Dietary management of patients with eczema: Cross‐sectional survey of dietitians in the United Kingdom

Abstract

To the Editor, The association between food allergy and eczema is well recognized. 1 Food allergy is more prevalent in patients with eczema, compared with the general population, and may exacerbate symptoms, but is not thought to be the underlying cause of eczema for most patients. 2 Yet, clinicians often feel pressurized by patients with eczema or their parents to investigate food allergy, particularly in those perceived to be unresponsive to standard medical management.Investigations for IgE-mediated and non-IgE-mediated food allergy may be instigated to guide dietary exclusion(s) and reduce symptom exacerbation. However, the unwarranted exclusion of foods can compromise nutritional status and can put sensitized individuals at risk of severe IgE-mediated allergic reactions. 3 Dietitians are often asked to provide dietary advice to patients with eczema, but there is currently no universal approach to the testing and dietary management of patients with eczema and possible food allergy.We sought to establish current practices amongst UK dietitians regarding the testing and dietary management of eczema patients.Of particular interest was the basis for dietary exclusion advice, how foods to be excluded were determined, the duration of exclusion and reintroduction of foods, and the favoured approach when more than one food was suspected to be exacerbating eczema symptoms.