Atopic Dermatitis (Atopic Eczema)

Atopic Dermatitis (or Atopic Eczema) is a chronic relapsing inflammatory skin disorder in infancy and childhood associated with increased serum IgE levels, allergen sensitisation and a family history of allergic diseases.

Symptoms for severe cases of atopic dermatitis are:

• persistent skin lesions;
• regular use of topical steroids;
• co-existent allergic morbidities (diarrhea, vomiting, rhinitis, wheeze);
• 
  
faltering growth.

Originally controversial, the association of food allergy with atopic dermatitis has now been clearly demonstrated, especially in severe disease of infancy.

The association between food allergy and atopic dermatitis has been demonstrated through various studies and clinical observations: 37% of children with atopic eczema have food allergy.

There is an increasing prevalence with increasing severity. Many children out-grow their allergies. Transient allergies include those to milk, eggs, soy and wheat, whereas allergies to peanut, tree nuts, fish and shellfish appear to be more persistent.

The management of infantile atopic dermatitis should therefore incorporate appropriate strategies to diagnose and manage underlying food allergies. Food elimination has been shown to resolve symptoms of atopic dermatitis.
In cases where appropriate dietary elimination must accompany measures taken to reduce inflammation in the skin, treatment goals are twofold the control of cutaneous symptoms and the promotion of optimal growth.

by AAA Editorial Board
Date of publication: 01/02/2006