title: Association of food allergy and atopic dermatitis exacerbations.
abstract: BACKGROUND
  Atopic dermatitis (AD) and food allergy frequently coexist in children.
  
  
  OBJECTIVE
  To examine the association between food allergy and AD.
  
  
  METHODS
  Between 2001 and 2011, children referred to our tertiary care center underwent double-blind, placebo-controlled food challenges (DBPCFCs) for one or more suspected food allergies as part of regular care. Immediate reactions were observed and recorded by allergy nursing staff, whereas late reactions were ascertained by semistructured telephone interview 48 hours after challenge. To test to which degree specific IgE results were predictive in the outcome of DBPCFCs in children with and without (previous and current) AD, logistic regression analysis was performed.
  
  
  RESULTS
  A total of 1186 DBPCFCs were studied. Sensitization to foods occurred significantly more often in children with previous AD. The association between specific IgE results and the outcome of DBPCFCs was significant for children with and without (previous and current) AD but stronger for children without current AD. The positivity rate of DBPCFCs in children with mild, moderate, and severe AD was 53.3%, 51.7%, and 100%, respectively. Children with AD and a history of worsening AD as their only symptom reacted as often to placebo as to challenge food.
  
  
  CONCLUSIONS
  Children with current AD are more frequently asymptomatically sensitized to the foods in question than those without AD. In addition, children suspected of food allergy should be considered for testing, regardless of the severity of their AD. Our results suggest that children with exacerbation of AD in the absence of other allergic symptoms are unlikely to be food allergic.
authors.affiliation: Department of Pediatric Pulmonology and Allergy, University of Groningen, University Medical Center Groningen, GRIAC Research Institute, Groningen, the Netherlands. Electronic address: emroerdink@gmail.com.
authors.forename: Emmy M
authors.initials: EM
authors.lastname: Roerdink
authors.affiliation: Department of General Practice, University of Groningen, University Medical Center Groningen, GRIAC Research Institute, Groningen, the Netherlands.
authors.forename: Bertine M J
authors.initials: BM
authors.lastname: Flokstra-de Blok
authors.affiliation: Department of Dermatology, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands.
authors.forename: Janine L
authors.initials: JL
authors.lastname: Blok
authors.affiliation: Department of Dermatology, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands.
authors.forename: Marie-Louise A
authors.initials: ML
authors.lastname: Schuttelaar
authors.affiliation: Department of Pediatric Pneumology and Immunology, University Hospital Charité, Berlin, Germany.
authors.forename: Bodo
authors.initials: B
authors.lastname: Niggemann
authors.affiliation: Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Werfel
authors.affiliation: Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, GRIAC Research Institute, Groningen, the Netherlands.
authors.forename: Sicco
authors.initials: S
authors.lastname: Van der Heide
authors.affiliation: Department of Pediatric Pulmonology and Allergy, University of Groningen, University Medical Center Groningen, GRIAC Research Institute, Groningen, the Netherlands.
authors.forename: Jeanet
authors.initials: J
authors.lastname: Kukler
authors.affiliation: Department of General Practice, University of Groningen, University Medical Center Groningen, GRIAC Research Institute, Groningen, the Netherlands.
authors.forename: Boudewijn J
authors.initials: BJ
authors.lastname: Kollen
authors.affiliation: Department of Pediatric Pulmonology and Allergy, University of Groningen, University Medical Center Groningen, GRIAC Research Institute, Groningen, the Netherlands.
authors.forename: Anthony E
authors.initials: AE
authors.lastname: Dubois
mesh_terms: D000284:Administration, Oral; D000485:Allergens / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D003876:Dermatitis, Atopic / Q000175:diagnosis / Q000453:epidemiology*; D018450:Disease Progression; D005260:Female; D005512:Food Hypersensitivity / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data*; D007073:Immunoglobulin E / Q000097:blood; D007223:Infant; D008297:Male; D009426:Netherlands; D011237:Predictive Value of Tests
chemical_list: D000485:Allergens; D007073:Immunoglobulin E