New Eczema Guidelines from the Allergy Societies: Takeaways and Surprises

Frustrated by eczema care that ignores patient priorities? New guidelines from the medical societies for allergists and immunologists may help change that. These guidelines were informed by the views of eczema patients and caregivers and based on evidence (hallelujah!). We chat with the guideline co-authors Dr. Lynda Schneider, founder and director of the Atopic Dermatitis Center at Boston Children’s Hospital, and Dr. Derek Chu, director of the challenge clinic for allergy diagnosis, research and treatment at McMaster University, about some of the new and surprising ideas they recommend.  Research mentionedAtopic dermatitis guidelines: 2023 Is Food-Triggered Atopic Dermatitis a Form of Systemic Contact Dermatitis?

Five GPER staff members attended the American Academy of Dermatology conference in February, the biggest gathering of dermatologists worldwide.  We bring you the newest treatments and latest research straight from the source.  Join our conversation with GPER staffers Korey Capozza, Kara Orevillo, Christine Cutaran and Michelle Tu about what stood out this year.  (And if you like our podcast, consider supporting it with a tax deductible donation).

Could we cure allergies by taking probiotics or transplanting the gut microbiome from a healthy person? What does all this mean for eczema/allergy prevention? To find out, join our conversation with Dr. Rima Rachid, allergist and immunologist at Harvard Children’s Hospital, and Meenal Lele, eczema mom and author of Baby and the Biome. We discuss the promising trials with fecal microbiota transplants for food allergic children as well as the best probiotic to take for eczema and when it’s important to take it. (And if you like our podcast, consider supporting it with a tax deductible donation). Literature featured in this podcastThe microbial origins of food allergyEvaluating the Safety and Efficacy of Oral Encapsulated Microbiota Transplantation Therapy in Peanut Allergic Patients Lactobacillus rhamnosus Used in the Perinatal Period for the Prevention of Atopic Dermatitis in InfantsThe Baby and the Biome book

The winners of the 2023 Big Ideas for Eczema contest share their novel ideas and how they came up with them.  Our citizen scientist winners are Elizabeth Shores, Hannah Mitchell and Armando de la Libertad.  Would you try these ideas?   (If you like our podcast consider supporting it with a tax deductible donation.) If you have an idea of your own, find out more about the Big Ideas 2024 competition here. 

What are the top research discoveries of 2023 related to eczema? Tune in to learn about new, needle-free Epi-Pen alternatives, painless tests for detecting eczema before it appears, and insights about how to address anxiety and depression related to eczema. Guests include Albert Chong of University of Southern California, Dr. Ruchi Gupta of Northwestern University, Dr. Ian Myles of NIH, and Dr. Kiwako Yamamoto-Hanada of National Children's Hospital, Tokyo. P.S. If you like our podcast, consider making a donation to GPER!Research discussed in this podcastmRNAs in skin surface lipids unveiled atopic dermatitis at 1 monthPatients' and Caregivers' Preferences for Mental Health Care and Support in Atopic Dermatitis Innovations in the treatment of anaphylaxis: A review of recent data - ScienceDirectPharmacokinetics and pharmacodynamics of epinephrine sublingual film versus intra-muscular epinephrine - Journal of Allergy and Clinical ImmunologyShotgun metagenomic sequencing on skin microbiome indicates dysbiosis exists prior to the onset of atopic dermatitis

Can moisturizers help prevent eczema? If so: when, what and how should they be applied? Can probiotics help? If so: who should take them - mother or baby? These questions and more are answered by Helen Brough, pediatric allergist and head of service at Evelina London Children's Hospital (UK). As part of our recent research symposium, she explains what research is going on in eczema management and prevention and what is still needed to make prevention a reality. She also has important tips for eczema care now. (If you like our podcast consider supporting it with a tax deductible donation.)Research discussed in this episodeEarly initiation of short-term emollient use for the prevention of atopic dermatitis in high-risk infants—The STOP-AD randomised controlled trialSkin care interventions in infants for preventing eczema and food allergyProbiotic supplementation for prevention of atopic dermatitis in infants and children: a systematic review and meta-analysisEarly intervention and prevention of allergic diseasesEmollients in infancy to prevent atopic dermatitis: a systematic review and meta‐analysisEpicutaneous sensitization in the development of food allergy: what is the evidence and how can this be prevented?

