title: Eczema exacerbation and food atopy beyond infancy: how should we advise Chinese parents about dietary history, eczema severity, and skin prick testing?
abstract: Issues related to empirical dietary restriction are important, but they have been inadequately studied among children with atopic dermatitis (AD). To evaluate whether any association exists between food atopy, food avoidance, and AD severity, investigators in the present study reviewed all skin prick tests (SPTs) performed between January 2005 and April 2006 at a pediatric dermatology clinic and correlated findings with history of food avoidance and eczema severity. Only 13% of 114 children with AD had a positive SPT for beef. The most commonly sensitized foods were egg yolk (53%), egg white (42%), shrimp (35%), peanuts (31%), and crab (29%). Disease severity was not associated with prevalence of sensitization to these foods. The investigators concluded that immediate immunoglobulin E reaction to beef, as suggested by positive SPT findings, is unlikely to occur in most children with AD. SPT information may be useful in reassuring parents about the unlikelihood of a severe and immediate reaction to beef. As for other foods, it is sensible to advise parents about specific avoidance strategies only in more severely affected children with a definite history of eczema exacerbation by specific food allergens.
authors.affiliation: Department of Pediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital Shatin, Hong Kong SAR, China. ehon@cuhk.edu.hk
authors.forename: Kam-Lun Ellis
authors.initials: KL
authors.lastname: Hon
authors.forename: Ting-Fan
authors.initials: TF
authors.lastname: Leung
authors.forename: Man-Ching Adrian
authors.initials: MC
authors.lastname: Lam
authors.forename: Kin-Yee
authors.initials: KY
authors.lastname: Wong
authors.forename: Chung-Mo
authors.initials: CM
authors.lastname: Chow
authors.forename: Wai-San Fanny
authors.initials: WS
authors.lastname: Ko
authors.forename: Tai-Fai
authors.initials: TF
authors.lastname: Fok
authors.forename: Alexander K C
authors.initials: AK
authors.lastname: Leung
mesh_terms: D000485:Allergens / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D003876:Dermatitis, Atopic / Q000453:epidemiology* / Q000276:immunology; D004032:Diet / Q000009:adverse effects; D005260:Female; D005512:Food Hypersensitivity / Q000453:epidemiology* / Q000276:immunology; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology*; D008297:Male; D008460:Meat / Q000009:adverse effects; D015995:Prevalence; D012720:Severity of Illness Index; D012882:Skin Tests
chemical_list: D000485:Allergens; D007073:Immunoglobulin E