Faculty Bibliography
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121
The International Guideline for the Definition, Classification, Diagnosis and Management of Urticaria
This update and revision of the international guideline for urticaria was developed in accordance with the methods recommended by Cochrane and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group. It is an initiative of the Global Allergy and Asthma Excellence Network (GA2LEN) and its Urticaria and Angioedema Centers of Reference and Excellence (UCAREs and ACAREs), with the participation of 210 delegates from 107 national and international societies, from 59 countries. The consensus conference was held on December 6th, 2024. This guideline was acknowledged and accepted by the European Union of Medical Specialists (UEMS). Urticaria is a frequent, mast cell-driven disease, defined by a rapid appearance of wheals, angioedema, or both. The lifetime prevalence of acute urticaria is estimated to be approximately 20%. Chronic urticaria, categorized as either chronic spontaneous urticaria or chronic inducible urticaria, is disabling, impairs quality of life, and affects performance at work and school, however, novel therapies are available. This updated version of the international guideline for urticaria covers the definition and classification of urticaria and outlines expert-guided and evidence-based diagnostic and therapeutic approaches for the different subtypes of urticaria.
PMID: 41649409
ISSN: 1398-9995
CID: 6000592
Global disparities in adrenaline access: A World Allergy Organization call for equity in anaphylaxis care [Editorial]
PMCID:12702309
PMID: 41399690
ISSN: 1939-4551
CID: 5979182
Correction: Complete/Near-Complete Itch Response Observed in Patients with Moderate-to-Severe Atopic Dermatitis Initiating Dupilumab: 3-Year, Real-World, Interim Data from the PROSE Registry
PMID: 40691414
ISSN: 2193-8210
CID: 5901302
Journal of allergy & clinical immunology. In practice. 2025:13(8):1888-1899.DOI: 10.1016/j.jaip.2025.06.023
Atopic Dermatitis With Comorbid Skin Diseases: Recognition and Successful Treatment
Atopic dermatitis (AD) is a common, chronic inflammatory skin disease that affects both children and adults. Atopic dermatitis is characterized by pruritus, erythema, induration, and scale, which can present with other conditions that may mimic or complicate AD; often leading to diagnostic challenges. Differential diagnoses include seborrheic dermatitis, contact dermatitis, psoriasis, infections, inflammatory/autoimmune disorders, cutaneous T-cell lymphoma, and immunodeficiency-related dermatoses; to name a few. This review article focuses on AD and its associated cutaneous comorbid diseases. Familiarity with the spectrum of these diseases and their distinguishing features is crucial for diagnostic accuracy and to optimize patient management.
PMID: 40571248
ISSN: 2213-2201
CID: 5904632
Journal of allergy & clinical immunology. In practice. 2025:13(8):1970-1979.DOI: 10.1016/j.jaip.2025.03.055
Contact Dermatitis and Patch Testing Education: A Workgroup Report from the Allergic Skin Diseases Committee of the AAAAI
Allergic Contact dermatitis (ACD) is effectively diagnosed and treated through the identification of causative allergens via patch testing (PT). Selection of allergens, along with the application and interpretation of PT results, necessitates specialized education and training. Our objective was to investigate the extent to which contact dermatitis (CD) education and PT training are components of the curriculum in Allergy and Immunology (A/I) training programs in the United States, and to assess where knowledge gaps may exist. A voluntary 16 item survey was sent to Program and Associate Program Directors (PDs) in A/I associated with the American Academy of Allergy, Asthma, and Immunology (AAAAI) in 2021. A total of 23 out of 84 (27%) A/I training programs responded. Of the responding programs, 22% did not have a faculty member who performs PT and 25% do not have fellows perform PT. However, programs that performed more patch tests tended to use custom and expanded series, used the patient's personal products, and provided patients with a personal avoidance plan (loadings > 0.65). With respect to scholarly activity, 30% of programs had published an article on CD in the last 3 years. In conclusion, the key findings of our survey include that programs that perform PT are more likely to provide expanded and customized panels, provide patients with an individualized avoidance plan, and present scholarly activity on the topic. Given the importance of CD in allergy practices, our results indicate that more instruction in this topic is needed in A&I fellowship programs.
