The Annual Scientific Meeting of the American College of Allergy, Asthma, and Immunology (ACAAI) was held in Boston, MA from October 24-28, 2024. This prestigious event provided a platform for esteemed thought leaders to share their expertise and innovative ideas, fostering discussions and collaborations that are essential for driving progress in the healthcare field.

A significant focus of the ACAAI 2024 Annual Scientific Meeting was on allergic skin conditions. The following are concise summaries of studies presented at the event that aimed to advance the most effective treatment options for managing allergic skin conditions:

New-onset Autoimmune Progesterone Dermatitis After In Vitro Fertilization

  • Autoimmune progesterone dermatitis (AIPD) is a rare hypersensitivity reaction to progesterone characterized by cyclical symptoms. These symptoms can vary from skin rashes to severe anaphylaxis and typically occur during the luteal phase of the menstrual cycle. While AIPD is uncommon, there have been a few documented cases of individuals developing this condition as a result of exogenous progesterone used in infertility treatments. In this study, the authors present a unique case of new-onset AIPD secondary to in vitro fertilization (IVF) treatment. This case highlights the importance of recognizing and managing potential adverse reactions to progesterone therapy, particularly in the context of assisted reproductive technologies. AIPD in the context of multiple IVF treatments poses a significant obstacle for women striving to conceive.
  • Women undergoing fertility treatments are often exposed to high doses of progesterone, yet there is a lack of scientific literature addressing the emergence of AIPD as a result of such elevated levels of exogenous progesterone in IVF patients. Various desensitization protocols have been developed for AIPD, whether stemming from hormonal contraceptives or fertility treatments, with options for either a gradual or rapid protocol depending on the individual’s circumstances. In a specific case, a patient underwent a rapid 1-day progesterone desensitization protocol due to the precise timing requirements of the IVF procedure. This case underscores the significance of conducting an allergy evaluation and the positive impact that progesterone desensitization can have on managing AIPD.
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Attention-Deficit Hyperactivity Disorder in Pediatric Patients with Atopic Dermatitis

  • Recent research indicates that individuals with atopic dermatitis (AD) may have a higher likelihood of being diagnosed with attention deficit hyperactivity disorder (ADHD). To further investigate this correlation, we analyzed patient data obtained from a prominent children’s hospital. Additionally, we examined whether the severity of AD was linked to an elevated probability of having ADHD. Children with AD who are treated at our hospital are more than twice as likely to also have a diagnosis of ADHD. The likelihood of being diagnosed with both ADHD and AD is higher among black children and males compared to white children and females. Patients with both AD and ADHD are more likely to have Atopy and psychiatric disorders than those with either condition alone. The likelihood of being diagnosed with ADHD is higher in patients with mild AD compared to those with moderate or severe AD.
  • The results of this study align with existing research indicating a correlation between AD and ADHD. This study contributes novel demographic information to enhance the understanding of this relationship. Furthermore, our findings indicate that as the severity of AD increases, the likelihood of being diagnosed with ADHD decreases.
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The Association of Longitudinal AD Phenotypes and ADHD in Childhood

  • Atopic dermatitis (AD) and attention-deficit/hyperactivity disorder (ADHD) are prevalent chronic pediatric conditions that have a significant impact on quality of life, particularly in terms of sleep disturbance and development. Previous studies have shown high rates of co-occurrence between AD and ADHD, but the association of longitudinal AD phenotypes with ADHD has not been thoroughly investigated. The researchers hypothesized that longitudinal AD phenotypes in pre-adolescence are linked to an elevated risk of developing ADHD.
  • In contrast to previous reports of the co-occurrence of AD and ADHD, our study did not uncover any association between longitudinal AD phenotypes and ADHD by age 10. Furthermore, the researchers did not observe an increased risk of ADHD with any AD phenotypes. This discrepancy may be attributed, at least in part, to prior studies involving populations that differ from those in our birth cohort.
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Relationship between Food Deserts and Pediatric Atopic Dermatitis in Rhode Island

  • Access to nutritious and affordable food plays a crucial role in determining various health outcomes. Previous research has indicated that consuming processed foods, such as fast food, processed meats, pickled vegetables, instant noodles, and soda, is linked to atopic dermatitis (AD). Additionally, studies have suggested that living in food deserts, areas where grocery stores are more than one mile away from residences, may be associated with atopic diseases like asthma and food allergies. In order to further explore the potential relationship between residing in a food desert and the prevalence of AD among children in Rhode Island, the study was conducted. This research aims to shed light on the impact of food accessibility on health outcomes, particularly in relation to atopic dermatitis. 
  • This retrospective study revealed that residing in a designated food desert area did not have a significant impact on the prevalence of AD in the community. However, further investigation is necessary to determine the generalizability of these findings to other communities.
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A Survey of Parental Eczema Perceptions and its Relationship to Dietary Intake in South Florida

