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Reliability of tests for specific IgE to food in atopic dermatitis *

The pathogenesis of AD is poorly understood, and studies exist which demonstrate the role of a genetic predisposition and environmental factors (4, 12, 20, 30). However, a relationship between food allergy and AD is indicated by a great deal of data, from which we can draw some conclusions (4, 17, 23): positive family history for atopic diseases are reported in most AD children; AD children frequently develop other atopic diseases; elevated serum IgE levels and positive immediate skin and radioallergosorbent (RAST) tests to dietary antigens are frequently positive in AD children; specific foods are able to provoke AD in some children; elimination diets are effective in the treatment in some AD children; manipulation of the diet in early infancy may affect the subsequent incidence of AD. However, the pediatrician treating a child with AD often experiences several difficulties in detecting the offending food(s). Clinical history (CH), skin test (SPT), RAST, elimination diets and food challenges have been reported to be able only partially elucidate the problem (4, 11, 19, 26). In this paper we report our experience in diagnosing food allergy in children with AD.