Allergic diseases of the skin and drug allergies – 2010. Intradermal skin testing with cefazolin regardless of the history of hypersensitivity to antibiotics

The prevalence of allergic diseases is increasing worldwide. It is estimated that more than 30% of the world population is now affected by one or more allergic conditions and a high proportion of this increase is in young people. The diagnosis of allergy is dependent on a history of symptoms on exposure to an allergen together with the detection of allergen-specific IgE. Accurate diagnosis of allergies opens up therapeutic options. Allergen specific immunotherapy is the only successful disease-modifying therapy for IgE-mediated allergic diseases. New therapeutic strategies have been developed or are currently under clinical trials. Besides new routes of administration, new types of allergens are being developed. The use of adjuvants may amplify the immune response towards tolerance to the antigens. In this review, we analyze different antigen-specific immunotherapies according to administration route, type of antigens and adjuvants, and we address the special case of food allergy.

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Predictive value of family history of allergy and cord blood IgE level for allergic diseases up to adulthood

Pediatric Allergy and Immunology ◽

10.1111/pai.12367 ◽

2015 ◽

Vol 26 (4) ◽

pp. 383-383 ◽

Cited By ~ 1

Author(s):

Qun Ui Lee

Keyword(s):

Family History ◽

Cord Blood ◽

Predictive Value ◽

Allergic Diseases ◽

History Of

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Hypersensitivity and the Working Environment for Allergy Nurses in Sweden

Journal of Allergy ◽

10.1155/2014/681934 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7

Author(s):

Pia Kalm-Stephens ◽

Therese Sterner ◽

Kerstin Kronholm Diab ◽

Greta Smedje

Keyword(s):

Allergic Diseases ◽

Working Environment ◽

National Guidelines ◽

Allergen Specific Immunotherapy ◽

Exhaust Ventilation ◽

Provocation Tests ◽

History Of ◽

Challenge Tests ◽

Skin Prick Tests ◽

Personnel Safety

Background. Allergy nurses are exposed to allergens and respiratory irritants, and there are no national guidelines addressing personnel safety when working with these agents. Objective. To investigate the prevalence of allergies, asthma, and hypersensitivity symptoms among allergy nurses and the use of protective equipment and measures when working with allergen concentrates and respiratory irritants. Methods. A questionnaire survey was performed among the members of the Swedish Association of Allergy Nurses. Results. Diagnosed asthma was reported by 17%, while 18% had allergy to pets, 28% had allergy to pollens, and 26% reported nasal symptoms. Fifty-one percent reported a history of asthma, allergic diseases, or hypersensitivity symptoms in their family. Exhaust ventilation was used by 24% during skin prick tests, 17% during allergen specific immunotherapy, and 33% when performing methacholine challenge tests. Tightly closed containers for disposable waste were used by 58% during skin prick tests, by 60% during immunotherapy, and by 40% during Pc provocation tests. Conclusion. Allergy nurses had a tendency to increased prevalence of lower respiratory symptoms, asthma, and allergic rhinitis and more than half of the nurses had a family history of asthma, allergic diseases, or hypersensitivity symptoms. Additional studies are needed to evaluate the validity of these results.

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Successful identification of culprit drugs of perioperative anaphylaxis by repeated skin testing after negative first skin tests in a patient with a long distant history of perioperative anaphylaxis

Heliyon ◽

10.1016/j.heliyon.2021.e08401 ◽

2021 ◽

pp. e08401

Author(s):

Wasurat Sungworn ◽

Orathai Theankeaw ◽

Aree Jameekornrak Taweechue ◽

Chamard Wongsa ◽

Torpong Thongngarm ◽

...

Keyword(s):

Skin Testing ◽

Skin Tests ◽

History Of

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Natural History of Allergic Diseases and Asthma

Pediatric Allergy: Principles and Practice ◽

10.1016/b978-0-323-29875-9.00002-1 ◽

2016 ◽

pp. 7-17.e4

Author(s):

Andrew H. Liu ◽

Fernando D. Martinez

Keyword(s):

Natural History ◽

Allergic Diseases ◽

History Of

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Diagnostic and Therapeutic Principles In Allergy

10.2310/im.1067 ◽

2018 ◽

Author(s):

Mitchell H. Grayson ◽

Peter Mustillo

Keyword(s):

