Allergen-specific immunotherapy for atopic eczema:  updated.
OBJECTIVE
Aeroallergens are relevant eliciting factors of not only respiratory allergy but also atopic eczema in subgroups of patients. Due to a low number of controlled studies, the use of allergen-specific immunotherapy (ASIT) as potentially curative therapy as in respiratory atopic diseases is controversial in treating atopic eczema. This article summarizes theoretical aspects and recent results of clinical trials associated with ASIT in atopic eczema.


RESULTS
Literature demonstrates variability in study design and results, but ASIT has potential to improve the course of atopic eczema if type I sensitizations are present. Studies suggest the efficacy of ASIT on eczema not only in house dust mite allergy but also in patients with birch or grass pollen sensitization. In several studies, only defined subgroups of patients with atopic eczema showed positive results of ASIT. A generally good tolerability of ASIT was seen.


CONCLUSIONS
Atopic eczema patients with relevant allergies might benefit from ASIT as an additional therapeutic option. Side effects have been overestimated in the past. Hypothetically, the atopy patch test helps to identify an atopic eczema patient subgroup for successful ASIT.
Department of Dermatology and Allergy Biederstein, Technische Universität München, ZAUM - Center for Allergy and Environment, Munich, Germany. ulf.darsow@lrz.tum.de
Ulf
U
Darsow
D003876:Dermatitis, Atopic / Q000276:immunology* / Q000628:therapy*; D003888:Desensitization, Immunologic / Q000379:methods*; D006801:Humans; D010328:Patch Tests; D018417:Th1 Cells / Q000276:immunology; D018418:Th2 Cells / Q000276:immunology