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Dr. Seneschal has been an investigator, speaker, or consultant for Novartis, Abbvie, Sanofi, LeoPharma and Eli Lilly. Dr. De Raeve is a consultant, member of scientific advisory boards and/ or received personal fees and non-financial support from LEO Pharma, Pierre Fabre, Sanofi-Genzyme and Bioderma. Dr. Vestergaard has been investigator, speaker, or consultant for Novartis, Abbvie, Sanofi, LeoPharma and Eli Lilly. [Extracted from the article]

Aims: Fractures and dislocations of the midfoot are relatively uncommon but can be life changing injuries. Within the literature, there has been scant specific reference to the identification and management of medial ray injuries in midfoot trauma. Moreover, it is appreciated that these injuries are associated with poor outcomes. We aim to clearly define these injury characteristics and demonstrate fixation techniques.Patients and Methods: A retrospective review of the case notes and imaging was conducted for operatively treated midfoot injuries between January 2013 and January 2018.Results: 161 patients were identified, 31 of these with imaging and operative diagnosis suggestive of medial ray injury. Studying these 31 injuries revealed five patterns of injury.Conclusion: When treating midfoot trauma, it is important to fully understand the injury pattern as this dictates the principles and techniques of fixation. Identification and knowledge of these five injury patterns will aid surgeons in future management of these injuries and may improve treatment outcomes. [ABSTRACT FROM AUTHOR]

Background: Atopic eczema (AE, atopic dermatitis) is one of the most common non‐communicable inflammatory skin diseases affecting 1–5% of the adult population in Europe with marked impairment in quality of life. In spite of great progress in understanding the pathophysiology of disturbed skin barrier and immune deviation, AE still represents a problem in daily clinical practice. Furthermore, the true impact of AE on individual suffering is often not recognized. Objectives: With a large European study, we wanted to provide insights into the actual suffering and individual burden of disease in adult patients with AE. Methods: A total of 1189 adult patients (18–87 years, 56% female) with moderate to severe AE were recruited in nine European countries by dermatologists or allergists together with the help of patient organizations. A computer‐assisted telephone interview was performed by experienced interviewers between October 2017 and March 2018. The following instruments were used to assess severity or measure quality of life: Patient‐Oriented Eczema Measure (POEM), Dermatology Life Quality Index (DLQI), Hospital Anxiety and Depression Scale (HADS‐D) and a newly developed Atopic Eczema Score of Emotional Consequences (AESEC). Patients were also asked to self‐assess the severity of their disease. Results: Despite current treatment, 45% of participants still had actual moderate to very severe AE in POEM. Due to their skin disease, 57% missed at least 1 day of work in the preceding year. DLQI showed moderate to extremely large impairment in 55%. According to HADS‐D, 10% scored on or above the threshold of eight points with signs of depressive symptoms. Assessed with AESEC, 57% were emotionally burdened with feelings such as 'trying to hide the eczema', 'feeling guilty about eczema', having 'problems with intimacy' and more. Of persons actually suffering from severe AE, 88% stated that their AE at least partly compromised their ability to face life. Conclusions: This real‐life study shows that adults with a moderate to severe form of AE are suffering more than what would be deemed acceptable. There is a need for increased awareness of this problem among healthcare professionals, policymakers and the general public to support research in the development of new and more effective treatments and provide access to better and affordable health care for affected patients. [ABSTRACT FROM AUTHOR]

The year 2020 was the year of the coronavirus pandemic, and this has been reflected in JEADV. A new area of "happiness research" may offer new insights - it has been shown that patients with psoriasis and atopic eczema experienced significantly lower levels of happiness (e.g. manifested by positive attention).26 Finally, a number of important guidelines have been published in 2020: Topical photodynamic therapy. Efficacy of risankizumab in patients with moderate-to-severe plaque psoriasis by baseline demographics, disease characteristics and prior biologic therapy: an integrated analysis of the phase III UltIMMa-1 and UltIMMa-2 studies. Functional and anatomical brain connectivity in psoriasis patients and healthy controls: a pilot brain imaging study after exposure to mentally induced itch. [Extracted from the article]

An editorial is presented on the developments in the field of oncology, immunology and treatments for autoimmune diseases. It talks about the use of biologics and emollient therapy for the treatment of dermatitis or eczema in children and adults. It tells about the cervico-facial rhytidectom and Conventional therapy being used frequently in dermatosurgery.

