Abstract
Background:
The use of blood specific IgE or skin prick tests (SPT) to guide dietary exclusions for disease control in children with atopic dermatitis (AD) is controversial. We undertook a consensus exercise on how to interpret SPT results and dietary history for cow's milk, hen's egg, wheat, and soy in children < 2 years old with AD.
Methods:
Fourteen clinicians from general practice, pediatrics, pediatric dermatology, pediatric allergy, and pediatric dietetics from UK and Ireland took part in an online modified Delphi study. Over three rounds, participants gave their anonymous opinions and received individualized and group feedback, based on the premise that all children had SPTs. The findings were discussed in an online workshop.
Results:
Of 18 symptoms, 12 were identified as relevant to immediate and 7 to delayed allergy. Regarding SPTs, there was consensus over which allergens to use for wheat and soy but not cow's milk or hen's egg; for all study foods, wheal size was determined as 0–1 mm negative, ≥ 5 mm sensitized, but between 2 and 4 mm, categorization varied by food. During the final workshop, consensus was reached on dietary advice for nine combinations of SPT results and dietary history.
Conclusion:
We attained consensus on how SPTs and dietary history for four common food allergens should be interpreted in young children under 2 years of age with AD. These pragmatic recommendations may support clinician education, consistency of decision-making, and future research.
The use of blood specific IgE or skin prick tests (SPT) to guide dietary exclusions for disease control in children with atopic dermatitis (AD) is controversial. We undertook a consensus exercise on how to interpret SPT results and dietary history for cow's milk, hen's egg, wheat, and soy in children < 2 years old with AD.
Methods:
Fourteen clinicians from general practice, pediatrics, pediatric dermatology, pediatric allergy, and pediatric dietetics from UK and Ireland took part in an online modified Delphi study. Over three rounds, participants gave their anonymous opinions and received individualized and group feedback, based on the premise that all children had SPTs. The findings were discussed in an online workshop.
Results:
Of 18 symptoms, 12 were identified as relevant to immediate and 7 to delayed allergy. Regarding SPTs, there was consensus over which allergens to use for wheat and soy but not cow's milk or hen's egg; for all study foods, wheal size was determined as 0–1 mm negative, ≥ 5 mm sensitized, but between 2 and 4 mm, categorization varied by food. During the final workshop, consensus was reached on dietary advice for nine combinations of SPT results and dietary history.
Conclusion:
We attained consensus on how SPTs and dietary history for four common food allergens should be interpreted in young children under 2 years of age with AD. These pragmatic recommendations may support clinician education, consistency of decision-making, and future research.
| Original language | English |
|---|---|
| Pages (from-to) | 259-266 |
| Number of pages | 8 |
| Journal | Pediatric Dermatology |
| Volume | 42 |
| Issue number | 2 |
| Early online date | 11 Nov 2024 |
| DOIs | |
| Publication status | Published - 1 Mar 2025 |
Bibliographical note
Publisher Copyright:© 2024 The Author(s). Pediatric Dermatology published by Wiley Periodicals LLC.
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Dive into the research topics of 'Food Allergy Test-Guided Dietary Advice for Children With Atopic Dermatitis: A Consensus Study'. Together they form a unique fingerprint.Projects
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CAESAR: Centre for Applied Excellence in Skin and Allergy Research
Ridd, M. J. (Principal Investigator), Turner, A. J. (Manager), Caldwell, C. C. (Administrator), Parslow, R. M. (Researcher), Granell, R. (Researcher), Huntley, A. L. (Researcher), Umasunthar, T. (Researcher), Jones, O. (Researcher), Brown, E. L. (Researcher), Gilbertson, A. (Student), Vincent, R. (Student), Feeney, M. (Student), Hutchison, E. J. (Student) & Wainman, H. (Student)
1/12/23 → 30/11/28
Project: Research
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