Atopic dermatitis (AD) and food allergy (FA) share similar type 2 inflammation and commonly co‐occur, but the precise proportion of AD patients with FA and vice versa, as well as the effect of AD disease severity on the strength of this association remains uncertain. The aim of this comprehensive systematic review and meta‐analysis was to determine the prevalence and bidirectional associations of AD with food sensitivity (FS), FA and challenge‐proven food allergy (CPFA). We searched PubMed and EMBASE and three independent reviewers performed title/abstract and full‐text review and data extraction. Overall, 557 articles (n = 225,568 individuals with AD, n = 1,128,322 reference individuals; n = 1,357,793 individuals with FS, FA or CPFA, n = 1,244,596 reference individuals) were included in quantitative analyses. The overall pooled prevalence of FS, FA and CPFA in individuals with AD were 48.4% (95% confidence interval: 43.7–53.2), 32.7% (28.8–36.6) and 40.7% (34.1–47.5) respectively. AD prevalence among individuals with FS, FA and CPFA were 51.2% (46.3–56.2), 45.3% (41.4–49.3) and 54.9% (47.0–62.8) respectively. Children with AD had higher pooled FS (49.8% (44.4–55.1)) and FA (31.4% (26.9–36.1)) prevalences than adults with AD (28.6% (13.4–46.8) and 24.1% (12.1–38.7) respectively). Prevalences of FS and FA numerically increased with AD severity. FS, FA and CPFA are common comorbidities of AD and are closely related. Physicians should be attentive to this relationship to optimize management and treatment strategies in patients.

https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/jdv.18919

Prevalence of and association between atopic dermatitis and food sensitivity, food allergy and challenge‐proven food allergy: A systematic review and meta‐analysis

In this case-control study the association between the approaches used to feed infants, together with known family and environmental factors, and the occurrence of atopic illness in toddlers between the ages of 4 months to 3 years in Hong Kong was examined. A total of 206 subjects were recruited from April to June of 2014. The results obtained by binary logistic regression indicated that atopy is associated with boys (OR 2.072, CI 1.089-3.941), the maternal use of antibiotics in utero or while breast feeding (OR 2.276, CI 1.151-4.504), the later commencement of mixed feeding (OR 2.497, CI 1.025-6.082), breast feeding exclusively for 3 months (OR 1.972, CI 1.009-3.857), and having a mother who was diagnosed with eczema (OR 4.510, CI 1.764-11.530). Although an exclusive reliance on breast feeding has been shown to be predictive of atopy among toddlers, the positive qualities of breast milk cannot be ignored. A further study of the contents and nutritional values of breast milk is warranted.

https://www.mdpi.com/1660-4601/12/3/2501/pdf

Factors Associated with Atopy in Toddlers: A Case-Control Study

Background: Despite an increasing body of clinical and laboratory evidence suggesting that food hypersensitivity plays a pathogenic role in Atopic Eczema (AE) in a subset of patients, whether IgE food sensitization has any impact on the clinical severity of AE is not clearly established. Objective: To investigate the association between the severity of eczema and immunoglobulin E mediated food sensitization among atopic eczema children in Hong Kong. Study Design: A retrospective chart review study of total 77 atopic eczema cases (age 0-14 years) was carried out. The eczema severity scores (three item severity scores TIS), skin prick test results (wheal diameters), and food specific immunoglobulin E levels, clinician diagnosed food allergy were recorded as main outcome measures. Immunoglobulin E mediated food sensitization was diagnosed when the skin prick test resulted in a wheal diameter of greater than 3 mm compared with the negative control and serum food specific immunoglobulin E level greater than 0.35 ku/L. Result: Overall IgE food sensitization to at least 1 food by either skin prick test or blood test was 81.8%. Eczema severity by TIS was not correlated with the frequency of immunoglobulin E mediated food sensitizations (p-value=0.1346). More than 60% of children in this study developed eczema before 6 months old and this early onset eczema group was highly associated with egg, cow's milk and fish sensitizations (p-value=0.0179, 0.015, and 0.0468 respectively). A positive association was found between the eczema severity and serum total IgE level (p-value=0.002). Conclusion: IgE food sensitization is very common in this small cohort of Hong Kong children with atopic eczema. Most eczema children with or without clinical history of food reactions have shown positive SPT and CAP-FEIA, or one of the two. Severity of atopic eczema is positively associated with the levels of total IgE. It was not shown that any particular food sensitization was associated with severity of eczema.

/pdf/ige-food-sensitizations-amongst-children-with-atopic-eczema-2olr2xc8c6.pdf

IgE food sensitizations amongst children with Atopic Eczema

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IgE food sensitizations amongst children with Atopic Eczema