Accidental Skin Contact With Food Allergens Does Not Trigger Anaphylaxis in Children: A Prospective Multicentre Study

Area of Science:

• Pediatric Allergy and Immunology
• Dermatology
• Clinical Immunology

Background:

• Children with food allergies (FA) and their caregivers often fear severe reactions from accidental skin contact with allergens.
• This fear can lead to significant psychosocial burden and unnecessary environmental restrictions.

Purpose of the Study:

• To evaluate the risk of systemic allergic reactions from controlled skin exposure to common food allergens in children with confirmed FA.
• To assess the clinical significance of skin contact with food allergens in pediatric populations.

Main Methods:

• A multicenter study involving children aged 1-18 years with confirmed FA.
• Patch testing with allergenic foods applied to the forearm for 15 minutes.
• Inclusion of age- and sex-matched control groups (atopic without FA, healthy).

Main Results:

• Out of 293 children, 192 had FA. Of 263 patch tests in the FA group, 83.7% were negative.
• 15.2% showed mild local skin reactions, and 1.1% had more extensive local reactions; no systemic reactions or anaphylaxis occurred.
• Cow's milk triggered reactions in 23.5% (mild local) and 2.9% (extensive local); younger age predicted skin reactivity.

Conclusions:

• Controlled skin exposure to allergenic foods in children with FA did not induce anaphylaxis.
• Incidental skin contact with food allergens poses minimal risk for systemic reactions.
• Findings may help alleviate unnecessary environmental restrictions and reduce associated psychosocial burden for families.