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Background: The World Health Organization (WHO) identified allergy as one of the major problems of the 21st century. It was also stated to be a key issue for health protection and public health care activity in the White Book on Allergy published in 2011. An allergy or atopy is called type I hypersensitivity. It may take the form of immediate (anaphylaxis) or late symptoms including allergic rhinitis and eye diseases, atopic dermatitis, food allergies, anaphylactic shock, allergic asthma and hives. Anaphylaxis and anaphylactic shock can occur at any age. Aim of the study: The goal of the study was to assess patient knowledge about allergies and appropriate actions to take in situations of severe allergic symptoms including anaphylactic shock. Material and methods: The study was conducted in 2018 among 150 adult patients in a clinic of Allergy at Optima Medycyna SA in Opole. The author's survey questionnaire contained 27 closed single or multiple-choice questions. Results: A satisfactory level of knowledge of the most life-threatening allergy exacerbations was found in 79.3% (119) of the examinees. 53.3% (80) had correct knowledge of how to act in the case of a severe allergic shortness of breath and symptoms that do not subside despite administering medications. In such instances, 46.7% did not know what to do. Only 84.7% (127) of respondents knew the definition of anaphylactic shock while 10% (15) did not know the concept at all. Conclusions: Patients showed a significantly higher level of knowledge about allergy complications than about their causes and prevention. Knowledge about the diagnosis of allergy exacerbations, as well as steps to take in life-threatening situations associated with acute allergic disease and anaphylactic shock in home situations was insufficient. In addition, it was found that nursing staff insufficiently educate patients on allergies and associated complications. [ABSTRACT FROM AUTHOR]

Summary: The aim of this study is the evaluation of the relation between the sensitisation to outdoor and indoor fungi and allergy to peanuts and walnuts in atopic dermatitis patients aged 14 years and older. The complete dermatological and allergological examinations were performed in all included patients; the occurrence of food allergy to peanuts and walnuts was recorded (specific IgE, skin prick test, history of allergic reaction) and the sensitisation to mixture of outdoor fungi and indoor fungi was also examined (skin prick test, specific IgE). The statistical evaluation of the relation between the sensitisation to outdoor and indoor fungi and the occurrence of food allergy to peanuts and walnuts was performed; 329 patients were included in the study, 110 men and 219 women, the average age 26.8 years. The sensitisation to outdoor fungi was recorded in 91 patients (28%), the sensitisation to indoor fungi was recorded in 61 patients (18.5%), the occurrence of food allergy to peanuts was confirmed in 90 (27%) patients and to walnuts in 121 (36.7%) patients. We confirmed, that patients suffering from sensitisation to outdoor fungi suffer significantly more from food allergy to peanuts and walnuts. The significant relation between the sensitisation to indoor fungi and food allergy to peanuts and walnuts was not confirmed. [ABSTRACT FROM AUTHOR]

Abstract: Background: Children with early‐onset atopic dermatitis (AD) are at substantial risk of developing asthma later in life, and identifying the critical window of detrimental exposure is advantageous for implementing preventive actions. The aim of this study was to evaluate the role of exposure to environmental modifiers during pregnancy and early childhood in asthma occurrence in an infantile AD cohort. Methods: Eligible study participants were selected from the Taiwan Birth Cohort Study, which enrolled 24 200 newborns in 2005. We enrolled those cases who had been diagnosed as having AD before 3 years of age and followed them up till age 8. We excluded those ever diagnosed with asthma before AD onset. The dependent variable was defined in terms of whether the participant was diagnosed as having asthma before 8 years of age. We applied logistic regression models to evaluate the risks of exposure to different determinants in asthma occurrence. Results: A total of 1549 children with AD had completed the 8‐year follow‐up, and 334 (21.6%) of them had asthma. The results revealed that male sex, lower birth order, maternal asthma history, maternal obesity before pregnancy, and environmental tobacco smoke exposure before 3 years of age were significant risk factors for further development of asthma. Furthermore, food allergy during early life, lower respiratory tract infection, and longer durations of symptomatic AD influenced asthma development later in life. Conclusions: The findings confirmed the critical determinants for asthma occurrence in infantile AD, which may enable a more personalized approach to the prevention of asthma. [ABSTRACT FROM AUTHOR]

