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The article reports on a study which assesses the diagnostic value of tomato atopy patch (APT) test in adult atopic dermatitis. The study enlisted a total of 98 patients with persistent mild-to-severe atopic eczema/dermatitis syndrome (AEDS), comprises of 42 males and 56 females with mean age of 34.7 years. Moreover, researchers stressed the importance of the tomato ingestion in the determinism of adult AEDS in a population with high tomato diet consumption.

Homozygous familial hypobetalipoproteinaemia (Ho-FHBL) is a rare co-dominant disorder characterized by extremely low levels of low-density lipoprotein cholesterol (LDL-C) and apolipoprotein B (apoB). Most patients with Ho-FHBL have mutations in APOB gene resulting in truncated apoBs. Some patients are asymptomatic, while others have fatty liver, intestinal fat malabsorption and neurological dysfunctions. We investigated three adult subjects with severe hypobetalipoproteinaemia and a family history of FHBL. Proband FHBL-47 had liver cirrhosis with hepatocarcinoma and a renal carcinoma but no clinical manifestations related to FHBL. He was a compound heterozygote for a 7-bp deletion in exon 21 and a base insertion in exon 26 resulting in truncated apoBs (apoB-22.46/apoB-66.51). Proband FHBL-53, with severe hepatic steatosis and fibrosis, had a nonsense mutation in exon 19 resulting in a truncated apoB (apoB-20.61) and a rare nucleotide substitution in intron 14 (c.2068-4T>A). The latter was also present in her daughter, found to have low plasma LDL-C and apoB. Proband FHBL-82 had chronic diarrhoea and steatorrhoea. She was found to be homozygous for a nonsense mutation in exon 24 resulting in a truncated apoB (apoB-26.65). In adult subjects, the presence of chronic liver disease and chronic diarrhoea, when associated with severe hypobetalipoproteinaemia, may lead to the diagnosis of Ho-FHBL. [ABSTRACT FROM AUTHOR]

Adverse reactions (ARs) to drugs administered during general anesthesia may be very severe and life-threatening, with a mortality rate ranging from 3 to 9%. The adverse reactions to drugs may be IgE and non-IgE-mediated. Neuromuscular blocking agents (NMBA) represent the first cause of perioperative reactions during general anesthesia followed by latex, antibiotics, hypnotic agents, opioids, colloids, dyes and antiseptics (chlorhexidine). All these substances (i.e. NMBA, anesthetics, antibiotics, latex devices) may cause severe systemic non-IgE-mediated reactions or fatal anaphylactic events even in the absence of any evident risk factor in the patient's anamnesis. For this reason, in order to minimize perioperative anaphylactic reactions, it is important to have rapid, specific, sensitive in vitro diagnostic tests able to confirm the clinical diagnosis of acute anaphylaxis. [ABSTRACT FROM AUTHOR]

We present the cases of 5 patients with a positive clinical history of cutaneous symptoms due to contact with latex products. A latex allergological assessment was made through skin prick tests (SPTs) both with commercial latex extracts and extemporaneous glove extracts, and serum-specific IgE to latex and glove-use tests. In addition, serum-specific IgE to recombinant allergens for Hevea brasiliensis was dosed. Molecular diagnostics in association with the glove-use test and, to a lesser extent, the SPTs with glove eluate are useful diagnostic tests to confirm the diagnosis of latex allergy in patients with mucocutaneous symptoms. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

The article presents the case study of a 49 year old man who was suffering from rhinitis and conjunctivitis after the intake of the medicine metamizole and had a history of nasal and ocular symptoms. He was suggested aspirin by the physician as he never consumed nonsteroidal anti-inflammatory drugs (NSAIDs). He underwent several test to confirm the reaction of metamizole as a cause for rhinitis and conjunctivitis. The article discusses the role of metamizole as an allergic agent.

The article focuses on a study done on the treatment of acquired cold urticaria (ACU) with rupatadine. It states that ACU is a physical urticaria triggered by the exposure of the skin to cold, and randomized clinical trials indicated the efficacy of rupatadine in patients with chronic idiopathic urticaria (CIU). It evaluates the efficacy of rupatadine in three nonatopic patients with idiopathic and refractory ACU, and concludes that rupatadine may be an effective drug for the treatment of ACU.

