Could food allergy testing be beneficial in adult patients with atopic dermatitis? Three case-reports

Abstract

Three patients, who suffered from moderate to severe form of atopic eczema in last years, were detailed examined in the diagnostic work-up of food allergy. The examination involved measurement of specific IgE, skin prick tests, atopy patch tests with common food allergens, and challenge tests with cow milk and wheat flour (open exposure test, double-blind, placebo-controlled food challenge test). The diagnostic hypoallergenic diet was recommended to the patients. In the course of such a diet the skin finding improved. The open exposure test with cow milk or wheat flour was positive in them, the diagnosis of food allergy to cow milk and wheat flour was confirmed with double-blind, placebo-controlled food challenge test. During the first year of diet without cow milk and wheat flour the patients were checked every 3 months, SCORAD decreased and the level of SCORAD was recorded every 3 months during last 3 years also. Two patients are usually without eczematic lesions or sometimes only with solitary lesions and suffer from dry skin. One patient suffers from mild form of atopic eczema. The role of food allergy remains controversial in older children and adult patients suffering from atopic eczema. According to our result we suggest that food allergy may play a role in pathogenesis of atopic eczema in adults.