Food Allergy ◽

Immunoglobulin E ◽

Skin Testing ◽

Allergic Sensitization ◽

Allergic Diseases ◽

Specific Ige ◽

Severe Form ◽

Therapeutic Principles ◽

Anticytokine Therapy ◽

Release Assay

The incidence of allergic diseases, like asthma, allergic rhinitis, and food allergy, is increasing in Westernized countries. This chapter discusses the importance of taking a careful and focused history and physical examination, as well as the laboratory studies that can be used to demonstrate the presence of allergic sensitization. Treatment for allergic disease is discussed, with an emphasis on new biologic therapies that have been developed. Finally, the chapter explores relatively new studies on the potential for interventions to prevent food allergy. Allergy is defined as an untoward physiologic event mediated by immune mechanisms, usually involving the interaction between an allergen and the allergic antibody, immunoglobulin E (IgE). Allergic reactions typically occur due to exposure to either airborne allergens, foods, drugs, chemicals, or Hymenoptera (such as wasps, bees and fire ants). Allergies manifest in numerous ways, including allergic asthma, allergic rhinoconjunctivitis, urticaria, eczema, and in its most severe form, anaphylaxis. This review contains 4 videos, 5 figures, 4 tables and 42 references Key Words: Delayed allergic reaction (Alpha-gal), Allergy diagnosis, Measurement of specific IgE, Allergy and asthma therapies, Anticytokine therapy (dupilumab, mepolizumab, reslizumab), AntiIgE therapy (omalizumab), Allergy skin testing, Basophil histamine release assay

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Egg Hypersensitivity and Measles-Mumps-Rubella Vaccine Administration

PEDIATRICS ◽

10.1542/peds.88.5.913 ◽

1991 ◽

Vol 88 (5) ◽

pp. 913-917

Author(s):

Suzanne A. Beck ◽

Larry W. Williams ◽

M. Annette Shirrell ◽

A. Wesley Burks

Keyword(s):

Atopic Dermatitis ◽

Skin Prick Testing ◽

Skin Testing ◽

Screening Method ◽

Negative Control ◽

Mmr Vaccine ◽

Double Blind ◽

Intradermal Testing ◽

Vaccine Administration ◽

History Of

Because reports have described egg-sensitive individuals in whom anaphylaxis developed after measles vaccination, current recommendations include delaying administration of egg-derived vaccines until skin testing can be performed. Specifically, the 1988 Red Book recommends skin testing via scratch, prick, or puncture with 1:10 dilution of the vaccine and, if the result is negative, intradermal testing is suggested. The purpose of this study was to evaluate the likelihood of reaction to measles-mumps-rubella (MMR) vaccine in patients with documented egg sensitivity and to delineate the efficacy of skin-prick testing (SPT) to MMR as a predictor of hypersensitivity to the vaccine. Egg sensitivity was documented by initial SPT to egg and then, if possible, double-blind placebo-controlled food challenge (DBPCFC). Patients with a positive DBPCFC to egg or a history of anaphylactic egg sensitivity had a SPT with the MMR vaccine and then were given the MMR vaccine. Additionally, children with atopic dermatitis who had been previously proven egg sensitive via DBPCFCs were evaluated retrospectively for sensitivity to the MMR vaccine. Sixteen children with a history of egg sensitivity underwent SPT to egg, with a positive result 3 mm greater than the negative control found in 12 patients. Eight of these children had a positive DBPCFC to egg. The SPT to MMR vaccine was negative in all 16 children; vaccine administration followed with no resultant systemic problems. Three children had a local reaction at the site of injection. Twelve additional children with atopic dermatitis and egg sensitivity were reviewed. Each child had a positive SPT and DBPCFC to egg. Ten of these children received the MMR vaccine prior to the time that their egg sensitivity was elucidated. Two other children were vaccinated elsewhere after they were documented egg sensitive. All 12 of these children tolerated the vaccine without incident. These results further substantiate the safety of MMR administration in egg-sensitive children and support routine vaccination of children who do not exhibit systemic allergic hypersensitivity to egg. It is suggested that SPT is an adequate screening method for children with anaphylactic egg sensitivity.

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Food Hypersensitivity as a Cause of Atopic Dermatitis

Paediatrica Indonesiana ◽

10.14238/pi34.5-6.1994.129-35 ◽

2018 ◽

Vol 34 (5-6) ◽

pp. 129-35

Author(s):

Hendra Santoso

Keyword(s):

Atopic Dermatitis ◽

Skin Prick Test ◽

Allergic Diseases ◽

Food Hypersensitivity ◽

Prick Test ◽

Skin Symptoms ◽

History Of ◽

Nineteen 6 ◽

Allergic Manifestations ◽

Positive Results

Thirty children from infancy to 12 years suffering from atopic dermatitis were evaluated for food hypersensitivity by means of history, skin prick test, total eosinophils count, and elimination of suspected food. Sixteen (53%) patients had history of allergy to suspected food, the other 16 (53%) had ether allergic diseases. Of the 30 patients, 15 (50%) had one of the parents with allergic diseases, and in 3 patients both parents suffered from a1Iergic diseases. Nineteen (6:3-1.) children had atopic dermatitis triggered by food; egg accounted for 400/o, fish for 53-lo and shrimp for 40% for the allergic manifestations. Skin prick test consisted of 20 food allergens was done to all children above 2 years of age, 12 (40%) of the pa1ients showed positive results. This study demonstrated that food hypersensitivity may play a pathogenic role in some children with atopic dermatitis. Appropriate diagnosis and restriction of diet can improve their skin symptoms.

