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Challenge of food allergy testing and avoidance in children with atopic dermatitis
  1. Stephanie Ann Kubala1,
  2. Paula Mariam Mohyi2,
  3. Kristin Sokol1 and
  4. Pamela Frischmeyer-Guerrerio1
  1. 1Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, USA
  2. 2Internal Medicine, George Washington University School of Public Health and Health Services, Washington, District of Columbia, USA
  1. Correspondence to Dr Paula Mariam Mohyi; paulamohyi1{at}


Atopic dermatitis (AD) is a common presenting complaint by children and their caretakers to their primary care providers. On testing, children with AD frequently exhibit positive food-specific IgE levels in the absence of immediate allergic reactions. Misinterpretation of these false positive tests can lead to unnecessary food avoidance, which can have tremendous psychosocial, economic and nutritional consequences and, in some cases, facilitate the development of an immediate hypersensitivity to the food. We present a child with persistent AD who underwent broad testing that led to unnecessary food avoidance resulting in Vitamin D deficiency, growth failure and the development of an IgE-mediated food allergy. This case underscores the need for caution by primary care clinicians in using food avoidance diets as a treatment for AD and the importance of limiting allergy testing to foods only when the clinical history indicates an immediate hypersensitivity reaction.

  • dermatology
  • immunology
  • childhood nutrition
  • allergy
  • asthma
  • paediatrics

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  • Contributors PMM, SAK and PF-G reviewed and evaluated all records and wrote the case report; KS and PF-G provided clinical care and critically reviewed the manuscript. All authors approved the final manuscript as submitted and agreed to be accountable for all aspects of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.