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The etiopathogenesis of AD is multifactorial and defects of the skin barrier, which physiologically constitutes the natural protection, are associated with the disease phenotype. The identification of the genetic and environmental factors paving the way for impaired barrier function is therefore important in developing new therapeutic and prevention strategies.Confirmed 100 cases were tested against 106 controls for filaggrin mutation and LELP-1 polymorphism by PCR-RFLP and chain termination sequencing. Total IgE and Vitamin D were estimated by ELISA. House dust mite sensitization was assessed by an in-vivo skin prick test.FLG deletion (2282del4) was present in 4% of the patients and all these were heterozygous carriers, whereas FLG null mutation (R501X) was not present in any of the cases. In the control group, both the mutations were not found. CT genotype and T allele of LELP-1 (rs7534334) were significantly associated with elevated IgE levels, early-onset, HDM sensitization, and disease severity (P 0.05). However, the genotypic and allelic distribution of LELP-1 among the cases and controls was found to be insignificant.The low frequency of 2282del4 deletion and the absence of R501X mutation suggest that filaggrin deficiency does not confer a major risk for AD in the Indian population. However, significant association of LELP-1 (rs7534334) variant allele with clinical variables may serve as a novel biomarker for the severity of Atopic Dermatitis as well as an indicator for the allergen-specific immunotherapy and hence bears important clinical implications and needs to study on larger sample size and diverse populations.

Background: Allergic diseases are hypersensitivity disorders induced by an allergen specific immunoglobulin E (IgE) mediated response; Skin PrickTest (SPT) remains the gold standard for the in vivo assessment of IgEs. Many drugs are known to have anti histaminic effects and as such need to be stopped prior to the testing. However, the role of alternative system of medicine and other herbal remedies remains controversial in this regard. Objectives: To study the effect of alternative system of medicine and other herbal remedies on the results of SPT. Methods: The patients having a strong history and clinical symptoms of allergic diseases like allergic rhinitis, bronchial asthma and chronic urticaria were subjected to skin prick testing. Results: There were six patients whose SPT results were negative although history and clinical symptoms suggested otherwise. On probing the drug intake of the patients prior to the testing, it was observed that the patients had taken certain herbal medications which interfered with the allergy testing and gave false negatives. Conclusion: It is for the first time that a study has reported the significant effect of alternative medicine and other herbal supplements in suppression of skin prick test results. Therefore it is extremely important to ask properly the history of intake of alternative medicine and other dietary herbal ingredients and then insist on its abstinence for 10 days before SPT. A protocol wherein the allergist recommends to stop the use of any regional herbs prior to allergy testing will be the right step in improving the results of allergy testing and preventing false positives. Keywords: Allergic disorders, Skin prick testing (SPT), Alternative medicine, Antihistaminic response

Sublingual immunotherapy (SLIT) with house dust mite (HDM) preparation has been shown to reduce disease severity in patientswith atopic dermatitis (AD). A 5-year-old girl with severe Atopic Dermatitis refractive to all possible pharmacotherapy was put onSLIT for dust mite and followed up for a period of one year. SLIT to dust mite proved highly effective in reducing the disease severityscore as well as prevention of exacerbations in this patient.