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Tuesday, September 18, 2012

Food Allergies and Eczema

Today's interview highlights a topic that's near and dear to my heart, atopic dermatitis.
My own experience with our food allergic children has shown a direct correlation between food allergies and atopic dermatitis (eczema). Read more about this condition that can be associated with food allergies.

Kosher with Food Allergies Interview Series
Interview #4- Food Allergies and Eczema , Dr. Jonathan Spergel
1- What is the connection between food allergies and eczema?
Many parents believe that food allergies can cause eczema or atopic dermatitis.
There are two types of reaction to foods in atopic dermatitis: foods causing
hives or foods worsening the atopic dermatitis. About 40% of the children with
moderate to severe atopic dermatitis have foods inducing their eczema. For the
children with mild disease, only 5% of the children have the atopic dermatitis
induced by foods. It is also important to remember that 10-30% of the children
with moderate to severe atopic dermatitis will have hives or anaphylaxis to the
food. However, over 70% of the children will have positive skin test or blood test
to foods. But, these results may not be clinical significant. For example, you may
be positive to wheat on a blood or skin test, but you could tolerate wheat without
any symptoms. The reason is that you have seasonal allergies and wheat skin test
is cross-reacting to grass pollen.

2- Is there a distinction between infant/childhood and adult eczema with regard
to food allergies?
It is very unusual for foods to induce adult eczema. Foods can induce infant
eczema, particular when it is severe. But, it is still less than 40% of the children
with severe eczema.

3- How does someone figure out if their eczema is caused by food allergies?
To determine if a food induces atopic dermatitis, there are two typical steps.
The first step is allergy testing by either blood or skin testing. If the testing
is negative, there is less than 5% chance that the foods are inducing atopic
dermatitis. If the test is positive, then a physician supervised food challenge
should be preformed. These challenges are usually done by an allergist. In a
food challenge, foods are given in a step-wise manner starting with a low dose
and gradually increasing. The physician monitors for symptoms and possibly
worsening of the atopic dermatitis.

4- What are effective treatments for eczema?
The basic therapy for eczema or atopic dermatitis is good skin care. It is
important to use moisturizers on a daily basis. For area of inflammation or
redness, the standard therapy is topical corticosteroids or other anti-inflammatory
medications. Individual therapies can vary depending on the triggers, severity of
the eczema and other factors.

Dr. Jonathan Spergel, MD- PhD
The Children's Hospital of Philadelphia (CHOP)
Chief, Allergy Section
Co-director, Center for Pediatric Eosinophilic Disorders
Associate Professor of Pediatrics, Perelman School of Medicine at the University of Pennsylvania
Education: MD - Mount Sinai School of Medicine, New York, NY
                         PhD in Biomedical Sciences - Mount Sinai School of Medicine, New York, NY
Internship- Pediatrics- Yale, New Haven Hospital- CT
ResidencyPediatrics - Yale-New Haven Hospital, New Haven, CT
FellowshipAllergy and Immunology - Children's Hospital, Boston, MA
Board Certification- Pediatrics, Allergy and Immunology
Special Interests- All areas of allergy, especially asthma, food allergy, eosinophilic esophogitis and atopic dermatitis


    1. In our case, watching my son break out as I nursEd him was a huge clue that his eczema was food-related. Blood tests later confirmed it. However, you cannot do blood tests on an infant, because the mother's antibodies in his blood will give inaccurate results.

      There is a direct relationship between the health of the gut and the skin. As my baby's poop turned consistently green, his skin also began to break out. Avoiding gluten (which irritates the gut) has made a significant difference in the health of his skin. Using probiotics also help. I believe that the root of some cases of eczema, especially those related to allergies, begin as gut issues that allow undigested food to slip into the body, to which the body then creates antibodies, and the future histamine reactions produce skin reactions.

      Just some thoughts on the topic. I'm no doctor, but I have two kids with eczema, so I do have some experience.

      1. Thanks for sharing your experiences with eczema Lisa.
        I'm glad you were able to identify the culprits of your son's eczema and found relief for him as well.
        As always parents should consult their Pediatricians first for accurate diagnosis and treatment.Sometimes a specialist consult (such as an allergist) can be very helpful.