Diagnosis of food allergy caused by fruit and vegetables in children with atopic dermatitis

: Atopic dermatitis (A.D.) is a frequent, complex and multifactorial disease: Food Allergy (F.A.), probably underestimated, especially for fruits and vegetables, seems to play an important pathogenetic role in children. The purpose of this study is to estimate, on a sample of children with A.D., the prevalence of F.A. (for fruits and vegetables), and the reliability of diagnosis of Prick+Prick test compared with the usual Prick test, RAST and challenge. Twentysix patients (17 M and 9 F), ranging in age from 5 months to 8 years, were enrolled in the study. All fulfilled the criteria of Hanifin and Rajka for the diagnosis of A.D. Food RAST, prick tests with inhalant and food extracts and Prick+Prick tests with fresh fruits and vegetables were carried out. In the case of positive result to fruits and vegetables with skin tests and/or RAST, open challenge for every type of food considered responsible was carried out, after healing or improvement of dermatitis. Three children (11.53%) suffered from F.A. for fruits and vegetables: allergy to celery of one patient was discovered only by usual Prick test; allergy to tomato and kiwi in another patient was spotted by Prick+Prick only; while in another case by both tests. In this last patient Prick+Prick test revealed a real allergy for 5 aliments (carrot, tomato, celery, cucumber, fennel) of which only 2 (carrot and celery) also caused a reaction with the Prick test. The combined use of both tests made it possible to increase the diagnosis of F.A. both for the number of patients and for a complete identification of implicated foods.