ABSTRACT
Background: Atopic dermatitis (AD) is characterised by
epidermal barrier impairment, associated with food allergen (FA)
sensitisation and AD severity. However, no clinical guidance has been
established for evaluations of food sensitisation (FS) in AD patients.
This study investigated how AD severity and epidermal barrier impairment
are associated with FS, and factors that can predict FS in children with
AD.
Methods: This cross-sectional study included 100 children
(12–60 months) diagnosed with AD. AD severity was determined using the
Scoring Atopic Dermatitis (SCORAD) index. FS was evaluated by measuring
serum specific IgE antibodies against 31 FAs using an immunoblotting
method. Epidermal barrier impairment was assessed by measuring
transepidermal water loss (TEWL) and stratum corneum hydration (SCH)
levels.
Results: 90% of participants were sensitised to at least one
tested FA, with cow’s milk, egg white, beef, almond, egg yolk, and
peanut being the most common. Children with moderate-severe AD had lower
SCH levels than those with mild AD. Children with AD who were sensitised
to > 10 FAs had significantly higher TEWL and lower SCH
levels, compared with those sensitised to 1–4 FAs and 5–10 FAs. The
SCORAD score and SCH level in lesional skin provided moderately
predictive value for sensitisation to FAs in children with AD.
Conclusion: FS is common in children with AD and closely
associate with AD severity as well as epidermal barrier impairment.
Evaluations of FS should be considered for children with moderate to
severe AD and/or low SCH levels.
Key words: atopic dermatitis, food sensitisation,
transepidermal water loss, stratum corneum hydration, paediatrics.