...a venom dose of 525 μg per month was used in the SLIT group, which considerably exceeds the standard dose of 100 μg for subcutaneous venom immunotherapy (VIT). ...it is possible that changes in ...the venom-specific IgG concentration were not a consequence of SLIT but might have been caused by field stings.
Objective: To identify the concentration of the fragrance compound hydroxyisohexyl 3‐cyclohexene carboxaldehyde (INCI) (HICC) that is sufficiently low not to cause an allergic reaction in patients ...with proven sensitization.
Methods: Repeated open application testing (ROAT) in 64 subjects with 2 preparations (perfume and cream) in different concentration (0.005–2.5%). Confirmatory patch testing with four preparations in two different concentrations (2.5% and 5%).
Results: The concentrations of HICC being tolerated by 90% of those sensitized to HICC are estimated as <88.2 ppm (cream) and <270 ppm (perfume) equivalent to 1.2 μg/cm2 (perfume) and 4.9 μg/cm2 (cream). Patch test preparations differed with regard to sensitivity (88.5–98.1%) and specificity (37.5–87.5%) against the ROAT result as external criterion. ROAT concentrations and the reaction strength in patch testing were inversely correlated (Kendall's tau‐b: 0.69), both indicating the existence of different degrees of susceptibility.
Conclusion: To protect 90% (50%) of people sensitized, the use concentration should be in the range of 0.009–0.027% (0.18–0.34%), depending on the product type. Taking into account these results, excessive concentrations should be avoided, as this would continue to sensitize people. Close monitoring is indispensable to prove the efficacy of any recommendations aiming to prevent induction.
Background
Hand hygiene measures in the general population and in health care workers have increased considerably since the outbreak of the COVID-19 pandemic.
Objectives
To investigate the prevalence ...and symptoms of hand eczema, as well as hygiene measures and concepts of care, in German health care workers.
Materials & Methods
This was an observational questionnaire study to investigate hygiene and skin care habits, as well as the prevalence and symptoms of hand eczema in 66 nurses and doctors of our dermatology department before and during the SARS-CoV-2 pandemic.
Results
Hand washing and hand disinfection procedures increased significantly during the COVID-19 pandemic. Self-diagnosed hand eczema was reported by 33% of the participants, with a median duration of 14 days. The majority of staff currently affected by hand eczema were free of eczema a month previously (82%) and would treat their skin condition with emollients (77%). Erythema, scaling, burning and fissures were reported by 66.1% of the participants and were classified as predominant signs of toxic-irritant hand dermatitis rather than contact allergy.
Conclusion
Overall, the SARS-CoV-2 pandemic has led to a significant increase in the incidence of signs of irritant hand eczema despite intensified emollient use as a preventive measure. Awareness of the prevalence of hand eczema in health care workers in Germany during the COVID-19 pandemic should be raised, and preventive measures should be intensified.
Mastocytosis and Hymenoptera venom allergy Ruëff, Franziska; Placzek, Marianne; Przybilla, Bernhard
Current opinion in allergy and clinical immunology,
2006-August, 2006-Aug, 2006-08-00, Volume:
6, Issue:
4
Journal Article
PURPOSE OF REVIEWMastocytosis is a rare disease characterized by increased mast cells in skin and/or internal organs. We evaluate the impact of mastocytosis on diagnosis and treatment of Hymenoptera ...venom allergy.
RECENT FINDINGSPatients with Hymenoptera venom allergy who suffer from mastocytosis develop life-threatening sting reactions more often than those who do not. When patients with Hymenoptera venom allergy were systematically examined for mastocytosis, it was found to be represented to an abnormally high extent. Most patients with mastocytosis tolerate venom immunotherapy with no or only minor systemic symptoms. Venom immunotherapy was found to be marginally less effective in patients with mastocytosis than in those without evidence of mast cell disease (defined as absent cutaneous mastocytosis combined with a serum tryptase concentration of <11.4 μg/l). Several deaths from sting reactions were reported in patients with mastocytosis after venom immunotherapy was stopped. These patients should have venom immunotherapy for the rest of their lives.
SUMMARYPatients suffering from mastocytosis and Hymenoptera venom allergy are at risk from a particularly severe sting anaphylaxis. They need optimal diagnosis and treatment. In patients presenting with Hymenoptera venom allergy, screening tests by measurement of serum tryptase concentration, and a careful skin examination, are highly recommended.
Hymenoptera venom allergy Przybilla, Bernhard; Ruëff, Franziska
Journal der Deutschen Dermatologischen Gesellschaft,
02/2010, Volume:
8, Issue:
2
Journal Article
Peer reviewed
Summary
Allergic reactions to Hymenoptera stings usually present as large local reactions or systemic reactions with symptoms of immediate type allergy (anaphylaxis). In Central Europe they are ...predominantly elicited by stings of the honeybee or Vespula spp. Acute reactions are managed by symptomatic treatment. Long‐term care includes patient education (allergen avoidance, course of action at re‐sting) and prescription of an emergency kit for self‐treatment. Venom immunotherapy is established as specific treatment for Hymenoptera venom allergic patients. Diagnosis of Hymenoptera venom anaphylaxis is based on history, skin tests and measurement of venom‐specific serum IgE antibodies. “False negative” or “false positive” results are possible with all test methods. If standard tests are negative, additional tests using the patient's peripheral blood leucocytes can be useful. Venom immunotherapy is usually well tolerated. After reaching the maintenance dose, therapeutic efficacy should be assessed by a sting challenge test. If the patient again develops a systemic reaction, an increase of the maintenance dose (usually 200 μg are sufficient) nearly always induces protection. In most patients venom immunotherapy can be stopped after (3 to) 5 years. However, if there is an increased risk of sting anaphylaxis due to intense allergen exposure (e.g. in beekeepers) or if there are individual risk factors for particularly severe reactions (especially mastocytosis and/or elevated baseline serum tryptase concentration, severe cardiovascular disease), modifications of the standard venom immunotherapy are necessary.
Unfortunately this article 1 was published with an error in the Funding section. The BM4SIT project is not acknowledged. This section should be corrected to the below:
Funding
EAACI and the BM4SIT ...project (Grant Number 601763) in the European Union's Seventh Framework Programme FP7.
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