Ramírez-Marín Hassiel A, Singh Anne Marie, Ong Peck Y, Silverberg Jonathan I
Department of Dermatology, Weill Cornell Medical College, New York, New York.
Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
JAAD Int. 2022 Aug 18;9:50-56. doi: 10.1016/j.jdin.2022.08.004. eCollection 2022 Dec.
Food allergy and food-related worsening of dermatitis can occur in patients with atopic dermatitis (AD). We reviewed the relationship of AD with food allergen hypersensitivity and the risks and benefits of food allergen testing and avoidance in patients with AD. Skin prick testing and specific immunoglobulin E to aeroallergens may identify patients with immediate hypersensitivity. Atopy patch tests may detect non-immunoglobulin E-mediated reactions but are not standardized or routinely used. Younger children with more severe AD in whom the optimal management failed may have food-triggered AD. Egg, milk, and peanut account for most food allergens. Elimination of relevant food allergens should improve AD but must be guided by appropriate allergy testing and establishing clinical relevance. Serum immunoglobulin E panels for food allergens are discouraged in the primary care setting because of their difficulty of interpretation. Empiric avoidance of foods is entirely discouraged in AD because of their risk of causing nutritional issues, food allergy, and other problems.
特应性皮炎(AD)患者可能会出现食物过敏以及与食物相关的皮炎加重情况。我们回顾了AD与食物过敏原超敏反应的关系,以及AD患者进行食物过敏原检测和避免食用相关食物的风险与益处。皮肤点刺试验和针对气传过敏原的特异性免疫球蛋白E检测可识别速发型超敏反应患者。特应性皮炎斑贴试验可检测非免疫球蛋白E介导的反应,但尚未标准化,也未常规使用。病情最严重且最佳治疗方案无效的年幼儿童可能存在食物诱发的AD。鸡蛋、牛奶和花生是最常见的食物过敏原。消除相关食物过敏原应能改善AD,但必须以适当的过敏检测和确定临床相关性为指导。由于血清食物过敏原免疫球蛋白E检测结果难以解读,因此不建议在初级保健环境中进行此项检测。由于存在导致营养问题、食物过敏和其他问题的风险,AD患者完全不建议凭经验避免食用某些食物。