According to a case presented at the ACAAI annual meeting, severe atopic dermatitis, or eczema, may respond to allergen immunizations.
Eczema is an allergic disease, and patients who have it often exhibit other allergies. Patients experience red, inflamed and/or dry skin, scaling, and itching, all of which can cause pain, sleep disturbance, and poor quality of life. A variety of therapies are frequently utilized to treat it, including topical moisturizers, topical corticosteroids, and biologics.
Anil Nanda, MD and Anita Wasan, MD, presented an abstract showing that allergy shots provided significant benefits in a medically challenging case. The 48-year-old male patient presented with severe atopic dermatitis that he had had since childhood. Previous therapies (including topical corticosteroids, tacrolimus, and pimecrolimus) had been ineffective. He also had required treatment with systemic corticosteroids. At the time of his treatment, biologic therapies were not yet an option. Additional findings of interest included an IgE level of 10,000 IU/mL and a 79.4 on the Scoring Atopic Dermatitis Index (SCORAD).
Nanda explained that the treatment team thought allergy shots might be beneficial because the patient also had multiple allergies. Testing revealed allergies to dust mites, weeds, trees, grasses, mold, cats, and dogs.
“Because his allergies could all be treated with allergy shots, we thought treating his allergies might also benefit his eczema,” Wasan said.
The patient was started on subcutaneous allergen immunizations, and he maintained his topical treatments. After one year, he reported significant improvement in his symptoms, and his SCORAD decreased to 48.5. Once he reached a maintenance dose of immunotherapy, he no longer needed systemic steroids.
The authors called for further research to explore the role of allergy shots in the treatment of eczema.