Atopic Dermatitis and Food Allergy: Best Practices and Knowledge Gaps—A Work Group Report from the AAAAI Allergic Skin Diseases Committee and Leadership Institute Project

Anne Marie Singh*, Sara Anvari, Pia Hauk, Peter Lio, Anil Nanda, Robert Sidbury, Lynda Schneider

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Allergists are often asked to evaluate children with atopic dermatitis (AD) for allergen triggers to disease. Testing, particularly for food triggers, often leads to elimination diets in an effort to improve AD control. However, the dual exposure hypothesis suggests that oral tolerance to food antigens is promoted through high-dose oral exposure, where sensitization occurs through lower dose cutaneous exposure. This suggests that strict elimination diets may pose some risks in children with AD. In addition, emerging evidence suggests an important role of skin inflammation in further allergic disease and the importance of dietary exposure to maintain oral tolerance. This work group report reviews current guidelines-based management for children with moderate-to-severe AD, the evidence for current recommendations for the evaluation and management of these children, provides a nuanced examination of these studies, and addresses current knowledge gaps in the care of these children.

Original languageEnglish (US)
Pages (from-to)697-706
Number of pages10
JournalJournal of Allergy and Clinical Immunology: In Practice
Volume10
Issue number3
DOIs
StatePublished - Mar 2022

Keywords

  • Atopic dermatitis
  • Food allergy
  • Skin care

ASJC Scopus subject areas

  • Immunology and Allergy

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