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Cited by 18Eosinophilic Disorders and SyndromesDermatology and Skin DiseasesEosinophilic Esophagitis

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Eosinophilia and elevated IgE serum levels: a red flag: when your diagnosis is not a common atopic eczema or common allergy

Criado, Paulo Ricardo, Miot, Hélio Amante, Ianhez, Mayra·2023·Inflammation Research
DOI 10.1007/s00011-023-01690-7
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Abstract

Objective and design The hallmark of type 2 inflammation is eosinophilia and/or high IgE serum levels, mostly in atopic dermatitis. Nevertheless, many dermatoses may present similar findings. Our aim is to explore the biological and clinical spectrum of cutaneous manifestations involving tissue and/or systemic eosinophilia, and distinct serum levels of IgE, where atopic dermatitis or other primary allergic eczema, not always is the definitive diagnosis. Materials/methods A total of 37 scientific papers were enrolled in this narrative review. Results A diagnostic approach for patients with elevated serum IgE level and a list of conditions not related to atopic dermatitis that runs through inborn errors of immunity, inflammatory disorders, lung disorders, malignancy, infections/infestations are displayed. Regarding to peripheral eosinophilia, differential diagnosis is also explored and clinical patterns of skin diseases associated with tissue eosinophilia are listed, to facilitate our diagnosis. Conclusions We should maintain a high level of suspicion about other differential diagnosis involving eosinophilia and IgE dysregulation, especially in patients very young (when innate errors of the immunity may present) and in middle to elderly patients classified as having atopic dermatitis, due to the possibility of cutaneous hematological malignancies, paraneoplasia or autoimmune blistering diseases.

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  • The presence of IgEs specific to certain allergens plays a role in the development of eczematous dermatitis resulting from IgE-mediated delayed-type hypersensitivity, functioning primarily as an amplifier of other factors involved in the pathogenesis of AD.

    “However, the presence of IgEs specific to certain allergens plays a role in the development of eczematous dermatitis resulting from IgE-mediated delayed-type hypersensitivity, functioning primarily as an amplifier of other factors involved in the pathogenesis of AD.79, 80”

    From Update on the pathogenesis of atopic dermatitis. (2024) · cites this paper as [80]

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Metadata

Authors
Criado, P. R., Miot, H. A., & Ianhez, M.
Affiliations
  • Faculdade de Medicina do ABC (BR)
  • Universidade Estadual Paulista (Unesp) (BR)
  • Universidade Federal de Goiás (BR)
Corresponding author
Criado, Paulo Ricardo
ORCID
Venue
Inflammation Research
Publisher
Springer Science and Business Media LLC
Published
2023-01-13
Volume
72
Issue
3
Pages
541-551
ISSN
  • 1023-3830 (ISSN-L)
  • 1420-908X
DOI
10.1007/s00011-023-01690-7
OpenAlex
W4315866401
Cited by
18
References
0
Citations by year
2026: 3 · 2025: 8 · 2024: 6 · 2023: 1
FWCI
0.79
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Inflammation Research (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Rheumatology › Eosinophilic Disorders and Syndromes
  • Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
  • Health Sciences › Medicine › Gastroenterology › Eosinophilic Esophagitis
Keywords
eosinophilia, serum IgE, atopic dermatitis, type 2 inflammation, differential diagnosis, primary immunodeficiency, paraneoplastic dermatosis, autoimmune blistering disease, tissue eosinophilia
MeSH terms
Aged, Dermatitis, Atopic, Eosinophilia, Eosinophils, Humans, Immunoglobulin E, Skin

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