[Wheat-dependent, exercise-induced anaphylaxis].

Wheat-dependent exercise-induced anaphylaxis (WDEIA) is a rare IgE-dependent anaphylaxis to wheat, which occurs in sensitized people after ingestion of wheat followed by physical exercise. The major allergen associated with WDEIA is the wheat protein Omega (omega)-5-Gliadin (Tri a 19). We present three cases of WDEIA, demonstrating that this disease might be more frequent than anticipated and that neither prick test nor specific IgE to allergen extracts but rather detection of specific IgE against the recombinant protein Tri a 19 leads to diagnosis.

[Aspects of occupational skin diseases in hair dressers].

Hairdressers are exposed to a broad variety of substances known for their strong sensitizing and irritant capacities. Especially wet work and handling of hair-care products causes a high risk for occupational skin disease. Lately, due to new regulations regarding substances and techniques used as well as improved skin protection, the prevalence of occupational skin disease in hairdressers has significantly declined.

The CONSORT statement checklist in allergen-specific immunotherapy: a GA2LEN paper.

The methodology of randomized clinical trials is essential for the critical assessment and registration of therapeutic interventions. The CONSORT (Consolidated Standards of Reporting Trials) statement was developed to alleviate the problems arising from the inadequate reporting of randomized controlled trials. The present article reflects on the items that we believe should be included in the CONSORT checklist in the context of conducting and reporting trials in allergen-specific immunotherapy.

Changes in content and synthesis of collagen types and proteoglycans in osteoarthritis of the knee joint and comparison of quantitative analysis with Photoshop-based image analysis.

Introduction: The different cartilage layers vary in synthesis of proteoglycan and of the distinct types of collagen with the predominant collagen Type II with its associated collagens, e.g. types IX and XI, produced by normal chondrocytes.

Allergen microarrays: a novel tool for high-resolution IgE profiling in adults with atopic dermatitis.

Microarray technology has recently been introduced into clinical allergology, but its applicability in adult patients with atopic dermatitis (AD) has not been investigated so far. We aimed to evaluate the utility of allergen microarrays in the diagnostic workup of adults with AD and to compare this new diagnostic tool with a conventional method of specific IgE (sIgE) measurement. In sera of 40 atopic adults, sIgE levels detected by microarray-analysis were correlated with the results of an established fluorescence enzyme immunoassay (FEIA).

In vitro detection and characterization of drug hypersensitivity using flow cytometry.

Background: The lymphocyte transformation test (LTT) is the only in vitro test for detecting drug sensitization at the cellular level irrespective of the reaction's phenotype. However, the LTT includes working with radioactive substances and is considered impracticable for routine laboratory investigation.

Objective: The aim of this study was to assess drug-specific cytokine production by means of flow cytometry as an alternative nonradioactive approach which may be more appropriate for routine testing and may provide in addition more information about the pathophysiology of the reaction than proliferation-based assays, like the LTT.

Pilot study: optical coherence tomography as a non-invasive diagnostic perspective for real time visualisation of onychomycosis.

The objective of this study was to compare optical coherence tomography (OCT) with conventional techniques such as KOH-preparation, culture and histology in the identification of the fungal elements in the nail. A total of 18 patients were examined; 10 with clinically evident onychomycosis in toe nails, two with psoriatic nail lesions, one with nail affection caused by lichen planus and five healthy controls. Serial in vivo OCT analyses of onychomycosis was performed prior to KOH-preparation, culture and punch biopsy of the nail plate for consecutive histology.

EAACI/GA(2)LEN/EDF/WAO guideline: management of urticaria.

This guideline, together with its sister guideline on the classification of urticaria (Zuberbier T, Asero R, Bindslev-Jensen C, Canonica GW, Church MK, Giménez-Arnau AM et al. EAACI/GA(2)LEN/EDF/WAO Guideline: definition, classification and diagnosis of urticaria. Allergy 2009;64: 1417-1426), is the result of a consensus reached during a panel discussion at the Third International Consensus Meeting on Urticaria, Urticaria 2008, a joint initiative of the Dermatology Section of the European Academy of Allergology and Clinical Immunology (EAACI), the EU-funded network of excellence, the Global Allergy and Asthma European Network (GA(2)LEN), the European Dermatology Forum (EDF) and the World Allergy Organization (WAO).

EAACI/GA(2)LEN/EDF/WAO guideline: definition, classification and diagnosis of urticaria.

This guideline, together with its sister guideline on the management of urticaria [Zuberbier T, Asero R, Bindslev-Jensen C, Canonica GW, Church MK, Giménez-Arnau AM et al. EAACI/GA(2)LEN/EDF/WAO Guideline: Management of urticaria. Allergy, 2009; 64:1427-1443] is the result of a consensus reached during a panel discussion at the 3rd International Consensus Meeting on Urticaria, Urticaria 2008, a joint initiative of the Dermatology Section of the European Academy of Allergology and Clinical Immunology (EAACI), the EU-funded network of excellence, the Global Allergy and Asthma European Network (GA(2)LEN), the European Dermatology Forum (EDF) and the World Allergy Organization (WAO).

Efficacy of grass pollen sublingual immunotherapy for three consecutive seasons and after cessation of treatment: the ECRIT study.

Background: Data supporting a carry-over effect with sublingual immunotherapy (SLIT) are scarce. This randomized, double-blind, placebo-controlled study evaluated the efficacy, carry-over effect and safety of grass pollen SLIT using co-seasonal treatment.

Methods: Patients (7.

