Unraveling the diet-dermatitis connection: A systematic review of dietary exclusion in children with atopic dermatitis

Abstract

This review focuses on atopic dermatitis (AD) impacting 10–30% of children and influenced by food and aeroallergens. It highlights the need for cautious interpretation of sensitization to foods, as it does not guarantee allergy and the potential harm of indiscriminate avoidance affecting nutrient intake. Tests such as skin prick tests, serum-specific immunoglobulin E tests, and food challenges are essential before implementing food elimination. The objective is to assess current dietary exclusion practices in AD children. By screening eight studies including randomized controlled trials, systematic reviews, and cohort studies, the review underscores the benefits of evidence-based dietary exclusion for moderate to severe cases. It establishes causal links between food allergy (FA) and AD emphasizing evidence-based dietary modification over blanket elimination. Temporal changes in allergen antigenicity also suggest evidence-based, supervised practices. In conclusion, the review supports the benefits of evidence-guided food exclusion for AD with 50% of studies backing moderate-to-severe cases. It highlights the need for robust trials to guide rational food restriction, ultimately aiding patients and parents.