Methods: We analyzed 40 patients with diagnosis of moderate/severe AD based on the SCORAD and allergological work-up in patients under follow-up in the Allergy Department of our Hospital between 2012 to 2014. The specific-immunotherapy was indicated based on the dust mite specific-IgE (Dermatophagoides pteronyssinus and/or Blomia tropicalis) and clinical relevance of these allergens. All the patients underwent cluster SCIT and were evaluated every 03 months considering the SCORAD and the need of systemic and topical medications during the first year. The follow up was proceeded by the same group of physicians.
Results: Of all 40 patients, 50% were women and the mean age was 12.4 years. Thirty-five (87%) patients had AD associated with other atopic diseases; 100% with allergic rhinitis and 14% with asthma. The median of SCORAD in the first evaluation was 38.9 and decreased to 5.1 after one year of SCIT (P <0.001). None of the patients had significant adverse reactions during the SCIT. All of them were in use of systemic anti-histaminic drugs in the first evaluation (70% more than twice per day); but after one year, 5% of those patients were in use of these drugs at the time of the last evaluation (P <0.001). Thirty-five patients (88%) were in use of topical corticosteroids (23% twice per day) before the SCIT and eight (20%) were in use of the same drugs once per day in the last evaluation (P <0.001).
Conclusions: This first Brazilian experience on achieving the effect of SCIT in moderate/severe AD, showed that the house-dust mite SCIT is effective in the management of moderate/severe AD, reducing the SCORAD and the use of both systemic and topical medications, but larger controlled prospective multi-centric studies shall respond to the question whether AD alone may be an indication of SCIT.