New biological therapies like dupilumab target Type 2 inflammation, but new research shows they are also modifying the skin microbiome. In this episode we discuss what Type 2 inflammation is, why it matter in eczema, and how it modifies the microbiome. Our guest is Dr. Lisa Beck (Co-Director of the Center for Allergic Disease Research, University of Rochester Medical Center, NY) who has dedicated her 35 year career to understanding why some eczema patients are susceptible to skin infections and finding safe and effective eczema treatments.Research associated with this podcastType 2 Inflammation Contributes to Skin Barrier Dysfunction in Atopic DermatitisTralokinumab treatment improves the skin microbiota by increasing the microbial diversity in adults with moderate-to-severe atopic dermatitisRapid Reduction in Staphylococcus aureus in Atopic Dermatitis Subjects Following Dupilumab Treatment

Dupixent has transformed the lives of people with moderate to severe eczema, but will patients need to use it indefinitely? In this episode we explore tapering Dupixent (also known as dupilumab) with two researchers from University Medical Center Utrecht in the Netherlands that have created a patient-led roadmap for successful tapering. They are: Pediatric Dermatologist Dr. Marlies de Graaf, Head of the National Expertise Center of Atopic Dermatitis in Children; and Dr. Celeste Boesjes, who is a PhD candidate and Medical Doctor.Research Discussed in this PodcastSuccessful tapering of dupilumab in atopic dermatitis patients with low disease activity: a large pragmatic daily practice study from the BioDay registryAssociation of serum dupilumab levels at 16 weeks with treatment response and adverse effects in patients with atopic dermatitis: a prospective clinical cohort study from the BioDay registryPatient‐centered dupilumab dosing regimen leads to successful dose reduction in persistently controlled atopic dermatitisDupilumab in daily practice for the treatment of pediatric atopic dermatitis: 28‐week clinical and biomarker results from the BioDay registryDupilumab dose spacing after initial successful treatment or adverse events in adult patients with atopic dermatitis: a retrospective analysis

Itch. It’s the hallmark symptom of eczema and the most troublesome. In this podcast we discuss why the eczema itch is so hard to treat and explore effective treatment options. We have the privilege of speaking with Dr. Shawn Kwatra, international leader in chronic itch research and Director of John Hopkins Itch Centre in Baltimore, and Dr. Shivani Patel, a practicing pediatric dermatologist who specializes in treating children with eczema. (If you like our podcast consider supporting it with a tax deductible donation.)Research discussed in this podcastMolecular and cellular mechanisms of itch and pain in atopic dermatitis and implications for novel therapeuticsCumulative Use of Strong Anticholinergics and Incident DementiaLiving with Itch - A Patient's Guide

What do microplastics, dishwasher rinse-aid, air pollution and processed foods have to do with eczema? Join us as we explore why allergic diseases were rare for our grandparents but now affect two billion people worldwide.   Explaining the link is our guest, Professor Cezmi Akdis. He is a global leader in immunology, specializing in allergic diseases, editor-in-chief of Allergy, and a Professor at the University of Zurich in Switzerland.  (If you like our podcast consider supporting it with a tax deductible donation.)Research discussed in this podcast:Scrubbing away our collective healthDoes the epithelial barrier hypothesis explain the increase in allergy, autoimmunity and other chronic conditions?Gut epithelial barrier damage caused by dishwasher detergents and rinse aidsEpithelial barrier hypothesis: Effect of the external exposome on the microbiome and epithelial barriers in allergic disease