Epicutaneous allergen administration as a novel method of allergen-specific immunotherapy  Gabriela Senti, MD, Nicole Graf, PhD, Susanne Haug, MD, Nadine.

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Epicutaneous allergen administration as a novel method of allergen-specific immunotherapy  Gabriela Senti, MD, Nicole Graf, PhD, Susanne Haug, MD, Nadine Rüedi, MD, Seraina von Moos, MD, Theodor Sonderegger, PhD, Pål Johansen, PhD, Thomas M. Kündig, MD  Journal of Allergy and Clinical Immunology  Volume 124, Issue 5, Pages 997-1002 (November 2009) DOI: 10.1016/j.jaci.2009.07.019 Copyright © 2009 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 The patch consisted of a 3 × 5 cm polyethylene pouch that was filled with grass pollen extract in Vaseline. The side of the pouch that faced the skin was perforated. The pouch was held onto the skin by a self-adhesive tape. Journal of Allergy and Clinical Immunology 2009 124, 997-1002DOI: (10.1016/j.jaci.2009.07.019) Copyright © 2009 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 Participant flow. Flowchart characterizing the study population. V4, visit 4; V5, visit 5. Journal of Allergy and Clinical Immunology 2009 124, 997-1002DOI: (10.1016/j.jaci.2009.07.019) Copyright © 2009 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 3 Local eczema reactions. At visit 2, each of 6 symptoms (erythema, edema/induration/ papule formation, excoriation, weeping/exudation/scab formation, desquamation, lichenification) was recorded as none, mild, moderate, or severe, and a sum score (0-18 points) was calculated. Verum patients (open triangles) showed significantly more local reactions than placebo patients (filled triangles; Mann-Whitney exact test, P = .03). Journal of Allergy and Clinical Immunology 2009 124, 997-1002DOI: (10.1016/j.jaci.2009.07.019) Copyright © 2009 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 4 NPTs. Scores using the allergen dose 100,000 SQ-U are depicted. The box plots show the median; the 10th, 25th, 75th, and 90th percentiles; and outliers. White box plots represent the placebo group, and gray box plots represent the allergen-treated group. Statistically significant P values are indicated where values differ from baseline (∗P < .05; ∗∗P < .01; ∗∗∗P < .001). Journal of Allergy and Clinical Immunology 2009 124, 997-1002DOI: (10.1016/j.jaci.2009.07.019) Copyright © 2009 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 5 Patient-recorded hay fever symptoms. Patients compared symptom severity during seasons 2006 and 2007 (posttreatment) with 2005 (pretreatment) and recorded scores between –10 (worst possible deterioration) and +10 (best possible improvement). Patients receiving verum (filled boxes) reported better improvement than placebo patients (open boxes; 2006, P = .02; 2007, P = .005). Box plots show median; 10th, 25th, 75th, and 90th percentiles; and outliers. Journal of Allergy and Clinical Immunology 2009 124, 997-1002DOI: (10.1016/j.jaci.2009.07.019) Copyright © 2009 American Academy of Allergy, Asthma & Immunology Terms and Conditions