The rising prevalence of food allergy and specifically peanut allergy has had significant implications for affected patients, families, and society. The current standard of care remains strict avoidance and the use of emergency medications for accidental ingestions. There is recent evidence-based information to suggest that one approach to preventing peanut allergy lies in early introduction of peanut. This represents a paradigm shift from previous recommendations and has led to updated guidelines in the United States, Europe, and Australasia on the introduction of potentially allergenic foods in the infant diet. This new approach to prevention has some practical obstacles and challenges associated with its implementation. There is also growing interest in the role of maintaining a healthy skin barrier in prevention of sensitization and food allergy. Other approaches, including pro- and prebiotics, prenatal maternal dietary avoidance, breastfeeding, and the use of specific formulas, have not shown reproducibly favorable results. As children with peanut allergy are unlikely to outgrow their food allergy, early oral immunotherapy in those with established peanut allergy is being investigated with the hopes of altering the natural history of an otherwise lifelong disease. [ABSTRACT FROM AUTHOR]

Summary: The aim of this study was to evaluate if there is some relation between the sensitisation to fungi and the occurrence of food hypersensitivity reactions in atopic dermatitis patients aged 14 years and older. Complete dermatological and allergological examination was performed in all included patients; the occurrence of food hypersensitivity reactions was recorded and the sensitisation to mixture of fungi was examined (skin prick test, specific IgE). The statistical evaluation of the relation between the sensitisation to fungi and the occurrence of food hypersensitivity reactions was performed; 331 patients were included in the study, 110 men and 221 women, the average age was 26.8 years. The sensitisation to fungi was recorded in 100 patients (30%), the occurrence of food hypersensitivity reactions was recorded in 261 patients (79%). We confirmed that patients suffering from sensitisation to fungi suffer significantly more often from food hypersensitivity reactions to nuts (walnuts, peanuts) and sea fish; no significant relation was confirmed between the sensitisation to fungi and the occurrence of food hypersensitivity reactions to tomatoes, kiwi, apples, spices, oranges, capsicum, celery and carrot. [ABSTRACT FROM AUTHOR]

Objective: Atopic dermatitis (AD) in studies conducted by the International Study of Asthma and Allergies in Childhood (ISAAC), children aged 6-7 years accounted for less than 2% in Iran, 16% in Japan and Sweden, and 13-14 years in Albania less than 1%, and over 15% in Northern Europe. House dust mite (HDM) sensitivity confers a distinct phenotype in AD. The current study aimed to determine the factors influencing the disease severity in HDMsensitized AD patients. Materials and Methods: Thirty-three patients with HDMsensitized AD were enrolled in the study. The medical charts were retrospectively evaluated for complaints, age at admission and diagnosis, delivery, gender, atopy in family, sensitizations, eosinophil counts, immunoglobulin and Vitamin D levels, treatment modalities and response to treatment. Results: The chief complaint was pruritus in 81.8%, rash in 45.5% and dryness in 9.1% of patients. Objective SCORAD (scoring atopic dermatitis) at admission was 45±15. Severe AD was detected in 21 patients according to their objective SCORAD index. Accompanying allergic diseases were allergic asthma (AA) in 71.9%, allergic rhinitis (AR) in 62.5% and food allergy in 27.3% of the patients. Sixteen (57.1%) patients showed decreased vitamin D levels. When familial atopy, type of delivery, and gender were set as grouping items, age at disease onset and diagnosis, laboratory parameters and objective SCORAD were similar in HDM-sensitized AD patients. On the other hand, patients with low vitamin D levels had significantly low levels of serum IgG and IgA and significantly high levels of specific IgE D1 (p=0.046, p=0.036, p=0.0023 respectively) when compared to those with normal vitamin D levels. In addition, serum vitamin D levels were found to have a strong negative correlation with specific IgE D1 levels (p=0.002, r= -0.617). Conclusion: HDM-sensitized AD has a severe and persistent phenotype. The correlation between low levels of vitamin D and high levels of D1-specific IgE in addition to lower levels of IgG and IgA in vitamin D deficient patients warrants further investigation of immunoregulatory effects of vitamin D in HDM-sensitized AD patients in larger sample sizes. [ABSTRACT FROM AUTHOR]

There is a lack of reports focusing on the course of atopic dermatitis (AD) with respect to its evolution and association with other allergic diseases and parameters. This study gives the review of results concerning the evaluation of different parameters in patients suffering from AD older than 14 years of age. This study evaluates the occurrence of food allergy, food intolerance, inhalant allergy, occurrence of asthma bronchiale, allergic rhinitis, peripheral blood eosinophilia, family history of atopy, onset of AD and the severity of AD according to the SCORAD index. [ABSTRACT FROM AUTHOR]

