Type 2 immunity, illustrated by T helper 2 lymphocytes (Th2) and downstream cytokines (IL-4, IL-13, IL-31) as well as group 2 innate lymphoid cells (ILC2), is important in host defense and wound healing. 1 The hallmark of type 2 inflammation is eosinophilia and/or high IgE counts and is best recognized in atopic diathesis. Persistent eosinophilia, such as seen in hypereosinophilic syndromes, leads to fibrosis and hence therapeutic Type 2 inhibition in fibrotic diseases is of high interest. Furthermore, as demonstrated in cutaneous T cell lymphoma, advanced disease is characterized by Th1 to Th2 switch allowing cancer progression and immunosuppression. Development of targeted monoclonal antibodies against IL-4Rα (eg, dupilumab) led to a paradigm shift for the treatment of atopic dermatitis (AD) and stimulated research to better understand the role of Type 2 inflammation in other skin conditions. In this review, we summarize up to date knowledge on the role of Type 2 inflammation in skin diseases other than AD and highlight whether the use of Type 2 targeted therapies has been documented or is being investigated in clinical trials. This manuscript reviews the role of Type 2 inflammation in dermatitis, neurodermatitis, IgE-mediated dermatoses (eg, bullous pemphigoid, chronic spontaneous urticaria), sclerodermoid conditions and skin neoplasms.

L yme disease, a multisystem infection primarily caused byBorrelia burgdorferi in North America and by Borrelia afzelii and Borrelia garinii in Europe and Asia, 1,2 progresses in 3 stages: early localized stage, early disseminated stage and late disseminated stage. 3 Cases of Lyme disease reported in Canada increased from 144 in 2009 to 992 in 2016, representing an increase from 0.4 to 2.7 per 100 000 population. 4 In Quebec, Lyme disease has been notifiable since November 2003, with the first locally acquired case reported in 2006. 5,6 Reported cases of Lyme disease and the proportion of cases with acquired infection have increased each year. 6 In 2017, 329 cases were declared to the public health authorities in Quebec, including 249 (76%) acquired in that province, particularly in Estrie (n = 138, 55% of Quebec-acquired cases) and Montérégie (n = 75, 30% of Quebec-acquired cases). 6 Despite the increase in cases, little is known about the management and clinical course of Lyme disease in Canada.Published evidence has focused on epidemiologic surveillance, risk of acquisition and clinical case characteristics. [7][8][9] We aimed to describe case management of Lyme disease in acute care facilities in Quebec and adherence to the 2006 guideline of the Infectious Diseases Society of America (IDSA). 3 We assessed the clinical course of patients treated in Quebec and temporal changes in case severity from 2004 to 2017.