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Dupilumab, an anti-IL (Interleukin) -4 receptorα mAb, inhibits IL-4/IL-13 signaling and is indicated for the treatment of inadequately controlled AD, asthma and CRSwNP because IL-4/IL-13 signaling is a key driver of type2/Th2 immune diseases (atopic/allergic diseases). As well as the above diseases, a therapeutic effect of dupilumab on PAR can be expected. We investigated the effect of dupilumab on PAR in severe AD patients with comorbid PAR.Prospective observational study. 21 severe AD patients with PAR who started dupilumab were enrolled and we devided them into 2 groups: more than moderate group and less than moderate group. We investigated subjective symptoms, QOL scores, face scale, findings of nasal cavity and laboratory findings before start of therapy and 12 months later.In more than moderate group, significant improvements were observed in subjective symptoms (except a part), QOL scores (except a part), face scale and findings of nasal cavity. On the other hand, in less than moderate group, no improvement was observed in all items. Subjective symptom assessments were estimated lowlier than objective finding assessments.Dupilumab has a therapeutic effect on severe PAR in severe AD patients.

A 16-year-old male high-school student experienced generalized itchy wheal and dyspnea during physical exercise after lunch. Each food material of his lunch was examined using a prick-prick test, allergen-specific IgE test (ImmunoCAP

Two cases of generalized urticaria after the dental treatment were reported. These cases had clearly positive RAST to formaldehyde, whereas skin prick testings were negative. We diagnosed them as type I allergy due to formaldehyde. Immediate type formaldehyde allergy is not widely recognized as a major allergic complication of dental treatment. Previous reports of immediate allergy to formaldehyde in dental treatment were reviewed. The characteristics are the followings, first, it tends to represent severe symptom like anaphylaxis, second, the symptom often appears a few hours later than usual cases of anaphylaxis. Allergen tests show highly positive ratio to formaldehyde RAST, whereas skin prick test often shows false negative. Assessment of specific IgE to formaldehyde is a useful and a diagnostic measurement, and is recommended in patients at risk.