The article presents a case study of a 65-year-old female patient who have an itchy, 4 centimeter violaceous, discoid, and bullous plaque on her right forearm. An overview of her medical history is offered. It notes that the patient was diagnosed with fixed drug eruption where the responsible drug agent is unclear, and thus considers ibuprofen, used by the patient as anti-inflammatory drug, as one possible cause. It concludes that injected sodium fluorescein is the cause of fixed drug eruption.

A letter to the editor is presented in response to the article about the dangerousness of tattoos with black henna, which may induce asthma due to Indigo argentea.

A letter to the editor is presented which discusses the allergic effect of fluconazole intake to a 42-year old patient.

Background. In the last few years, adverse reactions to mydriatic eyedrops have been investigated. However, is not still available a standardized protocol, capable of identify the pathogenetic mechanism. In the light of these findings we have evaluated the reliability of a protocol with well established concentration of specific allergens. METHODS: The diagnostic method includes the application of patch test series Gruppo Italiano Ricerca Dermatiti da Contatto e Ambientali (GIRDCA), medicaments, corticosteroids, local anesthetics, main eyedrops' excipients, pure active principles and extemporaneous preparations with mydriatic eyewashes. At the same time, skin prick test with a solution of atropine sulfate at 1‰ and an intradermal test with injection of atropine at 0.01‰ were carried out. RESULTS: After patch tests were removed, we detected seven positiveness to the phenylephrine, two to the benzalkonium chloride, one to thiomersal, one to the ethylendiamine and one to the atropine sulfate 1‰. With intradermal tests we obtained three positiveness in patients who reported adverse reactions to atropine. CONCLUSIONS: Our results show that phenylephrine is frequently responsible for allergic conjunctivitis (53.8%). In the case of atropine, even though the limited number of patients suggests to perform more extensive studies, it emerges that our diagnostic protocol is safe and might be able to screen allergic reactions in the field of ophthalmopathies. [ABSTRACT FROM AUTHOR]

I Dear Editor i , Recently, dupilumab, an anti-IL-4R antibody, has become available for the treatment of moderate-to-severe atopic dermatitis (AD).1-4 Baseline patient characteristics that can be used as predictors of response to dupilumab treatment in AD patients have not yet been identified. In conclusion, this study highlights that specific baseline patient characteristics may help to predict treatment outcomes and the time of a complete response to dupilumab in AD. [Extracted from the article]

Dear Editor, Dupilumab, an inhibitor of interleukin (IL)-4/13 activity, is a biological agent approved for the treatment of moderate-to-severe atopic dermatitis (AD).1 In this study, we aimed to assess the long-term effectiveness and safety of dupilumab in a real-world clinical setting. Primary effectiveness outcomes included the proportion of patients at week 52 achieving EASI improvements of 50%, 75% or 90% (EASI 50, EASI 75 or EASI 90). Laboratory safety of dupilumab in moderate-to-severe atopic dermatitis: results from three phase III trials (LIBERTY AD SOLO 1, LIBERTY AD SOLO 2, LIBERTY AD CHRONOS). [Extracted from the article]

Background: Emerging data have strengthened the importance of substance P (SP) as a proinflammatory mediator in human pathology. A role for SP in the pathogenesis of urticaria has long been hypothesized. Methods: Literature data regarding the possible role of SP in chronic urticaria/chronic spontaneous urticaria (CSU) have been reviewed and summarized in this manuscript. This review is based on pertinent articles that were retrieved by a selective literature search in the PubMed database. Articles in English published up to July 2018 were taken into consideration. Results: Recent studies in patients with CSU have demonstrated that circulating levels of SP are significantly elevated, in correlation with disease severity, and that SP-positive basophils are upregulated. SP has been shown to trigger degranulation in basophils derived from CSU patients. Moreover, SP can be involved in pseudoallergic reactions and may act as a histamine-releasing factor in a subset of patients with CSU. Current evidence suggests that the biological activity of SP can be exerted not only through the conventional NK-1 receptor but also through the recently identified Mas-related G protein-coupled receptors. MRGPRX2 can cause mast cell activation and has been found to be upregulated in the skin of patients with severe chronic urticaria. Conclusions: Many findings seem to support the pathogenic involvement of SP in chronic urticaria/CSU. However, further studies are necessary to elucidate the role of SP as a mediator in CSU pathogenesis and a potential new therapeutic target. [ABSTRACT FROM AUTHOR]

