Atopic dermatitis and psychosocial comorbidities Kage, Paula; Simon, Jan‐Christoph; Treudler, Regina
Journal der Deutschen Dermatologischen Gesellschaft,
February 2020, 2020-02-00, 20200201, Volume:
18, Issue:
2
Journal Article
Peer reviewed
Open access
Summary
Atopic dermatitis (AD) is a chronic inflammatory disease that may be associated with a number of comorbidities including psychosocial disorders, which are the primary focus of this article. ...The data presented is based on a literature search in PubMed and subsequent screening of relevant review articles and guidelines.
There is a greater prevalence of depression, anxiety, sleep disorders and suicidal ideation among individuals with AD. The disease negatively impacts patients’ quality of life. Children with AD have been shown to more commonly exhibit signs of attention‐deficit/hyperactivity disorder. Only little data exists on the association of AD with schizophrenia, eating disorders or obsessive‐compulsive disorder.
There is a great need for research in the field of AD‐related comorbidities, especially with respect to the question as to whether and how novel treatment options may potentially affect these comorbidities.
Summary
Acute urticaria (AU) is the most common cause of wheal formation. By definition, it does not persist for more than 6 weeks. It can occur at any age and is more commonly seen in atopic ...diathesis. Acute spontaneous urticaria is distinguished from inducible forms. This review highlights the clinical presentation, differential diagnosis, possible triggers, and therapeutic strategies. In childhood as in adulthood, viral infections are very frequently associated with acute urticaria, whereas drugs and food are less frequently described as triggers. However, it is not uncommon for multiple triggers to be present simultaneously. Therapeutically, oral nonsedating H1 antihistamines are mainly used. In some patients, concomitant short-term administration of glucocorticosteroids is also necessary.
Anaphylaxis to food additives Treudler, Regina; Simon, Jan Christoph
Allergo journal international,
07/2022, Volume:
31, Issue:
5
Journal Article
Peer reviewed
Open access
A variety of additives found in foodstuffs have been associated with triggering of a number of clinical pictures. Hypersensitivity reactions of allergic and non-allergic etiology have been widely ...described, but are reported to be rare overall. This review presents a selection of food additives for which anaphylactic reactions have been described. These include colorants (e.g., tartrazine, carmine, patent blue), preservatives (e.g., sulfites, sodium benzoate), and thickeners/gelling agents (e.g., carboxymethylcellulose, guar, gum arabic). Possible diagnostic procedures (skin test, specific IgE, cellular antigen stimulation test, oral provocation) are presented. For those affected, avoidance of consumption is facilitated by the mandatory declaration (class name, E‑number/designation) required in the European Union. Only sulfur dioxide and sulfites have to be highlighted as food allergens, depending on the concentration. Due to the limited diagnostic procedures available, it cannot be excluded that the frequency of hypersensitivity to food additives is underestimated.
Elicitors and symptoms of anaphylaxis are age dependent. However, little is known about typical features of anaphylaxis in patients aged 65 years or more.
The data from the Network for Online ...Registration of Anaphylaxis (NORA) considering patients aged ≥65 (elderly) in comparison to data from adults (18-64 years) regarding elicitors, symptoms, comorbidities, and treatment measures were analyzed.
We identified 1,123 elderly anaphylactic patients. Insect venoms were the most frequent elicitor in this group (
< 0.001), followed by drugs like analgesics and antibiotics. Food allergens elicited less frequently anaphylaxis (
< 0.001). Skin symptoms occurred less frequently in elderly patients (77%,
< 0.001). The clinical symptoms were more severe in the elderly (51% experiencing grade III/IV reactions), in particular when skin symptoms (
< 0.001) were absent. Most strikingly, a loss of consciousness (33%,
< 0.001) and preexisting cardiovascular comorbidity (59%,
< 0.001) were more prevalent in the elderly. Finally, adrenaline was used in 30% of the elderly (vs. 26% in the comparator group,
< 0.001) and hospitalization was more often required (60 vs. 50%,
< 0.001).
Anaphylaxis in the elderly is often caused by insect venoms and drugs. These patients suffer more often from cardiovascular symptoms, receive more frequently adrenaline and require more often hospitalization. The data indicate that anaphylaxis in the elderly tends to be more frequently life threatening and patients require intensified medical intervention. The data support the need to recognize anaphylaxis in this patient group, which is prone to be at a higher risk for a fatal outcome.
Lupine flour is a valuable food due to its favorable nutritional properties. In spite of its allergenic potential, its use is increasing. Three lupine species,
,
, and
.
are relevant for human ...nutrition. The aim of this study is to clarify whether the species differ with regard to their allergen composition and whether anaphylaxis marker allergens could be identified in lupine. Patients with the following characteristics were included: lupine allergy, suspected lupine allergy, lupine sensitization only, and peanut allergy. Lupine sensitization was detected via CAP-FEIA (ImmunoCAP) and skin prick test. Protein, DNA and expressed sequence tag (EST) databases were queried for lupine proteins homologous to already known legume allergens. Different extraction methods applied on seeds from all species were examined by SDS-PAGE and screened by immunoblotting for IgE-binding proteins. The extracts underwent different and successive chromatography methods. Low-molecular-weight components were purified and investigated for IgE-reactivity. Proteomics revealed a molecular diversity of the three species, which was confirmed when investigated for IgE-reactivity. Three new allergens,
profilin,
and
.
lipid transfer protein (LTP), were identified. LTP as a potential marker allergen for severity is a valuable additional candidate for molecular allergy diagnostic tests.
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