Taking the sting out of diagnosing contact dermatitis
“Have a high clinical suspicion for contact allergens or irritants in anyone presenting with eczematous rash.” —Dr. Rebecca PrattCreams that sting and rashes that won’t quit —welcome to the complex world of contact dermatitis. Dr. Rebecca Pratt joins Dr. Mariam Hanna to unpack why diagnosing and managing this condition is anything but straightforward.Dr. Pratt is an allergist and clinical immunologist in St. Catharines, Ontario, with a passion for dermatoimmunopathology and practical tools that empower patients. She breaks down when to patch test, what to suspect, and how to help patients take control.On this episode:Why 80% of contact dermatitis cases are irritant—not allergicClues that point to allergic contact dermatitis, especially in recurring facial, hand, or foot rashesHow to approach patch testing in adults and kids, including when immunosuppressants or UV exposure may interfereWhat to do when results are negative—and why that still mattersThe reality of managing allergens found in foods, not just topicalsWhy there’s no one-size-fits-all answer to the sunscreen question—and how physical blockers stack upThere may be no cure for contact allergy, but there’s power in knowing what to avoid.Visit the Canadian Society of Allergy and Clinical ImmunologyFind an allergist using our helpful toolFind Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_caThe Allergist is produced for CSACI by PodCraft Productions
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Trust your gut and test for primary atopic disorders
“If you're already wondering if a patient has an underlying inborn error of immunity, then it’s worthwhile to do that testing.” — Dr. Catherine BiggsWhat if that tough case in your allergy clinic isn’t just unusually severe, but fundamentally different? On this episode of The Allergist, Dr. Mariam Hanna speaks with pediatric immunologist Dr. Catherine Biggs about primary atopic disorders, rare inborn errors of immunity that masquerade as everyday allergy but demand a very different approach.Dr. Biggs breaks down the clinical signs that should raise your suspicion and explains why early recognition and genetic testing can make all the difference. From STAT6 gain of function to when (and when not) to reach for dupilumab, this episode offers a roadmap for spotting zebras.On this episode:What makes primary atopic disorders different from severe, polygenic allergic diseaseRed flags: when eczema, asthma, or food allergy suggest an underlying immune disorderWhich patients warrant genetic testing—and how to approach it in practiceThe most important lab work to order (and why it might still come back normal)STAT6 gain of function and other key genetic culprits allergists should knowWhen biologics are appropriate, and when they might delay definitive treatmentThe power of collaborative care: how one hospital built a severe atopy working groupDon’t let these patients fall through the cracks, because sometimes, it’s not “just” allergy.Visit the Canadian Society of Allergy and Clinical ImmunologyFind an allergist using our helpful toolFind Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_caThe Allergist is produced for CSACI by PodCraft Productions
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How to accidentally become a researcher
“It doesn’t have to start with a huge trial. It starts with a patient and it starts with a problem.” —Dr. Gord SussmanHow do we move from the exam room to the frontlines of discovery? On this episode of The Allergist, Dr. Mariam Hanna talks with Dr. Gord Sussman about how curiosity—not a research grant—launched his decades-long contribution to allergy science. From identifying the early signs of latex allergy to shaping the treatment landscape for urticaria and hereditary angioedema, Dr. Sussman shares what keeps him asking the next question, and how any allergist can get involved.On this episode:Why Dr. Sussman initially thought he’d never pursue research—and what changed his mindHow one nurse's anaphylactic reaction to latex launched a field of studyWhat it was like to design and run early research trials for food allergy challenges and peanut desensitizationWhy recruiting patients for trials has become harder—not easier—over timeWhat makes a good research coordinator and why infrastructure is criticalHow to identify patients who may be open to research, and when not to pushWhy some promising drugs never reach market—and what frustrates Dr. Sussman mostWhat advice he gives to allergists who are research-curious but hesitantYou don’t need a lab coat to help change practice. Just curiosity, commitment—and maybe a really good clinical coordinator.Visit the Canadian Society of Allergy and Clinical ImmunologyFind an allergist using our helpful toolFind Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_caThe Allergist is produced for CSACI by PodCraft Productions
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New Rules for Old Hives
“We have to keep in mind that urticaria has to be treated until it's completely gone. So, absolute control of the disease.” — Dr. Herminio LimaChronic spontaneous urticaria has long been managed with the goal of complete symptom control. But for many patients, that goal remains elusive. In this episode of The Allergist, Dr. Mariam Hanna talks with dermatologist and clinical immunologist Dr. Herminio Lima about the updated urticaria guidelines—and how new treatment options are giving clinicians more ways to act, and more hope for getting patients all the way to control.On this episode:What’s new in the 2025 guideline—including additional second-line options beyond antihistaminesWhy nearly 40% of patients may need to escalate to biologicsHow remibrutinib compares to omalizumab and what its trials revealedWhat the CUPID studies say about dupilumab, especially in biologic-naive patientsKey safety signals and clinical considerations for the new treatment optionsHow to move toward full disease control—and why suboptimal outcomes are no longer acceptableComplete control is still the destination, but the path to get there is about to get a lot more flexible.Visit the Canadian Society of Allergy and Clinical ImmunologyFind an allergist using our helpful toolFind Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_caThe Allergist is produced for CSACI by PodCraft Productions
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Biologics, Polyps, and the Power of Collaboration
"The emergence of biologics has really significantly transformed the management of these patients for me." — Dr. Yvonne ChanWhen it comes to nasal polyps, the landscape is shifting fast. On this episode of The Allergist, Dr. Mariam Hanna is joined by otolaryngologist Dr. Yvonne Chan to talk about how biologics, surgery, and multidisciplinary care are working together to reshape care for this stubborn condition. From recognizing key symptoms to navigating the latest therapeutic options, Dr. Chan shares practical insights to help physicians better support patients with nasal polyps.On this episode:How to differentiate nasal polyps from other causes of chronic nasal obstructionWhen imaging should be ordered and what findings are suggestive of polypsThe role of allergy testing and comorbid conditions like asthma and AERDHow biologics have changed the game—and which patients are ideal candidatesWhen surgery is still needed, even in the era of advanced medical therapiesThe importance of long-term follow-up and multidisciplinary collaborationListen now, because when it comes to managing nasal polyps, the right team and the right tools can make all the difference.Visit the Canadian Society of Allergy and Clinical ImmunologyFind an allergist using our helpful toolFind Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_caThe Allergist is produced for CSACI by PodCraft Productions
Welcome to your allergy lifeline..."The Allergist." A show that separates myth from medicine. Every episode of The Allergist is designed for YOU – the medical professional aiming to stay on the cutting edge of allergy care. We'll clarify, correct, and, most importantly, contextualize the latest evidence.
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