School of Medicine, University of California, Riverside.
Ronald O. Perelman Department of Dermatology, New York University, New York City.
Dermatitis. 2019 Mar/Apr;30(2):164-167. doi: 10.1097/DER.0000000000000446.
Allergic contact dermatitis (ACD) has been traditionally identified as TH1-mediated delayed-type hypersensitivity reactions. There is currently no Food and Drug Administration-approved systemic therapy indicated for ACD. Among patients with ACD, there is a subgroup that experience not only concomitant atopic dermatitis and ACD but also systemic allergic dermatitis driven by allergens encountered through dietary consumption. Basic science and clinical studies have supported the notion that ACD involves a complex interaction between both TH1 and TH2 axes of the secondary immune system on an allergen-by-allergen basis. Herein, we report the patients with systemic allergy syndrome with dermatitis to either Balsam of Peru or nickel who achieved remarkable improvement and regained their quality of life without continuing adherence to strict diets. Our study suggests that dupilumab may be an efficacious solution for a particular subgroup of patients with recalcitrant ACD when first- and second-line therapies have failed.
变应性接触性皮炎（ACD）传统上被认为是 TH1 介导的迟发型超敏反应。目前，尚无获得美国食品和药物管理局批准的用于 ACD 的全身性治疗方法。在 ACD 患者中，有一部分不仅患有特应性皮炎和 ACD，而且还患有由饮食摄入过敏原引起的全身性过敏性皮炎。基础科学和临床研究支持这样一种观点，即 ACD 涉及到次级免疫系统中 TH1 和 TH2 轴之间的复杂相互作用，这种相互作用是基于过敏原的。在此，我们报告了两例因秘鲁香脂或镍而出现全身性过敏综合征伴皮炎的患者，他们在不继续严格饮食的情况下，病情显著改善，生活质量得到恢复。我们的研究表明，当一线和二线治疗失败时，度普利尤单抗可能是治疗顽固 ACD 的特定亚组患者的有效方法。
