A 4-year-old boy is evaluated for moderate-to-severe atopic dermatitis that has persisted despite optimized topical therapy. His parents are concerned about possible food allergies and request allergy testing. The child has extensive active eczema involving his trunk and extremities. He takes cetirizine daily for pruritus. There is no history of immediate reactions after food ingestion.
Which of the following is the MOST appropriate next step in allergy evaluation?
Correct!
Wrong!
Explanation:
Children younger than 5 years with moderate-to-severe atopic dermatitis may be considered for evaluation of food sensitization, particularly when eczema remains poorly controlled despite optimized therapy. However, allergy testing should always be guided by clinical history. Extensive active eczema makes skin prick testing less practical and potentially less reliable. Serum allergen-specific IgE testing is appropriate because antihistamines do not affect results and testing can be performed despite significant skin disease.