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Hiller J, Göen T, Drexler H, Berking C, Wagner N. Elevated aluminum excretion in patients by long-term subcutaneous immunotherapy - A cross-sectional case-control study. Int J Hyg Environ Health 2024; 258:114337. [PMID: 38461738 DOI: 10.1016/j.ijheh.2024.114337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/19/2024] [Accepted: 02/06/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND Aluminum (Al) adjuvants have been used in vaccines and subcutaneous immunotherapy (SCIT) for decades. Despite indisputable neurotoxic properties of Al, there is no clear evidence of a causal relationship between their use and any neurotoxic side effects. However, recent rat studies have shown an accumulation of Al from adjuvants in tissues, especially in bones. OBJECTIVES Since the human toxicokinetics of Al-adjuvants are poorly understood, this study aimed to evaluate whether up-dosed or long-term SCIT with Al-coupled extracts leads to increased Al load in humans. METHODS This observational cross-sectional case-control study explored Al excretion in hymenoptera venom allergy patients recruited in 2020 before initiation (n = 10) and during ongoing (n = 12) SCIT with Al-based preparations. Urine samples were collected before and 24 h after the SCIT injections and analyzed for aluminum content by using atomic absorption spectrometry. The cumulative administered Al dose was extracted from patient records. Patients receiving long-term immunotherapy were treated between 2.8 and 13.6 years (mean 7.1). Other potential sources of Al exposure were surveyed. RESULTS Patients who had received Al-coupled immunotherapy for several years showed significantly (p < 0.001) higher Al excretion than the controls at initiation of immunotherapy (mean 18.2 μg/gC vs. 7.9 μg/gC) and predominantly (73%) were above the 95th percentile of the general populations' exposure (>15 μg/gC), however, without reaching levels of toxicological concern (>50 μg/gC). Taking both groups together excreted Al levels correlated with the cumulative administered Al dose from SCIT (linear regression: Alurine = 8.258 + 0.133*Alcum; p = 0.001). DISCUSSION These results suggest a relevant iatrogenic contribution of long-term SCIT to human internal Al burden and potential accumulation. Considering the medical benefits of Al-adjuvants and SCIT a differentiated risk-benefit analysis is needed. For certain scenarios of potential toxicological concern in clinical practice biomonitoring might be advisable.
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Affiliation(s)
- Julia Hiller
- Institute and Outpatient Clinic of Occupational, Social, and Environmental Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg, Henkestraße 9-11, 91054, Erlangen, Germany.
| | - Thomas Göen
- Institute and Outpatient Clinic of Occupational, Social, and Environmental Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg, Henkestraße 9-11, 91054, Erlangen, Germany.
| | - Hans Drexler
- Institute and Outpatient Clinic of Occupational, Social, and Environmental Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg, Henkestraße 9-11, 91054, Erlangen, Germany.
| | - Carola Berking
- Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Deutsches Zentrum Immuntherapie (DZI), Ulmenweg 18, 91054, Erlangen, Germany.
| | - Nicola Wagner
- Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Deutsches Zentrum Immuntherapie (DZI), Ulmenweg 18, 91054, Erlangen, Germany.
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Wagner N, Berking C. [Recognition and management of relevant comorbidities in chronic spontaneous urticaria]. Dermatologie (Heidelb) 2024; 75:289-294. [PMID: 38411698 DOI: 10.1007/s00105-024-05311-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/26/2024] [Indexed: 02/28/2024]
Abstract
Various mechanisms contributing to the activity of chronic spontaneous urticaria (CU) have been postulated. Associated comorbidities are increasingly leading to the discovery of further signaling pathways which may support the activity of chronic urticaria or contribute to low-grade systemic inflammation. Moreover psychoimmunological factors may also be involved. The aim of this work is to improve the clinical care of patients with CU by increasing knowledge regarding optional influencing factors due to comorbidities and to possibly influence disease activity. Chronic urticaria due to autoimmune mechanisms may dispose to other autoimmune diseases, especially autoimmune thyroiditis, which can trigger chronic disease. Association of CU with metabolic syndrome has received little attention to date. Obesity may contribute to low-grade systemic inflammation by cytokine-secreting adipose tissue and hence to mediator-release of mast cells. Furthermore, neuroimmunological pathways, especially increased release of substance P, an activating ligand of Mas-related G protein-coupled receptor X2 (MRGPX2) on mast cells, should be addressed when optimizing therapy.
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Affiliation(s)
- Nicola Wagner
- Hautklinik, Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054, Erlangen, Deutschland.
| | - Carola Berking
- Hautklinik, Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054, Erlangen, Deutschland
- Hautklinik, Uniklinikum Erlangen, 91054, Erlangen, Germany
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Höfer V, Dölle-Bierke S, Francuzik W, Ruëff F, Sabouraud-Leclerc D, Treudler R, Moeser A, Hartmann K, Pföhler C, Wagner N, Ensina LF, Wedi B, Cardona V, Worm M. Fatal and Near-Fatal Anaphylaxis: Data From the European Anaphylaxis Registry and National Health Statistics. J Allergy Clin Immunol Pract 2024; 12:96-105.e8. [PMID: 37816460 DOI: 10.1016/j.jaip.2023.09.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 09/20/2023] [Accepted: 09/29/2023] [Indexed: 10/12/2023]
Abstract
BACKGROUND Anaphylaxis is a serious systemic reaction-data on fatal and near-fatal reactions are limited. OBJECTIVE To better understand clinical patterns and risks factors of severe anaphylaxis by a deep analysis of data from fatal and near-fatal anaphylaxis. METHODS Data from the European Anaphylaxis Registry on fatal/near-fatal anaphylactic reactions and national data on anaphylaxis fatalities were investigated. RESULTS A total of 305 fatal/near-fatal reactions among children and adults including 35 fatalities from the European Anaphylaxis Registry were identified. The most frequent elicitors were drugs, insects, and food. Male patients (66%/60%) were more frequently affected. Male sex, higher age, concomitant mastocytosis, and cardiovascular disease were associated with a more severe outcome. With increasing reaction severity, skin symptoms were less frequently observed (45% of fatal reactions). In parallel, anaphylaxis mortality rates were studied. The data show that anaphylaxis mortality rates increased in Germany from 0.48 (2009) to 0.59 per 1,000,000 population per year (2020). This increase was apparent only in the female population. In this data set, drugs were the most frequent elicitor of anaphylaxis fatalities, and the rate for this increased over time. CONCLUSIONS We identified not only elicitors but also individual factors to be associated with an increased risk of fatal anaphylaxis. Such patients should be recognized and managed with great caution. The increase in drug-induced fatalities points to the need for a better allergological care of patients suffering from drug hypersensitivity.
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Affiliation(s)
- Veronika Höfer
- Division of Allergy and Immunology, Department of Dermatology, Venerology and Allergy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Sabine Dölle-Bierke
- Division of Allergy and Immunology, Department of Dermatology, Venerology and Allergy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Wojciech Francuzik
- Division of Allergy and Immunology, Department of Dermatology, Venerology and Allergy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Franziska Ruëff
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - Dominique Sabouraud-Leclerc
- Allergy Vigilance Network, Vandoeuvre les Nancy, France; American Memorial Hospital, Pediatrics Department, Reims University Hospital, Reims, France
| | - Regina Treudler
- Department of Dermatology, Venerology and Allergology, University of Leipzig Medical Center, Leipzig, Germany; Leipzig Interdisciplinary Allergy Center (LICA) - Comprehensive Allergy Center, University of Leipzig Medical Center, Leipzig, Germany
| | - Anne Moeser
- Institute for Infectious Diseases and Infection Control, Jena University Hospital, Jena, Germany
| | - Karin Hartmann
- Division of Allergy, Department of Dermatology, University Hospital Basel and University of Basel, Basel, Switzerland; Department of Biomedicine, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Claudia Pföhler
- Saarland University Medical Center, Department of Dermatology, Homburg/Saar, Germany
| | - Nicola Wagner
- Department of Dermatology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Luis Felipe Ensina
- Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil
| | - Bettina Wedi
- Department of Dermatology and Allergy, Comprehensive Allergy Center, Hannover Medical School, Hannover, Germany
| | - Victoria Cardona
- Allergy Section, Department of Internal Medicine, Hospital Universitari Vall d'Hebron, Barcelona, Spain; ARADyAL Research Network, Spain
| | - Margitta Worm
- Division of Allergy and Immunology, Department of Dermatology, Venerology and Allergy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
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Wagner N, Crippa L, Amaricci A, Hansmann P, Klett M, König EJ, Schäfer T, Sante DD, Cano J, Millis AJ, Georges A, Sangiovanni G. Mott insulators with boundary zeros. Nat Commun 2023; 14:7531. [PMID: 37985660 PMCID: PMC10662449 DOI: 10.1038/s41467-023-42773-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/17/2023] [Indexed: 11/22/2023] Open
Abstract
The topological classification of electronic band structures is based on symmetry properties of Bloch eigenstates of single-particle Hamiltonians. In parallel, topological field theory has opened the doors to the formulation and characterization of non-trivial phases of matter driven by strong electron-electron interaction. Even though important examples of topological Mott insulators have been constructed, the relevance of the underlying non-interacting band topology to the physics of the Mott phase has remained unexplored. Here, we show that the momentum structure of the Green's function zeros defining the "Luttinger surface" provides a topological characterization of the Mott phase related, in the simplest description, to the one of the single-particle electronic dispersion. Considerations on the zeros lead to the prediction of new phenomena: a topological Mott insulator with an inverted gap for the bulk zeros must possess gapless zeros at the boundary, which behave as a form of "topological antimatter" annihilating conventional edge states. Placing band and Mott topological insulators in contact produces distinctive observable signatures at the interface, revealing the otherwise spectroscopically elusive Green's function zeros.
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Affiliation(s)
- N Wagner
- Institut für Theoretische Physik und Astrophysik, Universität Würzburg, 97074, Würzburg, Germany
| | - L Crippa
- Institut für Theoretische Physik und Astrophysik and Würzburg-Dresden Cluster of Excellence ct.qmat, Universität Würzburg, 97074, Würzburg, Germany
| | - A Amaricci
- CNR-IOM, Istituto Officina dei Materiali, Consiglio Nazionale delle Ricerche, Via Bonomea 265, 34136, Trieste, Italy
| | - P Hansmann
- Department of Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - M Klett
- Max-Planck-Institut für Festkörperforschung, Heisenbergstr. 1, 70569, Stuttgart, Germany
| | - E J König
- Max-Planck-Institut für Festkörperforschung, Heisenbergstr. 1, 70569, Stuttgart, Germany
| | - T Schäfer
- Max-Planck-Institut für Festkörperforschung, Heisenbergstr. 1, 70569, Stuttgart, Germany
| | - D Di Sante
- Department of Physics and Astronomy, University of Bologna, Bologna, Italy
- Center for Computational Quantum Physics, Flatiron Institute, New York, NY, USA
| | - J Cano
- Center for Computational Quantum Physics, Flatiron Institute, New York, NY, USA
- Department of Physics and Astronomy, Stony Brook University, Stony Brook, New York, NY, 11974, USA
| | - A J Millis
- Center for Computational Quantum Physics, Flatiron Institute, New York, NY, USA
- Department of Physics, Columbia University, New York, NY, USA
| | - A Georges
- Center for Computational Quantum Physics, Flatiron Institute, New York, NY, USA
- Collège de France, PSL University, 11 place Marcelin Berthelot, 75005, Paris, France
- Department of Quantum Matter Physics, University of Geneva, 24 quai Ernest-Ansermet, 1211, Geneva, Switzerland
- CPHT, CNRS, École Polytechnique, IP Paris, F-91128, Palaiseau, France
| | - G Sangiovanni
- Institut für Theoretische Physik und Astrophysik and Würzburg-Dresden Cluster of Excellence ct.qmat, Universität Würzburg, 97074, Würzburg, Germany.
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Brans R, Wagner N. 67. Arbeitssitzung (Frühjahrssymposium) der Deutschen Kontaktallergie-Gruppe (DKG). J Dtsch Dermatol Ges 2023; 21:937-938. [PMID: 37574668 DOI: 10.1111/ddg.15198_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Affiliation(s)
- Richard Brans
- Institut für interdisziplinäre Dermatologische Prävention und Rehabilitation (iDerm) an der Universität Osnabrück, Am Finkenhügel 7a, 49076 Osnabrück Institut für Gesundheitsforschung und Bildung (IGB) Abteilung Dermatologie, Umweltmedizin und Gesundheitstheorie Universität Osnabrück Am Finkenhügel 7a, 49076 Osnabrück
| | - Nicola Wagner
- Hautklinik, Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Ulmenweg 18, 91054 Erlangen
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Dölle-Bierke S, Höfer V, Francuzik W, Näher AF, Bilo MB, Cichocka-Jarosz E, Lopes de Oliveira LC, Fernandez-Rivas M, García BE, Hartmann K, Jappe U, Köhli A, Lange L, Maris I, Mustakov TB, Nemat K, Ott H, Papadopoulos NG, Pföhler C, Ruëff F, Sabouraud-Leclerc D, Spindler T, Stock P, Treudler R, Vogelberg C, Wagner N, Worm M. Food-Induced Anaphylaxis: Data From the European Anaphylaxis Registry. J Allergy Clin Immunol Pract 2023; 11:2069-2079.e7. [PMID: 36990430 DOI: 10.1016/j.jaip.2023.03.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 02/22/2023] [Accepted: 03/12/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND Food is one of the most common elicitors of anaphylaxis, with an increasing incidence over recent years. OBJECTIVES To characterize elicitor-specific phenotypes and identify factors enhancing the risk or severity of food-induced anaphylaxis (FIA). METHODS We analyzed data from the European Anaphylaxis Registry applying an age- and sex-matched analysis of associations (Cramer's V) for single food triggers and calculated odds ratios (ORs) for severe FIA. RESULTS We identified 3,427 cases of confirmed FIA showing an age-dependent elicitor ranking (for children: peanut, cow's milk, cashew, and hen's egg; and for adults: wheat flour, shellfish, hazelnut, and soy). The age- and sex-matched analysis revealed defined symptom patterns for wheat and cashew. Wheat-induced anaphylaxis was more frequently associated with cardiovascular symptoms (75.7%; Cramer's V = 0.28) and cashew-induced anaphylaxis with gastrointestinal symptoms (73.9%; Cramer's V = 0.20). Furthermore, concomitant atopic dermatitis was slightly associated with anaphylaxis to hen's egg (Cramer's V = 0.19) and exercise was strongly associated with anaphylaxis to wheat (Cramer's V = 0.56). Additional factors influencing the severity were alcohol intake in wheat anaphylaxis (OR = 3.23; CI, 1.31-8.83) and exercise in peanut anaphylaxis (OR = 1.78; CI, 1.09-2.95). CONCLUSIONS Our data show that FIA is age-dependent. In adults, the range of elicitors inducing FIA is broader. For some elicitors, the severity of FIA seems to be related to the elicitor. These data require confirmation in future studies considering a clear differentiation between augmentation and risk factors in FIA.
