Expert consensus on diagnosis and management of food allergy in children with atopic dermatitis / 中华皮肤科杂志

ABSTRACT

In clinical practice, the diagnosis of food allergy has not been standardized, and food allergy is overdiagnosed in patients with atopic dermatitis (AD) . Unnecessary elimination diets due to overdiagnosis of food allergy may exert a potential adverse effect on health in children with AD. Unlike classic IgE-mediated food allergy, food allergy in AD patients may manifest as noneczematous reactions, isolated eczematous reactions and a combination of the two above. The diagnosis of food allergy in children with AD should be made in combination with a thorough clinical history (detailed allergic history and feeding history) , clinical manifestations and a laboratory work-up including skin prick tests, serum specific IgE measurements, atopy patch tests and oral food challenge tests. Once an underlying food allergy is confirmed in AD patients, comprehensive management is generally recommended. Avoidance of the incriminated food is the main treatment approach, but regular clinical follow-up is necessary, including evaluation of nutritional status, and supervision of growth and development. Multi-disciplinary cooperation of dermatologists, nutritionists and pediatricians is required.