Specific Hyposensitization in Atopic Dermatitis

Published data on the efficacy of hyposensitization therapy in atopic dermatitis (AD) are inconsistent, above all with regard to selection criteria for the subjects to be treated. We report the clinical results of tests in specific hyposensitization therapy which were conducted in AD patients. The patients demonstrated specific IgE against inhaled allergens, a clinical history of exacerbation of the dermatitis following contact with aggravating allergens, and they did not have clinical signs of food allergies. Our material consisted of 24 men and 39 women of ages varying from 4 to 45 years. Fifty of the 63 patients had associated asthma and/or hay fever. At the commencement of therapy, 10 were seriously affected by AD, 40 moderately and 13 mildly. We used delayed aluminium hydroxide-adsorbed vaccines. Initial administration was weekly, and was later reduced to fortnightly. Doses were lower and the build-up to maximum dose was more gradual than in normal treatment for asthma and hay fever, these measures being designed to minimize exacerbation of the dermatitis deriving from the treatment itself. 20 subjects were treated with vaccine for dermato-phagoides, 26 for grass pollen, 7 for parietaria or mug-wort, whilst 10 were submitted to two types of treatment (dermatophagoides and pollen). 17 patients underwent therapy for more than 24 months, 16 for more than 12 months, 30 for 6–12 months. In certain phases of the illness, topical emollients and antiseptics and systemic an-ti-histamines were applied. We evaluated the results by comparing the points scored at check-ups conducted every 3 months on a scoring system which took into account the following: the extent of the dermatitis, the frequency of relapses, the intensity of itching, and clinical characteristics of the dermatitis. None of the patients suffered noteworthy collateral effects from the treatment, except in 4 cases where, in the initial months of treatment, slight exacerbation of the dermatitis was evident during the 24 h following administration of the vaccine. Those subjects who recorded an improvement did so in the first 4–5 months of 1 Partially supported by ‘Foundation for Research in Dermatology’, Rome. therapy. At the last check up, no patient demonstrated a worsened condition, 22 patients showed no or slight improvement, 35 had improved significantly and 6 were totally free of skin lesions. Age distribution of those patients who responded satisfactorily to therapy was relatively uniform, although there was a slight prevalence in the 4–15 age group, which may probably be explained