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Affiliation(s)
- Sabine Dölle-Bierke
- Division of Allergy and Immunology, Department of Dermatology, Venerology and Allergy, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany
| | - Veronika Höfer
- Division of Allergy and Immunology, Department of Dermatology, Venerology and Allergy, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany
| | - Wojciech Francuzik
- Division of Allergy and Immunology, Department of Dermatology, Venerology and Allergy, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany
| | - Anatol-Fiete Näher
- Institute of Medical Informatics, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Division of Information and Research Data Management, Robert Koch Institute, Berlin, Germany
| | - Maria Beatrice Bilo
- Department of Clinical and Molecular Sciences, Università, Politecnica delle Marche, Ancona, Italy; Department of Internal Medicine/Allergy Unit, University Hospital Ospedali Riuniti, Ancona, Italy
| | - Ewa Cichocka-Jarosz
- Department of Pediatrics, Pulmonology-Allergology-Dermatology Clinic, Jagiellonian University Medical College, Krakow, Poland
| | - Lucila C Lopes de Oliveira
- Division of Allergy, Clinical Immunology, Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil
| | | | - Blanca E García
- Allergology Service. Hospital Universitario de Navarra. Pamplona, Spain
| | - Karin Hartmann
- Division of Allergy, Department of Dermatology, University Hospital Basel and University of Basel, Basel, Switzerland; Department of Biomedicine, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Uta Jappe
- Division of Clinical and Molecular Allergology, Research Center Borstel, Airway Research Center North, German Center for Lung Research, Borstel, Germany; Interdisciplinary Outpatient Clinic, Department of Pneumology, University of Lübeck, Lübeck, Germany
| | - Alice Köhli
- Division of Allergology, University Children's Hospital Zurich, Zürich, Switzerland; Division of Paediatric Allergology, Department of Pediatrics, Children's Hospital Lucerne, Lucerne, Switzerland
| | - Lars Lange
- Department of Pediatrics, GFO-Kliniken Bonn, St Marien-Hospital, Bonn, Germany
| | - Ioana Maris
- Department of Paediatrics and Child Health, University College Cork/Bon Secours Hospital Cork, Cork, Ireland
| | | | - Katja Nemat
- Pediatric Pulmonology and Allergology, Kinderzentrum Dresden-Friedrichstadt, Dresden, Germany; University Allergy Center Dresden, University Hospital Dresden, Dresden, Germany
| | - Hagen Ott
- Division of Pediatric Dermatology and Allergology, Children's Hospital Auf der Bult, Hannover, Germany
| | | | - Claudia Pföhler
- Saarland University Medical Center, Department of Dermatology, Homburg/Saar, Germany
| | - Franziska Ruëff
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | | | | | | | - Regina Treudler
- Department of Dermatology, Venerology, and Allergology, University Leipzig Medical Faculty, Leipzig Interdisciplinary Allergy Centre-CAC, Leipzig, Germany
| | - Christian Vogelberg
- Division of Pediatric Pneumology and Allergology, Department of Pediatrics, Universitätsklinikum Carl Gustav Carus an der TU Dresden, Dresden, Germany
| | - Nicola Wagner
- Department of Dermatology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Margitta Worm
- Division of Allergy and Immunology, Department of Dermatology, Venerology and Allergy, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany.
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Schubert S, Geier J, Brans R, Heratizadeh A, Kränke B, Schnuch A, Bauer A, Dickel H, Buhl T, Vieluf D, Wagner N, Worm M. Patch testing hydroperoxides of limonene and linalool in consecutive patients-Results of the IVDK 2018-2020. Contact Dermatitis 2023. [PMID: 37177844 DOI: 10.1111/cod.14332] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 04/21/2023] [Accepted: 04/27/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND Hydroperoxides of limonene (Lim-OOHs) and linalool (Lin-OOHs) are potent contact sensitizers. OBJECTIVES To investigate the prevalence of positive patch test (PT) reactions to Lim-OOHs and Lin-OOHs in consecutive patients, their demographic factors and concomitant reactions. METHODS Between 7/2018 and 12/2020, Lim-OOHs 0.3% pet. and Lin-OOHs 1% pet. were patch tested in 5511 consecutive patients. We assessed PT reactivity and analysed data from patients with either positive or negative PTs to Lim-OOHs and Lin-OOHs. RESULTS Positive PT results to Lim-OOHs (n = 170, 3.1%) and Lin-OOHs (n = 483, 8.8%) were frequent. Most of the positive reactions were weak (LimOOHs n = 134/LinOOHs n = 429), and even more frequently, doubtful (n = 252/n = 578) or irritant reactions (n = 81/n = 178) were documented. PT reactivity to Lim-OOHs and Lin-OOHs was increased in patients with irritant reactions to sodium lauryl sulphate (SLS). The proportion of leg dermatitis and concomitant positive reactions to fragrances and essential oils was increased in patients with reactivity to these hydroperoxides. CONCLUSION The observed reaction pattern suggests that both test preparations display an irritant potential with an increased risk of false positive reactions. Preparations should be chemically monitored in order to reduce irritancy. Mindful interpretation of PT results and aimed patch testing of lower concentrations is recommended.
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Affiliation(s)
- Steffen Schubert
- Information Network of Departments of Dermatology (IVDK), Institute at the University Medical Centre Göttingen, Göttingen, Germany
| | - Johannes Geier
- Information Network of Departments of Dermatology (IVDK), Institute at the University Medical Centre Göttingen, Göttingen, Germany
| | - Richard Brans
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
- Department of Dermatology, Environmental Medicine, and Health Theory, University of Osnabrück, Osnabrück, Germany
| | - Annice Heratizadeh
- Department of Dermatology and Allergy, Division of Immunodermatology and Allergy Research, Hannover Medical School, Hannover, Germany
| | - Birger Kränke
- Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria
| | - Axel Schnuch
- Information Network of Departments of Dermatology (IVDK), Institute at the University Medical Centre Göttingen, Göttingen, Germany
| | - Andrea Bauer
- Department of Dermatology, University Allergy Center, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Heinrich Dickel
- Department of Dermatology, Venereology and Allergology, St. Josef Hospital, University Medical Center, Ruhr University Bochum, Bochum, Germany
| | - Timo Buhl
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Dieter Vieluf
- Department of Allergology, Photodermatology and Occupational Dermatology, Dermatologikum Hamburg, Hamburg, Germany
| | - Nicola Wagner
- Department of Dermatology, Erlangen University Hospital, Friedrich-Alexander-University of Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Margitta Worm
- Division of Allergy and Immunology, Department of Dermatology, Venereology and Allergy, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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Geier J, Brans R, Weisshaar E, Wagner N, Szliska C, Heratizadeh A, Schubert S. Contact sensitization to benzisothiazolinone: IVDK-data of the years 2002 to 2021. Contact Dermatitis 2023; 88:446-455. [PMID: 36861774 DOI: 10.1111/cod.14300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/15/2023] [Accepted: 02/25/2023] [Indexed: 03/03/2023]
Abstract
BACKGROUND Benzisothiazolinone (BIT; CAS no. 2634-33-5) is used as a biocide in various products, including water-based paints, metalworking fluids, and household products. In recent years, increasing sensitization rates have been observed in Europe. OBJECTIVE To describe a time trend of sensitization to BIT, analyse concomitant reactions, and identify patients with increased risk of BIT sensitization. METHODS Retrospective analysis of data from 26 739 patients patch tested with BIT, sodium salt, 0.1% petrolatum as part of several special test series within the Information Network of Departments of Dermatology (IVDK), 2002 to 2021. RESULTS Positive reactions to BIT were noted in 771 patients (2.9%). Sensitization frequency varied over time and increased in recent years, peaking at 6.5% in 2020. Painters and metalworkers handling metalworking fluids, but not cleaners, had a significantly increased risk of BIT sensitization. From our data, there is no evidence of immunological cross-reactivity between BIT and other isothiazolinones. CONCLUSION The increasing frequency of sensitization justifies adding BIT to the baseline series. More research on the clinical relevance of positive patch test reactions to BIT and the cause for the rising numbers of BIT sensitization is needed. HIGHLIGHTS Frequency of sensitization to BIT has increased in recent years. The increasing frequency of sensitization justifies adding BIT to the baseline series. Painters and metalworkers handling metalworking fluids, but not cleaners, has a significantly increased risk of BIT sensitization. We found no evidence of immunological cross-reactivity between BIT and other isothiazolinones.
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Affiliation(s)
- Johannes Geier
- Information Network of Departments of Dermatology (IVDK), Institute at the University Medical Center Göttingen, Göttingen, Germany.,Lower Saxony Institute of Occupational Dermatology, University Medical Center Göttingen, Göttingen, Germany
| | - Richard Brans
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm), University of Osnabrück, Osnabrück, Germany.,Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany.,Lower Saxony Institute of Occupational Dermatology, University of Osnabrück, Osnabrück, Germany
| | - Elke Weisshaar
- Unit for Occupational Dermatology, Department of Dermatology, Ruprecht-Karls University, Heidelberg, Germany
| | - Nicola Wagner
- Department of Dermatology, University Hospital, Friedrich-Alexander University of Erlangen-Nürnberg (FAU), Erlangen, Germany
| | | | - Annice Heratizadeh
- Department of Dermatology and Allergy, Division of Immunodermatology and Allergy Research, Hannover Medical School, Hannover, Germany
| | - Steffen Schubert
- Information Network of Departments of Dermatology (IVDK), Institute at the University Medical Center Göttingen, Göttingen, Germany.,Lower Saxony Institute of Occupational Dermatology, University Medical Center Göttingen, Göttingen, Germany
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9
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Schubert S, Worm M, Dickel H, Wagner N, Brans R, Schröder-Kraft C, Bauer A, Koch A, Geier J. Patch testing shellac in consecutive patients-Data of the Information Network of Departments of Dermatology (IVDK) 2021. Contact Dermatitis 2023; 88:77-80. [PMID: 36163611 DOI: 10.1111/cod.14227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 01/06/2023]
Affiliation(s)
- Steffen Schubert
- Information Network of Departments of Dermatology (IVDK), Institute at the University Medical Center Göttingen, Göttingen, Germany
| | - Margitta Worm
- Allergy and Immunology, Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Heinrich Dickel
- Department of Dermatology, Venereology and Allergology, St. Josef Hospital, University Medical Center, Ruhr University Bochum, Bochum, Germany
| | - Nicola Wagner
- Department of Dermatology, Erlangen University Hospital, Friedrich-Alexander University of Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Richard Brans
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany.,Department of Dermatology, Environmental Medicine, and Health Theory, University of Osnabrück, Osnabrück, Germany
| | - Claudia Schröder-Kraft
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany.,Dermatologic Center, BG Klinikum Hamburg, Hamburg, Germany
| | - Andrea Bauer
- Department of Dermatology, University Allergy Center, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - André Koch
- Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany
| | - Johannes Geier
- Information Network of Departments of Dermatology (IVDK), Institute at the University Medical Center Göttingen, Göttingen, Germany
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Hanschmann T, Francuzik W, Dölle‐Bierke S, Hofmeier KS, Grabenhenrich L, Ruëff F, Renaudin J, Pföhler C, Treudler R, Beatrice BM, Lang R, Ensina LF, Christoff G, Cardona V, Wagner N, Reider N, Müller S, Dickel H, Worm M. Different phenotypes of drug‐induced anaphylaxis ‐ data from the European Anaphylaxis Registry. Allergy 2022. [DOI: 10.1111/all.15612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 10/11/2022] [Accepted: 11/01/2022] [Indexed: 12/13/2022]
Affiliation(s)
- Theresa Hanschmann
- Division of Allergy and Immunology, Department of Dermatology, Venerology and Allergology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, Berlin Institute of Health Berlin Germany
| | - Wojciech Francuzik
- Division of Allergy and Immunology, Department of Dermatology, Venerology and Allergology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, Berlin Institute of Health Berlin Germany
| | - Sabine Dölle‐Bierke
- Division of Allergy and Immunology, Department of Dermatology, Venerology and Allergology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, Berlin Institute of Health Berlin Germany
| | - Kathrin Scherer Hofmeier
- Allergy Unit, Department of Dermatology University Hospital Basel, Basel and Allergy Unit, Cantonal Hospital Aarau Switzerland
| | - Linus Grabenhenrich
- Division of Allergy and Immunology, Department of Dermatology, Venerology and Allergology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, Berlin Institute of Health Berlin Germany
- Department for Methodology and Research Infrastructure, Robert Koch‐Institut Berlin Germany
| | - Franziska Ruëff
- Department of Dermatology and Allergology, Ludwig‐Maximilian‐University Munich Germany
| | | | - Claudia Pföhler
- Saarland University Medical School Department of Dermatology, Homburg/Saar Germany
| | - Regina Treudler
- Department of Dermatology, Venereology and Allergology and Leipzig Interdisciplinary Center of Allergology (LICA) Comprehensive Allergy Center University Leipzig Medical Faculty Germany
| | - Bilò M. Beatrice
- Department of Clinical and Molecular Sciences, Università Politecnica delle Marche – Ancona ‐ Italy ‐ Department of Internal Medicine/Allergy Unit University Hospital Ospedali Riuniti Ancona Italy
| | - Roland Lang
- Department of Dermatology and Allergology, Paracelsus Medizinische Privatuniversität Salzburg Salzburg Austria
| | - Luis Felipe Ensina
- Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics Federal University of São Paulo São Paulo Brazil
| | - George Christoff
- Faculty of Public Health Medical University ‐ Sofia, Sofia, Bulgaria; Allergy Out‐patient Department, Acibadem CityClinic, Tokuda Medical Centre Sofia Bulgaria
| | - Victoria Cardona
- Allergy Section, Department of Internal Medicine, Hospital Vall d'Hebron, Barcelona, Spain; ARADyAL Research Network Spain
| | - Nicola Wagner
- Department of Dermatology University Hospital Erlangen, Friedrich‐Alexander‐Universität Erlangen‐Nürnberg (FAU), Erlangen Germany
| | - Norbert Reider
- Department of Dermatology, Venereology and Allergology Medical University of Innsbruck Innsbruck Austria
| | - Sabine Müller
- Department of Dermatology, Medical Center ‐ University of Freiburg, Faculty of Medicine, University of Freiburg Freiburg Germany
| | - Heinrich Dickel
- Department of Dermatology, Venereology and Allergology, St. Josef Hospital, University Medical Center Ruhr University Bochum Bochum Germany
| | - Margitta Worm
- Division of Allergy and Immunology, Department of Dermatology, Venerology and Allergology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, Berlin Institute of Health Berlin Germany
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11
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Basmanav FB, Cesarato N, Kumar S, Borisov O, Kokordelis P, Ralser DJ, Wehner M, Axt D, Xiong X, Thiele H, Dolgin V, Gossmann Y, Fricker N, Dewenter MK, Weller K, Suri M, Reichenbach H, Oji V, Addor MC, Ramirez K, Stewart H, Garcia Bartels N, Weibel L, Wagner N, George S, Kilic A, Tantcheva-Poor I, Stewart A, Dikow N, Blaumeiser B, Medvecz M, Blume-Peytavi U, Farrant P, Grimalt R, Bertok S, Bradley L, Eskin-Schwartz M, Birk OS, Bygum A, Simon M, Krawitz P, Fischer C, Hamm H, Fritz G, Betz RC. Assessment of the Genetic Spectrum of Uncombable Hair Syndrome in a Cohort of 107 Individuals. JAMA Dermatol 2022; 158:1245-1253. [PMID: 36044230 PMCID: PMC9434486 DOI: 10.1001/jamadermatol.2022.2319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 04/29/2022] [Indexed: 11/14/2022]
Abstract
Importance Uncombable hair syndrome (UHS) is a rare hair shaft anomaly that manifests during infancy and is characterized by dry, frizzy, and wiry hair that cannot be combed flat. Only about 100 known cases have been reported so far. Objective To elucidate the genetic spectrum of UHS. Design, Setting, and Participants This cohort study includes 107 unrelated index patients with a suspected diagnosis of UHS and family members who were recruited worldwide from January 2013 to December 2021. Participants of all ages, races, and ethnicities were recruited at referral centers or were enrolled on their own initiative following personal contact with the authors. Genetic analyses were conducted in Germany from January 2014 to December 2021. Main Outcomes and Measures Clinical photographs, Sanger or whole-exome sequencing and array-based genotyping of DNA extracted from blood or saliva samples, and 3-dimensional protein modeling. Descriptive statistics, such as frequency counts, were used to describe the distribution of identified pathogenic variants and genotypes. Results The genetic characteristics of patients with UHS were established in 80 of 107 (74.8%) index patients (82 [76.6%] female) who carried biallelic pathogenic variants in PADI3, TGM3, or TCHH (ie, genes that encode functionally related hair shaft proteins). Molecular genetic findings from 11 of these 80 individuals were previously published. In 76 (71.0%) individuals, the UHS phenotype were associated with pathogenic variants in PADI3. The 2 most commonly observed PADI3 variants account for 73 (48.0%) and 57 (37.5%) of the 152 variant PADI3 alleles in total, respectively. Two individuals carried pathogenic variants in TGM3, and 2 others carried pathogenic variants in TCHH. Haplotype analyses suggested a founder effect for the 4 most commonly observed pathogenic variants in the PADI3 gene. Conclusions and Relevance This cohort study extends and gives an overview of the genetic variant spectrum of UHS based on molecular genetic analyses of the largest worldwide collective of affected individuals, to our knowledge. Formerly, a diagnosis of UHS could only be made by physical examination of the patient and confirmed by microscopical examination of the hair shaft. The discovery of pathogenic variants in PADI3, TCHH, and TGM3 may open a new avenue for clinicians and affected individuals by introducing molecular diagnostics for UHS.