This article examines the influence of both individual and organizational moral identity centrality on prosocial behaviors. Furthermore, we hypothesize that the centrality of these two offer a substitute effect on these behavioral outcomes. Validated measures of organizational moral identity centrality and unethical prosocial behavior are introduced. Data were collected via two separate samples, University Greek Life organization members (n = 499) and restaurant workers (n = 137). Regression results supporting that individuals who claim centrality of moral identity and see their organizations to also embrace the centrality are more likely to engage in citizenship behaviors and less likely to commit unethical prosocial acts. Furthermore, results support that both forms of centrality of moral identity were substitutes in terms of affecting these two outcomes. Research that contributes to understanding how individuals within an organization consciously choose to act on behalf of the organization even when these very actions conflict with generally accepted morals of right and wrong within their society is valuable to academics and practitioners alike. This study contributes to this body of knowledge. Despite extensive attention to topics of ethics and identity, previous studies have largely overlooked the impact of an organizational moral identity. Our results provide a framework for understanding the role of moral identity and the prediction of organizational citizenship and unethical prosocial behaviors. [ABSTRACT FROM AUTHOR]

The enhanced expression of PD-L1 in tumour cells of ulcerated melanomas contributes to an immunosuppressive, tumour growth-promoting microenvironment with unfavourable prognosis and subsequent development of brain metastases.[4] Clinical trials with new therapeutic methods in atopic dermatitis often show very high placebo response rates, and this has given rise to a number of recommendations on how to deal with this problem for clinical trials in atopic dermatitis.[15] Increased tumour cell PD-L1 expression, macrophage and dendritic cell infiltration characterise the tumour microenvironment of ulcerated primary melanomas. Inverse association for diagnosis of Alzheimer's disease subsequent to both melanoma and non-melanoma skin cancers in a large, urban, single-centre, Midwestern US patient population. [Extracted from the article]

The adverse health effects of smoking are well known, including its effects on the musculoskeletal system. Limb reconstruction using external fixators is a high intensity process with high levels of patient contact time, complications and cost. The aim of this study was to examine smoking patterns in this group and in particular to assess trends in smoking cession. Data was collected from 41 patients all undergoing treatment using circular frame external fixation, for a variety of pathologies, most commonly acute tibial trauma. A patient reported questionnaire was used. Data was collected over a six-month period. In our population 56.1% of patients were smokers. During the study 47.8% patients stopped smoking and a further 39.1% decreased their smoking behaviour. 78.3% of patients could recall being given smoking cessation advice. In our group, 87% of patients were unaware of the effects of smoking on bone healing. Once made aware during discussion of proposed treatment, 73.9% stated that it was, in part, this knowledge that prompted them to positively change their smoking habits. The results of this study show that advice regarding smoking cessation during limb reconstruction treatment can potentially have a positive impact on patients smoking habits. The effect of smoking should be linked to the patient pathology and discussed during the consent process. Taking the time with the patient for this simple free intervention can have a positive impact on patient health, and potentially on the outcome of their current treatment, and is an opportunity not to be missed. [ABSTRACT FROM AUTHOR]

An interview with Professor Otto Braun-Falco is presented. He discusses his interest towards dermatology and his graduation from the University of Mainz. He shares value of Professor Dr. Egon Keining who offered him a job where he learns the different concept of Dermatology and Venereology. He mentions his discovery regarding ultrastructural aspects of the skin

Wrist and scaphoid fractures are common injuries seen and treated in everyday orthopaedic practice. The purpose of the study was to assess the trends and reasons for litigation related to wrist and scaphoid fractures within the NHS. Under a freedom of information (FOI) request, data from 1995 to 2012 were provided by the National Health Service Litigation Authority (NHSLA) on all litigation claims made as a result of wrist and scaphoid fractures. A total of 1354 claims relating to the hand and wrist were identified. Wrist and scaphoid fractures accounted for 492 (36.3%) of these claims, and 365 of these claims were settled, representing 74.2% of all wrist and scaphoid fracture claims. Overall, the most common reason for lost claims was due to incorrect, missed or delayed diagnosis (43.5%). Alleged mismanagement (29.5%), poor care (10.1%) and incompetent surgery (8.0%) were other common causes for litigation. This paper augments previous work published in this area and explores litigation trends specific to wrist and scaphoid fractures. We discuss the trends and reasons for litigation in this area, suggesting areas for improvement that may aid health-care professionals who deal with these injuries and potentially help reduce future litigation. [ABSTRACT FROM AUTHOR]

The article discusses the challenges in and actions to be taken to cure allergy caused by diseases such as asthma, eczema and anaphylaxis. It discusses the needs of public, which are not met like inadequate control of complex allergic diseases, lack of treatments and strategies to prevent it. It further discusses how environment plays vital role in the induction of allergic diseases as they have environmental factors like quality of air, nutrition, climate, and ultra violet radiations.

