This summary was compiled from the tweets posted by the following allergists/immunologists who attended the 2012 annual meeting of the American Academy of Allergy Asthma and Immunology (AAAAI): Dr. Melinda Rathkopf @mrathkopf. The tweets were labeled #AAAAI. The text was edited and modified by me.Food Allergy and Atopic Dermatitis (AD) were discussed by Dr Gideon Lack. The question is: Does AD lead to food allergy or food allergy lead to AD?
80-90% of egg allergic children have atopic dermatitis. In children with AD, 27-81% have food allergy.
Infants with early onset (before 6 months of age) of eczema, had twice the rate of food allergies compared to those with late onset eczema.
Does food allergy cause AD? A study looked at eczema exacerbations following food challenges - 50% had a delayed eczematous reaction. The triggers were wheat, milk, egg and soy (the usual suspects).
Can dietary restriction improve AD? 15 of 16 studies showed some response but variable/small effect. Benefit were noted with egg, milk, wheat avoidance.
AD is one of the 4 components of the allergic (atopic) march (click here to enlarge the image):
Loss of function filaggrin mutation was associated with 50% of moderate to severe eczema cases. However, filaggrin mutation does not play a role in African American patients with AD. About 12% of AD patients in the US have defects in fillagrin (FLG).
Filaggrin mutations increase the risk for persistent dry skin and eczema independent of sensitization (JACI, 2012).
PBL session on atopic dermatitis with Dr Schneider and Dr Hernandez-Trujillo:
Essential elements of atopic dermatitis include puritis, eczematous changes in typical distribution, chronic and relapsing.
AD differential diagnosis in adults includes:
- cutaneous T cell lymphoma (Mycosis fungoides)
- HIV associated dermatoses
- dermatomyositis
- GVHD
- pemphigious foliaceus
- drug eruptions
Barrier creams and emollients for AD include CeraVe (http://cerave.com), Mimyx, EpiCeram (http://epiceram-us.com), Eletone, Theraplex (http:/theraplex.com), Eucerin and Aquaphor.
AD exacerbation triggers:
- infections (URI/OM, bacterial, fungal, viral skin infections)
- allergens (foods,environmental, nickel)
- heat, dryness, anxiety, vaccinations
Here is my approach to Atopic Dermatitis Treatment (click to enlarge the image):
Figures:
Allergists achieved highest use of social media by any specialty
During the 2012 AAAAI meeting, the allergists achieved the highest use of social media by any specialty. There are more than 100 allergists on Twitter and 30 of them posted simultaneously from the annual meeting, broadcasting thousands of tweets tagged with #AAAAI. The annual AAAAI meeting was attended by approximately 5,000 people. In comparison, the 30 allergists on Twitter reached 250,000 people (measured by TweetReach.com on 03/04/2012).
This summary was compiled from some of the tweets posted by Dr. Melinda Rathkopf @mrathkopf. I would strongly encourage you to post updates on Twitter from the CME conferences that you are planning to attend in the future. Here is how to do it: Twitter for Physicians: How to use Twitter to keep track of the latest news and scientific meetings, and share information with colleagues and patients.
Disclaimer: The text was edited, modified, and added to by me. This is one of a series of posts that will be published during the next few weeks.