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Atopic Eczema — SCE Dermatology MCQ

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ModeratePaediatric DermatologyAtopic EczemaSCE Dermatology

A 3-year-old girl presents with pruritic, erythematous, papulovesicular dermatitis on her cheeks and extensor limbs. She has had the rash since age 4 months. Her mother asks about food allergy testing. According to NICE, when should food allergy be suspected in atopic eczema?

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Correct answer: C — Only when eczema does not respond to optimised topical treatment and dietary history is suggestive

NICE CG57 recommends considering food allergy as a possible aggravating factor in children with atopic eczema if the eczema has not been controlled by optimised management and there are symptoms suggesting food allergy (immediate reactions after eating, or persistent moderate-severe eczema despite treatment). Investigation should be guided by clinical history. Common allergens include cow's milk, egg, wheat, soy, and peanut. Elimination diets should only be undertaken with dietetic supervision. Universal allergy screening without clinical suspicion is not recommended.

Reference: NICE 2007 CG57 (updated 2023); NICE 2011 CG116 Food Allergy