Although high total serum IgE levels and filaggrin gene null mutations do tend to predict a more severe and protracted course of atopic dermatitis, obtaining total and/or allergen-specific IgE levels is not recommended for the routine assessment of severity. Total IgE levels are not a reliable marker for atopic dermatitis because

  • Elevated serum IgE is not present in about 20% of individuals with atopic dermatitis.
  • Some individuals with severe atopic dermatitis have total serum reference IgE levels.
  • Total serum IgE levels may be elevated in multiple nonatopic conditions (eg, parasitic infection, certain cancers and autoimmune diseases).
  • Elevated allergen-specific IgE levels are found in 55% of the US general population.
  • Elevated IgE levels may be a secondary phenomenon.

Elevated food-specific IgE levels are not representative of “triggering” foods in patients with atopic dermatitis and often-lead to mis-diagnosis of food allergy.  Food allergen IgE panel testing is not recommended in patients with atopic dermatitis (Sources: Pediatrics, Choosing Wisely) .

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The development of this information was made possible through support from Sanofi and Regeneron.