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Affiliation(s)
- F. Buket Basmanav
- Institute of Human Genetics, Medical Faculty & University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Nicole Cesarato
- Institute of Human Genetics, Medical Faculty & University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Sheetal Kumar
- Institute of Human Genetics, Medical Faculty & University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Oleg Borisov
- Institute for Genomic Statistics and Bioinformatics, Medical Faculty & University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Pavlos Kokordelis
- Institute of Human Genetics, Medical Faculty & University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Damian J. Ralser
- Institute of Human Genetics, Medical Faculty & University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Maria Wehner
- Institute of Human Genetics, Medical Faculty & University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Daisy Axt
- Institute of Human Genetics, Medical Faculty & University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Xing Xiong
- Institute of Human Genetics, Medical Faculty & University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Holger Thiele
- Cologne Center for Genomics, University of Cologne, Cologne, Germany
| | - Vadim Dolgin
- Genetics Institute at Soroka University Medical Center, Beer-Sheva, Israel
- Morris Kahn Laboratory of Human Genetics, National Center for Rare Diseases at the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- National Institute for Biotechnology in the Negev, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Yasmina Gossmann
- Institute of Human Genetics, Medical Faculty & University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Nadine Fricker
- Institute of Human Genetics, Medical Faculty & University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Malin Katharina Dewenter
- Institute of Human Genetics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Karsten Weller
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Mohnish Suri
- Nottingham Clinical Genetics Service, Nottingham University Hospitals NHS Trust, City Hospital Campus, Nottingham, England, United Kingdom
| | - Herbert Reichenbach
- MVZ Mitteldeutscher Praxisverbund Humangenetik, Praxis Leipzig, Leipzig, Germany
| | - Vinzenz Oji
- Department of Dermatology, University of Münster, Münster, Germany
| | - Marie-Claude Addor
- Department of Woman-Mother-Child, University Hospital Center CHUV CH 1011, Lausanne, Switzerland
| | - Karla Ramirez
- Neurología Pediátrica, Division de Pediatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Helen Stewart
- Oxford Centre for Genomic Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, England, United Kingdom
| | - Natalie Garcia Bartels
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Lisa Weibel
- Pediatric Dermatology Department, University Children’s Hospital Zurich, University Hospital Zurich, Zurich, Switzerland
- Dermatology Department, University Hospital Zurich, Zurich, Switzerland
| | - Nicola Wagner
- Department of Dermatology, Universitätsklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Susannah George
- Dermatology Department, Brighton General Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, England, United Kingdom
| | - Arzu Kilic
- Department of Dermatology, Faculty of Medicine, Balıkesir University, Balıkesir, Turkey
| | - Iliana Tantcheva-Poor
- Department of Dermatology and Venereology, University Hospital of Cologne, Cologne, Germany
| | - Alison Stewart
- Sheffield Clinical Genetics Service, Sheffield Children’s Hospital, South Yorkshire, England, United Kingdom
| | - Nicola Dikow
- Institute of Human Genetics, Heidelberg University, Heidelberg, Germany
| | | | - Márta Medvecz
- Department of Dermatology, Venereology, and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - Ulrike Blume-Peytavi
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Paul Farrant
- Dermatology Department, Brighton General Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, England, United Kingdom
| | - Ramon Grimalt
- Universitat Internacional de Catalunya, Barcelona, Spain
| | - Sara Bertok
- Department of Pediatric Endocrinology, Diabetes and Metabolic Diseases, University Children’s Hospital, University Medical Centre, Ljubljana, Slovenia
| | - Lisa Bradley
- Department of Clinical Genetics, Children’s Health Ireland (CHI) at Crumlin, Dublin, Ireland
| | | | - Ohad Samuel Birk
- Genetics Institute at Soroka University Medical Center, Beer-Sheva, Israel
| | - Anette Bygum
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
- Clinical Institute, University of Southern Denmark, Odense, Denmark
| | - Michel Simon
- Toulouse Institute for Infectious and Inflammatory diseases, Toulouse University, Toulouse, France
- CNRS, Inserm, Paul Sabatier Toulouse III University, Toulouse, France
| | - Peter Krawitz
- Institute for Genomic Statistics and Bioinformatics, Medical Faculty & University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Christine Fischer
- Institute of Human Genetics, Heidelberg University, Heidelberg, Germany
| | - Henning Hamm
- Department of Dermatology, Venereology, and Allergology, University Hospital Würzburg, Würzburg, Germany
| | - Günter Fritz
- Department of Cellular Microbiology, University of Hohenheim, Stuttgart, Germany
| | - Regina C. Betz
- Institute of Human Genetics, Medical Faculty & University Hospital Bonn, University of Bonn, Bonn, Germany
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12
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Brans R, Schröder‐Kraft C, Bauer A, Weisshaar E, Skudlik C, Geier J, Grabbe J, Siedlecki K, Strom K, Worm M, Simon D, Dickel H, Vieluf D, Koch A, Wagner N, Gina M, Kränke B, Werfel T, Schäkel K, Löffler H, Pföhler C, Schliemann S, Heine G, Treudler R, Nestoris S, Recke A, Becker D, Nicolay J, Stadler R, Rueff F, Brockow K, Brehler R, Raap U, Rieker‐Schwienbacher J, Wilfinger D, Weiß J, Trautmann A, Lang C. Contact sensitizations in massage therapists with occupational contact dermatitis: patch test data of the Information Network of Departments of Dermatology (
IVDK
), 2008 to 2020. Contact Dermatitis 2022; 88:43-53. [DOI: 10.1111/cod.14218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/26/2022] [Accepted: 09/07/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Richard Brans
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück Osnabrück Germany
- Department of Dermatology Environmental Medicine and Health Theory, University of Osnabrück Osnabrück Germany
| | - Claudia Schröder‐Kraft
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück Osnabrück Germany
- Dermatologic Centre, BG Klinikum Hamburg Hamburg Germany
| | - Andrea Bauer
- Department of Dermatology University Allergy Center, University Hospital Carl Gustav Carus, Technical University Dresden Dresden Germany
| | - Elke Weisshaar
- Division of Occupational Dermatology, Department of Dermatology Ruprecht Karls University Heidelberg Germany
| | - Christoph Skudlik
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück Osnabrück Germany
- Department of Dermatology Environmental Medicine and Health Theory, University of Osnabrück Osnabrück Germany
- Dermatologic Centre, BG Klinikum Hamburg Hamburg Germany
| | - Johannes Geier
- Information Network of Departments of Dermatology (IVDK) Institute at the University Medical Center Göttingen Göttingen Germany
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13
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Frazao C, Wagner N, Rabe K, Walther T. Construction of a synthetic metabolic pathway for direct production of 2,4‐dihydroxybutyric acid from one‐ and two‐carbon alcohols. CHEM-ING-TECH 2022. [DOI: 10.1002/cite.202255370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- C. J. R. Frazao
- TU Dresden Institute of Natural Materials Technology Bergstr. 120 01062 Dresden Germany
| | - N. Wagner
- TU Dresden Institute of Natural Materials Technology Bergstr. 120 01062 Dresden Germany
| | - K. Rabe
- TU Dresden Institute of Natural Materials Technology Bergstr. 120 01062 Dresden Germany
| | - T. Walther
- TU Dresden Institute of Natural Materials Technology Bergstr. 120 01062 Dresden Germany
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Wagner N, Frazão C, Walther T. Ethylene glycol is an interesting platform molecule for microbial CO
2
‐based product syntheses. CHEM-ING-TECH 2022. [DOI: 10.1002/cite.202255371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- N. Wagner
- TU Dresden Chair of Bioprocess Engineering Bergstr. 120 01069 Dresden Germany
| | - C. Frazão
- TU Dresden Chair of Bioprocess Engineering Bergstr. 120 01069 Dresden Germany
| | - T. Walther
- TU Dresden Chair of Bioprocess Engineering Bergstr. 120 01069 Dresden Germany
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Ohl K, Subramanyam SH, Verjans E, Clarner T, Böll S, Costa Filho IG, Li Z, Gan L, Schmitt E, Bopp T, Wagner N, Schulz S, Goodarzi T, Scheld M, Floess S, Huehn J, Lambrecht B, Beyaert R, Look T, Zenke M, Tenbrock K. Foxp3-specific deletion of CREB generates ST-2 positive regulatory
T-cells with shifts towards type 2 immune responses. Klinische Pädiatrie 2022. [DOI: 10.1055/s-0042-1754516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- K Ohl
- RWTH Aachen, Pediatrics, Aachen, Germany
| | | | - E Verjans
- RWTH Aachen, Pediatrics, Aachen, Germany
| | - T Clarner
- RWTH Aachen, Anatomy, Aachen, Germany
| | - S Böll
- RWTH Aachen, Pediatrics, Aachen, Germany
| | | | - Z Li
- RWTH Aachen, Computational Genomics, Aachen, Germany
| | - L Gan
- RWTH Aachen, Computational Genomics, Aachen, Germany
| | - E Schmitt
- Institut für Immunologie, Universität Mainz, Mainz,
Germany
| | - T Bopp
- Institut für Immunologie, Universität Mainz, Mainz,
Germany
| | - N Wagner
- RWTH Aachen, Pediatrics, Aachen, Germany
| | - S Schulz
- RWTH Aachen, Pediatrics, Aachen, Germany
| | - T Goodarzi
- RWTH Aachen, Pediatrics, Aachen, Germany
| | - M Scheld
- RWTH Aachen, Anatomy, Aachen, Germany
| | | | | | | | | | - T Look
- RWTH Aachen, Zellbiologie, Aachen, Germany
| | - M Zenke
- RWTH Aachen, Zellbiologie, Aachen, Germany
| | - K Tenbrock
- RWTH Aachen, Pediatrics, Aachen, Germany
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Wagner N, Bade F, Rabe K, Walther T. Engineering
E. coli
for the carbon‐conserving conversion of ethylene glycol to acetyl‐CoA and derived products. CHEM-ING-TECH 2022. [DOI: 10.1002/cite.202255365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- N. Wagner
- TU Dresden Chair of Bioprocess Engineering Bergstr. 120 01069 Dresden Germany
| | - F. Bade
- TU Dresden Chair of Bioprocess Engineering Bergstr. 120 01069 Dresden Germany
| | - K. Rabe
- TU Dresden Chair of Bioprocess Engineering Bergstr. 120 01069 Dresden Germany
| | - T. Walther
- TU Dresden Chair of Bioprocess Engineering Bergstr. 120 01069 Dresden Germany
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17
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Rein A, Ngo C, Van den Berg M, Böll S, Lassay L, Kontny U, Wagner N, Leonhardt S, Tenbrock K, Verjans E. Characterization of pulmonary function impairment in a pediatric
sickle cell anemia cohort using electrical impedance tomography. Klinische Pädiatrie 2022. [DOI: 10.1055/s-0042-1754474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- A Rein
- RWTH Aachen University Hospital, Pediatrics, Aachen,
Germany
| | - C Ngo
- Helmholtz Institute for Biomedical Engineering, Medical Information
Technology, Aachen, Germany
| | - M Van den Berg
- Helmholtz Institute for Biomedical Engineering, Medical Information
Technology, Aachen, Germany
| | - S Böll
- RWTH Aachen University Hospital, Pediatrics, Aachen,
Germany
| | - L Lassay
- RWTH Aachen University Hospital, Pediatrics, Aachen,
Germany
| | - U Kontny
- RWTH Aachen University Hospital, Pediatrics, Aachen,
Germany
| | - N Wagner
- RWTH Aachen University Hospital, Pediatrics, Aachen,
Germany
| | - S Leonhardt
- Helmholtz Institute for Biomedical Engineering, Medical Information
Technology, Aachen, Germany
| | - K Tenbrock
- RWTH Aachen University Hospital, Pediatrics, Aachen,
Germany
| | - E Verjans
- RWTH Aachen University Hospital, Pediatrics, Aachen,
Germany
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18
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King N, Linden B, Cunningham S, Rivera D, Rose J, Wagner N, Mulder J, Adams M, Baxter R, Duffy A. The feasibility and effectiveness of a novel online mental health literacy course in supporting university student mental health: a pilot study. BMC Psychiatry 2022; 22:515. [PMID: 35907852 PMCID: PMC9338643 DOI: 10.1186/s12888-022-04139-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 07/13/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND There is a need for effective universal approaches to promote and support university student mental health that are scalable and sustainable. In this pilot study we assess the feasibility and acceptability of a fully-digitalized, comprehensive mental health literacy course co-created with and tailored to the needs of undergraduate students. We also explore preliminary associations with mental health and positive behaviour change. METHODS An accredited online mental health literacy course was developed using state-of-the-art pedagogical principles and a reverse mentorship approach. The course was offered as an interdisciplinary undergraduate elective. Students completed an online survey before and after the 12-week course that collected demographic information and assessed mental health knowledge, emotional self-awareness, mental health, stigma, and health-related behaviors using validated measures. Dependent group t-tests were used to compare pre- and post-course levels of knowledge, mental health, sleep quality and substance use. Mental health outcomes of students who completed the course were compared to an age and sex-matched sample of students not enrolled in the course and who completed the same survey measures over the same academic year. Multivariable linear regression was used to examine the effect of course participation on outcomes at follow-up. RESULTS The course had good uptake and was positively reviewed by participants. Specifically, students found the course engaging, relevant, and applicable, and agreed they would recommend it to their peers. Among course participants there was improvement in mental health knowledge (p < 0.001) and emotional self-awareness (p = 0.02) at course completion. Compared to the matched comparison group, taking the course was associated with reduced alcohol (β = - 0.41, p = 0.01) and cannabis use (β = - 0.35, p = 0.03), and improved sleep quality (β = 1.56, p = 0.09) at the end of the term. CONCLUSIONS Findings suggest that delivering mental health literacy as an online accredited course may be an acceptable and effective way of promoting university student mental health through improved knowledge, emotional self-awareness, and healthy lifestyle choices. As the course is expanded to larger and more diverse student cohorts we will be able to further examine the short and long-term effectiveness of the course in supporting student mental health and the underlying mechanisms.
