PMID- 37248786
OWN - NLM
STAT- MEDLINE
DCOM- 20231023
LR  - 20231023
IS  - 1346-8138 (Electronic)
IS  - 0385-2407 (Linking)
VI  - 50
IP  - 10
DP  - 2023 Oct
TI  - Allergen-specific immunotherapy improves alopecia totalis in a severe atopic 
      dermatitis patient.
PG  - 1353-1356
LID - 10.1111/1346-8138.16841 [doi]
AB  - House dust mite (HDM) is the most common allergen exacerbating atopic dermatitis 
      (AD), and allergen-specific immunotherapy (AIT) using HDM exhibited significant 
      improvements in previous studies. Alopecia can occur as a complication of AD. 
      Alopecia totalis (AT), a severe form of alopecia areata (AA), does not respond 
      well to treatment and the chance of full recovery is less than 10%. For extensive 
      hair loss, topical immunotherapy such as diphenylcyclopropenone (DPCP) is used as 
      the first-line treatment. However, since DPCP is a kind of contact allergen, it 
      has the potential to exacerbate AD. A 38-year-old man with AD and AA visited our 
      clinic with symptoms worsening from 3 months ago. Although taking oral 
      methylprednisolone (8 mg/day) and cyclosporine (100 mg/day) for 3 months, he has 
      lost over 90% of his hair and the Eczema Area and Severity Index (EASI) was 43. 
      Total serum immunoglobulin E (IgE) levels were 4454 kU/L (normal <100 kU/L) and 
      the specific IgE levels for Dermatophagoides pteronyssinus and Dermatophagoides 
      farinae following ImmunoCAP(R) were 20.8 and 37.4 kU/L, respectively. This patient 
      did not respond well to previous treatment and was reluctant to use long-term 
      steroids, so subcutaneous AIT using HDM was administered along with oral 
      cyclosporine (100 mg/day). Topical tacrolimus was also applied to the AD lesions 
      throughout the body. To reduce itching, nonsedative antihistamines were used if 
      necessary. Hair loss was almost completely improved 1 year after the AIT 
      initiation and the skin lesions of AD also improved (EASI 2.4). The specific IgE 
      levels for D. pteronyssinus and D. farinae were 3.73 and 7.16 kU/L, respectively. 
      Herein, we report a patient with promising results following AIT for AT with 
      severe AD. In severe alopecic patients with AD refractory to conventional 
      treatment, including immunosuppressants, AIT could be considered as a treatment 
      option.
CI  - (c) 2023 Japanese Dermatological Association.
FAU - Kwon, Il Joo
AU  - Kwon IJ
AUID- ORCID: 0000-0003-1314-6829
AD  - Department of Dermatology and Cutaneous Biology Research Institute, Yonsei 
      University College of Medicine, Seoul, South Korea.
FAU - Park, Jung Won
AU  - Park JW
AUID- ORCID: 0000-0002-0076-0478
AD  - Department of Dermatology and Cutaneous Biology Research Institute, Yonsei 
      University College of Medicine, Seoul, South Korea.
FAU - Kim, Su Min
AU  - Kim SM
AUID- ORCID: 0000-0002-2280-1605
AD  - Department of Dermatology and Cutaneous Biology Research Institute, Yonsei 
      University College of Medicine, Seoul, South Korea.
FAU - Lee, Kwang Hoon
AU  - Lee KH
AUID- ORCID: 0000-0002-4361-1819
AD  - Department of Dermatology and Cutaneous Biology Research Institute, Yonsei 
      University College of Medicine, Seoul, South Korea.
FAU - Park, Chang Ook
AU  - Park CO
AUID- ORCID: 0000-0003-3856-1201
AD  - Department of Dermatology and Cutaneous Biology Research Institute, Yonsei 
      University College of Medicine, Seoul, South Korea.
AD  - Institute of Allergy, Yonsei University College of Medicine, Seoul, South Korea.
LA  - eng
GR  - Korean Health Technology R&D Project, Ministry of Health and Welfare/
PT  - Case Reports
PT  - Journal Article
DEP - 20230529
PL  - England
TA  - J Dermatol
JT  - The Journal of dermatology
JID - 7600545
RN  - 0 (Allergens)
RN  - 37341-29-0 (Immunoglobulin E)
RN  - 0 (Cyclosporins)
RN  - Diffuse alopecia
SB  - IM
MH  - Male
MH  - Humans
MH  - Adult
MH  - *Dermatitis, Atopic/complications/therapy
MH  - *Alopecia Areata/complications/therapy
MH  - Desensitization, Immunologic/methods
MH  - Allergens
MH  - Immunoglobulin E
MH  - *Cyclosporins
OTO - NOTNLM
OT  - allergen-specific immunotherapy
OT  - alopecia areata
OT  - alopecia totalis
OT  - atopic dermatitis
OT  - house dust mites
EDAT- 2023/05/30 06:42
MHDA- 2023/10/23 00:41
CRDT- 2023/05/30 03:42
PHST- 2023/04/12 00:00 [revised]
PHST- 2023/02/20 00:00 [received]
PHST- 2023/05/06 00:00 [accepted]
PHST- 2023/10/23 00:41 [medline]
PHST- 2023/05/30 06:42 [pubmed]
PHST- 2023/05/30 03:42 [entrez]
AID - 10.1111/1346-8138.16841 [doi]
PST - ppublish
SO  - J Dermatol. 2023 Oct;50(10):1353-1356. doi: 10.1111/1346-8138.16841. Epub 2023 
      May 29.