When and how to evaluate for immediate type food allergy in children with atopic dermatitis.

Keywords: allergy diagnosis; atopic dermatitis; food allergy EN allergy diagnosis atopic dermatitis food allergy 3845 3848 4 12/01/21 20211201 NES 211201 Atopic dermatitis (AD) typically develops in infancy and affects up to 20% of children in high-income countries.1 I Immediate i (IgE-mediated) food allergy (FA) affects around 3% of children.2 Children with AD are at higher risk of I immediate i - I type i FA.3,4 Up to a third of children with moderate to severe AD have FA.3 A Danish population-based study, evaluating children from birth to 6 years, showed that 15% of all children with AD had concomitant FA and almost all children with FA had concomitant AD.4 In a recent review, the likelihood of food sensitization was reported to be 6 times higher in patients with AD compared to healthy controls at 3 months of age.5 Furthermore, up to 15% of subjects with AD had a positive oral food challenge (OFC).5 A population-based study from Australia showed that one out of five infants with AD, mainly infants with early-onset AD (<3 months), were allergic to peanut, egg white, or sesame compared to one in 20 without AD,6 when evaluated by an oral food challenge at 12 months. Some of the guidance highlight increased risk factors for the development of FA, particularly AD, hence the importance of early diagnosis and management of AD and FA. As around 20% of children in the general population have AD and only around 3% of children have FA, an algorithm which directs the evaluation of infants and small children with AD for FA will prove useful for clinicians. [Extracted from the article]