If you manage pediatric patients with atopic dermatitis (AD), chances are you’ve navigated the same questions many of us have: When should I refer to allergy? When is dermatology the better fit? Could we be doing more, together? A recent study comparing allergy and dermatology referral and treatment patterns confirms what many of us have seen in practice: each specialty brings something different to the table. And that difference may just be our biggest strength.
The Study That Sparked the Conversation: New Study on Atopic Dermatitis: Allergy vs Dermatology Care
According to a 2025 retrospective chart review from the University of Virginia (UVA) Health System, researchers compared how allergists and dermatologists manage pediatric AD, and the findings were eye-opening. Dermatology visits were more likely to include prescriptions for topical corticosteroids, calcineurin inhibitors, and immunosuppressants. While Allergy visits were more likely to involve allergen panels, IgE testing, and identifying environmental or food triggers.
The authors also found that patients seen in a combined allergy-dermatology clinic were significantly more likely to receive both diagnostic testing and prescription treatments at the initial visit. This collaborative approach allowed for both symptom management and deeper insight into potential triggers, a win for everyone, especially the patient.
What This Means for Our Patients
Dermatologists often manage flares. Allergists aim to prevent them. But shouldn’t our patients benefit from both? When we silo care, patients miss out. The UVA study revealed that allergy clinics often didn’t initiate treatment, and dermatology clinics rarely conducted testing for underlying triggers. However, it’s important to note that dermatology providers often offer patch testing, particularly when allergic contact dermatitis is suspected or when the diagnosis of AD is uncertain. As a part of a targeted strategy, combined care filled in both gaps. This multidisciplinary dermatology approach helped bridge diagnostic and therapeutic gaps, improving eczema treatment outcomes.
This suggests a compelling opportunity: what if, instead of asking “which specialty should take the lead?” We started asking, “How can we work together?”
Rethinking Referral Patterns in Atopic Dermatitis
One of the UVA study’s more subtle revelations was how much referral patterns influence access to care. Over 95% of allergy visits were referral-based, while nearly half of dermatology patients were self-referred. This highlights the need for clearer guidance for primary care providers, who still drive the bulk of referrals. Rather than sending patients to one or the other, what if we encouraged co-management from the outset?
For example:
- A toddler with recurrent flares and suspected food sensitivities? Start with allergy, but loop in derm early.
- A school-aged child with moderate-to-severe AD that’s not responding to standard topicals? Refer to derm, but ask whether trigger testing has been done.
- A patient who’s been seen by both? Facilitate communication between teams, or better yet, create space for a shared visit.
Making Collaboration Happen in the Real World
We know not every clinic can launch a combined subspecialty service tomorrow. But collaboration doesn’t have to be formal to be impactful. Here are a few small steps that can make a big difference:
- Shared Care Plans: Use EMR messaging or care conferences to align treatment goals across specialties.
- Referral Templates: Add prompts that flag when cross-specialty input might be helpful (e.g., “consider allergy referral if patient has frequent flares without known triggers”).
- Standardized Patient Education: Coordinate allergy and dermatology messaging to avoid confusion and boost adherence.
- Telehealth Partnerships: Explore asynchronous consults or co-review visits if your clinic doesn’t have in-house allergy or derm support.
Escalating Care with Biologics and JAKs in a Collaborative Model
When a patient’s atopic dermatitis progresses to the point where topical therapies are no longer enough, escalation to systemic therapy, often with biologics, becomes the next step. This is where clear collaboration between dermatology and allergy can make the biggest difference.
In most cases, dermatology takes the lead in initiating biologic therapy, managing dosing schedules, and monitoring skin response. Allergy teams add value by identifying and addressing comorbid atopic conditions, optimizing environmental or food trigger management, and supporting the patient through education and follow-up.
By sharing information and aligning on treatment plans, both specialties can stay proactive. Dermatology ensures active disease is controlled, while allergy helps reduce future flares and manage the broader atopic picture. This approach not only streamlines patient care but also helps families feel supported by a cohesive team, rather than navigating two separate plans.
A Challenge To Us All
What would your practice look like if collaboration were the norm, not the exception? Could you improve efficiency? Prevent miscommunication? Provide more personalized care?
As healthcare providers, whether MD, NP, PA, or RN, we have a unique opportunity to set the tone for interdisciplinary partnership. The future of AD care doesn’t belong to one specialty. It belongs to teams that work together.
If you’re part of a practice or institution that’s found creative ways to bridge the gap between dermatology and allergy, we want to hear from you. Join the conversation, share your approach on social and tag @diversityindermatology or reach out to contribute to the next blog post. Let’s build a community of collaborative care, together.
Collaborative Summit Invitation: You’re invited to join the upcoming Collaborative Care Summit hosted by Diversity in Dermatology, an event designed to help providers learn more about collaborative approaches and multidisciplinary team models.
The Collaborative Care Summit is a two-day comprehensive medical education program (pending 11.25 CMEs/CEUs) for healthcare professionals in dermatology, rheumatology, allergy/immunology, and gastroenterology. This multi-sponsored, triple-accredited program features renowned faculty leading interactive sessions on inflammatory diseases, overlapping conditions, and collaborative treatment approaches. Attendees will also enjoy dedicated networking opportunities, including an evening reception.
REGISTER EARLY TO SAVE YOUR SEAT! Space is limited to foster an intimate and engaging learning environment.
References:
Edmonds NL, Heron CE, Lawrence MG, Zlotoff B. Differences between allergy and dermatology in referral, evaluation, and management patterns for pediatric patients with atopic dermatitis. Journal of Dermatological Treatment. 2025. https://www.tandfonline.com/doi/full/10.1080/09546634.2025.2515495#abstract
Jade Dupree Trevino, RN is a dermatology nurse and emerging health writer with a passion for inclusive skin health and patient education. With experience spanning clinical care, teaching, and business innovation, she is building a voice at the intersection of medicine and entrepreneurship. Her work aims to bridge clinical insight with real-world impact through writing, collaboration, and leadership in the dermatology space.