[Food allergy as a cause of atopic eczema]

Abstract

Atopic eczema/atopic dermatitis (AD) is very frequently the first clinical manifestation of allergic disease. The interactions between environmental and genetic factors are considered to play the most important role in the pathogenesis of this condition. Atopic eczema is one of the most frequently observed clinical manifestations in allergic food hypersensitivity. Clinical symptoms and signs are non-specific and vary greatly. Even though in each case of cow's milk protein allergy a similar group of allergenic proteins is responsible for adverse reactions, the clinical response in each patient, i.e. the clinical manifestation, is different. The localization of the allergic process and the underlying immunological mechanism determine the severity of the disease. They differ in individual patients, and they change with patients age. The diagnosis of food allergy is a very complex process and it requires careful consideration of each stage of clinical examination and observations. That is because currently it is not possible to diagnose food allergy basing on the results of a single diagnostic test or medical history findings due to insufficient specificity and sensitivity. The type of consumed food may be regulated as the sole cause of the disease only when its elimination from the patient's diet results in the remission of the clinical signs and symptoms or a marked decrease in their severity, and when its reintroduction causes their recurrence. The choice of a particular therapy is a consequence of the diagnostic and clinical complexity of allergy. In such a clinical context, the scope and duration of an elimination diet need to be adjusted to the individual case. Putting a patient on this type of diet should be justified by medical history findings, the clinical picture, tests, and food challenge tests. This approach reduces the risks of an unwarranted introduction of an elimination diet.