Initial validation of the Burden of Disease in Atopic Eczema instrument, a quality of life measure for adult atopic dermatitis

Abstract

The Harmonizing Outcome Measures for Eczema (HOME) initiative identified quality of life (QoL) as a core outcome domain that should be assessed in all atopic dermatitis (AD) trials.¹ However, based on a systematic review of the measurement properties of QoL instruments, HOME could not reach consensus on which QoL instrument should be recommended for adult AD.^2,3 In response to the need for a valid QoL instrument, we developed the Burden of Disease in Atopic Eczema (BODE) instrument.

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Issue Information

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Clinical Snippets

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Patients with psoriasis are frequently using sunbeds

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EAACI Guidelines on Allergen Immunotherapy: Executive Statement

Abstract

The allergist's community has recently celebrated 100 year of Allergen Immunotherapy (AIT). Unfortunately the implemention of this treatment is still impaired by some challenges. With the diversity of definitions, methodology and different allergen products used, research studies have produced conflicting outcomes. This has resulted in confusion about the benefits and risks of AIT amongst policymakers and professionals, as well as in the variable availability of AIT products, regulation and reimbursement policies globally. In 2015 EAACI initiated the AIT Guidelines project as part of the Presidential plan in order to settle the controversies.

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Prediction of the severity of allergic reactions to foods

Abstract

Background

There is currently considerable uncertainty regarding what the predictors of the severity of diagnostic or accidental food allergic reactions are, and to what extent the severity of such reactions can be predicted.

Objective

To identify predictors for the severity of diagnostic and accidental food allergic reactions and to quantify their impact.

Methods

The study population consisted of children with a double-blind, placebo-controlled food challenge (DBPCFC) confirmed food allergy to milk, egg, peanut, cashew nut and/or hazelnut. The data was analyzed using multiple linear regression analysis. Missing values were imputed using multiple imputation techniques. Two scoring systems were used to determine the severity of the reactions.

Results

734 children were included. Independent predictors for the severity of the DBPCFC reaction were: age (B=0.04, p=0.001), skin prick test ratio (B=0.30, p<0.001), eliciting dose (B=-0.09, p<0.001), level of specific immunoglobulin E (B=0.15, p<0.001), reaction time during the DBPCFC (B=-0.01, p=0.004), and severity of accidental reaction (B=0.08, p=0.015). The total explained variance of this model was 23.5%, and the eliciting dose only contributed 4.4% to the model. Independent predictors for more severe accidental reactions with an explained variance of 7.3% were: age (B=0.03, p=0.014), milk as causative food (B=0.77, p<0.001), cashew as causative food (B=0.54, p<0.001), history of atopic dermatitis (B=-0.47, p=0.006), and severity of DBPCFC reaction (B=0.12, p=0.003).

Conclusions

The severity of DBPCFCs and accidental reactions to food remain largely unpredictable. Clinicians should not use the eliciting dose obtained from a graded food challenge for the purposes of making risk-related management decisions.

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Mild phenotype of junctional epidermolysis bullosa with pyloric atresia due to a novel mutation of the ITGB4 gene

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