Speaker: Diet not likely cause of atopic dermatitis
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MIAMI BEACH, Fla. — Decreasing the concern about food-induced atopic dermatitis will allow patients to focus on proper skin therapy and lower the risk of developing food allergies, according to a speaker at South Beach Symposium.
“Many people jump right to food as a primary cause for atopic dermatitis,” Peter Lio, MD, FAAD, of Northwestern University Feinberg School of Medicine and Chicago Integrative Eczema Center, said during his presentation. “But I would say that in general, when we do a very careful review, the evidence says that in unselected patients, excluding certain foods really does not seem to have a repeatable benefit.”
While food may play a role in a select number of patients, Lio added, this trend is not an evidence-based finding. According to Lio, what tends to happen is families that are troubled by the burden of AD attribute the causes and flares to anything they possibly can.
In fact, Lio referenced a study where researchers hospitalized and tracked the diet of a group of patients that were convinced food was driving their AD. By the end of the study, 80% of patients agreed that food was not a primary factor.
On the other hand, avoiding certain foods may increase the risk of developing true allergies, including anaphylaxis. According to Lio, a retrospective review of 298 patients who avoided previously tolerated foods in an effort to treat eczema found that when foods were reintroduced, 19% had symptoms of acute immunoglobulin E reactions, of which 30% were classified as anaphylaxis.
“The gut is necessary to keep tolerance of foods,” Lio said, “and if we cut out foods, we’re going to really make an allergy.”
Nevertheless, if there is a consistent correlation of symptoms and specific foods, a diagnostic elimination diet for up to 4 to 6 weeks with suspected food items may be initiated, according to American Academy of Dermatology guidelines.
“We know that food plays an important role in health and disease,” Lio said. “But if we can first work on the skin with a drug, even if it’s for just 5 to 7 days, I think that would be worthwhile for patients.”
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Lio PA. Diet: How it impacts the skin and how to help. Presented at: South Beach Symposium; Feb. 9-12, 2023; Miami Beach, Fla.
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