Food allergies and eczema in children are why food allergies are more common in children who suffer from eczema, along with triggers.
Once you start looking after patients who’ve got food allergies. It very quickly becomes apparent that there’s, an enormous overlap with eczema. Most people who have got a food allergy will tell you that during the first year of life, they had eczema.
What the studies show us is that the more severe that the eczema is and the earlier that their xmas starts, the more likely is that they will develop food allergies typically to things such as egg peanuts tree nuts and sesame.
As so understanding is developed, it ‘s now become clear that this isn’t just a coincidence, but actually it’s, a causal association. It turns out that skin barrier dysfunction, which is the leakiness of a skin barrier, that you get an eczema actually predisposes to the development of allergies and the more leaky that your skin is the more of a chance.
There is that the immune system that sits underneath it will see food allergens in the environment during early infancy, typically before the babies started, to eat those foods and develop sensitization to them.
Eczema and Food Allergies
That then leads to allergy. Eczema is really common. It affects around 20 percent of UK infants and the majority of children with eczema don’t have any food allergies, in fact doing blankets. Screening for food allergies on all children with eczema is really unhelpful.
It often throws up lots of positive results that actually don’t mean very much so it doesn’t, add anything to the care of the child. However, there are certain children where allergy testing is definitely worth giving further consideration.
For example, those children have got more severe eczema, particular where the XM is proven difficult to treat or exome that started very early, and particularly in children where there appears to have been a reaction to something so, for example, the first time the child was given egg.
One of those common food allergies – and there seemed to be some sort of reaction. It’s. Children like that, where allergy testing, particularly when it’s more focused, and it has to be accompanied with a detailed clinical history, can be much more useful, [ Music ] for many years.
Those debates about what the underlying cause of eczema was. Some people believe that it was genetic and others believed that eczema was an allergic disease that was driven by other things in the diet or things in the environments.
And then, some years ago there was the discovery of the fill, a green gene which made it much clearer that the underlying problem in eczema is skin barrier dysfunction. It’s genetically programmed, but that very much predisposes children who have got that skin barrier dysfunction to get allergies, those allergies and in childhood it’s, typically food allergies.
That then, contribute to making the eczema worse, and that can happen by a number of different mechanisms with some children irritant foods. Nothing to do with allergies at all will cause flares of eczema, so classically things like tomatoes or strawberries will cause redness around the mouth.
That’s homeless and nothing to worry about, but with other children who do have allergies either through an immediate IgE mediated pathway. They can cause reactions typically with food such as egg peanuts tree nuts sesame, whether it’s, a very obvious flare of attic area and Judy mer, an Associated eczema very quickly after ingestion, but also there can be delayed type reactions, type 4 hypersensitivity.
We’re having foods such as milk or soy in the diet on a regular basis can cause the eczema to be chronically worse. This is harder to diagnose because it relies on a detailed clinical history and we don’t have reliable tests to do it, but an exclusion diet can often reveal that there’s.
An underlying problem followed by reintroduction, to confirm that that food does make things worse. It’s, notoriously difficult to try and work out. If particular foods are causing flare-ups.
So really, it requires a detailed history, together with allergy testing, where it’s appropriate to try to get to the bottom of whether it’s necessary to do food exclusions. I’m very aware in my practice that many patients will try and work our exclusions themselves and often not tell their GP, for example, that they’re doing these exclusion diets, and this can lead to quite significant nutritional issues.
So it’s really important to engage patients about their concerns. Understand what they’re worried about what foods they’re nervous about what they’ve, actually excluded, and how effectively they’ve done that.
So really, this all comes together as a complete package of proper eczema care that involves getting the first line measures around right, including the emollients, the topical steroids, together with a very open-minded conversation about the possibility of allergy and then exploring that further.
Dr. Adam Fox shares his info with us here at Eczema News, but if you would like to subscribe or follow him (619) Food allergies and eczema in children – YouTube
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