The aim of this study is the evaluation of the specificity and sensitivity of the skin prick tests (SPTs), specific IgE and atopy patch tests (APTs) in atopic dermatitis patients suffering from food allergy. A total of 301 patients were examined, complete dermatological and allergological examination was performed in all patients. The food allergy was confirmed to peanuts in 62 patients (20%), to egg in 16 patients (5%), to soy in 9 patients (3%), to wheat in 12 patients (4%) and to cow milk in 6 patients (2%). The specificity of SPT, specific IgE and APT is considered as good; the sensitivity of APT is low. The positive results in isolation cannot confirm the food allergy; however, together with other diagnostic methods, such as clinical history and open exposure test, these tests are valuable tool in examination of food allergy. [ABSTRACT FROM AUTHOR]

Aim: The evaluation of the importance of atopy patch tests in patients suffering from food allergy to egg’s white and yolk, peanuts, soy, cow’s milk and wheat.Methods: 240 patients were examined. Complete dermatological and allergological examination was performed in all patients including specific IgE, skin prick test, atopy patch test and the challenges tests.Results: The specificity of atopy patch tests is for soy 96%, for egg 95%, for wheat 95%, for peanuts 99% and for milk 99%. The sensitivity of atopy patch tests is for soy 62%, for egg 35.7%, for wheat 16.7%, for peanuts 20.8% and for milk 50%.Conclusion: The specificity of atopy patch tests may be considered good; regarding the sensitivity, the high percentage of false negative results should make us believe that these tests are not conclusive. [ABSTRACT FROM AUTHOR]

The aim of our study is to evaluate the count of eosinophils in peripheral blood in atopic dermatitis (AD) patients over 14 years of age and to compare it with the occurrence of food hypersensitivity (FH) reactions. Complete allergological and dermatological examination was performed in 212 patients included in the study (90 men, 122 women, average age 26.7 years, average SCORAD 32.9). According to our results, in AD patients the difference in count of eosinophils in patients with and without FH reactions is not statistically significant. When evaluating the occurrence of FH reactions to single foods, the count of eosinophils is significantly higher only in patients suffering from reactions to carrot. [ABSTRACT FROM AUTHOR]

Background Egg allergy is the most common food allergy in children with atopic dermatitis ( AD). This study aimed to determine the prevalence of egg allergy, component patterns and predictive values of screening tests in egg allergy in South African children with AD. Methodology This was a prospective, observational study in a paediatric university hospital in Cape Town. Children with AD, aged 6 months to 10 years, were recruited randomly. They were assessed for sensitization and allergy to egg by questionnaire, skin prick tests ( SPT), Immuno Solid Phase Allergen Chip ( ISAC 103®) test, Immuno CAP component tests to egg and ovomucoid ( Gal d 1) and incremental food challenges. Results Hundred participants (59 Black Africans and 41 of mixed ethnicity) were enrolled, median age 42 months. There was a high rate of egg sensitization of 54% and prevalence of confirmed egg allergy of 25%. History and screening laboratory tests overestimated egg allergy significantly. SPT to fresh egg white was significantly more sensitive in diagnosing egg allergy than SPT to the commercial egg white extract and produced the highest area under the receiver operator characteristics curve of all the screening tests in predicting true egg allergy. In those participants sensitized to egg, the component ovomucoid was best at differentiating true egg allergy from tolerance. Commonly used 95% positive predictive values ( PPVs) for SPT to egg and Immuno CAP egg white produced low PPV of 57% and 74%, respectively, in this population overall, with generally poorer predictive values amongst the Black Africans than the mixed ethnicity participants. A SPT to fresh egg of 17 mm and Immuno CAP egg white of 13 kU/l produced the best PPV for egg allergy in this population. Conclusion The prevalence of egg allergy is high in African children with AD, but history of egg allergy and sensitization to egg significantly overestimate the true egg allergy rate. SPT to fresh egg white was more sensitive than that to commercial egg white extract; hence, fresh egg white should be recommended in an egg allergy screening panel. The component ovomucoid was useful for differentiating allergy from tolerance in egg-sensitized participants. Population-specific 95% PPV for egg allergy tests may need to be established in developing world populations. [ABSTRACT FROM AUTHOR]