PMID: 40381990
ISSN: 2213-2201
CID: 5852632
Complete/Near-Complete Itch Response Observed in Patients with Moderate-to-Severe Atopic Dermatitis Initiating Dupilumab: 3-Year, Real-World, Interim Data from the PROSE Registry
INTRODUCTION/BACKGROUND:Atopic dermatitis (AD) is a chronic, relapsing disease that can start at any age and has a significant negative impact on quality of life, including a significant itch burden. Here we report the proportion of patients in a real-world study achieving a complete/almost complete resolution of itch, as measured by the Peak Pruritus Numeric Rating Scale (PP-NRS) and improvement in overall disease severity score (ODS), in patients aged ≥ 12 years with moderate-to-severe AD up to 3 years after commencing dupilumab treatment. METHODS:PROSE is an ongoing, prospective, observational, multicenter registry in the USA and Canada, collecting real-world data from patients aged ≥ 12 years with moderate-to-severe AD who initiated dupilumab in accordance with country-specific prescribing information. Assessments include patient-reported PP-NRS (range 0-10) and clinician-measured ODS score (range 0-4). RESULTS:A total of 857 patients were enrolled, of whom 42% were male and 6.4% were adolescents aged ≥ 12 to < 18 years. The mean [standard deviation (SD)] age was 40.1 (17.9) years, and the duration of AD was 17.4 (16.2) years. The subsequent mean (SD) duration of dupilumab treatment was 23.1 (13.7) months. The proportion of patients achieving complete/almost complete itch resolution (PP-NRS score of 0 or 1) improved consistently over time, from 2.7% (17/622) of patients at baseline to 56.3% (58/103) at 3 years. Additionally, by year 3, 65.1% (54/83) of patients had an ODS score of no/minimal disease (score of 0 or 1), versus 2.2% (19/852) at baseline. CONCLUSIONS:In this real-world setting of the PROSE registry, adult and adolescent patients with moderate-to-severe AD followed up for up to 3 years after the initiation of dupilumab treatment experienced sustained and substantial improvement in pruritus and ODS, using the stringent endpoints of PP-NRS 0 or 1 and ODS 0 or 1. TRIAL REGISTRATION/BACKGROUND:ClinicalTrials.gov identifier: NCT03428646.
PMID: 40234297
ISSN: 2193-8210
CID: 5827852
Journal of allergy & clinical immunology. In practice. 2024:12(9):2227-2241.DOI: 10.1016/j.jaip.2024.04.060
Recognizing and Managing Allergic Contact Dermatitis: Focus on Major Allergens
Patch testing is the reference standard for the diagnosis of allergic contact dermatitis. Identification and avoidance of culprit allergens are essential in the treatment of this disease. Each year, new allergens are identified as emerging or important. The authors discuss allergens that are common, enduring, emergent, incompletely recognized, and controversial for the practicing allergist and dermatologist. This Clinical Management Review will encompass a review of fragrances, preservatives, rubber, acrylates, metals, and medications; their common sources of exposure; controversies in diagnosis and patch testing; management and how to avoid those allergens. This review will also include practical aspects of diagnosis and management and will provide resources that can be used as guidance for physicians and patients on nickel, methylchloroisothiazolinone/methylisothiazolinone, and fragrance, the most common allergens positive on patch testing.
