Dietary restrictions in the treatment of adult patients with eczema.

Improvement was seen in the dermatitis of 262 of 675 patients who followed a restrictive diet for approximately 1 month. Patients included in the study were sensitive to metal salts, balsams or classical food allergens or reacted to oral challenge with food additives. Also included were patients who did not react to diagnostic tests but who experienced improvement of their dermatitis while maintaining an elimination diet.

Oral challenge with food additives.

A randomized, placebo-controlled oral challenge with food additives (preservatives and food colorings) was carried out in 101 patients with eczema of undetermined origin who suspected that the intake of certain foods aggravated their dermatitis. 37 reacted to 1 or more of the food additives but not to a placebo, while 16 reacted to the placebo, or both the placebo and food additives. 48 had no reactions.

Oral challenge with nickel and cobalt in patients with positive patch tests to nickel and/or cobalt.

During a 3-year period, 146 patients with positive patch tests to nickel and/or cobalt, for whom a systemic cause of dermatitis was suspected, were challenged orally with a single dose of 2.5 mg nickel given as nickel sulphate and 1 mg cobalt given as cobalt sulphate using a double-blind, placebo-controlled method. No following-up was possible for 2 patients.

Dermatitis induced or aggravated by selected foodstuffs.

The eczema of 113 patients with dermatitis other than classical urticaria or typical atopic dermatitis cleared or showed marked improvement after one to two months of dietary restriction. In their response to a questionnaire completed at least 6 months after the initiation of the diet, 61 (54%) of these patients said that diet restriction was effective in reducing the activity of or preventing recurrence of their dermatitis. Their most common symptoms were recurrent symmetrical hand eczema, anogenital eczema, pruritic papules and excoriations of the trunk as well as a "fixed" type of eczema.