Do you utilize AIT for atopic dermatitis if there is no AR present?

Allergen Immunotherapy (AIT) was included as an adjunctive treatment option for patients with moderate to severe atopic dermatitis (AD) in the updated 2023 Guidelines for Atopic Dermatitis. The recommendation was made based on results from a systematic review and meta-analysis of 23 randomized contr...

In the difficult-to-manage patient with atopic dermatitis and no allergies, who has failed topical anti-inflammatories, biologic therapy would be my next step.

However, never say never! There is a subset of patients with atopic dermatitis who have improved on AIT.

In a patient who has reproducible e...

I do not use AIT for atopic dermatitis, as there are much better FDA-approved therapies for AD treatment. The time commitment for AIT, cost, and the extract components (what would you put in the extract if they don't have any environmental sensitizations?) are all factors against using AIT for AD.

I would not do AIT for eczema if there isn’t evidence of sensitization to an allergen.

With allergic rhinitis, you would have skin testing to determine what you have IgE to so that the AIT shots can be prepared. If the skin test is negative, then there is nothing to prepare.