Pediatric Allergy Unit, Department of Pediatrics, University Hospitals of Geneva, Geneva, Switzerland.
J Allergy Clin Immunol Pract. 2013 Jan;1(1):22-8. doi: 10.1016/j.jaip.2012.11.005. Epub 2012 Dec 27.
Atopic dermatitis (AD) is a common skin disease characterized by inflammatory, chronically relapsing and pruritic eczematous flares. Its estimated incidence is 10% to 30% in children. Food allergy has been well documented in approximately one-third of children with a moderate-to-severe AD. Cow's milk, hen's egg, peanut, wheat, soy, nuts, and fish are responsible for >90% of food allergy in children with AD. The incidence and type of food can vary with age. In infants, cow's milk, hen's egg, peanut, and soy and, in older children, wheat, fish, tree nuts, and shellfish are the most common food allergens. Birch-associated foods have also been described as potential triggers of AD in children as well as in adults. The diagnosis of food allergy in AD is currently based on the clinical history, skin prick tests, or blood test screening, followed by an elimination diet and/or standardized oral food challenge. Once an underlying food allergy is confirmed, the avoidance of the incriminated food is generally recommended and usually leads to an improvement of the AD. Follow-up clinical evaluation with a detailed history and tracking of the level of specific IgE to implicated foods are typically used to evaluate the development of clinical tolerance, further confirmed by an oral food challenge.
特应性皮炎（AD）是一种常见的皮肤疾病，其特征为炎症性、慢性复发和瘙痒性湿疹发作。其在儿童中的估计发病率为 10%至 30%。大约三分之一的中重度 AD 儿童存在食物过敏。牛奶、鸡蛋、花生、小麦、大豆、坚果和鱼类是导致 AD 儿童食物过敏的 90%以上的过敏原。食物的发生率和类型会随年龄而变化。在婴儿中，牛奶、鸡蛋、花生和大豆，在较大的儿童中，小麦、鱼类、树坚果和贝类是最常见的食物过敏原。桦树相关食物也被描述为儿童以及成人 AD 的潜在触发因素。目前，AD 中食物过敏的诊断基于临床病史、皮肤点刺试验或血液检查筛查，随后进行饮食排除和/或标准化口服食物挑战。一旦确认存在潜在食物过敏，通常建议避免摄入可疑食物，这通常会导致 AD 改善。通过详细的病史和对致敏食物的特异性 IgE 水平进行跟踪进行后续临床评估，通常用于评估临床耐受的发展，并通过口服食物挑战进一步证实。
