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Clinical Reviews in Allergy & Immunology

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29-01-2024 | Atopic Dermatitis | Review

Is Food-Triggered Atopic Dermatitis a Form of Systemic Contact Dermatitis?

Authors: Kripa Ahuja, Christopher J. Issa, Susan T. Nedorost, Peter A. Lio

Published in: Clinical Reviews in Allergy & Immunology | Issue 1/2024

Abstract

Food allergy in atopic dermatitis is mediated by complex immune interactions between genetics, diet, environment, and the microbiome. When contact between inflamed skin and food antigens occurs, contact hypersensitivity can develop. Consequently, systemic contact dermatitis (SCD) can occur after ingestion of allergenic foods or food additives in the setting of a Th2 response with CLA-positive T cells, triggering dermatitis where skin resident memory lymphocytes reside. This phenomenon explains food-triggered dermatitis. Atopy patch tests (APTs) detect sensitization to food proteins responsible for SCD, which in turn can be confirmed by oral food challenge with delayed interpretation. We summarize the literature on using APTs to identify foods for oral challenge with dermatitis as an outcome. In dermatitis patients at risk for Th2 skewing based on a history of childhood-onset flexural dermatitis, shared decision-making should include a discussion of identifying and avoiding food and food additive triggers, as well as identifying and avoiding all contact allergens, prior to initiation of systemic therapy for dermatitis.

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Title: Is Food-Triggered Atopic Dermatitis a Form of Systemic Contact Dermatitis?
Authors: Kripa Ahuja
Christopher J. Issa
Susan T. Nedorost
Peter A. Lio
Publication date: 29-01-2024
Publisher: Springer US
Keywords: Atopic Dermatitis
Food Allergy
Published in: Clinical Reviews in Allergy & Immunology / Issue 1/2024
Print ISSN: 1080-0549
Electronic ISSN: 1559-0267
DOI: https://doi.org/10.1007/s12016-023-08977-x

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