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Basophilic granulocytes, containing and releasing histamine after a specific allergy stimulation, are directly involved in IgE-mediated allergic reactions. CD63 is a transmembrane protein of secretory lysosomes of basophils and its upregulation is related with the release of histamine to the extracellular space during IgE-mediated allergic reactions. Basophil activation test (BAT) measures the activation of circulating basophils upon the in vitro stimulation of living blood cells with specific allergens. Such a test is particularly safe and reproducible and has recently emerged as a new promising diagnostic tool for allergic diseases. BAT can be used to diagnose food allergy and represents a promising alternative to oral food challenge tests, especially in children as it is less invasive, safer, and cheaper than the gold standard tests. As a biomarker of tolerance and reactivity, it is also useful to monitor natural resolution and clinical response to immune-modulatory treatments. Regarding drug allergies, BAT is even the only possible applicable diagnostic tool for allergy reactions to some drugs, because of the lack of alternative test, or given that those commonly used are unreliable, or equivocal. Additionally, BAT allows to screen patients with more active urticarial and identify Hymenoptera-allergic patients with negative venom-specific immunoglobulin (Ig)E. In respiratory allergic diseases, BAT can facilitate the diagnosis of local allergic rhinitis and evaluate basophil allergen sensitivity in allergic asthma. Although IgE-sensitization in allergic asthma is usually demonstrated by skin prick test and specific IgE, those tests do not predict the clinical allergy contribution to asthma pathogenesis. To date, the potential of BAT in the diagnostic work-up of allergic diseases is well established, but a better standardization of its use is needed. This narrative review summarizes the state-of-the-art BAT technology and applications in pediatric allergic diseases, focusing on immune-related mechanisms and the BAT real clinical utility., Competing Interests: The authors have no conflicts of interest to declare that are relevant to the content of this article., (© 2024 Published by Elsevier Inc. on behalf of World Allergy Organization.)

Background: Reliable evidence to guide the management of melanoma in situ (MIS) and minimize the risk of recurrence is lacking., Objective: To identify clinicopathological predictors of local recurrence (LR) in patients with MIS and evaluate long-term outcomes according to pathological excision margins., Methods: A case-control study of patients with MIS treated at a large Australian melanoma treatment center from January 2008 to December 2012 was undertaken. Clinicopathological characteristics of patients who developed LR and those who did not were compared., Results: LR developed in 34 of 1407 patients with MIS (2.5%). Median time to LR was 20 months. The primary lesion was removed with pathological margins <4 mm ( P  < .001) in 67.6 % of patients with LR. Four patients died of metastatic melanoma following LR. Comparing patients with pathological margins <4 mm and ≥4 mm, the former were older (>60y, P  < .001), more frequently had MIS on the head or neck ( P  < .001), had a greater LR rate ( P  < .001), and had a higher mortality from all causes ( P  < .001)., Limitations: Retrospective, single-institution study., Conclusions: Pathological margins of ≥4 mm should be considered for patients with MIS who are treated with standard surgical excision and assessed by examining serial slices taken from the formalin-fixed, paraffin-embedded specimen., Competing Interests: RAS has received fees for professional services from Evaxion, Provectus Inc, Qbiotics, Novartis, Merck Sharp & Dohme, NeraCare, AMGEN Inc, Bristol-Myers Squibb, Myriad Genetics, and GlaxoSmithKline. JFT has received honoraria for advisory board participation from BMS Australia, MSD Australia, GSK, and Provectus Inc and travel and conference support from GSK, Provectus Inc, and Novartis., (© 2022 by the American Academy of Dermatology, Inc. Published by Elsevier Inc.)