Prevalence of and association between atopic dermatitis and food sensitivity, food allergy and challenge‐proven food allergy: A systematic review and meta‐analysis

Abstract

Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by intense itch, dry skin and recurrent eczematous lesions. 1 Food allergy (FA) is triggered by exposure to a food antigen, and can manifest as urticaria, angioedema, gastrointestinal symptoms, respiratory problems and anaphylaxis. 2 In patients with co-occurring AD, eczema may worsen in hours to days after food exposure, while reduced exposure, or complete exclusion of food allergens in infancy, may improve or completely prevent AD. [3][4][5] It was traditionally assumed that primary sensitization to food allergens mainly occur as a result of allergen exposure in the gut, but it is now recognized that food sensitization (FS) can develop following primary allergen exposure on the skin. [6][7][8] Individuals with FS and FA often have skin-barrier impairment, even without co-occurring AD, 9-11 but AD seems to increase risk of developing FS and FA in a severity dependent manner due to significant skin-barrier impairment. [12][13][14][15][16][17][18][19] The skin may be impaired due to multiple factors such as reduction in chain length of essential lipids including ceramides, but also due to reductions of crucial skin barrier

High loading-dose of dupilumab resulted in rapid disease control in pediatric patients with atopic dermatitis

“…Due to the driving of type II inflammation, the prevalence of allergic comorbidities was significantly elevated in individuals with AD, and some patients experienced AD in infancy, and gradually developed into allergic asthma and allergic rhinitis in childhood, which was called atopic march ( 26 , 27 ). Recent meta-analysis reported that the overall pooled prevalence of allergic rhinitis, asthma and food allergy in AD patients was 40.5%, 25.7% and 32.7%, respectively, which was significantly higher than patients without AD ( 28 – 30 ). And food allergy was more common in children compared with adults ( 30 ).…”

“…Recent meta-analysis reported that the overall pooled prevalence of allergic rhinitis, asthma and food allergy in AD patients was 40.5%, 25.7% and 32.7%, respectively, which was significantly higher than patients without AD ( 28 – 30 ). And food allergy was more common in children compared with adults ( 30 ). The overall prevalence of allergic rhinitis and food allergy in our data was comparable with the published data, but the prevalence of asthma was lower, which may be attributed to the small sample size.…”

Skin‐centered strategies in food allergy prevention

“…That was strongly supported by the fact that atopic dermatitis (AD), a chronic inflammatory skin disease, is a major risk factor for FA and is a major determinant of atopic trajectories 26 . As an illustration, a recent meta‐analysis found that 49.8% (95% CI: 44.4–55.1) of children with AD had an IgE sensitization to at least one food allergen and that 31.4% (26.9–36.1) an IgE‐mediated FA, 27 while a systematic review determined that having AD is a strong predictor of food sensitization at 3 months (odds ratio [OR]: 6.18, 95% CI: 2.94–12.98) 28 …”

Post‐COVID dermatology—life will continue to be exciting

“…Pollen in the air not only elicits rhinitis and asthma but can also lead to exacerbations of atopic eczema and food allergic reactions. 3 Progress in treatment goes on with biologics and kinase inhibitors, indicating challenges with dupilumab in headand-neck-dermatitis. 4 Dupilumab-associated ocular events have been attracting special attention.…”

“…As is well known through the media, spring marks the start of allergy season, with hay fever being one of the most common allergic diseases. Pollen in the air not only elicits rhinitis and asthma but can also lead to exacerbations of atopic eczema and food allergic reactions 3 …”