The role of food allergens in exacerbations of atopic dermatitis in adults

Introduction. Atopic dermatitis is a chronic disease influencing the quality of life. The potential role of food factors in evoking inflammatory skin reactions is still a matter of debate. Aim. Assessment of the contribution of food allergens in the pathogenesis of atopic dermatitis and the effect of elimination diet on the state of the skin. Material and methods. Thirty two subjects (18 women; 14 men; mean age 34.87 +/- 6.21 years) with diagnosed atopic dermatitis were asked to answer a questionnaire. Each of them underwent skin prick tests with 20 food allergens. Allergen- specific IgE serum levels against food allergens were assessed (Quantiscan, Immunogenetics). Elimination diet was administered for 4 weeks. After that time, the state of the skin was assessed with the use of SCORAD scale and compared with the results obtained before the diet. Results. The most numerous group of patients, 25% (n= 8), indicated milk as the main food factor exacerbating the course of the atopic dermatitis. The majority of positive skin prick tests were caused by chammomile (n= 6; 18.8%). Twelve subjects showed elevated specific IgE serum concentrations against potato allergens (37.5%), while eleven subjects (34.4%) were positive to cow milk proteins. Significant improvement of the skin condition to the extent that enabled shift to lower class of severity was observed in 60% (n= 6) of patients in the severe group, and in 18.9% (n= 2) of patients in the moderate group. None of the patients in the mild group showed signs of positive influence of the diet on the skin. Conclusions. Food hypersensitivity may contribute to the pathophysiology of atopic dermatitis. According to the opinion of the patients with atopic dermatitis, food allergy plays a greater role than it has been proved by the objective assessment according to the SCORAD scale. The elimination diet has been shown to offer most benefit to the subgroup with severe signs of atopic dermatitis.