other demographic and clinical characteristics such as gender and breastfeeding, apart from the severity of disease. The OFC test should be performed to confirm the food allergy in patients with food sensitivity before the recommendation of an elimination diet.
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