Center of Excellence in Eczema
The Department of Dermatology at The Mount Sinai Hospital is dedicated to research, diagnosis, and treatment of all forms of eczema (also known as atopic dermatitis) and associated conditions, such as viral and bacterial infections, skin allergies, namely allergic contact dermatitis. The Center of Excellence in Eczema at The Mount Sinai Hospital is unique in it combines our search for new molecules to create new therapies for the disease in our laboratory with state-of-the-art treatment for eczema patients.
Eczema Research and Clinical Trials
For many years, an active debate existed as to whether the primary defect involves the skin barrier or an immune deficiency. Recent therapeutic advancements point to a role of particular molecules in the development of eczema. Particularly, clinical trials with a specific immune antagonist demonstrated rapid reversal of disease activity, providing proof of its immune nature and opening the door to for targeted therapeutics. Biologic therapies have the potential to produce fewer side effects than traditional immune suppressants used widely to treat severe eczema.
The Mount Sinai Hospital is among the few centers in the United States offering many clinical trials with novel therapeutics developed for patients with moderate to severe eczema that target different pathways which are up-regulated in the disease. Some of these developments directly stem from research from our Eczema Program, such as a treatment targeting a new T lymphocyte, Th22, which we found to be highly increased in eczema cases and associated with disease activity.
We are happy to be able to offer our patients access to all the novel therapeutics that are being actively tested for patients with moderate to severe eczema, currently offered only at select sites in the United States and worldwide.
Comprehensive Evaluation and Care
At the Center of Excellence in Eczema, our board certified physicians have extensive knowledge in the diagnosis and treatment of eczema, as well as in the mechanisms underlying the disease. We are able to provide a bedside-to-bench-and-back approach to patient care, which will ultimately improve patients' therapeutic options. Patients are referred to our Eczema Center from all parts of New York tri-state area and other regions in the northeast. Those seeking treatment at Mount Sinai benefit from an expert, comprehensive evaluation and therapies tailored according to their individual needs. Since we specialize in treatment of eczema, we have high rates of success in achieving sustained disease improvement.
We also specialize in testing for allergic skin reactions that are often contributing to disease exacerbations in patients with eczema, especially since food allergies also are increasingly recognized as possibly contributing to exacerbation of eczema, particularly in children and adolescents. In case food allergies are suspected, patients will be referred to food allergy testing at the allergy experts of the Jaffe Food Allergy Institute at Mount Sinai.
Eczema is the number one inflammatory skin disease, affecting three percent of adults in the United States. Yet, unlike psoriasis, another common inflammatory skin disease that is currently treated successfully using specific therapies targeting single molecules (called biologics), treatment options for eczema are limited, particularly for patients with extensive disease.
At the Center of Excellence in Eczema, we recognize all great the challenges resulting during in treatment of patients with moderate to severe eczema. Eczema patients often experience the condition across large areas of the body, which makes it very challenging to treat with topical creams alone.
Overall, mild forms of eczema can be often treated satisfactorily with topical treatments, including topical steroids and non-steroidal calcineurin antagonists (e.g., elidel, protopic).
For moderate to severe disease, the treatments include narrowband UVB phototherapy and oral immune suppressants, which may have multiple side effects. Narrow band UVB is a good option for many patients, but, since it involves coming three times weekly to the doctor's office, for many it is not a feasible treatment. Cyclosporin A, a broad immune suppressant, is widely used to suppress disease in severe patients. Despite being successful in controlling the disease, this type of aggressive treatment can pose long-term side effects, including kidney damage, so it's not recommend to continuous use of this medication for eczema. Because of the complexity involved in treating eczema, our extensive expertise plays a critical part in monitoring and carefully adjusting the therapeutic approach. If necessary, other immune suppressants can be used; however, these also harbor side effects. For hand or feet eczema, we offer excimer laser treatment, which has shown good efficacy for these cases.
Meet Our Team
- Emma Guttman-Yassky, MD, Associate Professor of Dermatology and Clinical Immunology, Director of the Center of Excellence in Eczema
- Yeriel Estrada, BSc, Research Program Coordinator
- Ecaterina Ignat, MSc, Immunohistochemistry Specialist
- Xiangyu Peng, MSc, Associate Researcher
- Sharon Rose, MD, Clinical Fellow
- Giselle Singer, BSc, Director, Clinical Trials in Dermatology
- Donna Tapper, Medical Assistant