Abstract: Extremely low LDL-cholesterol concentrations are very unusual and generally related with comorbidities accompanying malnutrition. Less frequently low LDL-cholesterol levels result from mutations in the APOB, PCSK9, ANGPTL3, SAR1B and MTTP genes (primary hypobetalipoproteinemia). We investigated three patients with plasma LDL-cholesterol levels below the fifth percentile of the Spanish population. We recorded data on demographic and anthropometric characteristics, life style habits, physical examination, liver ultrasound and lipid and lipoprotein levels, in the probands and their first-degree relatives. Secondary causes of hypocholesterolemia were ruled out by clinical study, complementary tests and follow-up. The APOB, MTTP and SAR1B genes were sequenced. Patients were found to be heterozygotes for point mutations located in the exon 26 of the APOB gene. One patient, with fatty liver, carried a previously described mutation (c.7600C>T) (Arg2507X), causing the formation of truncated Apo B-55.25. The other two mutations producing truncations are new. One asymptomatic patient carried the Arg3672X (Apo B-80.93) and the other with fatty liver and steatorrhea carried the Ser2184fsVal2193X (Apo B-48.32). Our study reinforces the concept that in the heterozygous carriers of truncated Apo Bs, the clinical manifestations of FHBL are dependent on the size of the truncations. [Copyright &y& Elsevier]

Background: The aim of this study was to identify the prevalence of allergic disease in young soccer players compared to age-matched students and to evaluate if this prevalence changes as the intensity of training increases. Methods: A modified ECRHS questionnaire was administered to 194 soccer players divided by age as Beginners (8–11 years), Juniors (12–16 years) and Under 21 (17–20 years) to evaluate the prevalence of allergic diseases and symptoms as well as drug consumption. Subjects with a positive personal history of allergic diseases underwent skin prick and/or patch tests. Age-matched students ( n = 136) were used as a control group. Results: The prevalence of allergic diseases was 34.5% in soccer players and 31.6% in control subjects (n.s.). Skin sensitization to inhalant allergens was detected in 14.4% of symptomatic soccer players and in 19.2% of control students (n.s.). Patch tests were positive in 35.7% of soccer players and 23.0% of controls with allergic dermatitis (n.s.). The prevalence of allergic diseases did not significantly change in relation to the intensity of training. Although the relative prevalence of sensitization to perennial allergens and asthma was less frequent in soccer players than in controls, and the occurrence of exercise-induced bronchoconstriction was similar in the two groups, soccer players used twice as many anti-allergic and anti-asthmatic drugs as control students. Conclusions: An increasingly intensive training programme is not associated with greater risk of allergic disease in soccer players. Therapy regimens of allergic athletes and exercisers should be monitored more closely to guarantee adequate treatment yet avoid inappropriate drug use and doping practices. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 22-year-old man who was diagnosed with recurrent erythematous-oedematous dermatitis of the penis and balanoposthitis. Patch tests conducted by the Societa e Allergologia Professionale e Ambientale revealed that it was due to thiuram mix reaction and benzocaine. The relation between thiurams contact sensitization and contact dermatitis along with the clinical relevance of condom use are also discussed.

This article focuses on cutaneous adverse drug reactions to fluticasone propionate (Fp) and deflazacort in an asthmatic patient. A 57-year-old female patient was presented, affected by allergic asthma with sensitization to Grass, Parietaria and Olive pollens. During a therapy with a mixture of propyphenazone, dihydroergotamine and caffeine, the patient presented a generalized urticaria and asthmatic symptoms. The recommended therapy was formoterol and Fp. Following the consumption of Fluticasone for 2 weeks, the patient referred oral dryness, palate itch and dysphonia. The application of Fp ointment in occlusion and in the open on the forearm was responsible for an urticarial reaction.