Skin abnormalities in children with peanut allergy

Published: June 29, 2020

There is increasing evidence that peanut allergy occurs after contact of the patient’s skin with peanut in the environment. Consistent with this observation, Leung and collaborators have reported that the skin of children with eczema and peanut allergy is associated with skin barrier dysfunction. This is characterized by increased water loss from the skin, and low levels of natural moisturizing factors, even in areas where the child’s skin appears normal. The skin of children with peanut allergy but no eczema has not been previously studied. Such a study would have profound clinical implications because their skin is not receiving any treatment.

In a recently published article in The Journal of Allergy and Clinical Immunology (JACI), Berdyshev et al report a unique skin abnormality in patients with peanut allergy but no atopic dermatitis (also referred to as eczema). The content of natural moisturizing factors (also known as filaggrin breakdown products) that are required for skin hydration, was significantly lower in patients with peanut allergy irrespective of whether or not they had concomitant eczema. In patients who had peanut allergy without eczema, it was further found that their skin lipid profile overcompensated for the deficient levels of filaggrin.

This study demonstrates that the skin in children with peanut allergy has low levels of natural moisturizing factor, even when they do not have concurrent eczema.  This may leave the skin prone to dryness and ill prepared to prevent the cutaneous introduction of peanut antigens from the environment which triggers an allergic response. Further studies are needed to develop targeted skin care which may prevent food allergy.

The Journal of Allergy and Clinical Immunology (JACI) is an official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.

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