Food Allergy and Atopic Dermatitis: Separating Fact from Fiction
The relationship between food and atopic dermatitis (AD) is complex. A common misunderstanding
is that food allergies have a significant impact on the course of AD, resulting
in uncontrolled attempts at elimination diets and undertreatment of the skin itself. Studies
have shown that only a small portion of cutaneous reactions to food in the form of late,
eczematous eruptions will directly exacerbate AD in young infants who have moderate-tosevere
AD. Given the low frequency of food allergies actually inducing flares of AD, the
focus should return to appropriate skin therapy, and identification of true food allergies
should be reserved for recalcitrant AD in children in whom the suspicion for food allergy is
high. A different relationship between food and AD involves delaying or preventing AD in
high-risk infants by exclusive breastfeeding during the first 4 months of life. Finally, the skin
barrier defect in AD may allow for easier and earlier sensitization of food and airborne
allergens; therefore, exposure of food proteins on AD skin may act as a risk factor for
development of food allergies.
Semin Cutan Med Surg 29:72-78 © 2010 Published by Elsevier Inc.