ALERGOLOGÍA PARA MÉDICOS Y PACIENTES 2021

Reactivation of Varicella Zoster Virus after Vaccination for SARS-CoV-2 Authors:  Mina Psichogiou, Michael Samarkos, Nikolaos Mikos, and Angelos Hatzakis Abstract: Seven immunocompetent patients aged > 50 years old presented with herpes zoster (HZ) infection in a median of 9 days (range 7–20) after vaccination against SARS-CoV-2. The occurrence of HZ within the time window 1–21 days after vaccination defined for increased risk and the reported T cell-mediated immunity involvement suggest that COVID-19 vaccination is a probable cause of HZ. These cases support the importance of continuing assessment of vaccine safety during the ongoing massive vaccination for the COVID-19 pandemic and encourage reporting and communication of any vaccination-associated adverse event. DOI:   10.3390/vaccines9060572

Transitioning From Immunosuppressants to Dupilumab in Pediatric Atopic Dermatitis Authors: Catherine M. Ludwig,  Jennifer L. Hsiao, Peter A. Lio, and Vivian Y. Shi Abstract: Dupilumab has recently been approved by the Food and Drug Administration for use for treatment of moderate to severe atopic dermatitis in children aged 6 to 11 years. It presents a novel treatment option with a favorable safety profile for patients who are currently reliant on immunosuppressants, including cyclosporine A, methotrexate, and mycophenolate mofetil. Particularly during the current COVID-19 pandemic, immunosuppression should be avoided to retain intrinsic antiviral immunity. Transitioning to dupilumab should be executed strategically tapering immunosuppressants and minimizing risk of flare by overlapping with the biologic. Herein, we use results of outcome measurements from LIBERTY AD ADOL and LIBERTY AD PEDS trials of dupilumab in adolescents aged 12 to 18 years and children aged 6 to 11 years, res...

Wet Wrap Therapy in Moderate to Severe Atopic Dermatitis Authors:   Noreen Heer Nicol, Mark Boguniewicz Key points: - Atopic dermatitis (AD) remains a complex, common, chronic, and relapsing skin disorder, and a global public health problem. - National and international guidelines address AD care in a stepwise fashion. Wet wrap therapy (WWT) is a therapeutic intervention for moderate to severe AD. - WWT plays an important role as an acute therapeutic intervention for management of moderate to severe AD used with undiluted topical corticosteroids of appropriate potency. - WWT should not be used for mild AD or as a chronic or maintenance therapy. - WWT should be considered as a treatment option ahead of the systemic therapies for pa- tients failing conventional topical therapy. DOI:   10.1016/j.iac.2016.08.003

Benefits of baked milk oral immunotherapy in French children with cow's milk allergy Authors:   Vianney Gruzelle, Agnès Juchet, Audrey Martin-Blonde, Marine Michelet, Anne Chabbert-Broue, Alain Didier Abstract:  Background: Introduction and gradual incremental escalation of a low dose of baked milk may accelerate the resolution of severe cow's milk (CM) allergy for some children. The purpose of our study was to evaluate the efficacy and safety of baked milk oral immunotherapy (OIT) in children with CM allergy after a low-dose baked milk oral food challenge (OFC). Methods: In a retrospective analysis of OFC performed between 2013 and 2018 at the Children's Hospital of Toulouse (France), we identified 64 children with CM allergy and high milk and casein-specific IgE levels, who underwent a total of 171 milk OFC. Mean age at 1st OFC was 4.8 years. Mean CM-specific IgE was 47.9 kUA/L, and mean casein-specific IgE was 42.3 kUA/L. Results: Most children were...

