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Evidence summaries

Dietary Exclusions for Established Atopic Eczema

There appears to be some benefit in using an egg-free diet in infants with atopic eczema and suspected egg allergy with positive specific IgE to eggs. Level of evidence: "C"

A Cochrane review [Abstract] 1 included 9 studies with a total of 421 subjects. 6 were studies of egg and milk exclusion (N=288), 1 was a study of few foods (N=85) and 2 were studies of an elemental diet (N=48). There appears to be no benefit of an egg and milk free diet in unselected participants with atopic eczema. There is also no evidence of benefit in the use of an elemental or few-foods diet in unselected cases of atopic eczema. One study examined the use of an egg-free diet in infants with suspected egg allergy who have positive specific IgE to eggs; the body surface area affected by eczema improved with the exclusion diet compared to normal diet (RR 1.51, 95% CI 1.07 to 2.11; 1 study, n=55) and surface area and severity score improved in the exclusion diet compared to the normal diet at the end of 6 weeks (mean difference, MD 5.50, 95% CI 0.19 to 10.81) and end of treatment (MD 6.10, 95% CI 0.06 to12.14).

Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment and inadequate intention-to-treat adherence) and by imprecise results (limited study size for each comparison).

    References

    • Bath-Hextall F, Delamere FM, Williams HC. Dietary exclusions for established atopic eczema. Cochrane Database Syst Rev 2008 Jan 23;(1):CD005203. [PubMed]

Primary/Secondary Keywords