Food allergy and atopic dermatitis: separating fact from fiction.
The relationship between food and atopic dermatitis (AD) is complex. A common misunderstanding is that food allergies have a significant impact on the course of AD, resulting in uncontrolled attempts at elimination diets and undertreatment of the skin itself. Studies have shown that only a small portion of cutaneous reactions to food in the form of late, eczematous eruptions will directly exacerbate AD in young infants who have moderate-to-severe AD. Given the low frequency of food allergies actually inducing flares of AD, the focus should return to appropriate skin therapy, and identification of true food allergies should be reserved for recalcitrant AD in children in whom the suspicion for food allergy is high. A different relationship between food and AD involves delaying or preventing AD in high-risk infants by exclusive breastfeeding during the first 4 months of life. Finally, the skin barrier defect in AD may allow for easier and earlier sensitization of food and airborne allergens; therefore, exposure of food proteins on AD skin may act as a risk factor for development of food allergies.
Suh
Ki-Young
KY
Division of Dermatology, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA 90095, USA. ksuh@mednet.ucla.edu
D001942:Breast Feeding; D002648:Child; D015897:Comorbidity; D003876:Dermatitis, Atopic / Q000453:epidemiology* / Q000235:genetics / Q000276:immunology / Q000517:prevention & control; D018450:Disease Progression; D004485:Eczema / Q000453:epidemiology; D000091344:Filaggrin Proteins; D005512:Food Hypersensitivity / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology; D006801:Humans; D007381:Intermediate Filament Proteins / Q000235:genetics; D011498:Protein Precursors / Q000235:genetics; D012867:Skin / Q000276:immunology; D017592:Skin Care
D000091344:Filaggrin Proteins; D007381:Intermediate Filament Proteins; D011498:Protein Precursors