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Immunological changes associated with the onset of atopic dermatitis and a primer on cost effectiveness in the allergy clinic

| August 26, 2019

Immunological changes associated with the onset of atopic dermatitis and a primer on cost effectiveness in the allergy clinic

We are in the home stretch of the summer months. It will soon be Labor Day and we will be into football season and perhaps more relevant to us, fall weed season. I hope all of you have had an opportunity to peruse the August issue of the Annals of Allergy, Asthma and Immunology. We try to provide something for everyone along the clinical spectrum of our specialty. The emphasis this month is cutaneous allergy.  A review by Patrick Brunner, MD from New York provides an excellent overview of new information regarding the immunological changes associated with the onset of atopic dermatitis (AD). He presents information to suggest prenatal and antenatal changes in infants who were subsequently at risk to develop AD. He further reports on the Th2/Th22 imbalance and skin defects (in lipid barrier deposition and tight junction defects) as part of the pathophysiological risk profile and differentiates these profiles between pediatric and chronic adult versions of AD. This is an excellent opportunity to solidify concepts in this complex area that will improve our care of both children and adults with AD.

The cost of doing business always seems to increase at a rate that often outpaces improved revenues. This drives us to re-evaluate our clinical and business practices so we can optimize our margins to take care of our patients in exemplary fashion while still being able to feed our families. A review by Marcus Shaker, MD, FACAAI and Matthew Greenhawt, MD, FACAAI in this month’s issue provides a primer on cost effectiveness in the allergy clinic. They methodically explain the impact of cost effectiveness analyses to demonstrate how to optimize what we do from an economic standpoint. This is necessary as our American payer model evolves away from simple fee for service. This is a must read that you might also share with your office and/or business managers.

I hope everyone has a safe and restful Labor Day weekend coming up soon. Gearing up for fall season will make the time fly and, before we know it, we will be into the autumn season with shorter days and cooler temperatures. I hope the Annals is meeting your intellectual and practice-related needs. I look forward to seeing and greeting many of you at our annual meeting in Houston. As always, your feedback is welcome.

Gailen D. Marshall, Jr., MD PhD FACAAI
Editor-in-chief

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