{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T03:13:22Z","timestamp":1777518802511,"version":"3.51.4"},"reference-count":41,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2018,10,2]],"date-time":"2018-10-02T00:00:00Z","timestamp":1538438400000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Allergy"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Previous studies have indicated that in patients with atopic dermatitis (AD) and birch pollen allergy pollen\u2010related foods are able to cause late eczematous response. However, the relevance of AD worsening by ingestion of birch pollen\u2010related foods is still a matter of debate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>The purpose of this retrospective study was to determine how frequently birch pollen\u2010related foods induce a deterioration of eczema. Additionally, the diagnostic value of specific IgE (sIgE) determination was evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 182 children and adults with AD and suspected birch pollen\u2010related food allergy underwent 261 double\u2010blind placebo\u2010controlled food challenges (DBPCFC). Total and sIgE levels were determined prior to DBPCFC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty\u2010five patients developed allergic reactions (responders) upon DBPCFC with birch pollen\u2010related foods (n\u00a0=\u00a0103 DBPCFC). Of these, 32 patients exhibited significant deterioration of AD defined as a median increase of 15.4 severity scoring of atopic dermatitis index points (95% CI 12.4\u201016.3) from baseline making up 37% of all positive reactions. Responders showed significantly higher sIgE levels to birch pollen and apple as well as a higher prevalence of allergic rhinoconjunctivitis compared to nonresponders (<jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>.05). However, patients with late eczematous response could not be differentiated from those with isolated immediate\u2010type reactions by sIgE levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In a subpopulation of patients with AD and birch pollen sensitization, related foods should be considered as a trigger for an aggravation of eczema. As sufficient markers for prediction of late eczematous reactions are still lacking, DBPCFC cannot be replaced in diagnosis of birch pollen\u2010related foods in patients with AD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical implications<\/jats:title><jats:p>In patients with AD and birch pollen allergy, birch pollen\u2010related foods should be considered as a provocation factor for an aggravation of disease signs and symptoms.<\/jats:p><\/jats:sec>","DOI":"10.1111\/all.13454","type":"journal-article","created":{"date-parts":[[2018,4,14]],"date-time":"2018-04-14T03:13:58Z","timestamp":1523675638000},"page":"2046-2054","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Birch pollen\u2010related foods can cause late eczematous reactions in patients with atopic 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