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Treatment of infantile atopic dermatitis with a strict elimination diet
Insights
A strict elimination diet significantly improved atopic dermatitis in infants. Early intervention and short dermatitis duration were key factors for healing in babies under six months old.
Area of Science:
- Pediatrics
- Immunology
- Dermatology
Background:
- Atopic dermatitis is a common inflammatory skin condition in infants.
- Dietary factors, particularly cow's milk, are suspected triggers.
- Elevated blood eosinophil counts and serum IgE levels are often observed.
Purpose of the Study:
- To evaluate the efficacy of a strict elimination diet in treating infant atopic dermatitis.
- To assess the long-term outcomes of dietary intervention.
- To identify predictors of successful treatment.
Main Methods:
- Twenty-one infants with atopic dermatitis were included in the study.
- Nineteen infants underwent a strict elimination diet for up to six weeks.
- Cow's milk challenge tests were performed, and clinical outcomes were monitored up to two years of age.
Main Results:
- Seven infants healed completely, and twelve showed improvement.
- Infants who healed were younger than six months and had a shorter duration of dermatitis.
- Blood eosinophilia and elevated serum IgE significantly decreased during the diet.
- Twelve infants tested intolerant to cow's milk upon challenge.
- At two years, dermatitis had cleared in most children, though four remained affected, two of whom were cow's milk intolerant.
Conclusions:
- A strict elimination diet is an effective treatment for infant atopic dermatitis.
- Early treatment and shorter disease duration are associated with better healing outcomes.
- Cow's milk intolerance is a significant factor in persistent atopic dermatitis in some infants.
Abstract:
Of twenty-one infants with atopic dermatitis, twenty were treated with a strict elimination diet for a period of up to 6 weeks. Seven infants healed and twelve improved. The infants who healed were less than 6 months old and had had a short duration of dermatitis. For one infant the skin condition was unchanged. Another infant was breast-fed throughout the period with dermatitis. Blood eosinophilia and/or elevated serum IgE commonly found on admission decreased significantly (P less than 0.01) during the diet period. On challenge with cows' milk, twelve infants were considered as intolerant. At the age of 2 years the dermatitis had cleared in all but four children. Of these four children, two were still cows' milk intolerant. Another two infants were also cows' milk intolerant, but without dermatitis.