Allergen‐specific immunotherapy improves alopecia totalis in a severe atopic dermatitis patient

A 38-year-old man with severe atopic dermatitis (AD) and alopecia totalis (AT) showed significant improvement after undergoing allergen-specific immunotherapy (AIT) using house dust mite (HDM) allergens. Despite previous treatments with oral methylprednisolone and cyclosporine, the patient had lost over 90% of his hair and had a high Eczema Area and Severity Index (EASI) score of 43. After 1 year of AIT combined with oral cyclosporine and topical tacrolimus, the patient's hair loss was almost completely resolved, and his EASI score improved to 2.4. The specific IgE levels for Dermatophagoides pteronyssinus and Dermatophagoides farinae also decreased significantly. This case suggests that AIT could be a viable treatment option for severe alopecia in patients with AD who do not respond to conventional treatments.