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Affiliation(s)
- N. King
- grid.410356.50000 0004 1936 8331Department of Public Health Sciences, Queen’s University, Kingston, Canada
| | - B. Linden
- grid.410356.50000 0004 1936 8331Department of Public Health Sciences, Queen’s University, Kingston, Canada ,grid.410356.50000 0004 1936 8331Health Services and Policy Research Institute, Queen’s University, Kingston, Canada
| | - S. Cunningham
- grid.410356.50000 0004 1936 8331Department of Biomedical & Molecular Sciences, Queen’s University, Kingston, Canada
| | - D. Rivera
- grid.17063.330000 0001 2157 2938Department of Pharmacology and Toxicology, University of Toronto, Toronto, Canada
| | - J. Rose
- grid.410356.50000 0004 1936 8331Department of Psychiatry, Queen’s University, Kingston, Canada
| | - N. Wagner
- grid.410356.50000 0004 1936 8331Department of Biomedical & Molecular Sciences, Queen’s University, Kingston, Canada ,grid.410356.50000 0004 1936 8331Office of Professional Development & Educational Scholarship, Queen’s University, Kingston, Canada
| | - J. Mulder
- grid.410356.50000 0004 1936 8331Department of Biomedical & Molecular Sciences, Queen’s University, Kingston, Canada ,grid.410356.50000 0004 1936 8331Office of Professional Development & Educational Scholarship, Queen’s University, Kingston, Canada
| | - M. Adams
- grid.410356.50000 0004 1936 8331Department of Biomedical & Molecular Sciences, Queen’s University, Kingston, Canada ,grid.410356.50000 0004 1936 8331Office of Professional Development & Educational Scholarship, Queen’s University, Kingston, Canada
| | - R. Baxter
- grid.4305.20000 0004 1936 7988Centre for Research Collections, University of Edinburgh Main Library, University of Edinburgh, Edinburgh, UK
| | - A. Duffy
- grid.410356.50000 0004 1936 8331Department of Public Health Sciences, Queen’s University, Kingston, Canada ,grid.410356.50000 0004 1936 8331Department of Psychiatry, Queen’s University, Kingston, Canada ,grid.4991.50000 0004 1936 8948Department of Psychiatry, University of Oxford, Oxford, UK
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19
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Bizjak M, Košnik M, Dinevski D, Francis Thomsen S, Fomina D, Borzova E, Kulthanan K, Meshkova R, Aarestrup F, Melina Ahsan D, Al-Ahmad M, Altrichter S, Bauer A, Brockstädt M, Costa C, Demir S, Fachini Criado R, Felipe Ensina L, Gelincik A, Giménez-Arnau AM, Gonçalo M, Gotua M, Grønlund Holm J, Inomata N, Kasperska-Zajac A, Khoshkhui M, Klyucharova A, Kocatürk E, Lu R, Makris M, Maltseva N, Pasali M, Paulino M, Pesqué D, Peter J, Dario Ramón G, Ritchie C, Oliveira Rodrigues Valle S, Rudenko M, Sikora A, Wagner N, Xepapadaki P, Xue X, Zhao Z, Terhorst-Molawi D, Maurer M. Adrenaline autoinjector is under-prescribed in typical cold urticaria patients living in tropical climate countries. Qatar Med J 2022; 2022:19. [PMID: 35909392 PMCID: PMC9284591 DOI: 10.5339/qmj.2022.fqac.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Background: The diagnosis of typical cold urticaria (ColdU) relies on whealing in response to local cold stimulation testing (CST). It can also manifest with cold-induced anaphylaxis (ColdA). Till date, it is largely unclear how often patients with ColdU receive adrenaline treatment and are provided with an adrenaline autoinjector (AAI). Methods: An international, cross-sectional study, COLD-CE (i.e., comprehensive evaluation of ColdU and other cold-induced reactions), was carried out at 32 UCAREs. Detailed histories were taken and CST with an ice cube and/or TempTest® performed. ColdA was defined as an acute cold-induced (i.e., by cold water, air, or surfaces) involvement of the skin and/or visible mucosal tissue and at least one of the symptoms (cardiovascular manifestations, difficulty breathing, or gastrointestinal symptoms). Results: Of the 551 ColdU patients, 75% (n = 412) had a positive CST. Of them, concomitant chronic spontaneous urticaria was diagnosed in 10%. Of 372 patients with stand-alone ColdU, 69% were women and 91% adults. Their median age was 36 (IQR 26 − 48) years. Patients were also categorized into residents of countries with a tropical (n = 33), temperate (n = 264), or cold (n = 75) climate (Table 1: R13C1, R17C1, R21C1). AAI was more often prescribed to residents of temperate than tropical countries (30% vs. 12%, p = .038; Table 1: R31C1), although the frequency of ColdA did not significantly differ between these countries (44% vs. 42%, p = 1.000; R29C2). Residents of tropical countries had a higher frequency of ColdA induced by cold air than residents of temperate (36% vs. 12%, p = .001; R29C4) or cold (36% vs. 12%, p = .007; R25C4) countries. Cardiovascular manifestations induced by cold air were diagnosed in 33% (n = 11) of residents of tropical countries, but only 18% (n = 2) and 36% (n = 4) of them had received adrenaline and AAI, respectively (R13 − 15C7). Furthermore, hypotension and/or loss of consciousness induced by cold air occurred in 18% (n = 6) of patients, but only 17% (n = 1) received adrenaline (R13 − 14C10). ColdA was induced by complete cold water immersion in 9% (n = 3) of patients, and none of them received adrenaline treatment nor AAI (R13 − 15C3). Conclusion: Our findings suggest that ColdA is undertreated and call for changes in ColdU management.
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Affiliation(s)
- Mojca Bizjak
- COLD-CE steering committee member, *both authors have contributed equally E-mail:
- Faculty of Medicine, University of Maribor, Maribor, Slovenia
- Division of Allergy, Urticaria Center of Reference and Excellence (UCARE), University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia
| | - Mitja Košnik
- COLD-CE steering committee member, *both authors have contributed equally E-mail:
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- Division of Allergy, Urticaria Center of Reference and Excellence (UCARE), University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia
| | - Dejan Dinevski
- Faculty of Medicine, University of Maribor, Maribor, Slovenia
| | - Simon Francis Thomsen
- COLD-CE steering committee member, *both authors have contributed equally E-mail:
- Department of Dermatology, Urticaria Center of Reference and Excellence (UCARE), Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Daria Fomina
- Department of Clinical Immunology and Allergology, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
- Center of Allergy and Immunology, Urticaria Center of Reference and Excellence (UCARE), Clinical State Hospital 52, Moscow Ministry of Healthcare, Moscow, Russian Federation
| | - Elena Borzova
- Department of Clinical Genetics, Veltischev Research and Clinical Institute for Pediatrics of the Pirogov Russian National Research Medical University, Moscow, Russian Federation
- Department of Dermatology and Venereology, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Kanokvalai Kulthanan
- COLD-CE steering committee member, *both authors have contributed equally E-mail:
- Department of Dermatology, Urticaria Center of Reference and Excellence (UCARE), Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Raisa Meshkova
- COLD-CE steering committee member, *both authors have contributed equally E-mail:
- Department of Clinical Immunology and Allergology, Urticaria Center of Reference and Excellence (UCARE), Smolensk State Medical University, Smolensk, Russian Federation
| | - FernandoM Aarestrup
- Faculdade de Ciências, Médicas e da Saúde de Juiz de Fora (SUPREMA), Urticaria Center of Reference and Excellence (UCARE), Hospital Maternidade Therezinha de Jesus, Minas Gerais, Brazil
| | - Dalia Melina Ahsan
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
- Urticaria Center of Reference and Excellence (UCARE), Institute of Allergology, Charité –Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Mona Al-Ahmad
- Microbiology Department, Faculty of Medicine, Urticaria Center of Reference and Excellence (UCARE), Kuwait University, Safat, Kuwait
| | - Sabine Altrichter
- Department of Dermatology and Venerology, Urticaria Center of Reference and Excellence (UCARE), Comprehensive Allergy Center, Kepler University Hospital, Linz, Austria
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
- Urticaria Center of Reference and Excellence (UCARE), Institute of Allergology, Charité –Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Andrea Bauer
- Department of Dermatology, Urticaria Center of Reference and Excellence (UCARE), University Allergy Center, University Hospital Carl Gustav Carus, Technical University, Dresden, Germany
| | - Maxi Brockstädt
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
- Urticaria Center of Reference and Excellence (UCARE), Institute of Allergology, Charité –Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Célia Costa
- Immunoallergology Department, Urticaria Center of Reference and Excellence (UCARE), Hospital de Santa Maria, CHULN, Lisbon, Portugal
| | - Semra Demir
- Division of Allergy, Department of Internal Medicine, Istanbul Faculty of Medicine, Urticaria Center of Reference and Excellence (UCARE), Istanbul University, Istanbul, Turkey
| | - Roberta Fachini Criado
- Faculdade de Medicina do ABC (FMABC), Urticaria Center of Reference and Excellence (UCARE), Santo André, Brazil
| | - Luis Felipe Ensina
- Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Urticaria Center of Reference and Excellence (UCARE), Federal University of São Paulo, São Paulo, Brazil
| | - Asli Gelincik
- Division of Allergy, Department of Internal Medicine, Istanbul Faculty of Medicine, Urticaria Center of Reference and Excellence (UCARE), Istanbul University, Istanbul, Turkey
| | - Ana Maria Giménez-Arnau
- Department of Dermatology, Urticaria Center of Reference and Excellence (UCARE), Hospital del Mar, IMIM, Universitat Autònoma, Barcelona, Spain
| | - Margarida Gonçalo
- Clinic of Dermatology, Urticaria Center of Reference and Excellence (UCARE), University Hospital and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Maia Gotua
- Center of Allergy and Immunology, Urticaria Center of Reference and Excellence (UCARE), Tbilsi, Georgia
| | - Jesper Grønlund Holm
- Department of Dermatology, Urticaria Center of Reference and Excellence (UCARE), Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Naoko Inomata
- Department of Environmental Immuno-Dermatology, Urticaria Center of Reference and Excellence (UCARE), Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Alicja Kasperska-Zajac
- European Center for Diagnosis and Treatment of Urticaria/Angioedema (GA2LEN UCARE /ACARE Network) & Department of Clinical Allergology and Urticaria of Medical University of Silesia, Poland
| | - Maryam Khoshkhui
- Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Aliya Klyucharova
- Department of Internal Diseases, Institute of Fundamental Medicine and Biology (IFMB) of Kazan Federal University, Kazan, Russian Federation
- Department of Clinical Immunology and Allergology, Republican Center of Clinical Immunology and Allergology, Urticaria Center of Reference and Excellence (UCARE), Republican Clinical Hospital, Kazan State Medical University, Kazan, Russian Federation
| | - Emek Kocatürk
- Department of Dermatology, Urticaria Center of Reference and Excellence (UCARE), Koç University School of Medicine, Istanbul, Turkey
| | - Rongbiao Lu
- Department of Dermatology, Urticaria Center of Reference and Excellence (UCARE), The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Michael Makris
- Allergy Unit, Second Department of Dermatology and Venereology, Urticaria Center of Reference and Excellence (UCARE), National and Kapodistrian University of Athens, University General Hospital “Attikon”, Athens, Greece
| | - Natalya Maltseva
- Center of Allergy and Immunology, Urticaria Center of Reference and Excellence (UCARE), Clinical State Hospital 52, Moscow Ministry of Healthcare, Moscow, Russian Federation
| | - Maria Pasali
- Allergy Unit, Second Department of Dermatology and Venereology, Urticaria Center of Reference and Excellence (UCARE), National and Kapodistrian University of Athens, University General Hospital “Attikon”, Athens, Greece
| | - Marisa Paulino
- Immunoallergology Department, Urticaria Center of Reference and Excellence (UCARE), Hospital de Santa Maria, CHULN, Lisbon, Portugal
| | - David Pesqué
- Department of Dermatology, Urticaria Center of Reference and Excellence (UCARE), Hospital del Mar, IMIM, Universitat Autònoma, Barcelona, Spain
| | - Jonny Peter
- Allergy and Immunology Unit, University of Cape Town Lung Institute, Cape Town, South Africa
- Division of Allergy and Clinical Immunology, Department of Medicine, Urticaria Center of Reference and Excellence (UCARE), University of Cape Town, Cape Town, South Africa
| | - German Dario Ramón
- Instituto de Alergia e Inmunologia del Sur, Urticaria Center of Reference and Excellence (UCARE), Buenos Aires, Argentina
| | - Carla Ritchie
- Adults and Pediatrics Allergy Unit, Urticaria Center of Reference and Excellence (UCARE), Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Solange Oliveira Rodrigues Valle
- Department of Internal Medicine, Immunology Service, Urticaria Center of Reference and Excellence (UCARE), Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Michael Rudenko
- London Allergy and Immunology Centre, Urticaria Center of Reference and Excellence (UCARE), London, UK
| | - Agnieszka Sikora
- European Center for Diagnosis and Treatment of Urticaria/Angioedema (GA2LEN UCARE /ACARE Network) & Department of Clinical Allergology and Urticaria of Medical University of Silesia, Poland
| | - Nicola Wagner
- Department of Dermatology, Urticaria Center of Reference and Excellence (UCARE), University Hospital of Erlangen, University of Erlangen-Nuremberg (FAU), Germany
| | - Paraskevi Xepapadaki
- Allergy Unit, 2nd Pediatric Clinic, Urticaria Center of Reference and Excellence (UCARE), National and Kapodistrian University of Athens, Greece
