IgE-mediated food allergy is characterized immunologically by a type 1 immune response triggered upon exposure to specific foods and clinically by a broad range of manifestations and variable severity. Our understanding of food allergy within the allergic march of atopic dermatitis (AD) is still incomplete despite the related risk of unpredictable and potentially severe associated reactions such as anaphylactic shock. The aim of this pilot study was to investigate the effects of dupilumab, an IL-4/IL-13 monoclonal antibody approved for AD, on the allergic sensitization profile of patients with AD and type 1 hypersensitivity-related comorbidities, including oral allergy syndrome, anaphylaxis, and gastrointestinal disorders. We conducted an observational pilot study with a longitudinal prospective design, enrolling 20 patients eligible for treatment with dupilumab. Laboratory exams for total serum IgE, specific IgE, and molecular allergen components were performed at baseline and after 16 weeks of therapy. Our results demonstrate a statistically significant decrease in molecular components, specific IgE for trophoallergens, and specific IgE for aeroallergens following treatment with dupilumab. We suggest that modulating type 2 immunity may decrease IgE-mediated responses assessed with laboratory exams and therefore could minimize allergic symptoms in polysensitized patients. Upcoming results of randomized controlled trials investigating dupilumab in food allergy are highly anticipated to confirm its potential effect in the treatment of IgE-mediated food allergies.

Article: Nummular eczema following brigatinib administration in patient with lung cancer - Italian Journal of Dermatology and Venereology 2024 Nov 04 - Minerva Medica - Journals

Background: Melasma and facial hyperpigmentation are common dermatologic conditions that significantly impact patients’ quality of life. New approaches such as laser-assisted delivery of topical agents have been proposed to enhance treatment outcomes. Objective: To evaluate the comparative effectiveness of fractional CO₂ laser-assisted delivery of 2-mercaptonicotinoyl glycine (2-MNG) versus topical 2-MNG alone in a real-world clinical setting. Methods: Fourteen female patients with mild-to-moderate melasma or hyperpigmentation were enrolled, and eleven completed the 16-week study. Participants were allocated to either the laser +2-MNG group (n = 6) or topical 2-MNG only group (n = 5). Assessments were performed at baseline and every four weeks using VISIA CR^® imaging (visible, UV, and brown spots), Modified Melasma Area and Severity Index (mMASI), and Dermatology Life Quality Index (DLQI). Results: Both groups showed significant improvement in visible spots, brown spots, mMASI, and DLQI scores. The laser group showed earlier improvement, with significant changes starting at week 8, while the control group reached significance at week 12. No significant change in UV spot scores was observed. Conclusion: Both approaches were effective in reducing clinically visible pigmentation and improving quality of life. Fractional CO₂ laser-assisted delivery offered a faster onset of efficacy.