PMID: 38768899
ISSN: 2213-2201
CID: 5689632
Methylisothiazolinone-containing paint contributing to mucocutaneous and cutaneous symptoms: A case of aerosolized allergic contact dermatitis
PMID: 38705271
ISSN: 1534-4436
CID: 5658292
Definition, acronyms, nomenclature, and classification of angioedema (DANCE): AAAAI, ACAAI, ACARE, and APAAACI DANCE consensus
BACKGROUND:Angioedema (AE) manifests with intermittent, localized, self-limiting swelling of the subcutaneous and/or submucosal tissue. AE is heterogeneous, can be hereditary or acquired, may occur only once or be recurrent, may exhibit wheals or not, and may be due to mast cell mediators, bradykinin, or other mechanisms. Several different taxonomic systems are currently used, making it difficult to compare the results of studies, develop multicenter collaboration, and harmonize AE treatment. OBJECTIVE:We developed a consensus on the definition, acronyms, nomenclature, and classification of AE (DANCE). METHODS:The initiative involved 91 experts from 35 countries and was endorsed by 53 scientific and medical societies, and patient organizations. A consensus was reached by online discussion and voting using the Delphi process over a period of 16 months (June 2021 to November 2022). RESULTS:The DANCE initiative resulted in an international consensus on the definition, classification, and terminology of AE. The new consensus classification features 5 types and endotypes of AE and a harmonized vocabulary of abbreviations/acronyms. CONCLUSION/CONCLUSIONS:The DANCE classification complements current clinical guidelines and expert consensus recommendations on the diagnostic assessment and treatment of AE. DANCE does not replace current clinical guidelines, and expert consensus algorithms and should not be misconstrued in a way that affects reimbursement of medicines prescribed by physicians using sound clinical judgment. We anticipate that this new AE taxonomy and nomenclature will harmonize and facilitate AE research and clinical studies, thereby improving patient care.
PMID: 38670233
ISSN: 1097-6825
CID: 5657862
Abrocitinib efficacy and safety in moderate-to-severe atopic dermatitis by race, ethnicity, and Fitzpatrick skin type
BACKGROUND:Response to abrocitinib treatment for moderate-to-severe atopic dermatitis (AD) has not been evaluated across racial and ethnic subpopulations. OBJECTIVE:To assess the efficacy and safety of abrocitinib on the basis of patient race, ethnicity, and Fitzpatrick skin type (FST). METHODS:Data were pooled post hoc from patients treated with abrocitinib 200 mg, 100 mg, or placebo in 3 monotherapy trials (NCT02780167, NCT03349060, and NCT03575871). Race and ethnicity were self-reported; FST was determined by study investigators. Evaluations through Week 12 include the following: (1) Investigator's Global Assessment of clear or almost-clear skin; (2) greater than or equal to 75% improvement in Eczema Area and Severity Index or SCORing AD; (3) a greater-than-or-equal-to 4-point improvement in Peak Pruritus Numerical Rating Scale score; (4) least squares mean changes in Dermatology Life Quality Index and Patient-Oriented Eczema Measure scores; and (5) treatment-emergent adverse events. RESULTS:The sample comprised 628 White, 204 Asian, and 83 Black patients; 37 were Hispanic or Latino; 624 had FST I to III and 320 had FST IV to VI. Treatment with either abrocitinib dose was associated with greater proportions of patients achieving Investigator's Global Assessment of clear or almost-clear skin, ≥ 75% improvement in Eczema Area and Severity Index, ≥ 75% improvement in SCORing AD, and a ≥ 4-point improvement in Peak Pruritus Numerical Rating Scale, or greater score changes from baseline in Dermatology Life Quality Index and Patient-Oriented Eczema Measure vs placebo regardless of race, ethnicity, or FST. Dose-response was most prominent in White patients. In Black patients, the effects of the 2 doses were similar. Treatment-emergent adverse events were more common in White and Black than in Asian patients. CONCLUSION:Abrocitinib was more efficacious than placebo across the racial and ethnic groups and ranges of phototypes analyzed. Studies with increased representation of populations of color are warranted to elucidate potential variations in response across diverse populations. TRIAL REGISTRATION:Clinicaltrials.gov Identifier: NCT02780167 (phase 2b), NCT03349060 (phase 3 MONO-1), and NCT03575871 (phase 3 MONO-2).
PMID: 37949351
ISSN: 1534-4436
CID: 5722942