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The Study of a Possible Correlation between Serum Levels of Interleukin 17 and Clinical Severity in Patients with Allergic Rhinitis

Allergy & Rhinology ◽

10.2500/ar.2017.8.0207 ◽

2017 ◽

Vol 8 (3) ◽

pp. ar.2017.8.0207

Author(s):

Mai Aly Gharib Aly ◽

Mohamed Tawfik El Tabbakh ◽

Waheed Fawzy Heissam ◽

Said Hamed Abbadi

Keyword(s):

Allergic Rhinitis ◽

Immunoglobulin E ◽

Skin Testing ◽

Allergic Diseases ◽

Serum Levels ◽

Clinical Severity ◽

Total Serum ◽

Interleukin 17 ◽

Serum Ige ◽

Cluster Immunotherapy

Introduction Allergic rhinitis (AR) is one of the most common allergic diseases, which affects ~20% of the world's population. T-helper (Th) type 2 cells produce interleukin (IL) 4 and IL-13, and mediate allergic responses, and these cytokines have been extensively studied as key players in the atopic airway diseases. However, the involvement of Th17 cells and IL-17 in AR has not been clearly examined. Aim To reevaluate AR clinical severity with serum IL-17, whether IL-17 affects the disease alone or in contribution with the atopic predisposition. Patients and Methods During an 18-month period, 39 individuals were divided into three groups: A, (13 control), B (13 with mild-to-moderate AR), and C (13 with severe AR). Both group B and group C patients (26) were subjected to clinical examination and allergy skin testing, and to measurement of both total serum immunoglobulin E (IgE) and IL-17 levels. Eleven patients with AR then were exposed to 6 months of cluster immunotherapy, whereas the rest of the patients were not exposed. Results Revealed a significant elevation of serum IL-17 levels with an associated increase in serum IgE in the patients with AR compared with controls and revealed that the serum levels of both total serum IgE and IL-17 decreased significantly after cluster immunotherapy. Conclusion These preliminary results added new data about the use of injective immunotherapy as well as reported on the use of sublingual immunotherapy.

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The Impact of Penicillin Skin Testing on Aztreonam Stewardship and Cost Savings in Immunocompromised Cancer Patients

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz371 ◽

2019 ◽

Vol 6 (10) ◽

Cited By ~ 2

Author(s):

Farnaz Foolad ◽

Sheila Berlin ◽

Candice White ◽

Emma Dishner ◽

Ying Jiang ◽

...

Keyword(s):

Cancer Patients ◽

Immunoglobulin E ◽

Skin Testing ◽

Cost Savings ◽

Hematologic Malignancies ◽

Oral Challenge ◽

Beta Lactam ◽

History Of ◽

Antibiotic Cost ◽

The Impact

Abstract Objective Reported penicillin allergies result in alternative antimicrobial use and are associated with worse outcomes and increased costs. Penicillin skin testing (PST) has recently been shown to be safe and effective in immunocompromised cancer patients, yet its impact on antimicrobial costs and aztreonam utilization has not been evaluated in this population. Method From September 2017 to January 2018, we screened all admitted patients receiving aztreonam. Those with a self-reported history of possible immunoglobulin E (IgE)-mediated reaction to penicillin were eligible for PST with oral challenge. Results A total of 129 patients were screened, and 49 patients were included and underwent testing. Sixteen patients (33%) had hematologic malignancies and 33 patients (67%) had solid tumors. After PST with oral challenge, 46 patients (94%) tested negative, 1 patient tested positive on oral challenge, and 2 patients had indeterminate results. The median time from admission to testing was 2 days (interquartile range, 1–4). After testing negative, 33 patients (72%) were switched to beta-lactam therapy, which resulted in a total of 390 days of beta-lactam therapy. For identical therapy durations, the direct total antibiotic cost was $15 138.89 for beta-lactams versus $78 331.50 for aztreonam, resulting in $63 192.61 in projected savings. A significant reduction in median days of aztreonam therapy per 1000 patient days (10.0 vs 8.0; P = .005) was found during the intervention period. Conclusions Use of PST in immunocompromised cancer patients receiving aztreonam resulted in improved aztreonam stewardship and significant cost savings. Our study demonstrates that PST with oral challenge should be considered in all cancer patients with reported penicillin allergies.

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