State of the art and new horizons in the diagnosis and management of egg allergy.

Egg allergy is one of the most frequent food allergies in children below the age of three. Common symptoms of egg allergy involve frequently the skin as well as the gut and in more severe cases result in anaphylaxis. Non-IgE-mediated symptoms such as in eosinophilic diseases of the gut or egg-induced enterocolitis might also be observed. Sensitization to egg white proteins can be found in young children in absence of clinical symptoms. The diagnosis of egg allergy is based on the history, IgE tests as well as standardized food challenges. Ovomucoid is the major allergen of egg, and recent advances in technology have improved the diagnosis and follow-up of patients with egg allergy by using single allergens or allergens with modified allergenic properties. Today, the management of egg allergy is strict avoidance. However, oral tolerance induction protocols, in particular with egg proteins with reduced allergenic properties, are promising tools for inducing an increased level of tolerance in specific patients.

[Atopic dermatitis and food allergies]. / Dermatite atopique et altergies alimentaires.

Around 13% of children in Switzerland are affected by atopic dermatitis. Cutaneous defects with increased water loss and allergens permeability are hallmark of the disease. The prevalence of food allergy in children with moderate-to-severe atopic dermatitis is estimated to be 34%, mostly to eggs, milk and peanuts. Food allergy can cause immediate reactions with urticaria and anaphylaxis or delayed flares of eczema. In older patients and adults, exposition to respiratory allergens (dust mites, pollen) can also cause an exacerbation of the eczema. Allergy testing identifies patients with atopy, who are at greater risk of rhinitis and asthma. Skin prick tests, in vitro tests and food challenges can identify a concomitant allergy, leading to specific allergen avoidance mea-sures potentially improving skin symptoms.