Food Allergy Test‐Guided Dietary Advice for Children With Atopic Dermatitis: A Consensus Study
Year: 2024
Type: article
Abstract: BACKGROUND: The use of blood specific IgE or skin prick tests (SPT) to guide dietary exclusions for disease control in children with atopic dermatitis (AD) is controversial. We undertook a consensus exercise on how to interpret SPT results and dietary history for cow's milk, hen's egg, wheat, and soy in children < 2 years old with AD. METHODS: Fourteen clinicians from general practice, pediatrics, pediatric dermatology, pediatric allergy, and pediatric dietetics from UK and Ireland took part in an online modified Delphi study. Over three rounds, participants gave their anonymous opinions and received individualized and group feedback, based on the premise that all children had SPTs. The findings were discussed in an online workshop. RESULTS: Of 18 symptoms, 12 were identified as relevant to immediate and 7 to delayed allergy. Regarding SPTs, there was consensus over which allergens to use for wheat and soy but not cow's milk or hen's egg; for all study foods, wheal size was determined as 0-1 mm negative, ≥ 5 mm sensitized, but between 2 and 4 mm, categorization varied by food. During the final workshop, consensus was reached on dietary advice for nine combinations of SPT results and dietary history. CONCLUSION: We attained consensus on how SPTs and dietary history for four common food allergens should be interpreted in young children under 2 years of age with AD. These pragmatic recommendations may support clinician education, consistency of decision-making, and future research.
Source: Pediatric Dermatology
DOI: 10.1111/pde.15807
Authors: Ludivine Garside, Robert Boyle, Rosan Meyer, Isabel Skypala, Hilary Allen, Paula Beattie, Justine Dempsey, Matt Doyle, Helen Evans‐Howells, Mary Feeney, Siân Ludman, Tom Marrs, Jane Ravenscroft, Gary Stiefel, Thisanayagam Umasunthar, Deepan Vyas, Natalie Yerlett, Jo Walsh, Sara J. Brown, Matthew J. Ridd
Institutions: University of Bristol, Imperial College London, University of Winchester, KU Leuven, Guy's and St Thomas' NHS Foundation Trust, Royal Hospital for Children, Imperial College Healthcare NHS Trust, Allergy Clinic of Tulsa, Food Allergy Canada, King's College London, Royal Devon University Healthcare NHS Foundation Trust, Nottingham University Hospitals NHS Trust, University Hospitals of Leicester NHS Trust, Oxford University Hospitals NHS Trust, West Hertfordshire Hospitals NHS Trust, Great Ormond Street Hospital, Great Ormond Street Hospital for Children NHS Foundation Trust, University of Edinburgh
Language: English
Subfield: Immunology and Allergy
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,730
OpenAlex ID: W4404233374