| | - Xiaoyang Xue
- Department of General Practice, Urticaria Center of Reference and Excellence (UCARE), Community Health Service Center, Guangzhou City, China
| | - Zuotao Zhao
- Department of Dermatology and Venerology, Urticaria Center of Reference and Excellence (UCARE), Beijing Key Laboratory of Molecular Diagnosis on Dermatoses and National Clinical Research Center for Skin and Immune Diseases, Peking University First Hospital, Beijing, China
| | - Dorothea Terhorst-Molawi
- COLD-CE steering committee member, *both authors have contributed equally E-mail:
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
- Urticaria Center of Reference and Excellence (UCARE), Institute of Allergology, Charité –Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Marcus Maurer
- COLD-CE steering committee member, *both authors have contributed equally E-mail:
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
- Urticaria Center of Reference and Excellence (UCARE), Institute of Allergology, Charité –Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
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20
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Bizjak M, Košnik M, Dinevski D, Thomsen SF, Fomina D, Borzova E, Kulthanan K, Meshkova R, Aarestrup FM, Ahsan DM, Al‐Ahmad M, Altrichter S, Bauer A, Brockstädt M, Costa C, Demir S, Criado RF, Ensina LF, Gelincik A, Giménez‐Arnau AM, Gonçalo M, Gotua M, Holm JG, Inomata N, Kasperska‐Zajac A, Khoshkhui M, Klyucharova A, Kocatürk E, Lu R, Makris M, Maltseva N, Pasali M, Paulino M, Pesqué D, Peter J, Ramón GD, Ritchie C, Rodrigues Valle SO, Rudenko M, Sikora A, Wagner N, Xepapadaki P, Xue X, Zhao Z, Terhorst‐Molawi D, Maurer M. Adrenaline autoinjector is underprescribed in typical cold urticaria patients. Allergy 2022; 77:2224-2229. [PMID: 35258111 DOI: 10.1111/all.15274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 02/23/2022] [Accepted: 03/01/2022] [Indexed: 11/30/2022]
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21
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Uter W, Wilkinson SM, Aerts O, Bauer A, Borrego L, Buhl T, Cooper SM, Dickel H, Gallo R, Giménez-Arnau AM, John SM, Navarini AA, Pesonen M, Pónyai G, Rustemeyer T, Schliemann S, Schubert S, Schuttelaar MLA, Valiukevičienė S, Wagner N, Weisshaar E, Gonçalo M. European patch test results with audit allergens as candidates for inclusion in the European Baseline Series, 2019/20 - Joint results of the ESSCA A and the EBS B working groups of the ESCD, and the GEIDAC C. Contact Dermatitis 2022; 86:379-389. [PMID: 35099073 DOI: 10.1111/cod.14059] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/25/2022] [Accepted: 01/26/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND In 2019, a number of allergens (haptens), henceforth, 'the audit allergens,' were considered as potential additions to the European baseline series (EBS), namely, sodium metabisulfite, 2-bromo-2-nitropropane-1,3-diol, diazolidinyl urea, imidazolidinyl urea, Compositae mix II (2.5 or 5% pet), linalool hydroperoxides (lin-OOH), limonene hydroperoxides (lim-OOH), benzisothiazolinone (BIT), octylisothiazolinone (OIT), decyl glucoside, lauryl glucoside; Evernia furfuracea (tree moss), was additionally tested by some departments, too. OBJECTIVES To collect further data on patch test reactivity and clinical relevance of the audit allergens in consecutive patients across Europe. METHODS Patch test data covering the audit allergens in 2019 and 2020 were collected by those departments of the ESSCA testing these, as well as further collaborators from the EBS working group of the ESCD, and the Spanish GEIDAC. As patch test outcome, reactions between day (D) 3 and D5 were considered. RESULTS Altogether n=12403 patients were tested with any of the audit allergen. Positive reactions were most common to lin-OOH 1% pet. (8.74 (8.14-9.37)), followed by lin-OOH 0.5% pet., and lim-OOH 0.3% pet (5.41 (4.95-5.89)). Beyond these terpene hydroperoxides, BIT 0.1% pet. was the second most common allergen with 4.72 (4.2-5.28), followed by sodium metabisulfite 1% pet. (3.75 (3.32-4.23)) and Compositae mix 5% pet. (2.31 (1.84-2.87). For some allergens, clinical relevance was frequently difficult to ascertain. CONCLUSIONS Despite many positive patch test reactions, it remains controversial whether lin- and lim-OOH should be tested routinely, while at least the two preservatives BIT and sodium metabisulfite appear suitable. The present results are a basis for further discussion among the ESCD members and ultimately decision on their implementation into routine testing. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, Erlangen, Germany
| | - S Mark Wilkinson
- Dermatology Department, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Olivier Aerts
- Department of Dermatology, University Hospital Antwerp (UZA) and Research group Immunology, Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium
| | - Andrea Bauer
- Department of Dermatology, University Allergy Centre, Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Leopoldo Borrego
- Complejo Hospitalario Universitario Insular Materno Infantil. Universidad de las Palmas de Gran Canaria, Spain
| | - Timo Buhl
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Susan M Cooper
- Department of Dermatology, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Heinrich Dickel
- Department of Dermatology, Venereology and Allergology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
| | - Rosella Gallo
- Clinica Dermatologica, Department of Health Sciences, University of Genoa, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Ana M Giménez-Arnau
- Department of Dermatology, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Swen M John
- Department of Dermatology and Environmental Medicine, Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm), University of Osnabrück, Osnabrück, Germany.,Lower Saxony Institute for Occupational Dermatology (NIB), Osnabrück, Germany
| | | | - Maria Pesonen
- Occupational Health Unit, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Györgyi Pónyai
- Semmelweis University, Department of Dermatology, Venerology and Dermatooncology, Budapest, Hungary
| | - Thomas Rustemeyer
- Department of Dermatology-Allergology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | | | - Steffen Schubert
- Information Network of Departments of Dermatology, Institute at the University Medical Centre Göttingen, Göttingen, Germany
| | - Marie-Louise A Schuttelaar
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Skaidra Valiukevičienė
- Department of Skin and Venereal Diseases, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Nicola Wagner
- Department of Dermatology, University Hospital of Erlangen, University of Erlangen-, Nuremberg, (FAU), Erlangen, Germany
| | - Elke Weisshaar
- Occupational Dermatology, Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | - Margarida Gonçalo
- Department of Dermatology, University Hospital and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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22
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Wagner N, Manger B, Kittler J, Rech J, Sticherling M, Berking C, Kirchberger MC. Drei Generationen Leiden: Cryopyrin‐assoziiertes periodisches Syndrom mit familiärer
NLRP3
‐Mutation. J Dtsch Dermatol Ges 2022; 20:106-111. [PMID: 35040579 DOI: 10.1111/ddg.14650_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Nicola Wagner
- Hautklinik, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen.,Zentrum für seltene Erkrankungen (ZSEER), Erlangen.,DZI (Deutsches Zentrum für Immuntherapie)
| | - Bernhard Manger
- Rheumatologie und Immunologie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen- Nürnberg, Erlangen.,Zentrum für seltene Erkrankungen (ZSEER), Erlangen.,DZI (Deutsches Zentrum für Immuntherapie)
| | - Julia Kittler
- Rheumatologie und Immunologie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen- Nürnberg, Erlangen.,Zentrum für seltene Erkrankungen (ZSEER), Erlangen.,DZI (Deutsches Zentrum für Immuntherapie)
| | - Jürgen Rech
- Rheumatologie und Immunologie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen- Nürnberg, Erlangen.,Zentrum für seltene Erkrankungen (ZSEER), Erlangen.,DZI (Deutsches Zentrum für Immuntherapie)
| | - Michael Sticherling
- Hautklinik, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen.,Zentrum für seltene Erkrankungen (ZSEER), Erlangen.,DZI (Deutsches Zentrum für Immuntherapie)
| | - Carola Berking
- Hautklinik, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen.,Zentrum für seltene Erkrankungen (ZSEER), Erlangen.,DZI (Deutsches Zentrum für Immuntherapie)
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23
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Wagner N, Manger B, Kittler J, Rech J, Sticherling M, Berking C, Kirchberger MC. Three generations of suffering: cryopyrin-associated periodic syndrome with NLRP3 mutation in a family. J Dtsch Dermatol Ges 2021; 20:110-112. [PMID: 34904355 DOI: 10.1111/ddg.14650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Nicola Wagner
- Friedrich-Alexander-University of Erlangen-Nürnberg (FAU)Department of Dermatology, University Hospital Erlangen, Erlangen, Germany.,Centre for rare diseases Erlangen (ZSEER), Erlangen, Germany.,DZI (Deutsches Zentrum für Immuntherapie)
| | - Bernhard Manger
- Department of Rheumatology and Immunology, University Hospital Erlangen, Erlangen, Germany.,Centre for rare diseases Erlangen (ZSEER), Erlangen, Germany.,DZI (Deutsches Zentrum für Immuntherapie)
| | - Julia Kittler
- Department of Rheumatology and Immunology, University Hospital Erlangen, Erlangen, Germany.,Centre for rare diseases Erlangen (ZSEER), Erlangen, Germany.,DZI (Deutsches Zentrum für Immuntherapie)
| | - Jürgen Rech
- Department of Rheumatology and Immunology, University Hospital Erlangen, Erlangen, Germany.,Centre for rare diseases Erlangen (ZSEER), Erlangen, Germany.,DZI (Deutsches Zentrum für Immuntherapie)
| | - Michael Sticherling
- Friedrich-Alexander-University of Erlangen-Nürnberg (FAU)Department of Dermatology, University Hospital Erlangen, Erlangen, Germany.,Centre for rare diseases Erlangen (ZSEER), Erlangen, Germany.,DZI (Deutsches Zentrum für Immuntherapie)
| | - Carola Berking
- Friedrich-Alexander-University of Erlangen-Nürnberg (FAU)Department of Dermatology, University Hospital Erlangen, Erlangen, Germany.,Centre for rare diseases Erlangen (ZSEER), Erlangen, Germany.,DZI (Deutsches Zentrum für Immuntherapie)
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24
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Kamann S, Wagner N, Oppel E. Moderne Sensortechnik zur kontinuierlichen Glukosemessung: Anwendungseinschränkungen durch Kontaktallergien. J Dtsch Dermatol Ges 2021; 19:1715-1722. [PMID: 34894186 DOI: 10.1111/ddg.14621_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 07/30/2021] [Indexed: 11/29/2022]
Affiliation(s)
| | - Nicola Wagner
- Hautklinik, Universitätsklinik Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen
| | - Eva Oppel
- Klinik für Dermatologie und Allergologie, Ludwig-Maximilians-Universität, München
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25
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Bizjak M, Košnik M, Dinevski D, Thomsen SF, Fomina D, Borzova E, Kulthanan K, Meshkova R, Ahsan DM, Al‐Ahmad M, Altrichter S, Bauer A, Brockstädt M, Costa C, Demir S, Fachini Criado R, Ensina LF, Gelincik A, Giménez‐Arnau AM, Gonçalo M, Gotua M, Holm JG, Inomata N, Kasperska‐Zajac A, Khoshkhui M, Klyucharova A, Kocatürk E, Lu R, Makris M, Maltseva N, Miljković J, Pasali M, Paulino M, Pesqué D, Peter J, Ramón GD, Ritchie C, Rodrigues Valle SO, Rudenko M, Sikora A, Souza Lima EM, Wagner N, Xepapadaki P, Xue X, Zhao Z, Terhorst‐Molawi D, Maurer M. Risk factors for systemic reactions in typical cold urticaria: Results from the COLD-CE study. Allergy 2021; 77:2185-2199. [PMID: 34862605 DOI: 10.1111/all.15194] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/11/2021] [Accepted: 11/20/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Cold urticaria (ColdU), that is, the occurrence of wheals or angioedema in response to cold exposure, is classified into typical and atypical forms. The diagnosis of typical ColdU relies on whealing in response to local cold stimulation testing (CST). It can also manifest with cold-induced anaphylaxis (ColdA). We aimed to determine risk factors for ColdA in typical ColdU. METHODS An international, cross-sectional study COLD-CE was carried out at 32 urticaria centers of reference and excellence (UCAREs). Detailed history was taken and CST with an ice cube and/or TempTest® performed. ColdA was defined as an acute cold-induced involvement of the skin and/or visible mucosal tissue and at least one of: cardiovascular manifestations, difficulty breathing, or gastrointestinal symptoms. RESULTS Of 551 ColdU patients, 75% (n = 412) had a positive CST and ColdA occurred in 37% (n = 151) of the latter. Cold-induced generalized wheals, angioedema, acral swelling, oropharyngeal/laryngeal symptoms, and itch of earlobes were identified as signs/symptoms of severe disease. ColdA was most commonly provoked by complete cold water immersion and ColdA caused by cold air was more common in countries with a warmer climate. Ten percent (n = 40) of typical ColdU patients had a concomitant chronic spontaneous urticaria (CSU). They had a lower frequency of ColdA than those without CSU (4% vs. 39%, p = .003). We identified the following risk factors for cardiovascular manifestations: previous systemic reaction to a Hymenoptera sting, angioedema, oropharyngeal/laryngeal symptoms, and itchy earlobes. CONCLUSION ColdA is common in typical ColdU. High-risk patients require education about their condition and how to use an adrenaline autoinjector.