The new coronavirus (SARS-CoV-2) has affected the whole world within a couple of months by causing the new disease "coronavirus disease 2019 (COVID-19)". Whether oncological diseases, such as skin cancer, or inflammatory skin diseases, such as psoriasis or atopic eczema, are influenced and exacerbated by the virus is not known. Personal protective equipment induced facial dermatoses in healthcare workers managing COVID-19 cases. [Extracted from the article]

The existing evidence for treatment of atopic eczema (atopic dermatitis, AE) is evaluated using the national standard Appraisal of Guidelines Research and Evaluation. The consensus process consisted of a nominal group process and a DELPHI procedure. Management of AE must consider the individual symptomatic variability of the disease. Basic therapy is focused on hydrating topical treatment, and avoidance of specific and unspecific provocation factors. Anti-inflammatory treatment based on topical glucocorticosteroids and topical calcineurin inhibitors (TCI) is used for exacerbation management and more recently for proactive therapy in selected cases. Topical corticosteroids remain the mainstay of therapy, but the TCI tacrolimus and pimecrolimus are preferred in certain locations. Systemic immune-suppressive treatment is an option for severe refractory cases. Microbial colonization and superinfection may induce disease exacerbation and can justify additional antimicrobial treatment. Adjuvant therapy includes UV irradiation preferably with UVA1 wavelength or UVB 311 nm. Dietary recommendations should be specific and given only in diagnosed individual food allergy. Allergen-specific immunotherapy to aeroallergens may be useful in selected cases. Stress-induced exacerbations may make psychosomatic counselling recommendable. 'Eczema school' educational programs have been proven to be helpful. Pruritus is targeted with the majority of the recommended therapies, but some patients need additional antipruritic therapies. [ABSTRACT FROM AUTHOR]

Merkel cell carcinoma is a rare, but highly malignant tumor of the skin with high rates of metastasis and poor survival. Its incidence rate rises and is currently about 0.6/100000/year. Clinical differential diagnoses include basal cell carcinoma, cyst, amelanotic melanoma, lymphoma and atypical fibroxanthoma. In this review article clinical, histopathological and immunhistochemical features of Merkel cell carcinoma are reported. In addition, the role of Merkel cell polyomavirus is discussed. [ABSTRACT FROM AUTHOR]

Through the lens of social identity theory, this article investigates the influence of the social variable of the family as a catalyst for beneficial outcomes via a stewardship orientation within the firm. The family firm provides a unique perspective in that it possesses a broader range of influential social groupings. However, multiple identifications may not associate with only positive outcomes, as conflict may arise when such identities compete. We contend that the leadership within a family firm can capitalize on the benefits associated with multiple identifications and reduce conflict in the family firm based upon members' perceptions of transformational leadership. [ABSTRACT FROM AUTHOR]

The article presents information on the 7th International Meeting on Yeast Apoptosis held in Graz, Austria, from September 9-13, 2009. It is stated that to investigate cell-death pathways, many researchers presented their work with humanized yeast models. An overview of the progress of cell-death research in the last 20 years was presented by researcher Guido Kroemer.

The authors reflect on the query regarding the presence of the in vivo tests for contact dermatitis. They recount on the epidemiological studies which inferred that contact allergy is caused by sociodemographic parameters and plays an essential role in the general population. In addition, the authors impart that up to now, none of the in vitro tests for contact allergy fulfils the requisites of easy, accurate and safe test with sufficient specificity and sensitivity.

Atopic dermatitis is a chronic inflammatory skin disease characterized by recurrent intense pruritus and a distinctive distribution of skin lesions. The topical calcineurin inhibitors tacrolimus and pimecrolimus were approved in the USA, as an ointment and a cream, respectively, for the treatment of atopic dermatitis in 2000 and 2001, respectively. In 2005, the Pediatric Advisory Committee of the US FDA implemented a 'black box' warning for tacrolimus ointment and pimecrolimus cream due to the lack of long-term safety data and the potential risk of the development of malignancies. This article focuses on the safety aspects of these agents by discussing the findings from preclinical and clinical studies and postmarketing reports with regard to malignancies occurring after the use of tacrolimus ointment and pimecrolimus cream. [ABSTRACT FROM AUTHOR]

