Food allergy at 1 year predicts persistence of eczema at 6 years

Approximately 60% of eczema cases develop in the first year of life.1 There is a range of research suggesting that environmental food allergen exposure to eczematous skin, or skin with a poor barrier function may increase the risk of food sensitisation.2,3 However, whether challenged-confirmed food allergy is associated with eczema persistence or the incidence of late-onset eczema has not been well investigated. [...]we aimed to determine if challenge-proven food allergy at age 1 predicted persistence of eczema or late-onset eczema while taking other early-life factors into account, using the population-based HealthNuts cohort. Infants with a detectable wheal (≥1 mm) to egg, peanut, or sesame were invited for an oral food challenge (OFC) to ascertain their food allergy status.5 Eczema at age 1 was defined as having either a parent report of doctor-diagnosed eczema, history of itchy rash (other than diaper/nappy rash) treated with topical steroids, or eczema observed by trained researchers on the infants' face, back, or elbow flexures.5 The second longitudinal follow-up including a questionnaire survey among the entire cohort was conducted in the child's sixth year.6 Eczema at age 6 was determined by either having a positive response to the core question for current eczema in the validated International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire,7 or having a diagnosis of eczema with symptoms or with treatment by topical steroids in the last 12 months (Table E1, available in this article's Online Repository at www.jaci-inpractice.org). [...]we have shown that approximately 30% of infants with eczema at age 1 will have persistent disease up to age 6 years. Nicholas Osborne, Megan Mathers, Dean Tey, Marnie Robinson, Giovanni Zurzolo, Leone Thiele, Helen Czech, Deborah Anderson, Carley Garner, and John Molloy.Online Repository Resolved eczema (N = 1140) Persistent eczema (N = 481) Risks for persistent eczema Unadjusted Adjusted model 1∗ Adjusted model 2† n Percent n Percent OR 95% CI P value aOR 95% CI P value aOR 95% CI P value Food allergy at age 1 Egg allergy status Not sensitized 862 76.3 268 23.7 1.00 1.00 1.00 Sensitized tolerant‡ 39 61.9 24 38.1 1.98 1.17 3.35 .010 1.85 1.08 3.16 .025 1.26 0.62 2.56 .519 Allergic 150 50.8 145 49.2 3.11 2.38 4.06