{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T11:00:28Z","timestamp":1766401228490,"version":"3.40.5"},"reference-count":13,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,5,29]],"date-time":"2023-05-29T00:00:00Z","timestamp":1685318400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Dermatology"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>House dust mite (HDM) is the most common allergen exacerbating atopic dermatitis (AD), and allergen\u2010specific immunotherapy (AIT) using HDM exhibited significant improvements in previous studies. Alopecia can occur as a complication of AD. Alopecia totalis (AT), a severe form of alopecia areata (AA), does not respond well to treatment and the chance of full recovery is less than 10%. For extensive hair loss, topical immunotherapy such as diphenylcyclopropenone (DPCP) is used as the first\u2010line treatment. However, since DPCP is a kind of contact allergen, it has the potential to exacerbate AD. A 38\u2010year\u2010old man with AD and AA visited our clinic with symptoms worsening from 3\u2009months ago. Although taking oral methylprednisolone (8\u2009mg\/day) and cyclosporine (100\u2009mg\/day) for 3\u2009months, he has lost over 90% of his hair and the Eczema Area and Severity Index (EASI) was 43. Total serum immunoglobulin E (IgE) levels were 4454 kU\/L (normal &lt;100\u2009kU\/L) and the specific IgE levels for <jats:italic>Dermatophagoides pteronyssinus<\/jats:italic> and <jats:italic>Dermatophagoides farinae<\/jats:italic> following ImmunoCAP\u00ae were 20.8 and 37.4\u2009kU\/L, respectively. This patient did not respond well to previous treatment and was reluctant to use long\u2010term steroids, so subcutaneous AIT using HDM was administered along with oral cyclosporine (100\u2009mg\/day). Topical tacrolimus was also applied to the AD lesions throughout the body. To reduce itching, nonsedative antihistamines were used if necessary. Hair loss was almost completely improved 1\u2009year after the AIT initiation and the skin lesions of AD also improved (EASI 2.4). The specific IgE levels for <jats:italic>D. pteronyssinus<\/jats:italic> and <jats:italic>D. farinae<\/jats:italic> were 3.73 and 7.16\u2009kU\/L, respectively. Herein, we report a patient with promising results following AIT for AT with severe AD. In severe alopecic patients with AD refractory to conventional treatment, including immunosuppressants, AIT could be considered as a treatment option.<\/jats:p>","DOI":"10.1111\/1346-8138.16841","type":"journal-article","created":{"date-parts":[[2023,5,30]],"date-time":"2023-05-30T06:49:26Z","timestamp":1685429366000},"page":"1353-1356","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Allergen\u2010specific immunotherapy improves alopecia totalis in a severe atopic dermatitis patient"],"prefix":"10.1111","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1314-6829","authenticated-orcid":false,"given":"Il Joo","family":"Kwon","sequence":"first","affiliation":[{"name":"Department of Dermatology and Cutaneous Biology Research Institute Yonsei University College of Medicine  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0076-0478","authenticated-orcid":false,"given":"Jung Won","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Cutaneous Biology Research Institute Yonsei University College of Medicine  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2280-1605","authenticated-orcid":false,"given":"Su Min","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Cutaneous Biology Research Institute Yonsei University College of Medicine  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4361-1819","authenticated-orcid":false,"given":"Kwang Hoon","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Cutaneous Biology Research Institute Yonsei University College of Medicine  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3856-1201","authenticated-orcid":false,"given":"Chang Ook","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Cutaneous Biology Research Institute Yonsei University College of Medicine  Seoul South Korea"},{"name":"Institute of Allergy Yonsei University College of Medicine  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,5,29]]},"reference":[{"doi-asserted-by":"publisher","key":"e_1_2_6_2_1","DOI":"10.1016\/j.jaci.2020.02.030"},{"doi-asserted-by":"publisher","key":"e_1_2_6_3_1","DOI":"10.3349\/ymj.2016.57.2.393"},{"doi-asserted-by":"publisher","key":"e_1_2_6_4_1","DOI":"10.1016\/j.jaip.2021.10.060"},{"doi-asserted-by":"publisher","key":"e_1_2_6_5_1","DOI":"10.1016\/j.jaci.2013.02.044"},{"doi-asserted-by":"publisher","key":"e_1_2_6_6_1","DOI":"10.1111\/exd.14027"},{"doi-asserted-by":"publisher","key":"e_1_2_6_7_1","DOI":"10.1016\/j.det.2012.08.010"},{"doi-asserted-by":"publisher","key":"e_1_2_6_8_1","DOI":"10.1111\/ijd.13612"},{"doi-asserted-by":"publisher","key":"e_1_2_6_9_1","DOI":"10.3906\/sag-1807-230"},{"doi-asserted-by":"publisher","key":"e_1_2_6_10_1","DOI":"10.1007\/s10238-020-00673-w"},{"doi-asserted-by":"publisher","key":"e_1_2_6_11_1","DOI":"10.1016\/j.jaip.2020.01.052"},{"doi-asserted-by":"publisher","key":"e_1_2_6_12_1","DOI":"10.1111\/ced.12471"},{"doi-asserted-by":"publisher","key":"e_1_2_6_13_1","DOI":"10.1016\/j.jaip.2021.03.010"},{"doi-asserted-by":"publisher","key":"e_1_2_6_14_1","DOI":"10.1016\/j.jaci.2022.09.020"}],"container-title":["The Journal of Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1346-8138.16841","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T09:19:16Z","timestamp":1696411156000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1346-8138.16841"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,29]]},"references-count":13,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2023,10]]}},"alternative-id":["10.1111\/1346-8138.16841"],"URL":"https:\/\/doi.org\/10.1111\/1346-8138.16841","archive":["Portico"],"relation":{},"ISSN":["0385-2407","1346-8138"],"issn-type":[{"type":"print","value":"0385-2407"},{"type":"electronic","value":"1346-8138"}],"subject":[],"published":{"date-parts":[[2023,5,29]]},"assertion":[{"value":"2023-02-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-05-06","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-05-29","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}