CUTANEOUS MANIFESTATIONS OF FOOD ALLERGY - PRELIMINARY-RESULTS OF THECICBAA SURVEY (300 CASES) WITH PARTICULAR REFERENCE TO ATOPIC-DERMATITIS IN PEDIATRICS

In the context of the Cercle d'Investigations Cliniques et Biologiques en Allergologie Alimentaire (CICBAA) (Clinical and Laboratory Food Al lergology Investigation Group), the construction of a standard food al lergology case enabled us to record 300 cases over a period of 2 years : 78 patients over the age of 16 years and 212 patients between the ag es of 0 and 16 years. Symptoms of IgE-dependent food allergy vary with age. In children under the age of 3 years, in addition to egg white a nd cow's milk, which were considered to be the principal allergens, pe anuts now occupy second place. Although atopic eczema is frequent duri ng the first years of life; although asthma, urticaria and angioedema are observed at all ages; an isolated or multiple episodes of anaphyla ctic shock (30% of cases) and oral syndrome (90% of cases) are essenti ally observed after the age of 6 years. This change of clinical presen tation is accompanied by a different distribution of the foods respons ible: although egg white and peanuts are still major allergens after t he age of 6 years, the role played by fruit and vegetables, fish and s eafood, spices (particularly mustard in the South) increases significa ntly. Our findings also confirm that this type of allergy is intimatel y dependent on the cultural and dietary habits of the region or countr y. This preliminary study also shows the role played by IgE-dependent food sensitization in atopic dermatitis. The labial provocation test r epresents a useful diagnostic test, as it is easy to perform, minimall y invasive and inexpensive. As illustrated by the preliminary results of this study, this test deserves a place in the decisional tree betwe en skin allergy prick-tests and oral provocation tests. The positive a nd negative predictive value of these various tests will be discussed in another article by the CICBAA group.