What's new in pediatric allergology in 2007-2008? Part 3: Skin, food and drug allergies (A review of the international literature from October 2007 to September-October 2008).

Severity of atopic dermatitis appears to be related to the extend of Th 1 immune deficiency, leading to surinfection by Staphylococcus aureus and increased numbers of sensitizations to aeroallergens and foods. Diagnostic decision points for serum Specific IgE levels with good positive and negative predictive values in children with food allergy are difficult to determine. Remission of allergy to common foods occurs more frequently in children with a low level of sensitization (prick-tests and/or specific IgE) at the time of diagnosis and in children exhibiting a rapid decline in sensitization. Regular administration of heat-denaturated foods (milk, egg) may help the acquisition of tolerance to foods, and interesting results have been reported in children with persistent food allergy "hyposensitized" with foods administered by the oral and sublingual routes. Only 1 few children with suspected drug allergy are really allergic to commonly used drugs and biological Substances. Most children with negative responses in skin and challenge tests with betalactams do not develop sensitizations and allergy to betalactams administered during challenge tests and subsequent treatments with betalactams. Although cross-reactivity between penicillins and imiperiem is frequent, most Children with immediate-type allergy to penicillins have negative responses in skin and challenge tests with meropenem. Finally, more than 40% of the children with allergic-like reactions to non opioid analgesics, antipyretics and nonsteroidal anti-inflammatory drugs are really allergic or intolerant to these drugs, especially when the reactions are severe, immediate and accelerated. and relapse with the same and/or other drugs. (C) 2009 Elsevier Masson SAS. All rights reserved.