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Atopic dermatitis is a complex disease that often develops in connection with other conditions, such as asthma and rhinitis. Guidelines advise that diagnosing AD starts with a physical examination. During that evaluation, it may help to employ an allergy-focused patient history.1,12
The findings of this allergy-focused patient history may also suggest that the next best step is to order specific IgE tests. Specific IgE blood testing and skin-prick testing (SPT) can help you rule in or rule out allergen sensitization, which may give you the ability to correctly diagnose and improve clinical management.15,16 Specific IgE blood testing can be performed irrespective of skin condition, whereas SPT may not be applicable due to the skin condition of an AD patient.
With up to 70 percent of infants and young children with eczema having an underlying allergy that contributes to disease severity,13,14 healthcare providers can use specific IgE testing to enhance the diagnostic process and pinpoint those allergens. The specific information gleaned from test results can also be used to develop a personalized treatment plan.
Up to 80 percent of patients with allergies are sensitized to more than one allergen.18 The effect is cumulative: An individual patient may have a number of triggers, which, combined, may lead to symptoms.19, 20 The allergen symptom threshold is the point at which the cumulative allergen load leads to symptoms.19, 20
Atopic dermatitis (AD) poses a significant burden on not only healthcare resources, but also the quality of life of your patients and their caregivers.1
Specific IgE serological tests aid in the diagnosis of allergic disease. As such, anyone presenting with eczema or other allergy symptoms is a candidate for specific IgE testing. Here are common allergens that can add up to symptoms:17
Adding diagnostic testing to aid in a differential diagnosis has been shown to increase confidence in diagnosis to 90 percent.i,ii Conventionally, a diagnosis of allergic or autoimmune disease relies on the case history and a physical examination. However, adding diagnostic testing to aid in a differential diagnosis has been shown to increase confidence in diagnosis.i,ii Diagnostic testing can also help to improve the patient’s quality of life and productivity, reduce costs associated with absenteeism, and optimize use of medication, in addition to decreasing unscheduled healthcare visits.iii,iv
i. Duran-Tauleria E, Vignati G, Guedan MJ, et al. The utility of specific immunoglobulin E measurements in primary care. Allergy. 2004;59 (Suppl78):35-41.
ii. NiggemannB, Nilsson M, Friedrichs F. Paediatric allergy diagnosis in primary care is improved by in vitro allergen specific IgE testing. Pediatr Allergy Immunol. 2008;19:325-331
iii. Welsh N, et al. The Benefits of Specific Immunoglobulin E Testing in the Primary Care Setting. J Am Pharm Assoc. 2006;46:627.
iv. Szeinbach SL, Williams B, Muntendam P, et al. Identification of allergic disease among users of antihistamines. J Manag Care Pharm. 2004; 10 (3): 234-238
Skin disorders, including atopic dermatitis (eczema) and urticaria (wheals), are commonly seen by healthcare providers and managing patients with these conditions can often be challenging. Results from studies have demonstrated that atopic dermatitis and urticaria have a profoundly negative impact on health-related quality of live (HRQoL), particularly impacting social functioning and psychological well-being. And many patients with one or both conditions report problems attributable to their skin in facets of everyday life including home management, personal care, mobility, sleep, rest, school, and work.21, 22
The management of skin allergies consists of three major categories of treatment:21, 22, 23
1. Allergen avoidance and environmental control methods
2. Pharmocologic therapy
Guidelines suggest developing a treatment plan with intensity of management based on disease severity and fluctuation from acute flares to periods of disease control. The primary elements of the skincare plan include hydration, topical anti-inflammatory medications, and antibacterial measures.24, 25