Combined skin prick and patch testing enhances identification of food allergy in infants with atopic dermatitis☆,☆☆,★,★★
Section snippets
Patients
The study comprised 183 children ranging in age from 2 to 36 months (mean 14 months) and fulfilling the Hanifin criteria15 of atopic dermatitis in children. They had been referred to a teaching pediatric or dermatologic clinic for evaluation of atopic dermatitis and were not selected on the basis of suspected allergy to cow milk. The mean age (95% confidence interval, [CI]) at onset of dermatitis was 4 months (95% CI, 3.5 to 5 months), and the duration of breast-feeding, exclusively and
RESULTS
Of the total 183 cow milk challenges, 99 (54%) gave results interpreted as positive. The mean (95% CI) age of the patients was 14 months (12 to 16 months) in the positive and 14 months (13 to 16 months) in the negative group; t = 0.24, p = 0.81. The mean serum IgE concentration was higher in the positive group than in the negative group, viz. 45 kU/L (95% CI, 30 to 67 kU/L) versus 23 kU/L (95% CI, 14 to 37 kU/L); t = 2.16, p = 0.03. Cow milk–specific IgE antibodies, RAST ≥0.4 kU/L, were
DISCUSSION
Atopic dermatitis is a common and complex, chronically relapsing skin disorder of infancy and childhood. Immunologically it is characterized by increased, mainly allergen-specific, IgE production. Because elevated specific IgE can be demonstrated by skin prick testing, these tests are widely used to disclose food allergy in patients with atopic dermatitis.7, 8, 9 The results in our study support previous findings that T cell-mediated reactions can be distinguished in atopic dermatitis18, 19, 20
Acknowledgements
We thank SHS Int. Ltd., Liverpool, U.K., for providing Neocate, and Valio Ltd., Helsinki, Finland, for providing the whey hydrolysate formula for this investigation.
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From athe Medical School, University of Tampere and the Department of Pediatrics, and bthe Department of Dermatology, Tampere University Hospital.
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Supported by the Academy of Finland.
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Reprint requests: Erika Isolauri, MD, Medical School, University of Tampere, P.O. Box 607, 33101 Tampere, Finland.
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0091-6749/96 $5.00 + 0 1/1/64982