The aim of our study is to evaluate the count of eosinophils in peripheral blood in atopic dermatitis (AD) patients older than 14 years of age and to compare it with the occurrence of some other atopic diseases and parameters. One hundred and seventy-two patients were included in the study. According to our results, in AD patients with asthma bronchiale, rhinitis, food allergy, positive family history about atopy, with permanent skin lesions, with total IgE above 200 IU/ml, with the onset of AD under 5 years of age and in patients suffering from moderate or severe form of AD, the count of eosinophils is higher than the normal level of eosinophils. The normal count of eosinophils is recorded in patients suffering from mild form of AD and in patients suffering from food sensitization. [ABSTRACT FROM AUTHOR]

A few reports demonstrate the relationship between food allergy in atopic dermatitis patients and other allergic diseases and parameters. The objective of this study is to evaluate if some food allergens has the relationship to the occurrence of other atopic diseases and parameters. The following parameters were examined: food allergy to wheat flour, cow milk, egg, peanuts and soy; the occurrence of asthma bronchiale and rhinitis; duration of atopic dermatitis; family history; pollen allergy and onset of atopic dermatitis. The statistical evaluation of the relations among food allergy and monitored parameters was performed. Two hundred and seventy two patients were examined (87 men, 185 women). In general, atopic dermatitis patients with confirmed food allergy suffer significantly more often from rhinitis, asthma bronchiale, persistent eczematic lesions and pollen allergy and have positive data about atopy in their family history. Peanuts, soy and wheat are of great importance. [ABSTRACT FROM AUTHOR]

Background: In recent years, it has been proposed that the primary mechanism for the development of food allergies is percutaneous sensitization. Since 2010, in Japan, the number of immediate-type wheat allergy due to hydrolyzed wheat protein has dramatically increased among those who have been using soap containing hydrolyzed wheat. This incidence supports the hypothesis that food allergens arise through percutaneous sensitization. Clinical Summary: A 25-year-old man (case 1) and an 18-year-old girl (case 2) with atopic dermatitis visited our Department because of food allergy and hand eczema. After starting their work with fish, severe itchy eczema appeared on their hands. They subsequently started to experience oral allergic symptoms, intraoral itchiness and dyspnea after eating fish. Specific IgE antibodies were detected for many fishes, and skin prick tests showed positive reactions for a variety of fishes in both cases. Furthermore, the fluorescence intensities of specific IgE antibodies against parvalbumin from various types of fish in microarray immunoassay analysis showed positive reactions. We diagnosed them as contact urticaria caused by percutaneous sensitization to parvalbumin through job-related physical contact with fish. Conclusion: The patients' histories and findings indicate the possibility of percutaneous sensitization through occupational exposure to parvalbumin, leading to food allergy. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Only few population-based data exist on the association of food hypersensitivity reactions and atopic diseases. The objective of this study was to evaluate the dependence between the occurrence of food hypersensitivity reactions and other atopic diseases and parameters. Complete dermatological and allergological examination was performed. Statistical evaluation of the relations between the occurrence of food hypersensitivity reactions and the occurrence of asthma bronchiale, rhinitis, duration of atopic dermatitis, family history and onset of atopic dermatitis was performed. Two hundred and thirty-five patients were examined – 75 men and 160 women, average age 26.2 years (SD = 9.5). Patients suffering from food hypersensitivity reactions, in general, suffer significantly more often from rhinitis and from persistent eczematic lesions; the dependence was confirmed in patients with hypersensitivity reactions to nuts, kiwi, fishes and apple. Atopic march was confirmed in patients suffering from atopic dermatitis and from food hypersensitivity reactions. [ABSTRACT FROM PUBLISHER]

