Dermatologic Manifestations of Job Syndrome Differential Diagnoses

Updated: Mar 30, 2020
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
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DDx

Diagnostic Considerations

Differentiation from other disorders associated with eczema and increased serum IgE levels, such as other primary immunodeficiencies and atopic dermatitis, can be challenging. [41, 42, 19]

Chronic granulomatous disease with markedly elevated IgE levels may mimic hyperimmunoglobulin E syndrome. [43] However, tuberculosis may be associated with Job syndrome and may be first evident as miliary tuberculosis. [44]

The relevance of eosinophilia and hyper-IgE in immigrant children from Africa and Latin America has been explored. The prevalence and causes of eosinophilia and hyper-IgE in 362 immigrant children in Spain was prospectively evaluated, with the most frequent causes of absolute eosinophilia being filariasis (52.6%), strongyloidiasis (46.8%), and schistosomiasis (28.9%) and the most frequent causes of increased levels of IgE being filariasis (41.9%), strongyloidiasis (29.6%), and schistosomiasis (22.2%). [45] Thus, eosinophilia and hyper-IgE are important biomarkers of helminthiasis in children coming from tropical and subtropical areas.

Differential Diagnoses