The Atopic Dermatitis/Eczema Profile Blood Test is used to identify potential allergens or immune responses that may contribute to atopic dermatitis (eczema), a chronic skin condition characterized by inflammation, itching, and dryness. Atopic dermatitis is often associated with other allergic conditions, such as asthma and allergic rhinitis (hay fever), in a phenomenon known as the atopic triad. This blood test measures the level of IgE antibodies to specific allergens that may trigger or worsen eczema symptoms.

Purpose of the Atopic Dermatitis/Eczema Profile Blood Test

  • To detect IgE-mediated allergic responses that may trigger or exacerbate eczema symptoms.
  • To identify environmental or food allergens contributing to skin inflammation and itching in individuals with atopic dermatitis.
  • To guide treatment strategies for managing eczema, including allergen avoidance and medical therapies.

Allergens Tested in the Eczema Profile

The panel typically screens for allergens that are known to trigger or worsen eczema, including:

1. Food Allergens:

  • Cod Fish
  • Cow’s Milk
  • Egg White
  • Soyabean
  • Peanut
  • Hazelnut
  • Shrimp
  • Wheat
  • Apple

2. Environmental Allergens:

  • Dust mite – dermatophagoides pteronyssinus
  • Cat dander
  • Dog dander
  • Timothy grass
  • Common silver birch

Types of Blood Tests in the Eczema Profile

  1. Specific IgE Testing:
    • Measures the levels of IgE antibodies in the blood specific to certain food or environmental allergens.
    • A positive result indicates that the immune system has developed a hypersensitivity to a particular allergen.
  2. Total IgE Testing:
    • Measures the overall level of IgE antibodies in the blood. Elevated IgE levels suggest an atopic (allergic) predisposition but do not specify which allergens are involved.
    • Total IgE levels tend to be elevated in individuals with atopic dermatitis, especially during flare-ups.
  3. Component-Resolved Diagnostics (CRD):
    • This advanced testing method can identify specific allergenic proteins within foods or environmental triggers. It helps determine whether a reaction is due to genuine allergy or cross-reactivity.
    • CRD can provide more detailed information on which proteins within an allergen (e.g., peanuts or pollen) are causing the reaction.

Symptoms of Atopic Dermatitis (Eczema)

  • Itching: The hallmark of eczema, often intense and difficult to control.
  • Dry, Flaky Skin: Especially common on the face, neck, hands, and inside of elbows and knees.
  • Red, Inflamed Skin: Areas of redness and inflammation due to immune system activation.
  • Crusting or Oozing: During severe flare-ups, affected areas may weep or crust over.
  • Thickened Skin: Repeated scratching can cause the skin to thicken and become leathery, a condition known as lichenification.

Causes and Triggers of Atopic Dermatitis

  1. Immune System Dysregulation:
    • Atopic dermatitis is caused by a combination of genetic factors and an overactive immune response, leading to inflammation in the skin.
    • Individuals with eczema often have a heightened sensitivity to allergens and environmental factors, which can trigger flare-ups.
  2. Allergic Triggers:
    • Foods or environmental allergens (such as dust mites or pollen) can cause the immune system to release inflammatory mediators, worsening eczema symptoms.
    • In some cases, food allergies, particularly to milk, eggs, or peanuts, may cause or exacerbate eczema in children.
  3. Skin Barrier Dysfunction:
    • People with eczema often have a weakened skin barrier, which allows moisture to escape and irritants or allergens to penetrate more easily, causing inflammation and dryness.

Interpreting Test Results

  • Class 0: No detectable IgE to the allergen, suggesting that the allergen is unlikely to cause or worsen eczema.
  • Class 1-6: Increasing levels of IgE antibodies indicate increasing sensitivity to the allergen, with Class 6 representing a high likelihood of allergic reactions and the potential for eczema flare-ups.
    • Low-level IgE results may suggest mild sensitivity to a trigger.
    • High-level IgE results indicate a stronger immune response, suggesting the allergen is a significant contributor to eczema symptoms.

Diagnosis and Management of Eczema

  1. Avoidance of Allergens:
    • Identifying and avoiding allergens that trigger eczema flare-ups is crucial in managing the condition. For example:
      • Food Allergies: Eliminating foods like milk, eggs, or peanuts that may worsen eczema.
      • Environmental Allergens: Reducing exposure to dust mites, pet dander, or pollen by using air filters, frequent cleaning, and keeping pets out of bedrooms.
  2. Topical Treatments:
    • Moisturizers: Keeping the skin well-moisturized helps protect the skin barrier and reduce dryness and itching.
    • Topical Corticosteroids: Used to reduce inflammation during flare-ups.
    • Calcineurin Inhibitors: Non-steroidal treatments that help control inflammation and prevent flare-ups.
    • Barrier Repair Creams: Strengthen the skin’s natural barrier function.
  3. Systemic Treatments:
    • Oral Antihistamines: May be used to reduce itching, especially at night.
    • Immunosuppressive Drugs: In severe cases, medications like cyclosporine may be prescribed to suppress the overactive immune response.
    • Biologic Therapies: Dupilumab, a biologic treatment targeting specific immune pathways involved in eczema, is available for severe cases.
  4. Allergen Immunotherapy:
    • For individuals with severe environmental allergies that exacerbate eczema, allergen immunotherapy (e.g., allergy shots or sublingual tablets) may help reduce sensitivity over time.
  5. Dietary Management:
    • If food allergies are identified, working with a dietitian can help ensure a nutritionally balanced diet while avoiding trigger foods.
    • In infants and young children, food allergies associated with eczema may improve with age.
  6. Skin Care Routine:
    • A gentle, consistent skin care routine is critical for managing eczema. This includes using mild, fragrance-free cleansers and moisturizers, and avoiding harsh irritants.

When is the Atopic Dermatitis/Eczema Profile Blood Test Recommended?

  • If a child or adult experiences persistent symptoms of eczema, particularly when suspected to be related to allergies.
  • If there is a family history of atopic conditions such as asthma, allergic rhinitis, or food allergies.
  • To confirm or rule out specific allergens that may be triggering eczema symptoms.
  • For individuals with severe or difficult-to-manage eczema who may benefit from a more targeted treatment approach.

The Atopic Dermatitis/Eczema Profile Blood Test provides valuable insight into the allergens that may be contributing to eczema symptoms, helping patients and healthcare providers to tailor treatment plans and improve quality of life. Consulting with a dermatologist or allergist is essential for proper diagnosis and management.

Results – 2 days from Laboratory receiving sample