Point prevalence and risk factors for food allergy in a cohort of 386 children with atopic dermatitis attending a multidisciplinary dermatology/paediatric allergy clinic

Abstract

Background: There is considerable debate about the prevalence and relevance of food allergy (FA) in atopic dermatitis (AD). The aim of this study was to investigate the prevalence of and risk factors for FA in a cohort of children with AD attending a multidisciplinary paediatric allergy clinic. Methods: The analysis was performed on 386 children (50.8% boys, median age 4 years) consecutively evaluated for AD. A diagnosis of FA was established on positive skin tests and/or a specific IgE value or a positive oral food challenge. Results: Point prevalence of FA was 17.8%. Egg, peanuts, milk, tree nut and mustard accounted for 93% of cases. 37.7% of children had ≥2 positive food reactions. Risk factors associated with FA were young age (OR = 7.9 when ≤2 years compared with ≥5 years), moderate to severe AD (OR = 7.8 for severe and 2.4 for moderate AD) and onset of AD before 3 months of age (OR = 5.7). Conclusion: Point prevalence of FA in children with AD is lower than initially reported in patients recruited in a paediatric allergology setting. Children ≤2 years of age with early-onset or severe AD are at higher risk of FA and may be candidates for FA evaluation.