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Case History - Section 1

An adverse reaction to food is best referred to as food hypersensitivity. However, when immunological mechanisms have been demonstrated the appropriate term is food allergy.

When the role of IgE has been demonstrated, the term is IgE-mediated food allergy.

This case history focuses on IgE-mediated food allergy from infancy to 16 years of age.

James is now 16 years old.

He first presented at 8 months with severe atopic eczema (atopic dermatitis).

James was born full term and was breast fed exclusively for 6 months.

Atopic eczema commenced at 6 weeks and became generalized and severe. He was a colicky, unsettled baby.

Solids were introduced at 6 months beginning with rice cereal with some cow's milk formula. His atopic eczema worsened significantly at this stage.



Answer: Psychosomatic factors

THIS IS INCORRECT - The severity of pruritus in atopic eczema atopic eczema has been described as directly related to severity of depressive symptoms. Increased itch and sweating in lichenified skin areas, following emotional stimuli, can be recorded by psychophysiological methods.

Investigations of parent-child relationships have shown different emotional responses from diseased children when compared to controls. Increased "fear scores" on personality questionnaires of patients with atopic eczema have been reported by different investigators.

It is uncertain whether these findings have any impact on the etiology of eczema, as they may also result from the prolonged process of coping with chronic disease experienced by the patient and his/her family. Stressful emotional events have been shown to precede the deterioration of eczematous symptoms, not to follow them. These findings have been questioned with regard to children.

For further information on the causes of atopic eczema in children access the references below:

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