![]() Parents have asked me if a diagnosis of a food allergy can be made by placing the food on the skin. The answer is, not always. Why is that? Not all concentrations of the allergen can lead to a reaction.
𝐂𝐨𝐧𝐭𝐚𝐜𝐭 𝐃𝐞𝐫𝐦𝐚𝐭𝐢𝐭𝐢𝐬 happens when a substance gets in contact with the skin, causing a localised reaction. It can be either 𝘪𝘳𝘳𝘪𝘵𝘢𝘯𝘵 (80% of reactions) or 𝘢𝘭𝘭𝘦𝘳𝘨𝘪𝘤 (20% of reactions), leading to different reactions. It affects people that deal with the substances frequently, though it can happen to anyone.
Treatment starts with avoidance of contact with the substance causing the reaction. Following this, the creams used are very similar to the ones used in eczema. It is not frequent the need for oral or intravenous medication. How to make a diagnosis?
There is also a difference in signs.
Nickel can give irritant and allergic contact dermatitis. www.facebook.com/permalink.php?story_fbid=305625454898006&id=100063516604410
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![]() Recent publication showed there are significant peanut proteins in household dust. But what is the relevance of this study, and how does it apply to the development of allergies?
The best course of action to deal with eczema, and potentially prevent the development of allergies, should be:
(In due course, I will publish more information regarding eczema and the best way to take care of it.) (Main article – “Mass spectrometry confirmation that clinically important peanut protein allergens are in household dust”; Helen A. Brough, Elizabeth Naomi Clare Mills, Kerry Richards, Gideon Lack, Philip E. Johnson; 04 October 2019) www.facebook.com/permalink.php?story_fbid=131470248980195&id=100063516604410 ![]() Simple Food Protein Induced Enterocolitis Syndrome (𝐅𝐏𝐈𝐄𝐒) or Food Protein Induced Proctocolitis (𝐅𝐏𝐈𝐏) is often mistaken for a viral infection causing vomiting and diarrhoea, with occasional blood in stool. Often, and not wrongly, it may be diagnosed as a 𝘯𝘰𝘯-𝘐𝘨𝘌 𝘢𝘭𝘭𝘦𝘳𝘨𝘺, with the most common being CMPA.
Important to note that severe 𝐅𝐏𝐈𝐄𝐒 is relatively rare and less common than Anaphylaxis! 𝐅𝐏𝐈𝐄𝐒 most common triggers:
Most children will be able to tolerate the food causing the reaction by the age of 2 or 3 years old. In some cases, it may persist throughout life. Children with recurrent episodes may suffer from poor growth and weight loss - failure to thrive. Usually children will recover very fast from an episode of 𝐅𝐏𝐈𝐄𝐒, as long as appropriate diagnosis and treatment is made. For severe cases, the best treatment is fluid resuscitation.
Though you will often see all of them being used due to the worry it is either Anaphylaxis or Sepsis. In the case of 𝐅𝐏𝐈𝐏, most symptoms tend to resolve by 6 months of age (50%) or 9 months of age (95%). The advice is to reintroduce the causing food into the mother's diet after an exclusion period of 6 months or give it to the child when reaching 12 months of age. For both cases, if the child is formula fed be aware that:
In the case of a breastfeeding mother, a restriction diet needs to be guided by a dietitian.
For 𝐅𝐏𝐈𝐄𝐒, there seems to be a 30% chance of people involved to develop either 𝘢𝘵𝘰𝘱𝘪𝘤 𝘥𝘦𝘳𝘮𝘢𝘵𝘪𝘵𝘪𝘴 (eczema), 𝘢𝘴𝘵𝘩𝘮𝘢 or 𝘩𝘢𝘺𝘧𝘦𝘷𝘦𝘳 (allergic rhinitis). www.facebook.com/permalink.php?story_fbid=247380117092229&id=109164090913833 |
AuthorDr Costa is a Consultant Paediatrician and fellow of the Royal College of Paediatrics and Child Health. Categories
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