Chinese Expert Consensus on the Diagnosis and Management of Food Allergy in Children With Atopic Dermatitis#

• Main Authors: Pediatric Dermatology Committee, Chinese Dermatologist Association; Pediatric Dermatology Group, Chinese Society of Dermatology; Dermatology and Venereology Group, Chinese Pediatric Society, Chinese Medical Association, Hua Wang, Lin Ma, Qi Tan, Ji Chen, Ping Li, Jian-Ping Tang, Liu-Hui Wang, Yi-Feng Guo, Xiu-Ping Han, Zi-Gang Xu, Xiao-Yan Luo, Yan-Ping Guo, Feng-Lei Wei
• Format: Article
• Language: English
• Published: Wolters Kluwer Health 2020-09-01
• Series: International Journal of Dermatology and Venerology
• Online Access: http://journals.lww.com/10.1097/JD9.0000000000000091

Abstract. The diagnosis of food allergy in clinical practice has not been standardized, and food allergy is overdiagnosed in patients with atopic dermatitis (AD). This overdiagnosis of food allergy leads to unnecessary elimination diets that may exert potential adverse effects on the health of children with AD. Unlike classic IgE-mediated food allergy, food allergy in patients with AD may manifest as non-eczematous reactions, isolated eczematous reactions, or a combination of these reactions. The diagnosis of food allergy in children with AD should be made based on a thorough clinical history (detailed allergic history and feeding history), clinical manifestations, and laboratory workup including skin prick testing, serum specific IgE measurement, atopy patch testing, and oral food challenges. Once an underlying food allergy is confirmed in a patient with AD, comprehensive management is generally recommended. Avoidance of the food allergen is the main treatment approach, but there is a need for regular clinical follow-up, including evaluation of the nutritional status and supervision of growth and development. Multidisciplinary cooperation between dermatologists, nutritionists, and pediatricians is required.