Background Pimecrolimus cream 1% has been shown to effectively control atopic eczema (AE) when applied twice daily from the first signs or symptoms of AE until clearance. Moreover, pimecrolimus cream 1% has a favourable safety profile, lacking topical corticosteroid-related side-effects such as skin atrophy, making it particularly useful to treat delicate body regions (e.g. the face). Objective The objective of this naturalistic study was to monitor the safety, tolerability and efficacy of pimecrolimus when used in the long-term management of AE in a real-life setting. Methods A multicentre, open-label study was conducted in 2034 patients aged ≥ 3 months with mild to moderate AE for up to 12 months’ duration. Patients applied pimecrolimus cream twice daily, initiating treatment at first signs or symptoms of AE, continuing until clearance. Results Patients ( n= 1847; 91%) completed 3 months of the study. Treatment success (clear or almost clear AE) after 3 months of treatment was observed on the whole body in 59% of patients and on the face in 81% of patients. Disease improvement of whole body and face was seen in 77% and 63% of patients, respectively. Pruritus was absent or mild in 79% of patients. Pimecrolimus cream was well tolerated throughout the study. Conclusion In a daily practice setting, pimecrolimus cream 1% effectively and safely controls AE. [ABSTRACT FROM AUTHOR]

The increasing prevalence of food allergies (especially allergy to peanuts) has led to a discussion of how safe topical preparations containing peanut oil are with respect to allergy. The major allergens from peanuts are proteins that have been characterized at a molecular level and cloned. Clinical signs of peanut allergy symptoms can be observed on the skin (urticaria), or in the gastrointestinal and/or respiratory tract culminating in cardiovascular symptoms and anaphylactic reactions. In most cases, symptoms are elicited by oral uptake; rarely, a contact urticaria has been described. In vegetable oils, the contents of protein differ depending on the production process: crude oils contain approximately 100 times more proteins than refined oils. This has clear-cut implications for allergic individuals. Quantitative data are available regarding elicitation of symptoms in allergic individuals with a threshold dose of 0.1–1 mg peanut allergen in oral provocation tests. There are anecdotal reports of adverse reactions after topical use of peanut oils. In one epidemiological trial, an association between topical use of skin care products containing peanut oil and the development of peanut allergy was observed; however, the data reflect a retrospective analysis without specifying skin care products containing peanut oil and also without analysing the quantity of topicals used. In contrast, oral tolerance was prevented and allergic sensitization was enhanced in a mouse model using high concentrations of peanut protein. So far, no reliable data are available regarding doses required to induce sensitization against peanut allergen via the epidermal route. A possible induction of sensitization against peanut proteins through contact with the skin via skin care products and the respective protein concentrations is a matter of speculation. Patients with atopic diseases, namely eczema, need appropriate skin care because of the disturbed skin barrier function. The benefit of avoiding damage to skin barrier functions of atopic individuals by the use of peanut protein-containing skin care products seems to outweigh possible risks of sensitization and/or allergy induction against substances contained in those products containing refined peanut oil. [ABSTRACT FROM AUTHOR]

Topical dermatotherapy is an art - and in danger of being forgotten; it is the domain of the dermatologist together with the pharmaceutical chemist and pharmacist who hold the secrets of galenics, namely the science of bringing the right substance in the right vehicle to the right spot. Often industry-sponsored supplements focus on a new drug giving insight into the pathophysiology of a certain disease, mechanisms of action and pharmacological effects of the drug together with clinical results and safety data. Dermatologists and pharmaceutical chemists or pharmacists must have knowledge about the actual safety data of these substances, which are questioned in the media, and by the general public. [Extracted from the article]

Topical Calcineurin Inhibitors (TCIs) used for the treatment of atopic eczema modify the immune regulatory function of the skin and may have the potential to enhance immunosuppressive ultraviolet (UV) effects. Current recommendations on UV protection in eczema patients treated with PCIs are inconsistent and have given rise to uncertainty and anxiety in patients. Therefore, the European Dermatology Forum (EDF) developed a position statement which reviews critically the available data with regard to the problem, especially analysing and commenting the limitations of rodent models for the human situation. There is no conclusive evidence from rodent trials to indicate that long-term application of TCIs is photococarcinogenic. There is a need for further studies to investigate the validity of mouse models as well as long-term cohort studies in patients using TCIs. Available data suggest that long-term application of TCIs is safe, that there is no evidence of increased skin cancer risk and that it is ethical to treat patients with TCIs when indicated. [ABSTRACT FROM AUTHOR]

Ultraviolet (UV) radiation-induced oxidative stress may result in acute and chronic photodamage. Based on the endogenous antioxidant system, the administration of antioxidants for scavenging reactive oxygen species might be a promising strategy in the prevention of UV-induced skin reactions. The relevance of the most common antioxidants, vitamins E and C, is reviewed focusing on topical and systemic photoprotective effects in animals and humans. Topically applied vitamin C induced significant photoprotective effects at concentrations of at least 10% in animals and humans, whereas a photoprotective effect has not been demonstrated by oral administration even at high doses in humans. Topical vitamin E reduced erythema, sunburn cells, chronic UV-B–induced skin damage, and photocarcinogenesis in the majority of the published studies, whereas only high doses of oral vitamin E may affect the response to UV-B in humans. Combination of vitamins C and E, partly with other photoprotective compounds, did increase the photoprotective effects dramatically compared to monotherapies. This synergistic interplay of several antioxidants should be taken into consideration in future research on cutaneous photoprotection. [ABSTRACT FROM AUTHOR]