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Affiliation(s)
- Mojca Bizjak
- Division of Allergy Urticaria Center of Reference and Excellence (UCARE)University Clinic of Respiratory and Allergic Diseases Golnik Golnik Slovenia
- Faculty of Medicine University of Maribor Maribor Slovenia
| | - Mitja Košnik
- Division of Allergy Urticaria Center of Reference and Excellence (UCARE)University Clinic of Respiratory and Allergic Diseases Golnik Golnik Slovenia
- Faculty of Medicine University of Ljubljana Ljubljana Slovenia
| | - Dejan Dinevski
- Faculty of Medicine University of Maribor Maribor Slovenia
| | - Simon Francis Thomsen
- Department of Dermatology Urticaria Center of Reference and Excellence (UCARE)Bispebjerg HospitalUniversity of Copenhagen Copenhagen Denmark
| | - Daria Fomina
- Urticaria Center of Reference and Excellence (UCARE)Center of Allergy and ImmunologyClinical State Hospital 52Moscow Ministry of Healthcare Moscow Russian Federation
- Department of Clinical Immunology and Allergology I.M. Sechenov First Moscow State Medical University Moscow Russian Federation
| | - Elena Borzova
- Department of Dermatology and Venereology I.M. Sechenov First Moscow State Medical University Moscow Russian Federation
- Department of Clinical Genetics Veltischev Research and Clinical Institute for Pediatrics of the Pirogov Russian National Research Medical University Moscow Russian Federation
| | - Kanokvalai Kulthanan
- Department of Dermatology Urticaria Center of Reference and Excellence (UCARE)Faculty of Medicine Siriraj HospitalMahidol University Bangkok Thailand
| | - Raisa Meshkova
- Department of Clinical Immunology and Allergology Urticaria Center of Reference and Excellence (UCARE)Smolensk State Medical University Smolensk Russian Federation
| | - Dalia Melina Ahsan
- Urticaria Center of Reference and Excellence (UCARE) Institute for Allergology Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlin Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology Berlin Germany
| | - Mona Al‐Ahmad
- Microbiology Department Faculty of Medicine Urticaria Center of Reference and Excellence (UCARE)Kuwait University Safat Kuwait
| | - Sabine Altrichter
- Urticaria Center of Reference and Excellence (UCARE) Institute for Allergology Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlin Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology Berlin Germany
- Department of Dermatology and Venerology Urticaria Center of Reference and Excellence (UCARE)Comprehensive Allergy CenterKepler University Hospital Linz Austria
| | - Andrea Bauer
- Department of Dermatology Urticaria Center of Reference and Excellence (UCARE)University Allergy CenterUniversity Hospital Carl Gustav CarusTechnical University Dresden Germany
| | - Maxi Brockstädt
- Urticaria Center of Reference and Excellence (UCARE) Institute for Allergology Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlin Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology Berlin Germany
| | - Célia Costa
- Immunoallergology Department Urticaria Center of Reference and Excellence (UCARE)Hospital de Santa MariaCHULN Lisbon Portugal
| | - Semra Demir
- Division of Allergy Department of Internal Medicine Istanbul Faculty of Medicine Urticaria Center of Reference and Excellence (UCARE)Istanbul University Istanbul Turkey
| | - Roberta Fachini Criado
- Faculdade de Medicina do ABC (FMABC)Urticaria Center of Reference and Excellence (UCARE) Santo André Brazil
| | - Luis Felipe Ensina
- Division of Allergy, Clinical Immunology and Rheumatology Department of Pediatrics Urticaria Center of Reference and Excellence (UCARE)Federal University of São Paulo São Paulo Brazil
| | - Asli Gelincik
- Division of Allergy Department of Internal Medicine Istanbul Faculty of Medicine Urticaria Center of Reference and Excellence (UCARE)Istanbul University Istanbul Turkey
| | - Ana Maria Giménez‐Arnau
- Department of Dermatology Urticaria Center of Reference and Excellence (UCARE)Hospital del MarIMIMUniversitat Autònoma Barcelona Spain
| | - Margarida Gonçalo
- Clinic of Dermatology Urticaria Center of Reference and Excellence (UCARE)University Hospital and Faculty of MedicineUniversity of Coimbra Coimbra Portugal
| | - Maia Gotua
- Center of Allergy and ImmunologyUrticaria Center of Reference and Excellence (UCARE) Tbilsi Georgia
| | - Jesper Grønlund Holm
- Department of Dermatology Urticaria Center of Reference and Excellence (UCARE)Bispebjerg HospitalUniversity of Copenhagen Copenhagen Denmark
| | - Naoko Inomata
- Department of Environmental Immuno‐Dermatology Urticaria Center of Reference and Excellence (UCARE)Yokohama City University Graduate School of Medicine Yokohama Japan
| | - Alicja Kasperska‐Zajac
- Clinical Department of Internal Diseases European Center for Diagnosis and Treatment of UrticariaUrticaria Center of Reference and Excellence (UCARE)Dermatology and Allergology of Medical University of Silesia Zabrze Poland
| | - Maryam Khoshkhui
- Allergy Research CenterMashhad University of Medical Sciences Mashhad Iran
| | - Aliya Klyucharova
- Department of Clinical Immunology and Allergology Republican Center of Clinical Immunology and AllergologyUrticaria Center of Reference and Excellence (UCARE)Republican Clinical HospitalKazan State Medical University Kazan Russian Federation
- Department of Fundamental Principles of Clinical Medicine Institute of Fundamental Medicine and Biology (IFMB) of Kazan Federal University Kazan Russian Federation
| | - Emek Kocatürk
- Department of Dermatology Urticaria Center of Reference and Excellence (UCARE)Koç University School of Medicine Istanbul Turkey
| | - Rongbiao Lu
- Department of Dermatology Urticaria Center of Reference and Excellence (UCARE)The Third Affiliated Hospital of Sun Yat‐sen University Guangzhou China
| | - Michael Makris
- Allergy Unit Second Department of Dermatology and Venereology Urticaria Center of Reference and Excellence (UCARE)National and Kapodistrian University of AthensUniversity General Hospital “Attikon” Athens Greece
| | - Natalya Maltseva
- Urticaria Center of Reference and Excellence (UCARE)Center of Allergy and ImmunologyClinical State Hospital 52Moscow Ministry of Healthcare Moscow Russian Federation
| | | | - Maria Pasali
- Allergy Unit Second Department of Dermatology and Venereology Urticaria Center of Reference and Excellence (UCARE)National and Kapodistrian University of AthensUniversity General Hospital “Attikon” Athens Greece
| | - Marisa Paulino
- Immunoallergology Department Urticaria Center of Reference and Excellence (UCARE)Hospital de Santa MariaCHULN Lisbon Portugal
| | - David Pesqué
- Department of Dermatology Urticaria Center of Reference and Excellence (UCARE)Hospital del MarIMIMUniversitat Autònoma Barcelona Spain
| | - Jonny Peter
- Division of Allergy and Clinical Immunology Department of Medicine Urticaria Center of Reference and Excellence (UCARE)University of Cape Town Cape Town South Africa
- Allergy and Immunology Unit University of Cape Town Lung Institute Cape Town South Africa
| | - German Dario Ramón
- Urticaria Center of Reference and Excellence (UCARE)Instituto de Alergia e Inmunologia del Sur Buenos Aires Argentina
| | - Carla Ritchie
- Adults and Pediatrics Allergy Unit Urticaria Center of Reference and Excellence (UCARE)Hospital Italiano de Buenos Aires Buenos Aires Argentina
| | - Solange Oliveira Rodrigues Valle
- Department of Internal Medicine, Immunology Service Urticaria Center of Reference and Excellence (UCARE)Federal University of Rio de Janeiro Rio de Janeiro Brazil
| | - Michael Rudenko
- Urticaria Center of Reference and Excellence (UCARE)London Allergy and Immunology Centre London UK
| | - Agnieszka Sikora
- Clinical Department of Internal Diseases European Center for Diagnosis and Treatment of UrticariaUrticaria Center of Reference and Excellence (UCARE)Dermatology and Allergology of Medical University of Silesia Zabrze Poland
| | - Eduardo M. Souza Lima
- Faculdade de Ciências Médicas e da Saúde de Juiz de Fora (SUPREMA)Urticaria Center of Reference and Excellence (UCARE)Hospital Maternidade Therezinha de Jesus Minas Gerais Brazil
| | - Nicola Wagner
- Department of Dermatology Urticaria Center of Reference and Excellence (UCARE)University Hospital of ErlangenUniversity of Erlangen‐Nuremberg (FAU) Germany
| | - Paraskevi Xepapadaki
- Allergy Unit 2nd Pediatric Clinic Urticaria Center of Reference and Excellence (UCARE)National and Kapodistrian University of Athens Greece
| | - Xiaoyang Xue
- Department of General Practice Urticaria Center of Reference and Excellence (UCARE)Community Health Service Center Guangzhou City China
| | - Zuotao Zhao
- Department of Dermatology and Venerology Urticaria Center of Reference and Excellence (UCARE)Beijing Key Laboratory of Molecular Diagnosis on Dermatoses and National Clinical Research Center for Skin and Immune DiseasesPeking University First Hospital Beijing China
| | - Dorothea Terhorst‐Molawi
- Urticaria Center of Reference and Excellence (UCARE) Institute for Allergology Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlin Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology Berlin Germany
| | - Marcus Maurer
- Urticaria Center of Reference and Excellence (UCARE) Institute for Allergology Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlin Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology Berlin Germany
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26
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Skripnikov A, Wagner N, Shafer J, Beck M, Sherwood E, Burke M. Using localized Twitter activity to assess harmful algal bloom impacts of Karenia brevis in Florida, USA. Harmful Algae 2021; 110:102118. [PMID: 34887016 DOI: 10.1016/j.hal.2021.102118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 09/28/2021] [Accepted: 09/29/2021] [Indexed: 06/13/2023]
Abstract
Red tide blooms of the dinoflagellate Karenia brevis (K. brevis) produce toxic coastal conditions that can impact marine organisms and human health, while also affecting local economies. During the extreme Florida red tide event of 2017-2019, residents and visitors turned to social media platforms to both receive disaster-related information and communicate their own sentiments and experiences. This was the first major red tide event since the ubiquitous use of social media, thus providing unique crowd-sourced reporting of red tide impacts. We evaluated the spatial and temporal accuracy of red tide topic activity on Twitter, taking tweet sentiments and user types (e.g. media, citizens) into consideration, and compared tweet activity with reported red tide conditions, such as K. brevis cell counts, levels of dead fish and respiratory irritation on local beaches. The analysis was done on multiple levels with respect to both locality (e.g., entire Gulf coast, county-level, city-level, zip code tabulation areas) and temporal frequencies (e.g. daily, every three days, weekly), resulting in strong correlations between local per-capita Twitter activity and the actual red tide conditions observed in the area. Moreover, an association was observed between proximity to the affected coastal areas and per-capita counts for relevant tweets. Results show that Twitter presents a trustworthy reflection of the red tide's local impacts and development over time, and can potentially augment the already existing tools for efficient assessment and a more coordinated response to the disaster.
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Affiliation(s)
- A Skripnikov
- New College of Florida, Heiser Natural Sciences Complex, Room E156, 500 College Dr, Sarasota, FL 34243, USA; New College of Florida, Division of Natural Sciences, 500 College Dr, Sarasota, FL 34243, USA.
| | - N Wagner
- New College of Florida, Division of Natural Sciences, 500 College Dr, Sarasota, FL 34243, USA
| | - J Shafer
- Science and Environment Council of Southwest Florida, 1530 Dolphin Street, Suite 4, Sarasota, FL 34236, USA
| | - M Beck
- Tampa Bay Estuary Program, 263 13th Ave S, St. Petersburg, FL 33701, USA
| | - E Sherwood
- Tampa Bay Estuary Program, 263 13th Ave S, St. Petersburg, FL 33701, USA
| | - M Burke
- Tampa Bay Estuary Program, 263 13th Ave S, St. Petersburg, FL 33701, USA
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27
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Kamann S, Wagner N, Oppel E. Modern diabetes devices for continuous blood sugar measuring: Limitations due to contact allergies. J Dtsch Dermatol Ges 2021; 19:1715-1721. [PMID: 34751512 DOI: 10.1111/ddg.14621] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 07/30/2021] [Indexed: 12/29/2022]
Abstract
During the past years, diabetes diseases have increased significantly worldwide. However, new technologies such as continuous glucose measurement using a subcutaneous sensor are developing just as rapidly. A continuous improvement in insulin pump therapy is also contributing to an improved quality of life. A common feature of these modern devices for diabetes therapy is that they remain fixed in place on the skin for several days. In recent years, skin reactions, in particular pronounced contact dermatitis due to the devices and their adhesives have been increasingly reported. In particular, isobornyl acrylate, which used to be included in a glucose measurement sensor set, was identified as a main allergen. Development of contact allergy can result both in a necessity to quit the measuring system and in allergic cross-reactions to other systems.
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Affiliation(s)
- Stefanie Kamann
- Department of Dermatology and Allergology, Feldafing, Germany
| | - Nicola Wagner
- Department of Dermatology, University Medical Center Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Eva Oppel
- Department of Dermatology and Allergology, Ludwig-Maximilian University, Munich, Germany
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28
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Weller K, Maurer M, Bauer A, Wedi B, Wagner N, Schliemann S, Kramps T, Baeumer D, Multmeier J, Hillmann E, Staubach P. Epidemiology, comorbidities, and healthcare utilization of patients with chronic urticaria in Germany. J Eur Acad Dermatol Venereol 2021; 36:91-99. [PMID: 34622498 DOI: 10.1111/jdv.17724] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 09/02/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Comprehensive data on the epidemiology and comorbidities of chronic urticaria (CU) in Germany are either limited, or not contemporary. OBJECTIVES To investigate the epidemiology of CU, overall comorbidities and healthcare resource utilized by patients with CU in Germany, using an anonymized statutory health insurance (SHI) database. METHODS Anonymized SHI claims research database of the Institute for Applied Health Research, Berlin [InGef] (01 January 2015-30 September 2018) was used to analyse insured individuals with a confirmed diagnosis of CU (ICD-10-GM codes). Twelve-month diagnosed prevalence and incidence, comorbidities (vs. atopic dermatitis and psoriasis), and healthcare utilization by patients with CU were investigated. RESULTS Of 4 693 772 individuals of all ages listed in the database, 3 538 540 were observable during 2017. Overall, 17 524 patients (˜0.5%) were diagnosed with CU; chronic spontaneous urticaria (CSU: 71.2%), chronic inducible urticaria (CIndU: 19.7%), CSU+CIndU (9.1%). Females, vs. males, had higher diagnosed prevalence (0.62% vs. 0.37%) and diagnosed incidence (0.18% vs. 0.11%) of CU among all patients. Patients most frequently visited general practitioners (41.3% of total visits). Hypertensive diseases (43.5%), lipoprotein metabolism disorders (32.1%) and affective disorders (26.0%) were the most frequently reported comorbidities of special interest. Rates of most comorbidities of special interests were similar to atopic dermatitis and psoriasis patients, and all higher vs. overall population. More than half (54.1%) of all CU patients were not prescribed any treatment. Second-generation H1 -antihistamines were the most commonly prescribed medication for adult (17.9%) and paediatric (27.9%) patients. Patients with CIndU (paediatric, 15.5%; adult, 7.8%) were more often hospitalized versus patients with CSU (paediatric, 9.9%; adult, 4.6%). CONCLUSIONS In Germany, prevalence of CU along with multiple comorbidities may pose increased burden on the healthcare system. Awareness of adhering to treatment guidelines, and aiming for complete control of urticaria, needs to be driven and may improve outcomes.
