Researchers Identify Subtype of Eczema Tied to Food Allergies
Itchy, inflamed red rashes are a reality for everyone with the skin condition eczema. In about one-third of baby eczema cases, youngsters and their families also must avoid common food allergens, like peanuts, that can be life- threatening.
Eczema is a chronic, noncontagious skin disease most commonly treated with topical corticosteroids. Atopic dermatitis is the most prevalent type of eczema, and it results from skin barrier problems and a malfunctioning immune system. Healthcare providers and patients alike commonly use atopic dermatitis and eczema interchangeably.
â€œIf we knew who was at high risk, we could straightaway make sure to do everything we could to prevent it in the first place or test for those food allergies very early,â€ says Abigail Waldman, MD, a dermatologist at Brigham and Womenâ€™s Hospital in Boston and an instructor of dermatology at Harvard Medical School. Dr. Waldman was not involved in the study.
What Makes the Skin of Kids With Eczema and Food Allergies Different?
Researchers analyzed the skin of 62 people ages 4 to 17, whom they organized into three groups: those with normal skin, those with eczema, and those with eczema and a food allergy. At the time they took the skin samples, the skin of those participants with eczema was not inflamed.
They observed that skin samples of participants with eczema and food allergies had significant differences from the other two groups. These abnormalities included a lack of structural proteins required to keep moisture in and provide a barrier for skin, an increase in specific keratin proteins that are a sign of an underdeveloped skin barrier, and an increase in activity of type 2 immune genes, the gene response that causes allergies.
If you think of the protective outer layer of your skin like a brick wall, the skin cells are the bricks and the proteins and lipids are the mortar. If there are cracks in the cement, pathogens and bacteria can get in and water can get out.
â€œWith eczema, when you flex your hands or bend the skin, the skin cracks and starts bleeding, and you lose water from the skin, making it [drier]. Then things come in because itâ€™s all cracked. Itâ€™s inside out, outside in,â€ Dr. Leung says.
The study focused on patients with a peanut allergy. Researchers are further investigating their data to study other food allergies. Common food allergies include eggs, wheat, soy, shellfish, and milk, according to the organization Food Allergy Research & Education (FARE).
A Noninvasive Test May Hold the Key to Identifying Eczema Subtype
One advance of the study, Leung says, is the noninvasive, painless testing method. Researchers used a mild skin tape â€” similar to the sticky part of a bandage â€” to remove the superficial top layer of skin. The method has long been used for research but for simpler tests. â€œWhatâ€™s interesting is that researchers were able to do a lot of very sophisticated analysis from few skin cells,â€ Waldman says.
The method provides an alternative to more painful biopsies and blood tests, which Waldman says are rarely used because children and parents donâ€™t want to undergo them, and because usually by that point in the eczema progression, a blood test wonâ€™t necessarily help.
â€œItâ€™s declared itself at that point,â€ Waldman says, adding that the implications of this study are promising, but more research is needed. â€œThe paper definitely shows a benefit for the future, but I need to stress, itâ€™s not something that should be done in a clinic tomorrow.â€
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