ALERGOLOGÍA PARA MÉDICOS Y PACIENTES 2021

 Peanut Allergy: New Advances and Ongoing Controversies Auhtors: Elissa M Abrams  1 , Edmond S Chan  2 , Scott Sicherer  3 Abstract Peanut allergy is one of the most common food allergies in children, with increasing prevalence over time. The dual-allergen exposure hypothesis now supports transcutaneous sensitization to peanut as a likely pathophysiologic mechanism for peanut allergy development. As a result, there is emerging evidence that early peanut introduction has a role in peanut allergy prevention. Current first-line diagnostic tests for peanut allergy have limited specificity, which may be enhanced with emerging tools such as component-resolved diagnostics. Although management of peanut allergy includes avoidance and carrying an epinephrine autoinjector, risk of fatal anaphylaxis is extremely low, and there is minimal risk related to cutaneous or inhalational exposure. Quality of life in children with peanut allergy requires significant focus. Moving forward, oral and epicutan

 Therapeutic Strategy According to Differences in Response to Omalizumab in Patients With Chronic Spontaneous Urticaria Authors: A M Giménez Arnau  1 , A Valero Santiago  2 , J Bartra Tomás  3 , I Jáuregui Presa  4 , M Labrador Horrillo  5 , F J Miquel Miquel  6 , J Ortiz de Frutos  7 , J Sastre  8 , J F Silvestre Salvador  9 , M Ferrer Puga  10 Abstract Chronic spontaneous urticaria (CSU) is a heterogeneous condition that can severely impact quality of life. Consequently, rapid disease control is essential. First-line treatment of the symptoms of CSU is the licensed dose of second-generation H1 antihistamines. For second-line treatment, this dose may be increased by up to 4 times. In patients who fail to respond to higher doses of H1 antihistamines, omalizumab for up to 24 weeks is recommended to achieve disease control. After this 24-week period, the patient's response to omalizumab should be assessed in order to identify refractory patients. Optimal management of refractory pati

 Cross-reactivity in beta-lactams after a non-immediate cutaneous adverse reaction: experience of a reference centre for toxic bullous diseases and severe cutaneous adverse reactions Authors: V. Berot,1 G. Gener,1,2,† S. Ingen-Housz-Oro,1,2,3,† O. Gaudin,1,2 M. Paul,3,4 O. Chosidow,1,2,5 P. Wolkenstein,1,2,5, H. Assier1,2,* Abstract Background Cross-reactivity among beta-lactam antibiotics (BL) is essentially reported in immediate hypersensitivity. Objectives To evaluate cross-reactivity beyond BLs in patients with non-immediate cutaneous adverse drug reaction (non-immediate CADR) managed in a dermatology reference centre of toxic bullous and severe CADRs. Patients/Materials/Methods We conducted a retrospective single-centre study in consecutive patients consulting between 2010 and 2018 with an active BL-suspected non-immediate CADR and explored by cutaneous tests [patch tests (PT) and intradermal tests (P-IDR)] for at least three penicillin’s subclasses and amino- and non-amino-cepha

 Granulomatosis eosinofílica con poliangitis (GEPA) Dra. Natalia Aguirre 

Atopic Dermatitis Is a Barrier Issue, Not an Allergy Issue Authors: Monica T Kraft  1 , Benjamin T Prince  2 Abstract Atopic dermatitis (AD) is a chronic, relapsing disease that typically manifests in childhood and improves with age. Studies have demonstrated that the presence of AD increases the risk of developing food allergy, allergic rhinitis, and asthma later in life. Although children with AD are more likely to produce allergen-specific immunoglobulin E, there is conflicting evidence that allergen avoidance improves disease severity. Furthermore, food-elimination diets in patients with AD may increase the risk of developing immediate, life-threatening reactions to the removed food. The most effective treatments of AD aim to repair and protect the skin barrier and decrease inflammation. Keywords: Allergic rhinitis; Asthma; Atopic dermatitis; Atopic march; Eczema; Food allergy. DOI  10.1016/j.iac.2019.07.005

Pediatric Drug Allergies: Updates on Beta-Lactam, Nonsteroidal Anti-Inflammatory Drug, and Chemotherapeutic Reactions Authors: Shazia Lutfeali  1 , David A Khan  2 Abstract Adverse drug reactions are frequently reported in pediatric patients. In this review article, the authors discuss pediatric drug allergies with emphasis on the most common culprits, beta-lactam antibiotics and non-steroidal anti-inflammatory drugs. The authors also discuss reactions to non-beta-lactam antibiotics and chemotherapeutics. Skin testing has not yet been validated for many drugs, although notable exceptions include penicillin and carboplatin. The gold standard for diagnosis in most cases remains drug challenge, and the need for penicillin skin testing prior to oral provocation challenge has been questioned in recent studies. Successful desensitizations have also been reported with several drugs. Keywords: Beta lactam antibiotics; Chemotherapeutics; Hypersensitivity reactions; Non-beta lactam antibiotics;