Significant improvement of eczema with skin care and food elimination in small children.
OBJECTIVE
To evaluate common methods of investigation and treatment in children younger than 2 y of age with eczema, with or without sensitization to food allergens.


METHODS
One hundred and twenty-three children younger than 2 y of age with eczema and suspected food allergy were included in this prospective study. The children underwent skin-prick test with cow's milk, fresh hen's egg white and wheat. Specific IgE to milk and egg white was analysed. The eczema extent and severity was estimated with SCORAD before and after treatment. Children with a positive skin-prick test were instructed to exclude that food item from their diet. All children were treated with emollients and topical steroids when needed.


RESULTS
Sixty-two of the children were skin-prick positive to at least one of the allergens; 62% had mild, 30% moderate and 8% severe eczema at their first visit. After treatment, 90% had mild, 10% moderate and 0% severe eczema. Forty-six per cent of the children had circulating IgE antibodies to milk or egg white. Ten per cent had specific IgE but negative skin-prick test to the same allergen. This subgroup improved their eczema significantly without elimination diet.


CONCLUSIONS
The conventional treatments for children with eczema, i.e. skin care and food elimination, are effective. The beneficial effect of skin care as the first step should not be neglected, and it may not be necessary to eliminate food allergens to relieve skin symptoms in all food-sensitized children with eczema.
Norrman
Gunilla
G
Department of Molecular and Clinical Medicine, Division of Paediatrics, Linköping University, Sweden. gunilla.norrman@lg.se
Tomicić
Sara
S
Böttcher
Malin Fagerås
MF
Oldaeus
Göran
G
Strömberg
Leif
L
Fälth-magnusson
Karin
K
D000888:Antibodies, Anti-Idiotypic / Q000032:analysis / Q000276:immunology; D002675:Child, Preschool; D015331:Cohort Studies; D003131:Combined Modality Therapy; D003879:Dermatologic Agents / Q000627:therapeutic use; D004032:Diet; D004485:Eczema / Q000175:diagnosis* / Q000276:immunology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D005512:Food Hypersensitivity / Q000175:diagnosis* / Q000276:immunology / Q000628:therapy*; D006801:Humans; D007073:Immunoglobulin E / Q000032:analysis / Q000276:immunology; D007223:Infant; D008297:Male; D010328:Patch Tests; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017592:Skin Care / Q000379:methods*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
D000888:Antibodies, Anti-Idiotypic; D003879:Dermatologic Agents; D007073:Immunoglobulin E