Test‐guided dietary exclusions for treating established Atopic Dermatitis in children: A Systematic Review

Atopic Dermatitis (AD), synonymous with Atopic Eczema, is a chronic inflammatory skin disease, characterised by acute flares of pruritic lesions. It affects around 20% of children in the UK. While immediate, IgE-mediated food allergy, is more common in AD, non-IgE mediated food allergies causing eczema symptoms are more controversial, and literature on the use of exclusion diets for treating AD is mixed.1 The most recent Cochrane systematic review, published in 2008 and including randomised controlled trials (RCTs) up to March 2006, found that most studies were of poor quality and generally did not support dietary exclusion for treating established eczema.1 Since this review, landmark trials have demonstrated the risk of delayed food introduction,2 and dietary exclusions, which may cause loss of oral tolerance as well as nutritional deficiencies. Despite this, parents often seek food allergy testing, and/or exclude foods to help manage their child’s eczema, and healthcare professionals’ practice varies.3

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