Food Hypersensitivity in Atopic Dermatitis During Infancy: Skin Prick Testing for Whom?

Zeynep Şengül Emeksiz
Özlem Cavkaytar
İlknur Aksoy
Yıldız Daller
Özge Soyer

Abstract

Objective: Atopic dermatitis (AD) is a common disease during infancy. The data on food hypersensitivity (FH) in the first six months and especially in the first three months of life is limited in children with AD. The aim of this study was to find out the frequency of FH and related factors in infants with AD in regard to their referral age.

Materials and Methods: Infants younger than 1 years of age who were diagnosed as AD at the Ankara Training and Research Hospital’s Department of Pediatrics were included in our study. The demographic features, nutritional status, disease severity and skin test results were recorded. A diagnosis of FH was made in the presence of a positive skin test with the related allergen. All the patients with FH had resolution of the symptoms with the elimination of the relevant food from the diet.

Results: One-hundred and ten patients (70% male) were included. In patients younger than 3 months of age, the SCORAD-index and total IgE levels were higher in the patients with FH compared to patients without FH [(25.2(20.9-34.9) vs. 19.2(13.1-24.2), (p=0.034) and 22.2(11.6-52.6)kU/L vs. 4(4-10)kU/L, (p=0.04), respectively]. In patients aged between 3 and 6 months of age, the SCORAD index, total IgE and eosinophil levels were higher in patients with FH compared to patients without FH [36.2(29.3-44.7) vs. 18.8(13.3- 26.7), (p<0.001)], [42.1(6.3-283)kU/L vs. 8.3(4.8-8.3)kU/L, (p=0.033)], [7.5%(3.9-9.7) vs. 3.5%(1.8-5.8), (p=0.01)]. In patients older than 6 months of age, the SCORAD index, eosinophil and IgE levels were similar between patients with and without FH.

Conclusion: In infants with AD, the prevalence of food allergy in early life (≤3 months) might be higher in patients with a higher SCORAD index and IgE levels. These laboratory features are useful tools in order to predict food hypersensitivity and in relevant clinical conditions food allergy, and might avoid unnecessary testing.

Keywords

Food hypersensitivity, child, atopic dermatitis
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