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Evidence summaries

Egg Elimination Diet in the Treatment of Atopic Eczema

In addition to other treatment forms, the elimination of egg from the diet of children with specific IgE-mediated egg hypersensitivity and atopic eczema appears to offer some benefit. Level of evidence: "B"

A 12-week double-blind controlled crossover trial of a milk and egg elimination diet was carried out in children, aged from 2 to 8 years, with atopic eczema (n = 36) 1. The results of the milk and egg phase were compared with results achieved during a phase when the children received a soya-based product. Eczema activity and sleeplessness relieved significantly during the diet, and the antihistamine usage reduced; there was no effect on pruritus. The study also highlighted a significant effect of the study setting to the symptoms; eczema activity and sleeplessness relieved significantly during the first diet period, whatever the nature of the diet. There was no correlation between a positive skin prick test to egg and cow's milk antigen and the response to the trial diet. A significant number withdrew from the trial: 44 %, i.e. only 20 completed the trial.

A crossover study in patients with atopic eczema, aged 1 - 23 years: three 6-week phases (the first and last phases egg and milk free) 2. Minor, statistically insignificant differences and a large number of withdrawals (25 %); 40 subjects completed.

Sixty-two children with atopic eczema (all had positive egg specific IgE blood test, positive symptom history n = 8), parallel prospective 4-week RCT 3. Fifty-five evaluated: extent of eczema 19.6 > 10.9 % egg-free, vs. 21.9 > 18.9 % control; severity score showed no great differences.

References

  • Atherton DJ, Sewell M, Soothill JF, Wells RS, Chilvers CE. A double-blind controlled crossover trial of an antigen-avoidance diet in atopic eczema. Lancet 1978 Feb 25;1(8061):401-3. [PubMed]
  • Neild VS, Marsden RA, Bailes JA, Bland JM. Egg and milk exclusion diets in atopic eczema. Br J Dermatol 1986 Jan;114(1):117-23. [PubMed]
  • Lever R, MacDonald C, Waugh P, Aitchison T. Randomised controlled trial of advice on an egg exclusion diet in young children with atopic eczema and sensitivity to eggs. Pediatr Allergy Immunol 1998 Feb;9(1):13-9. [PubMed]

Primary/Secondary Keywords