Early management of atopic dermatitis can reduce food allergy in infants

It is already known that early-onset atopic dermatitis is one of the decisive risk factors for food allergy. This suggests an essential early effective treatment, which may play a preventive role in transcutaneous sensitization.

Considering this background, a team of researchers from the National Center for Child Health and Development, Japan, tested if enhanced treatment of atopic dermatitis to clinically affected and unaffected skin prevents hen's egg allergy compared to reactive treatment to clinically affected skin only.

The study points include the following:

• There were a total of 650 infants aged 6 to 13 weeks.
• At 28 weeks of age, the primary outcome was the proportion of immediate hen's allergy confirmed by oral food challenge.
• There were two groups, the enhanced group and the conventional group.
• Three hundred eighteen infants in the enhanced group received enhanced early skin treatment.
• Three hundred twenty-two infants in the conventional group received reactive therapy.
• In comparison, hen's egg allergy was significantly reduced in Enhanced treatment than conventional treatment, recorded as 31.4% vs 41.9%.
• The risk difference was –10.5%.
• Enhanced treatment lowered body weight and height at 28 weeks of age with a mean difference of –422 g and –0.8 cm, respectively.

Concluding further, the study has highlighted the importance of well-controlled atopic dermatitis management as a component of a hen's egg allergy prevention strategy.

The researchers said that enhanced treatment protocol should be modified before it can be considered an approach to prevent hen's egg allergy in daily practice-based. This is important to avoid side effects of topical corticosteroids (TCs).

Following remission induction by TCSs, maintenance therapy with lower potency TCSs can be used as an alternative proactive treatment. This can overcome the safety concerns of TCSs.

Further reading:

Enhanced early skin treatment for atopic dermatitis in infants reduces food allergy. Published: March 22, 2023DOI:https://doi.org/10.1016/j.jaci.2023.03.008