The role of dietary factors in chronic skin diseases has been a subject of controversy, but several investigators have shown the effectiveness of elimination diets in the management of some patients with atopic dermatitis. Chronic skin diseases are common, complex, and often difficult to treat; therefore, the physician should consider all possible causes. More people consider themselves to have food allergies than can actually be documented to have an immunologic reaction to foods. Six foods--egg, peanut, cow's milk, soy, fish, and wheat--account for most skin reactions to food in children, with egg, peanut, and cow's milk being most common. Elimination of the offending food can be an effective form of treatment, but it must be done with caution, and while ensuring that the patient maintains adequate nutrition.