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
- Total IgE levels may increase in multiple atopic and nonatopic conditions.
- Elevated serum IgE is not present in about 20% of individuals with atopic dermatitis.
- 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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