Tackling the tough questions parents sometimes have about food allergies is not easy for pediatric dermatologists, in part because there is so little consensus in the literature. Now a large review of the literature offers some guidance.
“Food allergies in general are challenging and can lead to difficult conversations with parents,” Dr. Robert Sidbury said. Part of the problem for Dr. Sidbury and other pediatric dermatologists is “the complicated association [between] atopic dermatitis and food allergy.”
Many parents, for example, are convinced their child’s atopic dermatitis (also commonly called eczema) is caused by a food allergy, no matter what you tell them, said Dr. Sidbury, Chief of the Division of Dermatology, Department of Pediatrics at Seattle Children’s Hospital.
Concerned parents will have a lot of questions. Because not everything about food allergy is straightforward, doctors sometime struggle with the answers. Physicians now can cite the findings of a systematic review published in JAMA earlier this year for more concrete answers, Dr. Sidbury said at a seminar on women’s and pediatric dermatology sponsored by the Skin Disease Education Foundation (SDEF).
Patients and parents may ask how many people have food allergies. It is at least 1% to 2% but no more than 10% of the population, according to this systematic review of 70 published studies. The researchers also stated it is unclear if the number of food allergies is increasing or not over time.
There are few rigorous data to support use of an elimination diet, even though they are widely used for diagnosis of food allergies.
In addition, they found no significant difference between two other diagnostic strategies: skin prick tests and food-specific IgE antibody tests.
There is still a need for more research. A lack of standard definition or diagnostic criteria is one of the main challenges to overcome before additional consensus can be reached on food allergy prevalence, diagnosis, management, and prevention.
Dr. Sidbury had no relevant disclosures. I am a reporter for Skin & Allergy News, which is owned by Elsevier. The SDEF is also an Elsevier company.
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