Background: Studies of Australian infants have reported that more than 80% of those with moderate atopic eczema (AE) have high levels of IgE food sensitization (IgE-FS) that are commonly associated with IgE food allergy.
Objectives: To explore the relationship between high levels of IgE-FS and AE in a large cohort of young children with eczema participating in a multi-centre, international study.
Methods: Two thousand one hundred and eighty-four subjects (mean age 17.6 months, range 11.8-25.4; 1246 males) with active eczema from atopic families from 94 centres in 12 countries were studied. Clinical history, Scoring Atopic Dermatitis index as a measure of eczema severity and CAP-FEIA measurements for total IgE and IgE antibody levels to cow milk, egg and peanut were entered into a database. If CAP-FEIA levels exceeded previously reported age-specific cut-off levels for 95% positive predictive values (PPVs) for food allergy, subjects were defined as having high-risk IgE-FS (HR-IgE-FS).
Results: Serum was available from 2048 patients; 55.5% were atopic. The frequency of HR-IgE-FS to milk, egg and/or peanut was the greatest in patients whose eczema developed in the first 3 months of life and the least in those whose eczema developed after 12 months (P<0.0001). In a regression analysis to allow for potential confounding factors, children with HR-IgE-FS had the most severe eczema and the youngest age of onset (P<0.001); 64% of infants with severe eczema of onset-age <3 months had HR-IgE-FS.
Conclusion: Early-onset severe eczema in infancy was associated with HR-IgE-FS.
Clinical implications: Food allergies should be routinely assessed in infants with moderate or severe eczema. Capsule summary: In eczematous infants, the earlier the age of onset, and the greater the severity of eczema, the greater the frequency of associated high levels of IgE-FS.

, , , ,
the EPAAC Study Group,
Clinical and Experimental Allergy
Erasmus MC: University Medical Center Rotterdam

Hill, D., Hosking, C. S., de Benedictis, F. M., Oranje, A., Diepgen, T. L., & Bauchau, V. (2007). Confirmation of the association between high levels of immunoglobulin E food sensitization and eczema in infancy. Clinical and Experimental Allergy, 38(1), 161–168. doi:10.1111/j.1365-2222.2007.02861.x