08/11/2025
Atopic eczema comes with a higher risk of type I allergies and severe allergic reaction to food and environmental allergens, as well as delayed contact allergies. The link is bimodal, multidirectional and therefore complex.
The link between eczema and type I (food and environmental allergens) allergies can be traced to one of the main functions of skin: protection against foreign invaders and pathogens. When eczema impairs skin barrier in early life, infants and children develop allergies by exposure to invaders coming from the environment. These invaders can be food and materials, dust and mould. However, current understand is our capacity of desensitisation by oral route - keeping an inclusive diet ensures minimising risk of developing food allergies in early life.
Contact Allergy on the other hand begins with immune system ‘recognising and memorising’ an allergen-hapten complex, a protein complex product manufactured by skin lymphoid tissue, leading to a delay in reaction. Onset and intensity of symptoms can be less dramatic compared with type I reaction and anaphylaxis, but nonetheless severely incapacitating. Onset can be many months and after many times of exposure to an allergen to manifest in sudden red hot swelling and peeling of skin, heavily damaging to skin barrier in the epidermis. In addition to clinical history delayed hypersensitivity is a subspeciality in demanding the very best and inquisitive clinician in a very long consultation 😆