Background It is known that atopic dermatitis ( AD) is associated with food or environmental allergens and increased levels of serum IgE. However, the role of hypersensitivity to food antigens in adult patients remains controversial. Aim To evaluate the association between food hypersensitivity and AD in 126 adult Korean participants. Methods Patients with AD were assessed for a previous history of food hypersensitivity that aggravated the symptoms of AD. Blood samples were taken from the patients to measure food allergen-specific IgE. Based on history and laboratory results, open oral food challenge ( OFC) tests were performed. Results Of 126 participants, 33 (26.2%) claimed to have experienced previous food hypersensitivity. Both pork and wheat ( n = 5 each) were the main foods mentioned, followed by beef ( n = 4) and shellfish ( n = 3). We found that 20 participants (15.9%) had raised levels of food-specific IgE, with beef ( n = 7), pork ( n = 6), milk ( n = 5) and wheat ( n = 5) being the most common (some patients had more than one). However, when the open OFC tests were conducted in 48 participants with self-reported food hypersensitivity or raised levels of food-specific IgE, only one showed a positive reaction; this participant had a previous history of pork consumption exacerbating AD. Conclusions Although some participants claimed to have a history of AD aggravation related to food intake, when an open OFC test was conducted, few of them had positive results. Our study result indicates that there is a positive reaction rate of only 0.79% for adults. We therefore conclude that adults are less sensitive than children with regard to the association between AD and food hypersensitivity. [ABSTRACT FROM AUTHOR]

Atopic dermatitis is associated with food allergies. The aim of this study is to evaluate soy allergy in patients suffering from atopic dermatitis. Altogether 228 persons were included; specific IgE, skin prick tests, atopy patch tests, challenge tests with soy and history of soy allergy were evaluated. Soy allergy was confirmed in eight patients (3.5%, in four patients with worsening of atopic dermatitis, in four patients with oral allergy syndrome), sensitisation to soy was found in another 47 patients (20%) with no clinical manifestation after soy ingestion. Dependence was confirmed statistically between soy allergy and pollen allergy and soy sensitivity and pollen allergy. About 20% of patients suffering from atopic dermatitis are sensitised to soy. Clinical symptoms of soy allergy occur only in 3.5% of patients suffering from atopic dermatitis. [ABSTRACT FROM AUTHOR]

Atopic dermatitis ( AD) is a chronic inflammatory skin disease with a large impact on quality of life of the patients and their families. In most cases, the diagnosis of AD can easily be made based on (family) history and clinical examination. If necessary, a practical set of diagnostic criteria such as the UK diagnostic criteria can be used. During the diagnostic phase, it is important to pay attention to atopic comorbidity, such as allergic airway disease (allergic asthma and/or rhinitis), allergic eye disease (atopic (kerato) conjunctivitis) and immediate-type food allergy. This will not have direct consequences for the treatment of AD, but may be important for the overall well-being of the patient. Psychological factors, such as family circumstances, work/school performance and lifestyle factors should also be explored. Severity scoring using properly validated scoring lists may not be necessary for the diagnosis, however, is recommended for monitoring therapy. Simple scoring systems, such as TIS and IGA are easy to perform in daily practice. Several flare factors in AD, such as exposure to irritants or UV light, can be identified by history and clinical examination: in individual cases, additional diagnostic tests may sometimes be useful to confirm clinical suspicion. There is only limited evidence that allergen exposure to aeroallergens and/or food allergens influences AD severity. Therefore, routine allergen testing is not necessary for diagnosis and treatment of AD. The decision to perform allergen tests mainly depends on atopic comorbidity. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to investigate the role of specific IgG4 antibodies to hen's egg white and determine their utility as a marker for the outcome of oral challenge test in children sensitized to hen's egg. Methods: The hen's egg oral food challenge test was performed in 105 sensitized children without atopic dermatitis, and the titers of egg white-specific immunoglobulin G4 (IgG4) and immunoglobulin E (IgE) antibodies were measured. To set the cut-off values of IgG4, IgE, and the IgE/IgG4 ratio for predicting positive results in oral challenges, receiver operating characteristic curves were plotted and the area under the curves (AUC) were calculated. Results: Sixty-four of 105 oral challenges with whole eggs were assessed as positive. The AUC for IgE, IgG4, and IgE/IgG4 for the prediction of positive results were 0.609, 0.724, and 0.847, respectively. Thus, the IgE/IgG4 ratio generated significantly higher specificity, sensitivity, positive predictive value (%), and negative predictive value (%) than the individual IgE and IgG4. The negative predictive value of the IgE/IgG4 ratio was 90% at a value of 1. Conclusions: We have demonstrated that the egg white-specific serum IgE/IgG4 ratio is important for predicting reactivity to egg during food challenges. [ABSTRACT FROM AUTHOR]

