Results of a food exclusion diet in children with atopic dermatitis

Abstract

Introduction: The relationship between diet and atopic dermatitis remains a complex issue, and the use of elimination diets as a therapeutic approach continues to be a subject of debate and division within the scientific community. We examined the effects of an elimination diet on the clinical course of atopic dermatitis in Congolese children.

Materials and Methods: We conducted a prospective observational study of 36 children with atopic dermatitis, aged six months to 14 years. Food allergens were identified using skin prick testing. Each parent received instructions to exclude from their child’s diet, for eight weeks, the foods that elicited a positive reaction during the prick test. To prevent any nutritional deficiencies, the foods excluded from the diet were replaced with non-allergenic alternatives. The collected data were then statistically analyzed using SPSS software, version 27.

Results: The implementation of a food elimination diet led to a favorable improvement in skin lesions in 28 patients, representing 77.8% of cases. This positive therapeutic response showed a statistically significant association with the patients’ age, ranging from 6 months to 5 years (p=0.022), as well as with parental occupation, particularly among parents who were employed or workers (p=0.025). A statistically significant association was also established between the progression of skin lesions and the exclusion of certain foods, particularly peanuts, where an improvement in lesions was observed in 71.4% and 45.5% of cases, with a transition from a severe form to a mild or moderate form (p=0.026). Similar results were observed for milk and eggs (p=0.001 for both), with a transition from severe atopic dermatitis (SCORAD score > 50%) to moderate atopic dermatitis (SCORAD score < 50%) in 71.4% and 53.8% of subjects, respectively. The exclusion of African eggplant and wheat also revealed a notable correlation, with resolution of lesions observed in 35.3% and 50% of patients, respectively (p=0.001 and p=0.002). Furthermore, a worsening of atopic dermatitis symptoms was observed in association with the exclusion of fish (55.6%) and potatoes (71.4%), with marked statistical significance for both (p=0.000).

Conclusion: A statistically significant reduction in severity scores was observed following the implementation of a food elimination diet alone. This dietary intervention led to a reduction, or even complete resolution, of skin lesions in the majority of patients.

Keywords: Exclusion diet; atopic dermatitis; food; SCORAD; North Kivu