Sloper K S, Wadsworth J, Brostoff J
Department of Immunology, University College and Middlesex Hospital School of Medicine, London.
Q J Med. 1991 Aug;80(292):677-93.
The role of foods in the exacerbation of atopic eczema was studied by offering a food elimination diet and subsequent random order, double-blind food challenges to 91 eczematous patients, [49 males and 42 females, median age 4.5 years (range 0.5-15)]. Eczema improved in 49 of 66 (74 per cent) (skin score fall greater than or equal to 3) after stopping cows' milk, eggs and various other foods, with significant decreases in erythema, excoriation, lichenification and extent of eczema. One hundred and ninety-four food challenges were given to 64 patients who had shown objective or subjective improvement. Eczema and associated symptoms were significantly worse after cows' milk and tomato compared with placebo. Egg did not worsen eczema, but 48 per cent of 44 challenges were incomplete, mainly due to hypersensitivity reactions and challenge refusal. The longer a food had been avoided, the less likely was the chance of a positive food reaction. Clinical history did not predict response to dietary manipulation. A standard elimination diet avoiding cows' milk, egg, tomatoes and possibly colours and preservatives should help up to three-quarters of patients, and is easy to implement with the help of a dietician. This diet may be considered in all children with moderate or severe eczema.
通过对91例湿疹患者（49例男性，42例女性，中位年龄4.5岁，范围0.5 - 15岁）采用食物排除饮食，随后进行随机顺序、双盲食物激发试验，研究食物在特应性湿疹加重中的作用。停止食用牛奶、鸡蛋和其他各种食物后，66例患者中有49例（74%）湿疹有所改善（皮肤评分下降大于或等于3），红斑、擦伤、苔藓化和湿疹范围均显著减小。对64例显示出客观或主观改善的患者进行了194次食物激发试验。与安慰剂相比，食用牛奶和番茄后湿疹及相关症状明显更严重。鸡蛋不会使湿疹恶化，但44次激发试验中有48%未完成，主要原因是过敏反应和拒绝激发试验。食物避免食用的时间越长，出现阳性食物反应的可能性越小。临床病史无法预测对饮食调整的反应。避免食用牛奶、鸡蛋、番茄以及可能的色素和防腐剂的标准排除饮食应能帮助多达四分之三的患者，并且在营养师的帮助下易于实施。所有中重度湿疹儿童都可考虑采用这种饮食。
