title: The use of dietary manipulation by parents of children with atopic dermatitis.
abstract: BACKGROUND
  In 1989 we demonstrated that 71% of children referred to our paediatric dermatology clinic with atopic dermatitis (AD) had been subject to dietary manipulation by their parents in order to manage their disease. We have re-examined our clinic population to determine whether the documented rise in the use of complementary therapy in children with skin disease has been accompanied by a rise in dietary manipulation.
  
  
  OBJECTIVE
  To qualify and quantify the usage of dietary manipulation in children with AD in secondary care.
  
  
  METHODS
  A face-to-face structured questionnaire study of 100 children with AD.
  
  
  RESULTS
  The mean age of the children interviewed was 7.3 years (median 5.9, range 0.6-17.1) and ethnic origin was 59% white, 35% Indo-Asian, 3% Afro-Caribbean and 3% mixed race. Seventy-five per cent of patients (75 of 100) had tried some form of dietary exclusion; the most common foods omitted were dairy products in 48% (36 of 75), eggs in 27% (20 of 75) and cow's milk in 25% (19 of 75). Forty-one per cent of patients (41 of 100) had tried some form of dietary supplementation. The most common dietary supplement was evening primrose oil in 59% (24 of 41), of whom 13% (three of 24) felt this had helped their skin. Only 51% (38 of 75) had consulted a doctor or dietician before commencing any dietary change, but 39% (29 of 75) felt that their skin had improved as a result of this dietary manipulation.
  
  
  CONCLUSIONS
  In comparison with our previous study, the proportion of patients excluding foods from their diet had increased from 71% to 75%. The proportion of these dietary changes that are unsupervised has remained the same, as have the food types avoided. The proportion of patients who report that unsupervised dietary manipulation is beneficial has increased from 10% to 39%.
authors.affiliation: Department of Dermatology, Leicester Royal Infirmary, LE1 5WW, U.K. graham.johnston@uhl-tr.nhs.uk
authors.forename: G A
authors.initials: GA
authors.lastname: Johnston
authors.forename: R M
authors.initials: RM
authors.lastname: Bilbao
authors.forename: R A C
authors.initials: RA
authors.lastname: Graham-Brown
mesh_terms: D000293:Adolescent; D000818:Animals; D002648:Child; D002675:Child, Preschool; D003611:Dairy Products; D003876:Dermatitis, Atopic / Q000178:diet therapy* / Q000209:etiology; D004032:Diet; D019587:Dietary Supplements; D004531:Eggs; D005228:Fatty Acids, Essential / Q000008:administration & dosage; D005260:Female; D005512:Food Hypersensitivity / Q000150:complications; D006801:Humans; D007223:Infant; D008041:Linoleic Acids; D008297:Male; D008892:Milk; D031665:Oenothera biennis; D010290:Parents; D010938:Plant Oils; D012648:Self Care; D017965:gamma-Linolenic Acid
chemical_list: D005228:Fatty Acids, Essential; D008041:Linoleic Acids; D010938:Plant Oils; C028498:evening primrose oil; D017965:gamma-Linolenic Acid