Experience with an elemental diet (Vivonex).

Six patients with intractable atopic dermatitis completed this study which consisted of a baseline week, 1 to 2 weeks on an elemental diet, then sequential specific food additions. Symptom/sign scores, total eosinophil counts, and IgE and IgG4 radioimmunoassays for wheat alpha-gliadin, bovine serum albumin, beta-lactoglobulin, and egg white were carried out as part of the protocol. Symptom/sign scores improved in five of six patients, some dramatically. Total eosinophil counts generally dropped after a week on the elemental diet and then increased as foods were added to the diet. The elemental diet used (Vivonex) appears to be beneficial in the management of at least some adult patients who have severe atopic dermatitis.