Atopic dermatitis AD (otherwise known as Infantile Eczema) is a common skin condition affecting 15-20% of children under the age of 2 years, manifesting with an itchy dry dermatitis in the skin creases (flexures) and often associated with a family or personal history of rhinitis and asthma (UK diagnostic criteria). Of great interest is that 55% of these AD children will also be sensitized to one or more food or inhalant allergens. The debate continues as to whether this allergic sensitization to one or other food or inhalant allergens contributes adversely towards their eczema control, when exposed or whether the concomitant allergen sensitization has no real impact on their eczema. Recent studies indicate that although concomitantly sensitized to foods (cow’s milk, hen’s egg and peanut) or inhalants (dust mite, pollen & pet dander), only a small percentage of sensitised AD sufferers will have a clinically relavant allergy contributing to the dermatitis. They conclude that routine food and inhalant allergy testing in infants with eczema may flag up clinically irrelevant sensitivities and lead to unnecessary allergen avoidance and hardship, most of which aren’t actually contributing to their dermatitis. Some authorities even actively discourage routine allergy testing in infants with eczema and suggest only testing if there is a documented associated deterioration in the eczema or associated urticaria (hives).
Reference: de Bruin Weller MS, Knuslt AC, Meijer Y, Bruijnzeel-Koomen CA, Pasmans SG. Evaluation of the dhild with atopic dermatitis. Clinical Experimental Allergy 2012; 42: 352-362