The significance of component-resolved allergy diagnostics in atopic dermatitis patients when prescribing allergen-specific immunotherapy

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Abstract

The paper presents clinical cases of patients with severe atopic dermatitis with polyvalent sensitization in an adult patient and in a pediatric patient. Standard topical and systemic therapy proved to be an insufficiently effective strategy in these patients. Both patients underwent component-resolved allergy diagnostics, which made it possible to identify the causally significant components of allergens, sensitization to which affects the course of atopic dermatitis. On the basis of the survey, indications for allergen-specific immunotherapy with causally significant allergens were determined. The treatment made it possible to achieve non-drug remission not only of atopic dermatitis but also of concomitant respiratory allergic diseases.

The cases demonstrate the efficacy and safety of allergen-specific immunotherapy in patients with proven sensitization to causally significant allergens based on component allergy diagnostics.

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About the authors

Olga G. Elisyutina

National Research Center ― Institute of Immunology; Peoples’ Friendship University of Russia

Author for correspondence.
Email: el-olga@yandex.ru
ORCID iD: 0000-0002-4609-2591
SPIN-code: 9567-1894

MD, Dr. Sci. (Med.)

Russian Federation, Moscow; Moscow

Elena S. Fedenko

National Research Center ― Institute of Immunology

Email: efedks@gmail.com
ORCID iD: 0000-0003-3358-5087
SPIN-code: 5012-7242

MD, Dr. Sci. (Med.), Professor

Russian Federation, Moscow

Eugeniy V. Smolnikov

National Research Center ― Institute of Immunology; Peoples’ Friendship University of Russia

Email: qwertil2010@yandex.ru
ORCID iD: 0000-0003-1302-4178
SPIN-code: 4874-8100
Russian Federation, Moscow; Moscow

Alla O. Litovkina

National Research Center ― Institute of Immunology; Peoples’ Friendship University of Russia

Email: dr.litovkina@gmail.com
ORCID iD: 0000-0002-5021-9276
SPIN-code: 2337-7930
Russian Federation, Moscow; Moscow

Olga V. Shtyrbul

National Research Center ― Institute of Immunology

Email: ovs-495@yandex.ru
ORCID iD: 0000-0001-8254-9715
SPIN-code: 4146-1788

MD, Cand. Sci. (Med.)

Russian Federation, Moscow

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Supplementary files

Supplementary Files
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1. JATS XML
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2. Fig. 1. The back skin of the patient V. before treatment: severe infiltration, hyperemia, papular rashes with scales, linear excoriations, crusts. Index SCORAD 82.6 points.

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3. Fig. 2. The back skin of the patient V. after treatment: the severity degree of infiltration, hyperemia, papular rashes with scales decreased. Linear excoriations and crusts regressed. Index SCORAD 28 points.

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4. Fig. 3. The hand skin of the patient P. before treatment: erythematous areas, papular rashes with scales, severe lichenification, excoriations and superficial fissures covered by crusts. Index SCORAD 76.5 points.

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5. Fig. 4. The hand skin of the patient P. after 4 weeks of treatment: the severity degree of erythema and lichenification, the amount of papular rashes with scales decreased. Excoriations and superficial fissures regressed. Index SCORAD 49.9 points.

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6. Fig. 5. The hand skin of the patient P. on follow-up visit: rare papules, post-inflammatory areas of hypopigmentation, mild lichenification.

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