Aim. The evaluation of the occurrence of peanut allergy in adolescent and adult patients suffering from atopic dermatitis. Methods. Altogether 175 persons suffering from atopic dermatitis were included in the study. A diagnostic work-up for food allergy to peanuts was performed (specific IgE, skin prick tests, atopy patch tests, history), and the patients were also examined for pollen allergy containing Bet v 1 and Bet v 2 allergens. Results. Allergic reactions to peanuts were recorded in 23% of patients, and another 16% of patients were sensitised to peanuts. A dependency between the occurrence of pollen allergy with Bet v 1 and Bet v 2 allergens and the results of the examination for peanut allergy is confirmed in our study. Conclusion. One-fifth of patients with atopic dermatitis suffer from peanut allergy; the most common symptom is oral allergy syndrome. [ABSTRACT FROM PUBLISHER]

Increased Th2 polarity weakens the innate immune response and predisposes children with atopic dermatitis (AD) to skin superinfection. This study was designed to evaluate the relationship between IgE level and bacterial superinfection in children with AD. A medical chart review was performed on 103 children with AD to assess the association between IgE level and skin superinfection. A multivariable logistic regression model was used to assess the relationship between categorized IgE level and the presence of bacterial superinfection after adjusting for cofounding variables including allergic rhinitis, asthma, and food allergy. A Wilcoxon signed-rank test was used to compare pre- and postskin superinfection median IgE levels in a subset of patients. Compared with children with an IgE level of <300 IU/mL, children with an IgE level of >1001 IU/mL were 66.00 times more likely to have a skin superinfection (p = 0.003) and children with an IgE level between 301 and 1000 IU/mL were 12.38 times more likely to have a skin superinfection (p < 0.001). After controlling for cofounding variables including asthma, allergic rhinitis, and food allergy, children with an IgE level of >1001 IU/mL were 71.89 times more likely to have a skin superinfection (p = 0.018) and children with an IgE level between 301 and 1000 IU/mL were 8.79 times more likely to have a skin superinfection (p < 0.001) when compared with children with an IgE level of <300 IU/mL. There was a significant increase in IgE levels from baseline in 13 children treated for a skin superinfection (p = 0.001). IgE level is associated with Staphylococcus aureus superinfection in children with AD. [ABSTRACT FROM AUTHOR]

Abstract: Food allergy plays a pathogenetic role in subset of patient with atopic dermatitis, as proven over the past decade by laboratory and clinical investigations. Likely 40% of infants and young children may present with food allergy, whatever the severity of atopic dermatitis. The identification of the subset of patient with relevant food allergy requires a thorough a clinical history, the appropriate laboratory tests, food allergy being proven in all cases by elimination diets followed by provocation tests. Atopic dermatitis may be cured or largely improved by elimination diets, but the latter need a peculiar education of patient and physicians because the common causal foods involved (egg, milk, wheat, soil, peanut) are ubiquitous in industrial foods and since elimination diets are at risk of nutritional imbalances. Most food allergies resolve following early childhood and atopic dermatitis in older children and adults is largely less related to food allergy. [Copyright &y& Elsevier]

Presents abstracts of articles related to food allergy published in the July 2000 issue of "Allergy." "Precocious Sensitization in Infants and Small Children With Atopic Dermatitis," by G. Ricci, F. Speechia, A. Patriz, C. Lagalla and M. Masi; "Double-Blind Placebo-Controlled Food Challenge (BBPCFC) in 17 Patients With Allergy to Carrots," by B. K. Ballmer-Weber and B. Wüthrich; "Influence of Sucrose on Skin Status of Patients With Atopic Dermatitis: Results Double-Blind, Placebo-Controlled Oral Provocation Tests," by I. Ehlers, M. Worm, W. Sterry and T. Zuberbier.

IgE and IgG4 antibodies to bovine milk fat globule membrane (FGM) were measured in atopic eczema patients to determine whether their presence would account for allergy to milk in cases where whole or individual milk protein-specific antibodies are not detectable. The study demonstrates that the measurements of IgE and IgG4 antibodies to FGM do not offer any additional diagnostic value in milk exacerbated cases of atopic eczema. Furthermore, cross-inhibition studies with four milk proteins showed that these FGM-reactive IgE and IgG4 antibodies are directed against α-casein. [ABSTRACT FROM AUTHOR]

