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

Idit Lachover-Roth1,2,3, Sharon Polakow-Farkash4, Ido Lusky5

  • 1Allergy and Clinical Immunology Unit, Meir Medical Center, Kfar-Saba, Israel.

Acta Paediatrica (Oslo, Norway : 1992)
|June 19, 2026
PubMed

Insights

Skin contact with food allergens rarely causes reactions in children with food allergies (FA). This study found no anaphylaxis from skin exposure, suggesting minimal risk and reduced need for strict environmental avoidance.

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.
Abstract

Keywords:
contact skin reactionfood allergypatch testsystemic reaction

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