Marginal Zone illustrates Annals concepts

| August 28, 2023

Marginal Zone illustrates Annals concepts

Each issue of Annals of Allergy, Asthma and Immunology features a cartoon called “Marginal Zone” that is related to allergy/immunology. They are drawn by Erin L. Reigh, MD, MS, Assistant Professor of Medicine, Section of Allergy and Clinical Immunology at Dartmouth Hitchcock Medical Center. Dr. Reigh answered a few questions about her artistry.

You’ve been the official cartoonist for the Annals for a while now – when did you start drawing and how has it influenced your practice and teaching?

I started drawing comics when I was a kid. I’m an animal lover so they included a lot of cats! During my fellowship, I expanded my repertoire and started drawing immunology cartoons. As I was reading Abbas, I’d find my mind wandering, thinking about T cells and B cells as characters on adventures. I started drawing out the ideas and including them in my didactic presentations. I include cartoons in all my immunology lectures now. Unlike textbook diagrams, trainees really light up when they see the cartoons. It keeps them engaged, and they know I really care about the subject and want to make it meaningful to them. Plus, it gives me an excuse to keep drawing cats.

Why the name “Marginal Zone”?

As the marginal zone of the spleen separates the white pulp from the red pulp, the Marginal Zone of Annals separates the reviews from the original articles. Art imitates nature, as they say.

These cartoons are so engaging and fun – how do you come up with the ideas?

The best ideas come from letting yourself get bored. Eventually the brain finds ways to entertain itself, and you’ve got an idea. Sometimes I’m very familiar with the journal’s theme and an idea comes quickly, like “Penicillin Allergy Delabeling Kit” (May 2023), which was inspired by my own penicillin allergy quality improvement work. Other times I search for inspiration by reading. One month I was so stumped that I stopped by Marc Shaker’s office to say, “We’re doing what with biologics for food allergy now?” Which inspired July 2023’s “Umbrella.”

A favorite part of the Marginal Zone is not just the cartoons, but also the “cartootorials.”  What are the most important things you try to communicate with these clinical pearls?

I always review the literature so my cartoons are scientifically accurate. The cartootorial lets me share the interesting facts I come across in that process. Why is HHV-6 reactivation a marker for DRESS (February 2023)? Why did humans stop expressing alpha-gal (March 2023)? The cartootorial answers these burning questions in 150 words or less – surely you have enough time in your day for that?

What are your favorite Marginal Zones, and why?

I love timeline cartoons like “Venom Anaphylaxis: A History” (August 2023) because the history of medicine is so fascinating. “To Vax or Not to Vax” (July 2022) is another favorite because it allowed me to encourage COVID vaccination in a unique way. I also love “Allergen Zodiac” (June 2022) because it includes a pretty rad poem about thunderstorm asthma and a drawing of my dog Sophie.

Thanks for all your creativity, work and teaching with the Marginal Zone. If a member has feedback or questions about Marginal Zone, how can they reach you?

I love to hear from readers! Just email the editorial office at