The information in this website is intended only for healthcare professionals. By entering this site, you are confirming that you are a healthcare professional.
The information in this website is intended only for laboratory professionals. By entering this site, you are confirming that you are a laboratory professional.
Guidelines advise that diagnosis of atopic dermatitis starts with a physical examination and an allergy-focused patient history.1,2 Guided by the allergy-focused patient history, the most appropriate next step should be allergy testing. When added to an allergy-focused patient history, the use of skin-prick tests (SPT), serological tests, or both increases your confidence in diagnosis and clinical management by ruling in or ruling out allergies.3,4
KEY ALLERGY TEST DIFFERENCES
Specific IgE blood testing
Skin prick testing
|Typically ordered and reviewed by a clinician||YES||YES|
|Patients do not need to discontinue allergy medications||YES||NO|
|Requires only on needle stick (a single blood sample)||YES||NO|
|Carries no risk of severe allergic reaction||YES||NO|
|Can be used when extensive skin rash is present||YES||NO|
|Component testing is available
|Same day results in office||NO||YES|
Just as diagnostic testing is routine for diagnosis of chronic diseases such as type 2 diabetes and dyslipidemia, specific IgE tests can be routine to aid in the diagnosis of allergic disease.
When clinically assessing patients with atopic eczema, healthcare professionals should seek to identify potential trigger factors including:2
House Dust Mites
With up to 70% of infants and young children with eczema having an underlying allergy that contributes to disease severity,6,7 healthcare professionals can utilize 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.
Patient presents with skin manifestations consistent with AD
|Evaluation based on history and exam diagnostic for AD dermatitis|
|Consideration of other conditions|
Up to 80% of patients with allergies are sensitized to more than one allergen.7 The effect is cumulative: An individual patient may have a number of triggers, which, combined, may lead to symptoms.8 The allergen symptom threshold is the point at which the cumulative allergen load leads to symptoms.8
Each patient has a different level of IgE antibodies at which he or she will show symptoms. Until the symptom threshold is reached, the patient may not show symptoms. However, when these allergens add up, they have a cumulative effect, pushing the patient over his or her symptom threshold.8 By reducing exposure to relevant triggers, symptoms can be avoided.8
Identifying all relevant sensitizing allergens will help you outline a comprehensive exposure reduction plan to keep your patient below his or her symptom threshold.
Before exposure reduction8,9
After exposure reduction10-12
ImmunoCAP Whole Allergen provides an objective measurement of the circulating IgE antibodies and the sensitization to a specific allergen. Specific IgE antibodies appear as a result of exposure and following sensitization to an allergen. ImmunoCAP Whole Allergen measures IgE antibodies to specific allergens in human serum or plasma and allows quantitative measurements of a wide range of individual allergens and allergen components. Over 550 whole allergens and mixes are available for determinations.
ImmunoCAP Allergen Components measure specific IgE antibodies to individual molecular allergens in serum or plasma. These allergens, which are purified or recombinant proteins, offer the unique opportunity to assess a person’s allergic sensitization pattern at the molecular level. Different component groups often elicit different types of reactions, so testing them can indicate if a patient’s prior symptoms or positive test results were caused by allergy to a given substance or by a cross-reaction with another allergen. Component testing also helps the clinician weigh a patient’s risk of a systemic reaction versus a more mild or localized response. Over 100 different components are available for determinations.
The higher the concentration of slgE antibodies, the higher the risk for symptomatic allergy
Guided by IgE-mediated test results, an individual plan to manage and treat the allergy can be tailored, in order to achieve improved quality
of life and overall well-being.
Results should be read in conjunction with the clinical history;16 patients should be provided with a personalized allergy action plan including exposure reduction advice for all their confirmed triggers.
Allergic dermatitis has been shown to have significant impact on daily functioning, social health, and emotional health for children and their families:1,16
AD usually starts in early childhood as skin barrier dysfunction that may lead to both food and aeroallergens entering through the impaired barrier, initiating immunological reactions and inflammation.1 About half of the children with early-onset eczema develop allergen sensitization by the age of two when eggs and milk are first introduced.19