  • Children who have been diagnosed with atopic dermatitis (AD) are at an increased risk of developing food allergies. However, it is important to note that food elimination diets are not recommended as a treatment for patients who are able to tolerate foods orally, according to the ACAAI/AAAAI/AAD 2023 Practice Parameters. 
  • The survey found that parents’ understanding of AD and its connection to diet had a significant impact on their children’s eating habits. Despite implementing elimination diets, only one-third of respondents reported seeing a slight improvement in their children’s AD lesions.
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Efficacy and Safety of Ruxolitinib Cream in Children With Atopic Comorbidities: TRuE-AD3 Subgroup Analysis

  • Patients with atopic dermatitis (AD), a highly itchy inflammatory skin disease, often experience additional health conditions as part of a progression of allergic conditions known as the atopic march during infancy and childhood. These comorbidities, such as food allergies, asthma, and allergic rhinitis, indicate an underlying type 2 inflammation. In a recent phase 3 clinical trial known as TRuE-AD (NCT04921969), the use of Ruxolitinib, a JAK1/JAK2 inhibitor cream, showed promising results in reducing inflammation and relieving itching in children with AD. The study was double-blind, randomized, and vehicle-controlled, demonstrating the cream’s efficacy and safety.
  • Among patients with atopic comorbidities at the beginning of the study, those who applied either 0.75% or 1.5% Ruxolitinib cream experienced significantly greater reductions in their Patient-Oriented Eczema Measure (POEM) scores at Week 2 compared to those using the vehicle alone. These improvements were maintained or further enhanced by Week 8, as shown in Figure 4. Similar positive outcomes were observed among patients without atopic comorbidities, highlighting the potential benefits of Ruxolitinib cream in managing AD symptoms regardless of additional allergic conditions.
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A Comparative Effectiveness Analysis of Topical vs Systemic Corticosteroids for DRESS Syndrome

  • There is currently a lack of randomized controlled trials evaluating the efficacy of treatment for Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome. The standard treatment approach involves promptly discontinuing the offending drug and administering systemic steroid therapy. Recent observational data has indicated that in certain cases, topical corticosteroids alone may be effective in treating DRESS syndrome. The objective of this study was to compare treatment outcomes in patients with DRESS syndrome who were treated with either topical or systemic steroids.
  • The systemic steroid group showed a tendency towards lower mortality rates but longer hospital stays. Although no statistically significant differences were observed, there was a trend towards more favorable mortality outcomes in the systemic steroid group compared to the topical steroid group. Additionally, over 50% of patients in the topical steroid group eventually required systemic steroids. Based on the findings, it is advisable to exercise caution when considering treatment with topical steroids alone for DRESS syndrome.
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The Association of Atopic Dermatitis and Asthma Among Asian American and Pacific Islander Children

  • Research studies have indicated a higher prevalence of atopic dermatitis (AD) in Asian countries compared to estimates among non-Hispanic White adults. However, there is a lack of research on AD prevalence among Asian American and Pacific Islander (AAPI) children. AD has been associated with asthma through the concept of the atopic march, yet the connection between AD and asthma among AAPI groups remains understudied. Previous research has shown that East Asians with AD exhibit unique immune dysregulation, highlighting the importance of identifying sub-populations at higher risk who may benefit from targeted therapies. The aim of this study is to investigate the prevalence of atopic dermatitis among AAPI subgroups across different childhood age groups and to explore the association between AD and asthma in children within racial and ethnic groups, including AAPI subgroups.
  • The findings show that AD prevalence is consistently higher among AAPI subgroups compared to non-Hispanic White children, particularly among Filipino and Chinese children. These trends remain consistent across different age groups. Furthermore, our research reveals that across all groups, AD is associated with a twofold increased risk of asthma, supporting the concept of the atopic march within the AAPI population. 
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Thank you for joining us for this recap of the ACAAI 2024. We recommend visiting this link to explore all the posters presented at the event, including ongoing trials. We look forward to seeing you at ACAAI 2025 in Orlando, FL!

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