Peanut allergy: An increasingly common life-threatening disorder

Allergic reactions to peanuts in children have become a significant medical and legal concern worldwide, with a rising incidence of this potentially fatal condition. Peanut allergy represents an immunoglobulin E (IgE)-mediated hypersensitivity reaction to peanut proteins and is responsible for the majority of cases of food-induced anaphylaxis. Even trace quantities of peanut in a sensitized individual can be fatal, with rapid onset of symptoms often including the cutaneous findings of urticaria, angioedema, or a diffuse nonspecific dermatitis. Peanut allergy is usually a lifelong condition, since only about 20% of affected individuals outgrow it. Some schools ban peanut butter and jelly sandwiches, once a common dietary option, as fear of medical and legal consequences is escalating. Children with peanut allergy and their families should be knowledgeable about management: strategies, including carrying and properly administering self-injectable epinephrine. New immunotherapeutic options are being investigated and appear promising. (J Am Acad Dermatol 2012;66:136-43.)