Successful topical treatment of sorafenib-induced hand-foot skin reaction in a child with hepatocellular carcinoma.

Orally active kinase inhibitors such as Sorafenib are known to elicit cutaneous side effects in the majority of adult patients, whereas specific cutaneous complications of this agent have not been described in children so far. We here present the first pediatric case of Sorafenib-induced hand-foot-skin reaction and its successful topical therapy facilitating continuation of kinase inhibitor treatment.

Para-phenylenediamine and allergic sensitization: risk modification by N-acetyltransferase 1 and 2 genotypes.

Background: Para-phenylenediamine (PPD) is a common contact sensitizer causing allergic contact dermatitis, a major skin problem. As PPD may need activation to become immunogenic, the balance between activation and/or detoxification processes may influence an individual's susceptibility. PPD is acetylated and the metabolites do not activate dendritic-like cells and T cells of PPD-sensitized individuals.

Drug skin metabolites and allergic drug reactions.

Purpose Of Review: Presentation of recent studies about xenobiotica metabolism of the skin and its impact on drug-allergic reactions.

Recent Findings: The skin possesses not only multiple cytochrome P450 isoenzymes but also influx and efflux transporter proteins. The pattern of cytochrome P450 isoenzymes in the skin differs from the pattern in the liver.

Total serum IgE as a parameter to differentiate between intrinsic and extrinsic atopic dermatitis in children.

Atopic dermatitis (AD) has been sub-classified into extrinsic and intrinsic types according to the presence or not of allergen-specific IgE antibodies. Although total serum IgE levels are frequently elevated in AD, their potential to predict allergen-specific IgE (asIgE) has rare ly been studied. We investigated 103 children with AD and suspected allergen-specific sensitization.

Diagnosis of immediate-type beta-lactam allergy in vitro by flow-cytometric basophil activation test and sulfidoleukotriene production: a multicenter study.

Introduction: This multicenter study aimed to evaluate the diagnostic value of 2 cellular tests based on basophil reactivity--the basophil activation test (BAT, Flow-CAST) and the sulfidoleukotriene release assay (CAST-ELISA)--in immediate-type beta-lactam allergy, particularly in patients with a clinical history of allergy and a negative skin test result.

Material And Methods: In a multicenter study encompassing 10 European centers, 181 patients with a history of immediate-type beta-lactam allergy, and 81 controls, we evaluated the diagnostic efficiency of specific IgE determinations and of 2 cellular tests based on basophil reactivity, the BAT and the sulfidoleukotriene release assay.

Results: With Flow-CAST, sensitivity varied for individual beta-lactam allergens from 16% for penicilloyl-polylysine to 33% for amoxicillin, reaching 50% when all 5 allergens were considered.

Surgical treatment for lumbar lateral recess stenosis with the full-endoscopic interlaminar approach versus conventional microsurgical technique: a prospective, randomized, controlled study.

Object: Extensive decompression with laminectomy where appropriate is often still described as the method of choice in surgery for lateral recess stenosis. Nonetheless, tissue-sparing procedures are becoming more common. Endoscopic techniques have become the standard in many areas because of the advantages they offer in surgical technique and in rehabilitation.

Calcium pantothenate modulates gene expression in proliferating human dermal fibroblasts.

Topical application of pantothenate is widely used in clinical practice for wound healing. Previous studies identified a positive effect of pantothenate on migration and proliferation of cultured fibroblasts. However, these studies were mainly descriptive with no molecular data supporting a possible model of its action.

[Contact sensitization to azole antimycotics].

Contact sensitization to azole antimycotics is rare, even though they are widely used. We present the case of a man who developed allergic contact dermatitis due to topical application of a variety of antimycotics. Patch testing revealed positive reactions to clotrimazole, croconazole, oxiconazole and tioconazole.

Recurrent lumbar disc herniation after conventional discectomy: a prospective, randomized study comparing full-endoscopic interlaminar and transforaminal versus microsurgical revision.

Study Design: Prospective, randomized, controlled study of patients with recurrent lumbar disc herniations after conventional discectomy, operated either in a full-endoscopic or microsurgical technique.

Objective: Comparison of results of lumbar revision discectomies in full-endoscopic interlaminar and transforaminal technique with the conventional microsurgical technique.

Summary Of Background Data: Recurrences after lumbar disc operations cannot be prevented.

Pharmacovigilance of drug allergy and hypersensitivity using the ENDA-DAHD database and the GALEN platform. The Galenda project.

Nonallergic hypersensitivity and allergic reactions are part of the many different types of adverse drug reactions (ADRs). Databases exist for the collection of ADRs. Spontaneous reporting makes up the core data-generating system of pharmacovigilance, but there is a large under-estimation of allergy/hypersensitivity drug reactions.

Neonatal and infantile erythrodermas.

The term neonatal or infantile erythroderma designates a generalized erythema covering more than 90% of the body surface area of neonates and young infants. Erythrodermas are not rare in this age group and have been associated with more than 40 diseases of different degrees of severity. Regardless of the underlying illness, impending acute symptoms of an impaired epidermal barrier function (hypothermia, dehydration, sepsis) must be recognized and treated adequately.

Update on the evaluation of hypersensitivity reactions to betalactams.

Hypersensitivity reactions to betalactams (BLs) are classified as immediate or nonimmediate. The former usually appear within 1 h of drug-intake and are mediated by specific IgE-antibodies. Nonimmediate reactions are those occurring more than 1 h after drug-intake, and they can be T-cell mediated.