We conducted a prospective open study of immediate- and delayed-type contact hypersensitivity to food and other allergens in 33 children with atopic dermatitis (AD). The design of the study was exploratory and not randomized. Various methods for detecting immediate-type hypersensitivity were compared. Thirty-three children age 5 to 15 years with persistent AD were initially enrolled, but 3 dropped out. Nine patients had positive reactions to foods in the patch-scratch test, four had positive reactions in the skin application food test, and five had positive reactions to foods in the prick tests. Positive reactions to foods were observed in only three patients on the delayed-type patch tests. In all tests, but especially the patch-scratch and prick tests, positive reactions to food allergens were observed without clinically related symptoms. None of these tests gave ideal results. Twenty (67%) of the 30 children had positive reactions to inhalants in prick testing. Fourteen showed positive patch-test reactions with the European standard series (True Test). The most positive reactions were to nickel (9 patients), cobalt, and balsam of Peru. Restrictive measures led to evident improvement of AD only in some children. The results of this study illustrate that food allergy plays only a limited role in patients with AD age 5 to 15 years. We could not conclude which of the tests would predict which children might benefit from dietary manipulation. [ABSTRACT FROM AUTHOR]

Fourteen adults and 10 children with active atopic dermatitis entered this double blind cross-over study of oral disodium cromoglycate (DSCG) (adults 200 mg qid, children 100 mg qid) compared with placebo. Oral DSCG and placebo were given for 6 weeks in random order. According to the investigators' assessments of eczema, significant differences between active and placebo were found after 6 weeks' treatment, DSCG being favoured (p < 0.05). No differences were detected in the investigators' assessment of lichenization and overall disease. No significant differences between the two treatments were demonstrated in the patients' assessments. Results from food allergic patients. Two patients reported possible side effects of arthralgia and urticaria respectively. There were no treatment effects on serum IgE values or any other laboratory data. [ABSTRACT FROM AUTHOR]

Food intolerance is a popular notion in the general population but limited data are available on the presence of food allergy in adult patients with eczema. We wanted to characterize food hypersensitivity in this group of patients. A retrospective study was carried out on all patients with food related symptoms attending a cutaneous allergy clinic. Our study showed that while the reported prevalence of food allergy in adult patients with eczema is low (10%), more than half of these will show immunological evidence of a food allergy which support the clinical history. Immediate symptoms are usual, with nuts and tomatoes the major allergens. Demographic factors such as age, gender and duration of eczema did not significantly correlate with number of foods or an allergen-specific IgE of ≥ grade 2. Food-related symptoms were associated with significant anxiety in all our patients leading to a profound effect on their behaviour. [ABSTRACT FROM AUTHOR]

Investigates the role of food antigens in adolescent and adult patients with atopic dermatitis. Number of subjects included in the study; Response of skin-derived T-cell lines from reactive patients to birch pollen extract or Bet v 1.

Background: A subset of subjects with atopic dermatitis (AD) are susceptible to serious infections with herpes simplex virus, called eczema herpeticum, or vaccina virus, called eczema vaccinatum. Objective: This National Institute of Allergy and Infectious Diseases–funded multicenter study was performed to establish a database of clinical information and biologic samples on subjects with AD with and without a history of eczema herpeticum (ADEH+ and ADEH− subjects, respectively) and healthy control subjects. Careful phenotyping of AD subsets might suggest mechanisms responsible for disseminated viral infections and help identify at-risk individuals. Methods: We analyzed the data from 901 subjects (ADEH+ subjects, n = 134; ADEH− subjects, n = 419; healthy control subjects, n = 348) enrolled between May 11, 2006, and September 16, 2008, at 7 US medical centers. Results: ADEH+ subjects had more severe disease based on scoring systems (Eczema Area and Severity Index and Rajka-Langeland score), body surface area affected, and biomarkers (circulating eosinophil counts and serum IgE, thymus and activation-regulated chemokine, and cutaneous T cell–attracting chemokine) than ADEH− subjects (P < .001). ADEH+ subjects were also more likely to have a history of food allergy (69% vs 40%, P < .001) or asthma (64% vs 44%, P < .001) and were more commonly sensitized to many common allergens (P < .001). Cutaneous infections with Staphylococcus aureus or molluscum contagiosum virus were more common in ADEH+ subjects (78% and 8%, respectively) than in ADEH− subjects (29% and 2%, respectively; P < .001). Conclusion: Subjects with AD in whom eczema herpeticum develops have more severe TH2-polarized disease with greater allergen sensitization and more commonly have a history of food allergy, asthma, or both. They are also much more likely to experience cutaneous infections with S aureus or molluscum contagiosum. [Copyright &y& Elsevier]