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Episode 048

Eczema Essentials: Diagnosing and Managing Atopic Dermatitis in Practice

Episode summary

For primary care providers, seeing a patient presenting with atopic dermatitis (eczema) is common, yet misconceptions persist regarding its underlying cause and optimal management. This episode tackles the critical clinical dilemma: when and how should specific IgE testing for food and environmental allergens shape routine eczema care? Key topics include the evolution of pathophysiology—shifting focus from allergy-driven disease to barrier dysfunction and type 2 inflammation—plus risk stratification, differential diagnosis, the role and interpretation of specific IgE tests, evidence-based guideline updates, environmental and food allergen impacts, targeted therapeutics, and practical patient counseling. Special attention is given to environmental triggers such as dust mites and pet dander and structured elimination diets. Clinicians will gain actionable insights on refining diagnostic workups, individualizing treatment plans, and supporting long-term disease control in pediatric and adult eczema populations.

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Episode transcript

Time stamps

00:00 – The Itch That Rashes Explained

04:51 - Dermatology Diagnosis and Testing

08:29 - Eczema: A Chronic Inflammatory Cycle

10:43 - Targeted Allergy Testing Advice

14:38 - 2023 Guidelines for Atopic Dermatitis

19:08 - Food Allergy Evaluation Insights

20:35 - Elimination Diets: A Structured Approach

25:32 - Proactive Eczema Management Strategies

27:54 - Selective IgE Testing in Dermatitis

29:43 - Allergy Testing Info

References used in this episode
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  • AAAAI/ACAAI JTF Atopic Dermatitis Guideline Panel; et al. Atopic dermatitis (eczema) guidelines: 2023 American Academy of Allergy, Asthma and Immunology/American College of Allergy, Asthma and Immunology Joint Task Force on Practice Parameters GRADE- and Institute of Medicine-based recommendations. Ann Allergy Asthma Immunol. 2024 Mar;132(3):274-312.
  • Moosbrugger-Martinz V, Leprince C, Méchin MC, Simon M, Blunder S, Gruber R, Dubrac S. Revisiting the Roles of Filaggrin in Atopic Dermatitis. Int J Mol Sci. 2022 May 10;23(10):5318.
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  • Chong AC, Chwa WJ, Ong PY. Aeroallergens in Atopic Dermatitis and Chronic Urticaria. Curr Allergy Asthma Rep. 2022 Jul;22(7):67-75. doi: 10.1007/s11882-022-01033-2. Epub 2022 Apr 1. PMID: 35362938.