Ann Dermatol.  2011 Sep;23(Suppl 1):S91-S95. 10.5021/ad.2011.23.S1.S91.

Treatment of Atopic Dermatitis with a Low-histamine Diet

• Chung BY
• Cho SI
• Ahn IS
• Lee HB
• Kim HO
• Park CW
• Lee CH

• KMID: 2156761
• DOI: http://doi.org/10.5021/ad.2011.23.S1.S91

Abstract

Atopic dermatitis (AD) has numerous trigger factors. The question of whether foods can aggravate AD remains open to debate. Although a number of published papers have detailed the relationship between food allergies and AD, little research has examined the question of how food intolerance affects AD. For the purposes of this study, a six-year-old Korean boy with AD was admitted to the hospital for evaluation of the possibility of food, particularly pork, as a triggering factor in his skin disease. He had a history of worsening of symptoms when eating pork. Total serum IgE concentration was 157 IU/ml. House dust was class 2.2 (1.5 IU/ml) in MAST. All other MAST items were negative. In an oral food challenge test, he showed a positive result after eating 200 g of pork, but did not show a positive result after eating 60 g of pork. After discharge, we attempted to keep him on a balanced diet that included various types of food and prohibited him from eating food that contains a high level of histamine. After keeping the patient on a balanced and low-histamine dietary regimen, his AD symptoms showed improvement and have not worsened for more than seven months. A low-histamine, balanced diet could be helpful for AD patients having symptoms that resemble histamine intolerance in which their AD symptoms worsened after intake of histamine-rich foods, but in which food allergy tests are negative.

Keyword

Atopic dermatitis; Histamine; Oral food challenge

MeSH Terms

Dermatitis, Atopic
Diet
Dust
Eating
Food Hypersensitivity
Histamine
Humans
Immunoglobulin E
Skin Diseases
Dust
Histamine
Immunoglobulin E

Figure

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  Fig. 1 Immediately after being hospitalized, cutaneous examination revealed small erythematous papules and excoriations on the neck (A) and erythematous scaly patches on both popliteal (B) and cubital fossae (C).

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  Fig. 2 After application of a Vaseline® occlusive dressing, small erythematous papules and excoriations on the neck and erythematous scaly patches on popliteal and cubital fossae showed improvement (A~C).

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  Fig. 3 Seven hours after ingestion of 200 g of boiled pork for breakfast, the number of papules on the patient's neck increased, and the central area of the lesion became intensely erythematous (A). Lesions on the patient's arms did not showed any change (B), however, erythematous scaly lesions on the flexural areas of his legs became more exacerbated (C).

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  Fig. 4 Nine hours after ingestion of 200 g of boiled pork for breakfast, the number of erythematous papules increased and oozing occurred in some areas of the neck lesion (A). Severe oozing also occurred on the lateral flexural part of the patient's right arm (B), and erythematous patches and plaques in the flexural areas of the lower limbs became darkened (C).

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  Fig. 5 Three months after maintaining a balanced and low-histamine dietary regimen, the patient had only slight erythematous patches on his neck (A) and the flexural areas of his limbs (B, C).

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