The prevalence of atopic diseases has increased dramatically during recent decades; the reasons are not known. Among various plausible hypotheses the so-called hygiene hypothesis (jungle hypothesis) has gained public interest recently. According to this hypothesis improved hygiene leading to a decreased stimulation of the immune system by infections, parasites, vaccinations or contact with immunostimulating agents has led to an immunodeviation with T helper (Th)2-enhancing effects followed by increased occurrence of IgE-mediated allergies.The hygiene hypothesis is not defined precisely, and some questions remain open: the influence of actual infectious disease or specific vaccinations, the nature of infectious agents (virus, bacteria, fungi, parasites), the definition of the term‘hygiene’, the nature of other immunostimulating agents and the effects upon different atopic diseases. As arguments in favour of the hygiene hypothesis, the following study results are quoted: children of farmers have less allergies; children from academic parents show an increased risk of atopic diseases; children from anthroposophic families have decreased allergy prevalence rates; effects of endotoxin and CD14 gene polymorphism; and the protective influence of gut flora with high amounts of lactobacilli. The following findings argue against the hygiene hypotheses: parasite infections are associated with an increased risk of urticaria and atopic eczema; some microorganisms e.g. respiratory syncytial virus (RSV),Bordetella pertussisenhance IgE production; patients with active tuberculosis have high Th2 reactions; pertussis vaccination has a protective effect; high allergy prevalences in very poor regions (inner city slums in the United States, Africa, Southern America); germfree conditions prevent the spontaneous outbreak of atopic eczema in certain mouse strains, many other influences (e.g. traffic exhaust exposure) are associated with allergy and sensitization. Comparing the prevalence of atopic diseases and sensitization in East and West German children after reunification there was a striking difference with regard to higher prevalence rates of respiratory atopic diseases in West German children compared to the East, which was not seen for atopic eczema. No single factor has been established to explain this East–West German difference. When differences in pertussis vaccination strategy (in West Germany in the 1980s only about 50% of the children were vaccinated, while in East Germany this was obligatory for everyone) were included in the analysis, it became obvious that 20% of West German children were suffering from pertussis infection compared to 0.5% of East German children and pertussis infection increased the risk for atopic respiratory disease, although not for eczema and sensitization. When pertussis vaccination and infection was included among the confounders to be adjusted for in the multivariate logistic regression, the East–West German difference disappeared for asthma and wheezing, so it can be concluded that pertussis vaccination does prevent pertussis infection and thereby prevents asthma and wheezing independent of atopic sensitization. Furthermore, it has become clear that pollens are not only allergen carriers but also produce proinflammatory mediators of eicosanoid-like activity. These pollen-associated lipid mediators (PALMs) − among them pollotrienes − are able to attract neutrophils and activate the innate immune system. They should be regarded together with pollutants and allergens as modulating factors in the determination of allergic disease development.From a critical evaluation of the evidence it is concluded that the hygiene hypothesis represents an attractive theory and stimulus for further research, particularly the more precise aspect of the jungle hypothesis, with an inverse relationship between parasite infestation and respiratory atopy. It seems that the hygiene hypothesis fits only for atopic respiratory but not for atopic skin disease. Regarding the partly controversial data it is too early to give practical recommendations for allergy prevention based on this hypothesis. There is no rationale to recommend avoidance of vaccinations or adequate body cleaning measures. Effective programmes for primary prevention will be possible only after increased research efforts have elucidated the true causes of increased allergy prevalence. [ABSTRACT FROM AUTHOR]

Evaluates the expression pattern of a panel of desmosomal adhesion molecules by immunohistochemistry in skin biopsies obtained from two patients with Dowling-Degos disease (DDD). Characteristic digitiform downgrowths; Comparison of desmocollin 3 distribution in normal skin and seborrheic keratosis skin.

