{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T05:11:06Z","timestamp":1788930666388,"version":"build-2803163510"},"reference-count":36,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Food allergy testing is frequently requested in atopic dermatitis (AD), yet international guidance appears inconsistent. We performed a structured narrative review of major guidelines, practice parameters, and society statements from North America, Europe, the United Kingdom, and East Asia, current through August 23, 2026. Recommendations were compared by clinical purpose, treatment\u2010response condition, test modality, and intended consequence. The apparent conflict largely reflects three questions being combined: diagnosis of a suspected immediate immunoglobulin E (IgE)\u2010mediated reaction, safe introduction of an allergenic food, and investigation of food as a driver of eczema. Across documents, testing is history\u2010directed and indiscriminate panels are discouraged. For eczema\u2010trigger investigation, NIAID, NICE, Japanese, and Korean guidance uses a treatment\u2010response gate; the AAAAI 2022 work group requires optimal skin care before additional testing, while EuroGuiDerm version 4.0 limits testing for suspected food\u2010triggered eczema to moderate\u2010to\u2010severe disease with a supporting history or suspicion. Prevention guidance differs on pre\u2010introduction peanut screening but agrees on timely introduction. The 2023 Joint Task Force recommendation addresses elimination diets as treatment, not a diagnostic threshold. Positive skin prick testing or food\u2010specific IgE indicates sensitization, not clinical allergy; automatic elimination may cause nutritional harm and loss of oral tolerance. A purpose\u2010first pathway reconciles most apparent conflict and supports clinical confirmation before long\u2010term avoidance.<\/jats:p>\n                  <jats:p>\n                    <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                      <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/ijd70669-gra-0001-m.png\">\n                        <jats:alt-text>image<\/jats:alt-text>\n                      <\/jats:graphic>\n                    <\/jats:boxed-text>\n                  <\/jats:p>","DOI":"10.1111\/ijd.70669","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T04:44:57Z","timestamp":1788929097000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Food Allergy Testing in Atopic Dermatitis: A Purpose\u2010First Comparison of International Guidelines"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9760-2048","authenticated-orcid":false,"given":"Wen\u2010Guo","family":"Chen","sequence":"first","affiliation":[{"name":"Ho Wen Tsao Skin Clinic  New Taipei City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiung\u2010Chin","family":"Chen","sequence":"additional","affiliation":[{"name":"Ho Wen Tsao Skin Clinic  New Taipei City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun\u2010Ying","family":"Chen","sequence":"additional","affiliation":[{"name":"Ho Wen Tsao Skin Clinic  New Taipei City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shih\u2010Cheng","family":"Hsu","sequence":"additional","affiliation":[{"name":"Ho Wen Tsao Skin Clinic  New Taipei City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4975-4375","authenticated-orcid":false,"given":"Wen\u2010Tsao","family":"Ho","sequence":"additional","affiliation":[{"name":"Ho Wen Tsao Skin Clinic  New Taipei City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,8]]},"reference":[{"issue":"3","key":"e_1_2_14_2_1","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1016\/j.anai.2023.11.009","article-title":"Atopic Dermatitis (Eczema) Guidelines: 2023 American Academy of Allergy, Asthma and Immunology\/American College of Allergy, Asthma and Immunology Joint Task Force on Practice Parameters GRADE\u2010 and Institute of Medicine\u2010Based Recommendations","volume":"132","author":"Chu D. 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