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In 145 patients, revaccination was performed with the culprit vaccine, which was well tolerated in 126 of the patients, and 15 of the patients had an alternative COVID-19 vaccine (other mRNA vaccine for 12), which was well tolerated in 13 of the patients (Figure 1). Keywords: allergy; anaphylaxis; COVID-19-mRNA vaccines EN allergy anaphylaxis COVID-19-mRNA vaccines 2320 2323 4 08/02/23 20230801 NES 230801 To the Editor, The mechanisms of allergic reactions to COVID-19-mRNA vaccines have not been elucidated. One hundred and sixty patients (84%) were revaccinated (122 under antihistamine premedication), 139 patients (87%) had good tolerance, and 30 patients refused further COVID-19 vaccination. [Extracted from the article]

Chronic spontaneous urticaria (CSU) is characterized by recurring hives and/or angioedema lasting for at least 6 weeks, while Chronic Inducible Urticaria (CIndU) is triggered by specific stimuli. A recent Turkish study analyzed 423 patients with different types of CIndU and found that isolated CIndU was more common than cases where CSU coexisted with CIndU. The study also identified demographic differences among CIndU subtypes, with cholinergic urticaria affecting younger male patients more frequently. Systemic reactions were observed in some subtypes of CIndU, such as cold urticaria and cholinergic urticaria, but not in CSU. Understanding the distinct clinical presentations of CIndU subtypes is important for developing appropriate therapeutic approaches. [Extracted from the article]

Background: Anaphylaxis, which is rare, has been reported after COVID‐19 vaccination, but its management is not standardized. Method: Members of the European Network for Drug Allergy and the European Academy of Allergy and Clinical Immunology interested in drug allergy participated in an online questionnaire on pre‐vaccination screening and management of allergic reactions to COVID‐19 vaccines, and literature was analysed. Results: No death due to anaphylaxis to COVID‐19 vaccines has been confirmed in scientific literature. Potential allergens, polyethylene glycol (PEG), polysorbate and tromethamine are excipients. The authors propose allergy evaluation of persons with the following histories: 1—anaphylaxis to injectable drug or vaccine containing PEG or derivatives; 2—anaphylaxis to oral/topical PEG containing products; 3—recurrent anaphylaxis of unknown cause; 4—suspected or confirmed allergy to any mRNA vaccine; and 5—confirmed allergy to PEG or derivatives. We recommend a prick‐to‐prick skin test with the left‐over solution in the suspected vaccine vial to avoid waste. Prick test panel should include PEG 4000 or 3500, PEG 2000 and polysorbate 80. The value of in vitro test is arguable. Conclusions: These recommendations will lead to a better knowledge of the management and mechanisms involved in anaphylaxis to COVID‐19 vaccines and enable more people with history of allergy to be vaccinated. [ABSTRACT FROM AUTHOR]

(C) Positive prick test with undiluted Desomedine on delayed reading at day 2 (same prick test as in B) gl Prick tests were performed with undiluted Desomedine (hexamidine 0.1%), and these confirmed both immediate and delayed type hypersensitivity on immediate (Figure 1B) and delayed readings on day (D)2 (Figure 1C). Although allergic contact dermatitis in response to antiseptics is common, we should be aware that occasionally this may co-exist with immediate-type hypersensitivity, and also with molecules frequently sold over the counter. Keywords: case report; delayed hypersensitivity; hexamidine; immediate hypersensitivity EN case report delayed hypersensitivity hexamidine immediate hypersensitivity 580 582 3 10/22/21 20211101 NES 211101 CASE REPORT A 66-year-old man with a history of arterial hypertension (treated by dietary approaches only), allergic rhinitis, asthma, and atopic dermatitis, developed a grade II anaphylactic reaction 5 minutes after the first intranasal application of hexamidine (Desomedine, Chauvin Bausch & Lomb laboratory, Montpellier, France) for a cold. [Extracted from the article]