Chronic urticaria (CU) is a common, often excruciating skin disease that can lead to severe deterioration in quality of life. Although the itchy, erythematous wheals associated with this disorder result in large part from the vasoactive and neural effects of histamine, other mediators are also involved in some types of urticaria. Wheals exhibit a perivascular infiltrate, with eosinophil accumulation occurring as early as 4 hours after the initial appearance of swellings. Pruritus, which many patients consider the most distressing feature of CU, is also a chronic manifestation of the late-phase response. In human cell cultures, desloratadine, a long-acting, selective histamine H receptor antagonist, exerted balanced inhibitory effects on both the early- and late-phase allergic responses, binding with high affinity to the H receptor in vitro and also attenuating the release or expression of chemokines, cytokines and cellular adhesion molecules. A recent 6-week multicentre, randomised, double-blind, placebo-controlled study showed that once-daily therapy with this nonsedating antihistamine (5 mg/day) significantly lessened the severity of pruritus, number and size of hives, and sleep disturbances and interference with daily activities in 190 patients with moderate to severe disease. These benefits were observed within hours after the first dose and were maintained throughout the 24-hour dosing interval and at each weekly visit. Interim results from a subsequent 4-week open-label trial indicated that approximately 50% of patients with moderate to severe CU at baseline were completely free of urticaria at study endpoint, and about 70% reported that they no longer experienced hives or pruritus at night, when CU symptoms tend to be most severe. Desloratadine thus constitutes a sound option for nonsedating therapy of CU. [ABSTRACT FROM AUTHOR]

Background Combinations of topical treatments and ultraviolet (UV) B phototherapy for plaque psoriasis may be more beneficial than either type of treatment used alone. Objectives To determine the efficacy of calcitriol 3 µg g[sup -1] ointment in combination with UVB phototherapy in treating plaque psoriasis. Methods Calcitriol ointment with UVB was compared with vehicle plus UVB in a randomized, double-blind study in 104 patients. Results Mean global improvement scores for both groups increased over the 8-week study period; there was a statistically significant difference (P < 0·05) in favour of the calcitriol/UVB combination from week 1. At end-point, 45% of the calcitriol/UVB group showed considerable improvement or clearing of psoriasis, compared with 21% of the control group. The superiority of calcitriol plus UVB was also reflected in the global severity and Psoriasis Area and Severity Index (PASI) scores; at end-point the mean percentage decrease in PASI score was 65% for the calcitriol/ UVB group and 43% for vehicle/UVB (P = 0·0014). The incidence of skin-related adverse events was low (< 12%) and similar in the two treatment groups. No clinically significant changes in blood chemistry, in particular calcium levels, occurred. The greater efficacy of combined calcitriol and phototherapy allowed a 34% decrease in total UVB exposure. Conclusions Calcitriol 3 µg g[sup -1] ointment and UVB phototherapy in combination provides a promising therapy for managing chronic plaque psoriasis. [ABSTRACT FROM AUTHOR]

Chronic idiopathic urticaria (CIU) is a common dermatologic disorder that may severely impair quality of life. Patients may suffer symptoms such as pruritus and disfigurement due to wheals for years or decades. Advances have been made in the last 10 years with the identification of an autoimmune pathogenesis in a significant proportion of patients. Despite this, treatment remains symptomatic, and antihistamines are the first choice of therapy once the diagnosis of CIU has been established. The goal of treatment is rapid, long-lasting symptom relief, and currently available antihistamines fail to provide this in many cases. Desloratadine is a novel, potent H[sub 1]-receptor antagonist with additional inhibitory effects on inflammatory mediators such as cytokines and adhesion molecules. Newly published data on the efficacy and safety of desloratadine in CIU is highly encouraging, suggesting that the drug may improve symptom control above that currently available. [ABSTRACT FROM AUTHOR]

Aeroallergens and food allergens are relevant eliciting factors of atopic eczema. This article focuses on the methods used for diagnosis in patients with suspected allergy to airborne or dietary allergens and who are suffering from atopic eczema. In addition to classical tests of IgE-mediated hypersensitivity (intracutaneous or in vitro testing), the role of provocation procedures is described. For aeroallergens, the atopy patch test yields the most specific results with regard to clinical history as compared with classical methods. For food allergens and pseudoallergic reactions to additives, this holds true for the double-blind, placebo-controlled food challenge. The methods and their limitations are discussed from a practical point of view. [ABSTRACT FROM AUTHOR]

This paper addresses the intense personal and professional preparation necessary for becoming an effective anti-racism trainer. The author draws upon diversity training models and theory, as well as personal experiences and reflections charted as a white man actively involved in this field over the past ten years. [ABSTRACT FROM AUTHOR]

There is no doubt that itch - also called pruritus - is the major symptom of skin diseases; some even use it to define dermatology as the specialty dealing with diseases of all surfaces which are able to itch, from skin to the invisible borders at the level of mucous membranes. Generally, when people talk about itchy dermatoses they think of inflammatory skin diseases like atopic eczema, urticaria, lichen planus and bullous pemphigoid, but also psoriasis can itch, and this has been underestimated. Although every human being knows the sensation of itch, the understanding of the etiopathophysiological mechanisms involved in the wide variety of different itch sensations is still incomplete. [Extracted from the article]

Focuses on the investigation of the role of the skin in allergy. Focus on the pro-inflammatory potential of various cells; Role of the infiltrating inflammatory cells in cell-cell interactions; Clinical expressions of allergy in common selected skin diseases.

