Food allergy, atopic dermatitis and superficialism in medicine.

Although the essential immunology underlying atopic diseases is now being clarified, there are still few accountable diagnostic tests. Therefore the recognition and treatment of these diseases continues to be based mainly on clinical skill and, in particular, on the taking of a careful history. This means that the observer bias can be a significant factor, and so whether or not the diagnosis is made may dependent on a clinician's preconceptions. Furthermore, the general interest in the subjects has tended to divided the medical consensus between believers and nonbelievers. In infancy, food allergy has protean manifestations and is provoked by many different food allergens. In addition to the lack of really useful diagnostic tests, there is the difficulty of easily and reliably conducting double-blind challenges in general pediatric practice. Thus it is crucial that a scientific, and critical, approach is adopted and that doctors attentively record the case history and observe the response to elimination diets and challenges. True science has nothing to do with superficialism.