Contact urticaria: Frequency, elicitors and cofactors in three cohorts (Information Network of Departments of Dermatology; Network of Anaphylaxis; and Department of Dermatology, University Hospital Erlangen, Germany) Authors: Helene Süß, Sabine Dölle-Bierke,  Johannes Geier, Burkhard Kreft, Eva Oppel, Claudia Pföhler, Christoph Skudlik, Margitta Worm, Vera Mahler Abstract:   Background: Contact urticaria (CU) is an infrequent, mostly occupational disease that may be life-threatening (CU syndrome stage 4). Objectives: To identify the current frequency, elicitors and cofactors of CU. Patients: Three cohorts were retrospectively analysed for CU: (a) patients from the Information Network of Departments of Dermatology (IVDK) database (2000-2014; n = 159 947); (b) patients from an allergy unit (Department of Dermatology, University Hospital Erlangen, 2000-2015; n = 4741); and (c) patients from the Anaphylaxis Registry (2007-2015: 6365 reported cases, in...

Crisaborole Ointment, 2%, for Treatment of Patients with Mild-to-Moderate Atopic Dermatitis: Systematic Literature Review and Network Meta-Analysis Authors: Kyle Fahrbach . Jialu Tarpey . Evelien Bergrath Washington . Rachel Hughes . Howard Thom . Maureen P. Neary . Amy Cha . Robert Gerber . Joseph C. Cappelleri Abstract:  Introduction: There is a need to compare efficacy and safety profiles of crisaborole ointment, 2%, versus other topical treatments across randomized clinical trials (RCTs). We performed this review/network meta-analysis to evaluate the comparative efficacy and safety of crisaborole versus other topical pharmacologic therapies for mild-to-moderate atopic dermatitis (AD) among patients aged >2 years Methods: Searches were conducted in MEDLINE, Embase, the Cochrane Collection Central Register of Clinical Trials, and the Database of Abstracts of Reviews of Effects using Ovid to identify English language articles reporting RCTs of topical anti-inflammatory agents i...

Prevention and management of allergic reactions to food in child care centers and schools: Practice guidelines Authors:  Susan Waserman, MD, MSc,a Heather Cruickshank, BA,a Kyla J. Hildebrand, MD, MSsCH,b Douglas Mack, MD,a Laura Bantock, RN,c Theresa Bingemann, MD,d,e Derek K. Chu, MD, PhD,a Carlos Cuello-Garcia, MD, PhD,f,g Motohiro Ebisawa, MD,PhD,hDavidFahmy,MD,aDavidM.Fleischer,MD,i,j Lisa Galloway, BA,BEd,kGreg Gartrell, MA,k Matthew Greenhawt, MD,j Nicola Hamilton, RN, Jonathan Hourihane, MD,l,m Michael Langlois, CES, CHSC, CRSP,n Richard Loh, MD,o Antonella Muraro, MD, PhD,p Lana Rosenfield, MD,q Sally Schoessler, MSEd, BSN, RN, AE-C,r Mimi L. K. Tang, MD,s,t Brenda Weitzner, MD,u Julie Wang, MD,v and Jan L. Brozek, MD, PhDa,f Abstract: Food allergy management in child care centers and schools is a controversial topic, for which evidence-based guidance is needed. Following the Grading of Recommendations Assessment, Development, and Evaluation approach, we conducted systemat...

Triggers of Exacerbation in Chronic Urticaria and Recurrent Angioedema—Prevalence and Relevance Authors:  Anete Sevciovic Grumach, MD, MS, PhD , Petra Staubach-Renz, MD, Ricardo Cardona Villa, MD, MS, Susana Diez-Zuluaga, MD, Imke Reese, PhD, and William R. Lumry, MD Abstract: Patients with urticaria and angioedema often have triggers that cause an outbreak or a swelling episode or worsen their chronic condition. Exploring these factors with each patient may result in better understanding and control of their disease. Patients should be advised to avoid known triggers, if feasible, or prepare to prevent or control an exacerbation with appropriate pretreatment if avoidance is not possible. In this review, we describe and discuss a variety of factors for which there is evidence that they cause or exacerbate chronic spontaneous urticaria and angioedema. These potentially exacerbating factors include drugs, food additives, and naturally occurring pseudoallergens, mental stress, and tra...