Not Everything Is Allergic: Skin Sometimes Tells a Different Story at the Immunology and Allergy Clinics

Patients frequently present to allergy and immunology clinics with cutaneous complaints attributed to self-perceived allergic conditions; however, many have non-allergic dermatologic diseases. We aimed to evaluate the demographic and clinical characteristics of non-allergic patients with dermatologic complaints.

In this prospective study, patients presenting between June 1 and December 31, 2025, who received a non-allergic dermatologic diagnosis were included. Initial assessments were conducted in the immunology and allergy clinic, with dermatology consultation when needed. Demographic data, symptom characteristics and duration, prior dermatology visits, and final diagnoses were recorded.

A total of 218 patients were included. Median age was 45 years; 68.3% were female. Median symptom duration was 10.5 months, with 57.8% experiencing symptoms >3 months. Previous dermatology clinic applications were reported by 62.4%. Allergy beliefs included unspecified (49.5%), food-related (22.5%), drug-related (9.6%), and no suspicion (18.4%). The most frequent symptom was pruritus (83.9%). Common diagnoses included xerosis cutis (26.6%), insect bite reactions (10.6%), prurigo simplex (8.3%), seborrheic dermatitis (6.4%), acne vulgaris (6.0%), and rosacea (6.0%). Allergy-related beliefs were not significantly associated with age, sex, education, or symptom duration. Longer symptom duration was associated with a higher likelihood of previous dermatology visits (p<0.001).

Non-allergic dermatologic conditions are common among patients with self-perceived allergic dermatologic conditions presenting to immunology and allergy clinics. Improved triage, interdisciplinary collaboration, and public education may reduce misinterpretation and unnecessary healthcare utilization.