Food allergy and features of nutritional status as a manifestation of epithelial barrier dysfunction in children with congenital ichthyosis

Congenital ichthyosis is a group of rare genetic disorders characterized by impaired keratinization and skin barrier dysfunction. The common pathogenetic link for various forms of ichthyosis is structural damage to the epidermis, leading to increased transepidermal water loss and reduced protective function, which creates conditions for transcutaneous sensitization to food allergens. This mechanism is particularly well described in Netherton syndrome, associated with a mutation in the SPINK5 gene, and vulgar ichthyosis, associated with mutations in the filaggrin gene. However, in other forms of congenital ichthyosis, the characteristics of food sensitization and manifestations of food allergy have not been studied. The penetration of food allergens through the damaged skin barrier triggers a cascade of immune reactions that contribute to the activation of the Th2 immune response and the production of specific IgE, often leading to food sensitization and food allergy. The development of food allergies in the context of congenital ichthyosis exacerbates the course of the underlying disease and contributes to the formation of nutritional status disorders and growth retardation due to both restrictive diets without adequate nutritional support and a deficiency of nutrients and trace elements. This review focuses on the role of epidermal barrier dysfunction as a key link in the development of comorbid food allergies in patients with congenital ichthyosis and emphasizes the need for an interdisciplinary approach for this category of patients.

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