Dietary intervention in eczema

Eczema is a chronic inflammatory dermatosis that affects 20% of the population in industrialized nations, and usually manifests in early childhood. The precise aetiology and pathogenesis of eczema are not yet fully understood, but a complex interaction between genetic and environmental factors has been implicated in the predisposition and development of the disease. Food allergy plays a pathogenic role in a subset of patients with eczema, primarily infants and children with severe eczema. Identifying this subset of patients and isolating the relevant food allergens requires a high index of suspicion based on a good clinical history, the use of appropriate laboratory tests, and in some cases, oral food challenges. Maternal dietary restrictions during pregnancy or lactation do not appear to have any effect on the incidence or severity of eczema, but breastfeeding may reduce the incidence of eczema, especially in high risk infants. Other nutritional interventions, such as the use of essential fatty acids, may have an effect on eczema. Nutritional intervention to impact eczema is quite a new field and further studies are needed to guide patients and physicians in this area.