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Affiliation(s)
- K Weller
- Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Allergology, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Berlin, Germany
| | - M Maurer
- Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Allergology, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Berlin, Germany
| | - A Bauer
- Department of Dermatology, University Allergy Center, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - B Wedi
- Department of Dermatology and Allergy, Comprehensive Allergy Centre, Hannover Medical School, Hannover, Germany
| | - N Wagner
- Department of Dermatology, Universitätsklinikum Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - S Schliemann
- Department of Dermatology, University Hospital Jena, Jena, Germany
| | - T Kramps
- Novartis Pharma GmbH, Nuremberg, Germany
| | - D Baeumer
- Novartis Pharma GmbH, Nuremberg, Germany
| | | | - E Hillmann
- Novartis Pharma GmbH, Nuremberg, Germany
| | - P Staubach
- Department of Dermatology, University Medical Center Mainz, Mainz, Germany
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29
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Schubert S, Schnuch A, Bauer A, Wagner N, Schröder-Kraft C, Dickel H, Weisshaar E, Effendy I, Becker D, Buhl T, Simon D, Koch A, Kreft B, Vieluf D, Löffler H, Geier J. Very late reactions in the patch test with fragrance mix I and oak moss absolute (Evernia prunastri, INCI): Data of the Information Network of Departments of Dermatology (IVDK). Contact Dermatitis 2021; 86:54-57. [PMID: 34515343 DOI: 10.1111/cod.13971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 09/08/2021] [Accepted: 09/10/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Steffen Schubert
- Information Network of Departments of Dermatology (IVDK), Institute at the University Medical Center Göttingen, Göttingen, Germany
| | - Axel Schnuch
- Information Network of Departments of Dermatology (IVDK), Institute at the University Medical Center Göttingen, Göttingen, Germany
| | - Andrea Bauer
- Clinic and Policlinic for Dermatology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Nicola Wagner
- Department of Dermatology, Erlangen University Hospital, Erlangen, Germany
| | | | - Heinrich Dickel
- Department of Dermatology, Venereology and Allergology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
| | - Elke Weisshaar
- Department of Dermatology, Occupational Dermatology, University Medical Center, Heidelberg, Germany
| | - Isaak Effendy
- Department of Dermatology, Bielefeld Medical Center, Bielefeld, Germany
| | - Detlef Becker
- Department of Dermatology, University of Mainz, Mainz, Germany
| | - Timo Buhl
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Dagmar Simon
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - André Koch
- Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany
| | - Burkhard Kreft
- Department of Dermatology and Venereology, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Dieter Vieluf
- Department of Allergology, Photodermatology and Occupational Dermatology, Dermatologikum Hamburg, Hamburg, Germany
| | - Harald Löffler
- Department of Dermatology, SLK Hospital Heilbronn, Heilbronn, Germany
| | - Johannes Geier
- Information Network of Departments of Dermatology (IVDK), Institute at the University Medical Center Göttingen, Göttingen, Germany
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30
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Pilz AC, Zink A, Schielein MC, Hell K, Romer K, Hillmann E, Bäumer D, Reinhardt M, Wagner N. Trotz einer großen Auswahl wirksame Medikamente: Psoriatiker scheinen immer noch untertherapiert zu sein. J Dtsch Dermatol Ges 2021; 19:1003-1012. [PMID: 34288484 DOI: 10.1111/ddg.14387_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 12/01/2020] [Indexed: 11/26/2022]
Abstract
HINTERGRUND UND ZIELE Durch die Entwicklung neuer anti-psoriatischer Medikamente und verbesserte Strukturen zu deren flächendeckender Einführung hat sich die medizinische Versorgung von Psoriasis-Patienten deutlich verbessert. In dieser Studie haben wir die tatsächliche Inanspruchnahme des Gesundheitswesens untersucht und Gründe für die Unzufriedenheit der Betroffenen ermittelt. PATIENTEN UND METHODIK Diese nicht-interventionelle Querschnittsstudie wurde als anonyme Online-Befragung von 12/2018 bis 01/2019 in Deutschland durchgeführt. Teilnehmer mit einer selbstberichteten, von einem Arzt gestellten Psoriasis-Diagnose und Symptomen beantworteten Fragen zu ihrer Erkrankung, deren Einfluss auf das tägliche Leben und ihrer medizinischen Versorgung. ERGEBNISSE 649 Teilnehmer mit einem mittleren Alter von 42,5 ± 13,7 Jahren und ausgewogener Geschlechterverteilung (männlich: 50,2 %) wurden ausgewertet. 54,1 % waren zum Zeitpunkt der Studie in ärztlicher Behandlung, 45,9 % nicht. Von den Teilnehmern mit medizinischer Versorgung waren 59,3 % nur mäßig oder weniger zufrieden mit ihrer Behandlung. Gründe für die Unzufriedenheit mit der Medikation waren unter anderem mangelnde Wirksamkeit und Nebenwirkungen. Von den nicht in ärztlicher Behandlung befindlichen Teilnehmern wurde "Zeitmangel des Arztes" als Hauptgrund für die Nichtinanspruchnahme ärztlicher Hilfe angegeben. SCHLUSSFOLGERUNGEN Trotz der Verfügbarkeit effizienter Therapieoptionen in Deutschland sind viele Betroffene mit Psoriasis unzufrieden. Diese unterbehandelte Gruppe wurde als neue Zielgruppe identifiziert.
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Affiliation(s)
- Anna Caroline Pilz
- Klinik für Dermatologie und Allergologie, Medizinische Fakultät, Technische Universität München
| | - Alexander Zink
- Klinik für Dermatologie und Allergologie, Medizinische Fakultät, Technische Universität München
| | - Maximilian C Schielein
- Klinik für Dermatologie und Allergologie, Medizinische Fakultät, Technische Universität München
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität, München
| | - Katharina Hell
- Klinik für Dermatologie und Allergologie, Medizinische Fakultät, Technische Universität München
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität, München
| | | | | | | | | | - Nicola Wagner
- Hautklinik, Universitätsklinikum der Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen
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31
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Balato A, Scala E, Ayala F, Bauer A, Crépy MN, Gonçalo M, Duus Johansen J, John SM, Rustemeyer T, Wagner N, Wilkinson M, Giménez-Arnau A. Patch test informed consent form: position statement by European Academy of Dermatology and Venereology Task Force on Contact Dermatitis. J Eur Acad Dermatol Venereol 2021; 35:1957-1962. [PMID: 34286888 DOI: 10.1111/jdv.17483] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 05/27/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND To our knowledge, an international consensus is lacking regarding the development of an adequate informed consent form for a patch test (PT) and the information that should be included in such document. OBJECTIVES The aim of the study was to reach a consensus on the specific points that need to be addressed in a PT consent form. METHODS A Delphi survey, comprising 2 rounds and 1 final discussion, was used to gather and analyse data, which was conducted over the Internet. Each statement that reached a consensus with the respondents (9 expert dermatologists from Europe) was defined as a median consensus score (MED) of ≥7 and agreement among panelists as an interquartile range (IQR) of ≤3. All study participants were members of the EADV task force on contact dermatitis. RESULTS The expert panel addressed several topics that should be included in an informed consent form for a PT: introduction, preparation for PT, testing procedure, allowed activities, adverse events and additional authorizations. CONCLUSIONS Our results assess recommendations regarding points to be contained in an informed consent form for a PR. Future actions towards standardization and harmonization of this specific consent form are needed.
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Affiliation(s)
- A Balato
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - E Scala
- Division of Dermatology and Venereology, Department of Medicine Solna, and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - F Ayala
- Professor Emeritus of Dermatology, University of Naples Federico II, Naples, Italy
| | - A Bauer
- Department of Dermatology, University Allergy Center, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - M-N Crépy
- Department of Occupational and Environmental Diseases, Hôtel-Dieu Hospital, AP-HP, University Hospital of Centre of Paris, Paris, France.,Department of Dermatology, Cochin Hospital, AP-HP, University Hospital of Centre of Paris, Paris, France
| | - M Gonçalo
- Department of Dermatology, University Hospital and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - J Duus Johansen
- National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - S M John
- Department of Dermatology, Environmental Medicine, Health Theory, Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, University of Osnabrück, Osnabrück, Germany
| | - T Rustemeyer
- Department of Dermatology-Allergology and Occupational Dermatology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - N Wagner
- Department of Dermatology, Universitätsklinikum Erlangen-Nürnberg, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - M Wilkinson
- Department of Dermatology, Chapel Allerton Hospital, Leeds, UK
| | - A Giménez-Arnau
- Department of Dermatology, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
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Pilz AC, Zink A, Schielein MC, Hell K, Romer K, Hillmann E, Bäumer D, Reinhardt M, Wagner N. Despite large choice of effective therapies: Individuals with psoriasis still seem undertreated. J Dtsch Dermatol Ges 2021; 19:1003-1011. [PMID: 33955676 DOI: 10.1111/ddg.14387] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 12/01/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Due to the development of new anti-psoriatic drugs in combination with improved structures for implementation throughout Germany, the medical care of psoriasis patients has markedly improved. In this study we investigated the real-life utilization of the health care system and identified reasons for dissatisfaction in affected individuals. PATIENTS AND METHODS This non-interventional cross-sectional study was conducted as an anonymous online survey from 12/2018 to 01/2019 in Germany. Participants with a self-reported physician-confirmed diagnosis of psoriasis and symptoms answered questions about their disease, its influence on daily life and their medical care. RESULTS 649 participants with a mean age of 42.5 ± 13.7 years and equal gender distribution (male: 50.2 %) were evaluated. 54.1 % received medical treatment at the time of the study, 45.9 % did not. Among the participants with medical care, 59.3 % were only moderately or less satisfied with their treatment. Reasons for dissatisfaction with the medication included lack of efficacy and side effects. Participants without medical treatment specified a physician's lack of time as a main reason for not seeking medical help. CONCLUSIONS Despite the availability of efficient therapeutic options in Germany, many individuals with psoriasis are not satisfied. This under-treated group was identified as a new target population.
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Affiliation(s)
- Anna Caroline Pilz
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - Alexander Zink
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - Maximilian C Schielein
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany.,Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilian-University, Munich, Germany
| | - Katharina Hell
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany.,Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilian-University, Munich, Germany
| | | | | | | | | | - Nicola Wagner
- Department of Dermatology, University Hospital, Friedrich-Alexander-University of Erlangen-Nuremberg (FAU), Erlangen, Germany
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Wagner N, Zink A, Hell K, Reinhardt M, Romer K, Hillmann E, Baeumer D, Schielein MC. Patients with Chronic Urticaria Remain Largely Undertreated: Results from the DERMLINE Online Survey. Dermatol Ther (Heidelb) 2021; 11:1027-1039. [PMID: 33945120 PMCID: PMC8163939 DOI: 10.1007/s13555-021-00537-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 04/16/2021] [Indexed: 11/28/2022] Open
Abstract
Introduction Chronic urticaria (CU) is an unpredictable disease, with high disease burden and a significant negative impact on quality of life, especially in patients of working age. Many patients are undertreated, and there is poor awareness of strategies to manage patients with CU in the real-world setting. The current study aimed to gain a better understanding of CU from the patients’ perspective, including the body areas most affected by wheals and angioedema, the disease burden and current use of the healthcare system. Methods A nationwide online survey was performed in Germany involving individuals who reported a diagnosis of CU and experienced symptoms within 3 months prior to inclusion. Results This self-report survey included 1037 participants (89.2% female), with a mean ± standard deviation (SD) age of 33.4 ± 11.0 years and a mean ± SD disease duration of 10.0 ± 9.4 years. On average, participants suffered from urticaria symptoms for 3.0 ± 4.3 years before diagnosis. In 73% of participants, symptoms worsened due to external factors, with the majority specifying stress in their personal life or work-related stress as eliciting factors. Within the previous 3 months, 87.4 and 44.1% of participants experienced wheals and angioedema, respectively, at multiple body areas, and most (79.6%) participants had uncontrolled symptoms as measured with the Urticaria Control Test. Despite the high burden of disease, 60.3% of participants stated that they were not currently receiving treatment. The most commonly used therapies to treat CU were oral (72.8%) and non-prescription (43.3%) and prescription (47.3%) topical drugs, with 18.0% of the participants receiving injectable/infused drugs. Conclusion The majority of the participants responding to the survey reported that CU is not sufficiently controlled, thereby severely influencing a highly productive time in their life. The body areas most affected by wheals and angioedema are specified, based on data provided by a large group of affected participants. A greater awareness of disease burden and available treatment options is needed. Supplementary Information The online version contains supplementary material available at 10.1007/s13555-021-00537-5.
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Affiliation(s)
- Nicola Wagner
- Department of Dermatology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
| | - Alexander Zink
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - Katharina Hell
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany.,Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig Maximilian University (LMU), Munich, Germany
| | | | | | | | | | - Maximilian C Schielein
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
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Maris I, Dölle‐Bierke S, Renaudin J, Lange L, Koehli A, Spindler T, Hourihane J, Scherer K, Nemat K, Kemen C, Neustädter I, Vogelberg C, Reese T, Yildiz I, Szepfalusi Z, Ott H, Straube H, Papadopoulos NG, Hämmerling S, Staden U, Polz M, Mustakov T, Cichocka‐Jarosz E, Cocco R, Fiocchi AG, Fernandez‐Rivas M, Worm M, Grünhagen J, Wittenberg M, Beyer K, Henschel A, Küper S, Möser A, Fuchs T, Ruëff F, Wedi B, Hansen G, Buck T, Büsselberg J, Drägerdt R, Pfeffer L, Dickel H, Körner‐Rettberg C, Merk H, Lehmann S, Bauer A, Nordwig A, Zeil S, Hannapp C, Wagner N, Rietschel E, Hunzelmann N, Huseynow I, Treudler R, Aurich S, Prenzel F, Klimek L, Pfaar O, Reider N, Aberer W, Varga E, Bogatu B, Schmid‐Grendelmeier P, Guggenheim R, Riffelmann F, Kreft B, Kinaciyan K, Hartl L, Ebner C, Horak F, Brehler R, Witte J, Buss M, Hompes S, Bieber T, Gernert S, Bücheler M, Rabe U, Brosi W, Nestoris S, Hawranek T, Lang R, Bruns R, Pföhler C, Eng P, Schweitzer‐Krantz S, Meller S, Rebmann H, Fischer J, Stichtenoth G, Thies S, Gerstlauer M, Utz P, Neustädter I, Klinge J, Volkmuth S, Plank‐Habibi S, Schilling B, Kleinheinz A, Brückner A, Schäkel K, Manolaraki I, Kowalski M, Solarewicz‐Madajek K, Tscheiller S, Seidenberg J, Cardona V, Garcia B, Bilo M, Cabañes Higuero N, Vega Castro A, Poziomkowska‐Gęsicka I, Büsing S, Virchow C, Christoff G, Jappe U, Müller S, Knöpfel F, Correard A, Rogala B, Montoro A, Brandes A, Muraro A, Zimmermann N, Hernandez D, Minale P, Niederwimmer J, Zahel B, Dahdah L, Arasi S, Reissig A, Eitelberger F, Asero R, Hermann F, Zeidler S, Pistauer S, Geißler M, Ensina L, Plaza Martin A, Meister J, Stieglitz S, Hamelmann E. Peanut-induced anaphylaxis in children and adolescents: Data from the European Anaphylaxis Registry. Allergy 2021; 76:1517-1527. [PMID: 33274436 DOI: 10.1111/all.14683] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 10/26/2020] [Accepted: 11/10/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND Peanut allergy has a rising prevalence in high-income countries, affecting 0.5%-1.4% of children. This study aimed to better understand peanut anaphylaxis in comparison to anaphylaxis to other food triggers in European children and adolescents. METHODS Data was sourced from the European Anaphylaxis Registry via an online questionnaire, after in-depth review of food-induced anaphylaxis cases in a tertiary paediatric allergy centre. RESULTS 3514 cases of food anaphylaxis were reported between July 2007 - March 2018, 56% in patients younger than 18 years. Peanut anaphylaxis was recorded in 459 children and adolescents (85% of all peanut anaphylaxis cases). Previous reactions (42% vs. 38%; p = .001), asthma comorbidity (47% vs. 35%; p < .001), relevant cofactors (29% vs. 22%; p = .004) and biphasic reactions (10% vs. 4%; p = .001) were more commonly reported in peanut anaphylaxis. Most cases were labelled as severe anaphylaxis (Ring&Messmer grade III 65% vs. 56% and grade IV 1.1% vs. 0.9%; p = .001). Self-administration of intramuscular adrenaline was low (17% vs. 15%), professional adrenaline administration was higher in non-peanut food anaphylaxis (34% vs. 26%; p = .003). Hospitalization was higher for peanut anaphylaxis (67% vs. 54%; p = .004). CONCLUSIONS The European Anaphylaxis Registry data confirmed peanut as one of the major causes of severe, potentially life-threatening allergic reactions in European children, with some characteristic features e.g., presence of asthma comorbidity and increased rate of biphasic reactions. Usage of intramuscular adrenaline as first-line treatment is low and needs to be improved. The Registry, designed as the largest database on anaphylaxis, allows continuous assessment of this condition.