In fourteen patients with food allergy, intragastral provocation under endoscopical control (IPEC) was performed. In all patients positive immediate-type reactions of the gastric mucosa were observed consisting of oedema, erythema and petechial bleeding. Microscopically, mast cell degranulation was observed and measured by mast cell counts using the o-phthaldialdehyde technique, Concomitantly, tissue histamine content in gastric mucosa decreased significantly after allergen provocation, while there was no change in normal volunteers. Plasma histamine concentration increased in most patients; the increases were most evident in four patients showing mild systemic reactions (urticaria and bronchospasm). The technique described might prove to be useful in establishing the diagnosis in doubtful cases of food allergy. [ABSTRACT FROM AUTHOR]

Components of the renin angiotensin system, namely renin, angiotensinogen, angiotensin I and II and aldosterone were measured in plasma of patients with hymenoptera venom anaphylaxis (n = 50) and healthy non-allergic controls (n = 25). Patients with a history of anaphylactic reactions to hymenoptera venom who did not undergo immunotherapy showed significantly reduced renin, angiotensinogen, angiotensin I and angiotensin II in plasma as compared with controls (P<0.05). There was no difference in the aldosterone concentration between patients and controls. Angiotensin I, angiotensin II, renin and angiotensinogen levels were the same in male and female patients. There was also no difference in the angiotensin I, II, renin or angiotensinogen levels between young and older patients. A significant inverse correlation between the severity of clinical symptoms and the plasma levels of renin (r = -0.382, P < 0.001), angiotensinogen (r = -0.567, P < 00001), angiotensin I ( r= -0.656, P < 00001) and angiotensin II (r = 0.0762, P < 0 0001) was found: the lower the levels the more severe the clinical symptoms. No correlation was found for aldosterone. Hymenoptera venom allergic patients with repeated anaphylactic reactions during hyposensitization did not tolerate the sting of a living insect (n = 6). In these patients, renin, angiotensinogen, angiotensin I and II remained significantly lower than in healthy non-allergic controls. Patients with successful immunotherapy (n = 27) who tolerated the sting of a living insect had renin, angiotensin I and II significantly higher than patients without immunotherapy. These findings suggest a possible role of the renin angiotensin system in hymenoptera venom anaphylaxis. [ABSTRACT FROM AUTHOR]

Histamine is known to be a classical inducer of pruritus. In atopic eczema, itch is a prominent feature (regarded by some even as a `primary lesion'!). One of the most potent chemical mediators of itch is histamine. Histamine, together with other mediators may play a role in the pathophysiology of a topic eczema: the increased release of histamine from basophil leucocytes of atopic patients has been described, as well as elevated histamine levels in plasma and skin during acute exacerbations of eczematous lesions. Therefore, application of H1 antagonists seems to be a rational regime in the symptomatic treatment of atopic eczema. Nevertheless, some controversy exists regarding the clinical efficacy of orally applied H1 antagonists in this disease, especially with regard to the newer non-sedating compounds such as terfenadine, astemizole, loratadine and cetirizine. Review of the literature shows that there are studies demonstrating a clear-cut antipruritic effect of non-sedating H1 antagonists. Thus the sedative action does not seem necessarily to be connected with therapeutic efficacy in treating itch in atopic eczema. Newer studies show that cetirizine exerts an additional inhibitory effect on eosinophils. This may broaden the therapeutic spectrum of this H1 antagonist in diseases with eosinophil involvement. [ABSTRACT FROM AUTHOR]

Summary Although known for more than 80 years, histamine still remains a fascinating substance for allergy research. Histamine antagonists have been in clinical use since 1942. The classical H [ABSTRACT FROM AUTHOR]

Although known for more than 80 years, histamine still remains a fascinating substance for allergy research. Histamine antagonists have been in clinical use since 1942. The classical H1-antagonists with sedative side-effects have been more or less replaced by newer non-sedating H1-antagonists; the role of H2-receptors in allergic diseases is still controversial. There, are however, increasing reports of beneficial effects of H1- antagonists, mostly in combination with Hi-antagonists. in a variety of allergic and pseudoallergic conditions such as chronic urticaria, anaphylactoid reactions due to colloid volume substitutes, opioid analgesics and radiographic contrast media. The combined use of H1- and H2-antagonists might not only act as specific histamine antagonism but exert a mast cell stabilizing effect, as demonstrated in animal experiments and some clinical studies. Future research will show whether the combined use of H1- and H2-antagonists will become a routine therapeutic procedure in allergy therapy. [ABSTRACT FROM AUTHOR]

