Sampson H A
J Allergy Clin Immunol. 1983 May;71(5):473-80. doi: 10.1016/0091-6749(83)90464-5.
Twenty-six children with atopic dermatitis and markedly elevated serum IgE concentrations were evaluated for clinical evidence of hypersensitivity to foods with double-blind placebo-controlled food challenges. Selection of foods for challenges was based on positive prick skin tests (greater than 3 mm wheal) or a convincing history. At least one positive skin test to a food antigen was found in 24/26 patients. A total of 111 double-blind placebo-controlled challenges were performed in these children after suspect foods were eliminated from their diets for 10 to 14 days. There were 23 positive challenges in 15 children, 21 of which manifested as cutaneous symptoms, primarily pruritus and an erythematous macular and/or maculopapular rash involving 5% (or greater) of the body surface. In all, 14 children (54%) developed cutaneous symptoms after food challenges. All symptoms occurred within 10 min to 2 hr of challenge; nasal symptoms, mild wheezing, and gastrointestinal symptoms were seen in some children. No symptoms occurred in 104 placebo challenges. There were 86/111 clinically insignificant positive skin tests (77%) and three false-negative skin tests. These studies demonstrate that in some children with atopic dermatitis, immediate food hypersensitivity can provoke cutaneous pruritus and erythema, which leads to scratching and subsequent eczematoid lesions.
对26名患有特应性皮炎且血清IgE浓度显著升高的儿童进行了双盲安慰剂对照食物激发试验，以评估其对食物过敏的临床证据。激发试验食物的选择基于皮肤点刺试验阳性（风团大于3mm）或可靠的病史。26例患者中有24例至少对一种食物抗原皮肤点刺试验呈阳性。在将可疑食物从饮食中排除10至14天后，对这些儿童共进行了111次双盲安慰剂对照激发试验。15名儿童中有23次激发试验呈阳性，其中21次表现为皮肤症状，主要为瘙痒以及累及体表5%（或更多）的红斑性斑疹和/或斑丘疹。总共14名儿童（54%）在食物激发试验后出现皮肤症状。所有症状均在激发试验后10分钟至2小时内出现；部分儿童出现鼻部症状、轻度喘息和胃肠道症状。104次安慰剂激发试验未出现症状。111次中有86次（77%）皮肤试验阳性但临床意义不显著，还有3次皮肤试验假阴性。这些研究表明，在一些特应性皮炎儿童中，速发型食物过敏可引发皮肤瘙痒和红斑，进而导致搔抓及随后的湿疹样皮损。
