Successful treatment of atopic dermatitis with house dust mite sublingual immunotherapy tablets

Ploykarn Kiatiwat,¹ Wat Mitthamsiri,¹ Tadech Boonpiyathad,¹ Panitan Pradubpongsa,¹ Atik Sangasapaviliya¹

¹ Division of Allergy and Clinical Immunology, Department of Medicine, Phramongkutklao Hospital, Bangkok, Thailand

Abstract

Background: Atopic dermatitis (AD) is the most common chronic inflammatory skin disease. Allergen-specific immunotherapy is a treatment option for selected patients with severe AD sensitization to house dust mites (HDM).
Objective: To report the first case of successful treatment with HDM sublingual immunotherapy (SLIT) tablets in patients with severe AD.
Method: A Thai male patient with HDM sensitization and severe AD who had not responded to topical corticosteroids and calcineurin inhibitors underwent 1 month of HDM subcutaneous immunotherapy (SCIT), after which his skin symptoms were minimally improved. He lost follow-up SCIT and the symptoms worsened, with large wheal lesions appearing at the SCIT injection site, so we decided to switch from SCIT to HDM SLIT tablets.
Results: After the SLIT treatment, the AD and skin lesions improved and the medication could be stopped.
Conclusion: HDM SLIT might be an alternative treatment in patients with HDM sensitization and severe AD who are refractory to conventional treatment.
Key words: house dust mites, allergen-specific immunotherapy, atopic dermatitis, SLIT, SCORAD