Researchers have urged caution around the timing of food allergy testing in patients with atopic dermatitis (AD), saying treatment for the condition should be optimised before testing is carried out.
At the American College of Allergy, Asthma and Immunology (ACAAI) Annual Scientific Meeting in Houston this weekend, researchers presented details of an “unfortunate case" of food allergy in a three-year-old child who had presented with AD and asthma at the age of two years.
The authors reported that skin prick testing (SPT) to a broad food panel was performed despite suboptimal AD therapy. After positive results to egg (8x3 mm), peanut (16x9 mm) and sesame seed (20x12 mm), these were removed from the child’s diet despite prior tolerance and no clear association between eating these foods and AD flare or immediate reaction. A year later, the child passed oral food challenges to egg and sesame but experienced anaphylaxis to peanut.
The authors cautioned that removing foods from a child’s diet to improve AD may lead to food allergy later in life. They said testing should only be carried out when AD treatment is first optimised to clearly demonstrate any associations between food ingestion allergic reaction/AD.