Significance of Atopic Patch Tests and Other Diagnostic Methods in the Diagnostics of Food Allergy to Cow’s Milk and Wheat Flour in Patients with Atopic Eczema Older Than 14 Years

Czech version

Authors: J. Čelakovská ¹; K. Ettlerová ²; K. Ettler ¹; J. Vaněčková ¹; J. Bukač ³
Authors‘ workplace: Klinika nemocí kožních a pohlavních FN a LF UK Hradec Králové přednosta doc. MUDr. Karel Ettler, CSc. ¹; Ambulance klinické imunologie a alergologie, Hradec Králové vedoucí MUDr. Květuše Ettlerová ²; Ústav lékařské biofyziky LF UK Hradec Králové, přednosta doc. Ing. Josef Hanuš, CSc. ³
Published in: Čes-slov Derm, 84, 2009, No. 5, p. 254-263
Category: Clinical and laboratory Research

Overview

The significance of food allergy in children with atopic eczema, especially those younger than 3 years was confirmed by extensive studies. On the contrary, extensive study of food allergy in adults with atopic eczema is not available.

The aim of our study
was to evaluate the importance of atopy patch test and other diagnostic methods in the diagnostics of food allergy in patients with atopic eczema older than 14 years in comparison with double-blind, placebo-controlled food challenge – a gold standard in the diagnostics of food allergy.

Results showed food allergy to cow’s milk and wheat flour in one patient at the same time and to wheat flour in four patients of 149 patients. During one year of elimination diet the important improvement of skin involvement was observed.

This pilot study proved that the double-blind, placebo-controlled food challenge is the most important for the diagnosis of food allergy. Regarding cow’s milk, relation between skin prick tests positivity with confirmed food allergy was found, on the contrary, wheat showed relation between specific IgE positivity with confirmed food allergy, only. Atopy patch tests were not helpful in diagnosis of this type of food allergy and, in our opinion, are not suitable, as separated tests, for the determination of food allergy in adult patients with moderate to severe atopic eczema. Oral food challenge test and double-blind, placebo-controlled food challenge may help to prevent unnecessary restrictive diets based on inproper diagnostics.

Key words:
atopic eczema – atopy patch test – food allergy

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Article was published in

Czech-Slovak Dermatology

2009 Issue 5