The Importance of Food Open Challenge Test in Atopic Dermatitis: The Comparison of Allergy History, Skin-Prick Test, and Specific IgE Detection

Food allergies play an important role in Atopic Dermatitis (AD). Dietary manipulation is essential in the management of AD. However, there has been a paucity of data reporting the prevalence of food allergies in AD patients in Korea. In this study, the Food Open Challenge Tests (FOCT) were conducted to investigate food allergies in AD patients. The skin-prick test and the detection of specific IgE, as well as allergy history of patient were used to detect food allergies in all AD patients. Elimination diet was conducted for two weeks prior to FOCTs. The prevalence of food allergies by FOCT is as follows: milk (67.3%); chicken (64.2%); pork (62.8%); eggs (61.0%); beef(55.4%) ; wheat (52.0%) and soybean (45.2%). Allergenic food items in Korean AD patients were different from people in other foreign countries. The seven major foods those tested positively by FOCTs were completely eliminated from the replaced diets for two weeks, and were subsequently reintroduced one at a time. Results from FOCTs were not comparable with allergy history or skin-prick tests or specific IgE detection. The sensitivity and specificity of skin-prick tests and specific IgE detection were lower than FOCTs. Allergy history, skin-prick tests, and specific IgE detection are useful for the identification of food allergen but its clinical significance differed according to food items. Therefore, we conclude that even though a 10-day delay was necessary after food challenge, FOCT is a useful and valid method to confirm food allergies and may be essential for the effective control of food allergies for treatment of AD.