This study was designed to compare in vitro leucocyte histamine release in patients with a history of previous radiographic contrast media (RCM) reactions and normal controls. Peripheral leucocytes of ten patients with a positive history of RCM incompatibility and nineteen normal volunteers were stimulated in vitro with different RCM in different concentrations and the amount of histamine released was measured in the supernatant. There was a significant increase in histamine release induced by RCM in low doses (0.02-0.1 M) in the patients as compared to the normals. At the high doses (0.2-0.3 M), no significant differences were found. Leucocytes from four of the patients were stimulated preferentially by the dye responsible for the incompatibility. Six patients showed no such preference. The increased 'releasability' of the patients' leucocytes could not be transferred by serum. Normal leucocytes, when incubated with serum from 'high releasing' patients did not show increased histamine release after stimulation with the respective dye. It is suggested that an excessive non-immunological response of basophil leucocytes to RCM stimulation might, in part, account for the adverse clinical reactions observed. Furthermore, leucocyte histamine release might be a useful diagnostic tool for detecting patients with a high risk of developing contrast media reactions. [ABSTRACT FROM AUTHOR]

Peripheral leucocytes and platelets from twenty healthy volunteers were incubated in vitro with radiographic contrast media (diatrizoate--Hypaque, iothalamate--Conray and iodipamide--Cholografin) under varying conditions. All radiographic contrast media (RCM) were able to induce histamine release from peripheral leucocytes and the release reaction was dose-dependent. There were individual differences in the sensitivity of leucocytes to different RCM. The highest values (up to 80% histamine release) were found with high concentrations (0.07-0.3 M) of diatrizoate. The addition of normal human serum (NHS) to the reaction mixture led to a further increase in histamine release (P < 0.01), probably due to complement activation. The mechanism seems to be mediated by proteins of the alternative pathway, because serum depleted of complement components (factor B, factor D, properdin) did not show this synergistic effect. IgG-depleted serum, however, was able to show the augmented release reaction. Washed platelets incubated with RCM released serotonin in a dose- and time-dependent reaction. The most powerful serotonin-releasing RCM was found to be iodipamide, which produced a release reaction in all people investigated at concentrations of 0.04-0.09 M, while diatrizoate and iothalamate were effective only in half of the tested individuals at high concentrations (0.3 and 0.2 M respectively). The addition of plasma proteins to the reaction mixture inhibited the serotonin release quantitatively. There was no difference in inhibitory potency between autologous and heterologous plasma or serum; sera depleted of various complement components showed similar effects as NHS. The serotonin release was not due to platelet lysis, as determined by the concentration of lactic dehydrogenase present in the supernatant during serotonin release. Incubation of the leucocytes with RCM produced ultrastructural changes, including degranulation of basophils, aggregation of platelets and infiltration of the aggregates by polymorphonuclear leucocytes. The most prominent changes were observed when complement was present in the reaction mixture. [ABSTRACT FROM AUTHOR]

The article focuses on the importance of skin, which is a multifunctional organ with its own metabolism. Skin is not only the envelope that holds the organism, but skin reflects the health of the human soul through many skin diseases including eczema, urticaria, psoriasis and more. It explains the relation between cardiovascular diseases and inflammatory skin diseases, most notably psoriasis.

An introduction is presented in which the editor discusses various reports within the issue on topics including the Nobel Prizes in dermatology, the Spring Symposium in Budva, Montenegro and the reviewers of the journal's issue.

An introduction is presented in which the editor discusses various articles within the issue on topics including Psoriasis, Atopic dermatitis, and interview with dermatologists.

COVID-19 has changed our society as well as Dermatology COVID-19 has also influenced dermatology; many departments and offices had to decrease their patient consultations. That COVID-19 patients themselves may have cutaneous manifestations was first described in the beginning of March in a letter by Dr. S. Recalcati who observed skin manifestations in more than 20% of COVID-19 patients. [Extracted from the article]

The author reflects on the global health problem allergy and allergic diseases. It has been estimated an epidemic increase in prevalence of allergic diseases with 10-30 percent. It mentions allergic diseases are a life-threatening diseases present. Further it discusses the development of innovative therapies for allergy.

The article discusses the survey on the possibility of cat allergen exposure on the passengers of the airlines in-cabin transportation of cats. It presents a table of the approved and banned airlines for the in-cabin transportation. It says that passengers should keep anti allergic drugs including carticosteroids, and epinephrine. It also says that allergen exposure also derive from many different sources including transportation of cat's owners clothing, and contaminated seats.