ATOPIC DERMATITIS (AD) AND POOD ALLERGY (FA):

During 1981-1982 we have consecutively seen for the first time 96 children with AD. In order to ascertain whether AD was due to FA or not, we recorded in all children the age of onset of AD, duration of breast feeding and familiarity for atopy. RAST to cow's milk (CM),egg, other foods if suspected, and inhalants was made. All children were initially prescribed a CM- and egg-free diet for 4 weeks. Subsequently, the children who improved had separate provocation tests with each previously eliminated food. Improvement during the diet and relapse during provocation tests were considered suggestive of AD. 42 children did not complete the study mainly because of parents’ refusal of the elimination diet. CM and/or egg was found to be the causative agent of AD in 30 children. In this group the age of onset of AD was mainly before the 4th month of life, and RAST and skin tests were positive to the offending food in 50% of cases. 24 children did not improve with the CM- and egg-free diet. A new diet also free of wheat, citrus fruit, tomato and many vegetables was started. 11 children improved and a polysensitization (to 3 or more foods) was demonstrated. In these children the age of onset of AD was mainly after the 6th month, and RAST and skin tests did not always correlate with the clinical findings. In the remaining 13 children FA was not confirmed as no improvement was shown. Elemental diets (e.g. Vivonex) could be useful in these cases, but Italian children refuse to consume this type of diet because of its unpalatability. Also in this group the age of onset of AD was after the 6th month, but RAST and skin tests were usually negative.