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Food allergy in atopic eczema II. Response of children and adults to hypoallergenic diets
Author(s) -
Neild V.S.,
Bailes J.A.,
Armstrong D.,
Marsden R.A.
Publication year - 1985
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/j.1365-2133.1985.tb12980.x
Subject(s) - hypoallergenic , atopic dermatitis , medicine , allergy , elimination diet , food allergy , milk allergy , fish <actinopterygii> , atopy , pediatrics , allergen , dermatology , food science , immunology , biology , fishery
The role of food allergy in atopic eczema remains controversial. There are no simple tests and the diagnosis is based upon the response to an exclusion diet, followed by open and then double‐blind challenge with the suspected foodstuff. Thirty‐eight unselected patients with atopic eczema have taken part in such a study and i8 of the 35 patients who completed 3 weeks on an empirical diet (excluding egg, milk, chicken, beef, fish, wheat, citrus and berry fruits, colouring and preservatives, chocolate and nuts) improved. Only one often non‐responders was later helped by a much stricter oligo‐allergenic diet suggesting that this empirical diet excludes most relevant foodstuffs and is suitable for routine use. All 18 responders proceeded to re‐introduced individual excluded foods at weekly intervals; nine of these patients failed to react unequivocally to any food in the re‐introduction phase. In the other nine responders open challenges provoked definite eczematous reactions on 20 occasions with over half of these reactions being to egg, milk or chicken. The practical difficulties of conforming these observations by double‐blind challenge will be discussed. Our study suggests that although patients with atopic eczema may improve while on an exclusion diet, few show evidence of true food allergy or intolerance judged by the results of open and double‐blind challenges.