While in residency, I took care of a toddler who was hospitalized following an anaphylactic reaction. During a diaper change at home the child suddenly developed lip swelling and severe difficulty breathing for no apparent reason. The child was urgently brought to the hospital by ambulance and initially treated in the emergency room. By the time I met her on the inpatient floor her breathing and swelling had significantly improved. The first thing I noticed, however, was the child’s bumpy and irritated red skin which was covered with a thick layer of ointment. While I examined her she would claw and scratch at her skin with little relief. She looked miserable. Her mother had been suspecting food allergies and described a frustrating process of selective food avoidance and various skin treatments with little to no improvement.