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Affiliation(s)
- Ioana Maris
- Bon Secours Hospital Cork/Paediatrics and Child HealthUniversity College Cork Cork Ireland
| | - Sabine Dölle‐Bierke
- Division of Allergy and Immunology Department of Dermatology, Venereology and Allergology Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| | | | - Lars Lange
- Department of Paediatrics St. Marien‐Hospital Bonn Germany
| | - Alice Koehli
- Division of Allergology University Children’s Hospital Zurich Zürich Switzerland
| | - Thomas Spindler
- Department of Paediatrics Medical Campus Hochgebirgsklinik Davos Davos Switzerland
| | - Jonathan Hourihane
- Paediatrics and Child Health Royal College of Surgeons in Ireland Dublin Ireland
- Children’s Health Ireland Dublin Ireland
| | | | - Katja Nemat
- Practice for paediatric pneumology and allergology Kinderzentrum Dresden‐Friedrichstadt Dresden Germany
| | - C. Kemen
- Department of Paediatrics Children’s Hospital WILHELMSTIFT Hamburg Germany
| | - Irena Neustädter
- Department of Paediatrics Hallerwiese Cnopfsche Kinderklinik Nuremberg Germany
| | - Christian Vogelberg
- Department of Paediatrics Universitätsklinikum Carl Gustav CarusTechnical University Dresden Germany
| | - Thomas Reese
- Department of Paediatrics Mathias‐Spital Rheine Rheine Germany
| | - Ismail Yildiz
- Department of Paediatrics Friedrich‐Ebert‐Krankenhaus Neumuenster Germany
| | - Zsolt Szepfalusi
- Division of Paediatric Pulmonology, Allergology and Endocrinology Department of Paediatrics and Adolescent Medicine Competence Center Paediatrics Medical University of Vienna Vienna Austria
| | - Hagen Ott
- Division of Paediatric Dermatology and Allergology Epidermolysis bullosa‐Centre HannoverChildren’s Hospital AUF DER BULT Hanover Germany
| | - Helen Straube
- Division of Allergology Darmstädter Kinderkliniken Prinzessin Margaret Darmstadt Germany
| | - Nikolaos G. Papadopoulos
- Allergy Department 2nd Paediatric Clinic National and Kapodistrian University of Athens Athens Greece
- Division of Infection Immunity& Respiratory Medicine University of Manchester Manchester UK
| | - Susanne Hämmerling
- Division of Paediatric Pulmonology and Allergology University Children`s Hospital Heidelberg Heidelberg Germany
| | - Ute Staden
- Paediatric Pneumology & Allergology Medical practice Klettke/Staden Berlin Germany
| | - Michael Polz
- Department of Paediatrics GPR Klinikum Rüsselsheim Germany
| | - Tihomir Mustakov
- Chair of Allergy University Hospital Alexandrovska Sofia Bulgaria
| | - Ewa Cichocka‐Jarosz
- Department of Paediatrics Jagiellonian University Medical College Krakow Poland
| | - Renata Cocco
- Division of Allergy Clinical Immunology and Rheumatology Department of Paediatrics Federal University of São Paulo São Paulo Brazil
| | | | | | - Margitta Worm
- Division of Allergy and Immunology Department of Dermatology, Venereology and Allergology Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
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Kraft M, Dölle-Bierke S, Renaudin JM, Ruëff F, Scherer Hofmeier K, Treudler R, Pföhler C, Hawranek T, Poziomkowska-Gęsicka I, Jappe U, Christoff G, Müller S, Fernandez-Rivas M, García BE, De Vicente Jiménez TM, Cardona V, Kleinheinz A, Kreft B, Bauer A, Wagner N, Wedi B, Wenzel M, Bilò MB, Worm M. Wheat Anaphylaxis in Adults Differs from Reactions to Other Types of Food. J Allergy Clin Immunol Pract 2021; 9:2844-2852.e5. [PMID: 33831620 DOI: 10.1016/j.jaip.2021.03.037] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 03/04/2021] [Accepted: 03/17/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Wheat is one of the most commonly consumed foods and a known elicitor of anaphylaxis in children and adults. Reactions in adults are often cofactor dependent and characterized by a prolonged time between food intake and the onset of symptoms making the diagnosis of wheat anaphylaxis challenging. OBJECTIVE To characterize a cohort of patients with the history of wheat anaphylaxis to better understand this atypical phenotype of anaphylaxis. METHODS Data from the European Anaphylaxis Registry from 2007 to 2019 (n = 10,636) including 250 patients (213 adults and 37 children) with a history of anaphylaxis caused by wheat were analyzed. RESULTS Wheat was the most common food elicitor of anaphylaxis in adults in the registry in Central Europe. Reactions to wheat in adults were frequently associated with exercise as a cofactor (82.8%) and partially delayed (57.5%). Only 36.9% of patients had atopic comorbidities, which was uncommonly low for adult patients allergic to other kinds of foods (63.2%). Anaphylaxis to wheat presented frequently with cardiovascular symptoms (86.7%) including severe symptoms such as loss of consciousness (41%) and less often with respiratory symptoms (53.6%). The reactions to wheat were more severe than reactions to other foods (odds ratio [OR] = 4.33), venom (OR = 1.58), or drugs (OR = 2.11). CONCLUSIONS Wheat is a relevant elicitor of anaphylaxis in adults in Central Europe. Wheat anaphylaxis is highly dependent on the presence of cofactors and less frequently associated with atopic diseases compared with other food allergies. More data on mechanisms of wheat-induced anaphylaxis are required to develop preventive measures for this potentially life-threatening disease.
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Affiliation(s)
- Magdalena Kraft
- Division of Allergy and Immunology, Department of Dermatology, Venerology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany; Department of Emergency Medicine, University Hospital Halle (Saale), Medical Faculty of Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Sabine Dölle-Bierke
- Division of Allergy and Immunology, Department of Dermatology, Venerology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Jean-Marie Renaudin
- Presidency on behalf of Allergy Vigilance Network, Vandoeuvre les Nancy, France
| | - Franziska Ruëff
- Department of Dermatology and Allergology, Klinikum der Universität München, Munich, Germany
| | - Kathrin Scherer Hofmeier
- Division of Allergy, Department of Dermatology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Regina Treudler
- Department of Dermatology, Venereology and Allergology and Leipzig Interdisciplinary Center of Allergology (LICA) Comprehensive Allergy Center, University Hospital, Leipzig, Germany
| | - Claudia Pföhler
- Department of Dermatology, The Saarland University Medical Center, Homburg/Saar, Germany
| | - Thomas Hawranek
- Department of Dermatology and Allergology, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | | | - Uta Jappe
- Division of Clinical and Molecular Allergology, Research Center Borstel, Airway Research Center North (ARCN), German Center for Lung Research, Borstel, Germany; Interdisciplinary Allergy Outpatient Clinic, Department of Pneumology, University of Lübeck, Lübeck, Germany
| | - George Christoff
- Faculty of Public Health, Medical University - Sofia, Sofia, Bulgaria; Allergy Out-patient Department, Acibadem CityClinic, Tokuda Medical Centre, Sofia, Bulgaria
| | - Sabine Müller
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Montserrat Fernandez-Rivas
- Department of Allergy, Hospital Clinico San Carlos, Universidad Complutense, IdISSC, ARADyAL, Madrid, Spain
| | - Blanca E García
- Allergology Service, Complejo Hospitalario de Navarra, Pamplona, Spain
| | | | - Victoria Cardona
- Allergy Section, Department of Internal Medicine, Hospital Vall d'Hebron, Barcelona, Spain; ARADyAL Research Network, Spain
| | | | - Burkhard Kreft
- Department of Dermatology and Venereology, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Andrea Bauer
- Department of Dermatology, University Allergy Center, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Nicola Wagner
- Department of Dermatology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Bettina Wedi
- Department of Dermatology and Allergy, Comprehensive Allergy Center, Hannover Medical School, Hannover, Germany
| | - Markus Wenzel
- Allergy Department, Fachkrankenhaus Kloster Grafschaft, Schmallenberg, Germany
| | - Maria Beatrice Bilò
- Department of Clinical and Molecular Sciences, Marche Polytechnic University - Allergy Unit, University Hospital Ospedali Riuniti di Ancona, Ancona, Italy
| | - Margitta Worm
- Division of Allergy and Immunology, Department of Dermatology, Venerology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
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Bauer A, Dickel H, Jakob T, Kleinheinz A, Lippert U, Metz M, Schliemann S, Schwichtenberg U, Staubach P, Valesky E, Wagner N, Wedi B, Maurer M. Expertenkonsensus zu praxisrelevanten Aspekten bei der Behandlung der chronischen Urtikaria. Allergo J 2021; 30:40-55. [PMID: 33785991 PMCID: PMC7994058 DOI: 10.1007/s15007-021-4772-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Hintergrund: Die chronische Urtikaria (CU) ist eine häufige und für viele Patienten stark belastende Erkrankung. Die aktuelle Urtikaria-Leitlinie beschreibt die evidenzbasierte Diagnostik und Therapie der CU. Darüber hinaus treten jedoch oftmals Fragen im praktischen Alltag auf, die durch die Leitlinie nicht beantwortet werden. Methoden: Im Mai 2020 fand ein digitales Treffen deutscher Urtikaria-Experten statt, in dem praxisrelevante Aspekte der Behandlung der CU erörtert und unterstützende Hilfestellungen für den klinischen Behandlungsalltag formuliert wurden. Die resultierenden Hinweise dieses Dokumentes fokussieren auf praktische Fragen und der hierzu verfügbaren Literatur und Erfahrungen der Teilnehmer. Ergebnisse: Die Diagnose einer CU kann in kurzer Zeit mittels gründlicher Anamnese, einer körperlichen Untersuchung und einer laborchemischen Basisdiagnostik gestellt werden. Hierzu werden in dieser Arbeit praktische Empfehlungen für den Praxisalltag gegeben. Eine erweiterte Diagnostik ist nur in wenigen Fällen indiziert und sollte grundsätzlich parallel zu einer effektiven Therapie erfolgen. Generell gilt, dass die CU immer auf gleiche Weise zu therapieren ist, unabhängig davon, ob Quaddeln, Angioödeme oder beides auftreten. Eine symptomatische Therapie sollte nach dem von den Leitlinien empfohlenen Stufenschema erfolgen. Die vorliegende Publikation gibt hierzu praktische Hinweise für Fragen in der Praxis, wie zum Beispiel dem Vorgehen in der aktuellen COVID-19-Pandemie, dem kardialen Risiko unter höher dosierten H 1-Antihistaminika, der Selbstapplikation von Omalizumab sowie dem Impfen unter Omalizumab-Therapie. Zusätzlich zu den Behandlungsempfehlungen werden Themen wie die Dokumentation in der Praxis und Familienplanung bei Urtikaria besprochen. Diskussion: Diese unterstützenden Behandlungsempfehlungen dienen als Ergänzung zu den aktuellen Leitlinien der CU und geben beim Umgang mit Patienten mit CU eine Hilfestellung für den Praxisalltag. Ziel ist es, dass Patienten, die unter einer CU leiden, mithilfe einer optimalen Therapie eine vollständige Beschwerdefreiheit erreichen.
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Affiliation(s)
- Andrea Bauer
- Universitätsklinikum Carl Gustav Carus \/ TU Dresden, Fetscherstr. 74, 1307 Dresden, Germany
| | - Heinrich Dickel
- Klinik für Dermatologie, Venerologie und Allergologie, Gudrunstr. 56, 44791 Bochum, Germany
| | - Thilo Jakob
- Universitäts-Hautklinik Gießen, Gießen, Germany
| | | | - Undine Lippert
- Universitätsmedizin Göttingen, Klinik für Dermatologie, Venerologie und Allergologie, Göttingen, Germany
| | - Martin Metz
- Charité – Universitätsmedizin Berlin, Klinik für Dermatologie, Venerologie und Allergolo, Berlin, Germany
| | | | | | | | - Eva Valesky
- Universitätsklinikum Frankfurt, Klinik für Dermatologie, Venerologie und Allergologie, Frankfurt, Germany
| | - Nicola Wagner
- Klinikum Darmstadt, Heidelberger Landstraße 379, 64297 Darmstadt-Eberstadt, Germany
| | - Bettina Wedi
- Universitätsmedizin Göttingen, Klinik für Dermatologie, Venerologie und Allergologie, Göttingen, Germany
| | - Marcus Maurer
- Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
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Loman L, Uter W, Armario‐Hita JC, Ayala F, Balato A, Ballmer‐Weber BK, Bauer A, Bircher AJ, Buhl T, Czarnecka‐Operacz M, Dickel H, Fuchs T, Giménez Arnau A, John SM, Kränke B, Kręcisz B, Mahler V, Rustemeyer T, Sadowska‐Przytocka A, Sánchez‐Pérez J, Scherer Hofmeier K, Schliemann S, Simon D, Spiewak R, Spring P, Valiukevičienė S, Wagner N, Weisshaar E, Pesonen M, Schuttelaar MLA. European Surveillance System on Contact Allergies (ESSCA): Characteristics of patients patch tested and diagnosed with irritant contact dermatitis. Contact Dermatitis 2021; 85:186-197. [PMID: 33729576 PMCID: PMC8360089 DOI: 10.1111/cod.13833] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 03/07/2021] [Accepted: 03/09/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Irritant contact dermatitis (ICD) is caused by the acute locally toxic effect of a strong irritant, or the cumulative exposure to various weaker physical and/or chemical irritants. OBJECTIVES To describe the characteristics of patients with ICD in the population patch tested in the European Surveillance System on Contact Allergies (ESSCA; www.essca-dc.org) database. METHODS Data collected by the ESSCA in consecutively patch-tested patients from January 2009 to December 2018 were analyzed. RESULTS Of the 68 072 patients, 8702 were diagnosed with ICD (without concomitant allergic contact dermatitis [ACD]). Hand and face were the most reported anatomical sites, and 45.7% of the ICD was occupational ICD (OICD). The highest proportions of OICD were found in metal turners, bakers, pastry cooks, and confectionery makers. Among patients diagnosed with ICD, 45% were found sensitized with no relevance for the current disease. CONCLUSIONS The hands were mainly involved in OICD also in the subgroup of patients with contact dermatitis, in whom relevant contact sensitization had been ruled out, emphasizing the need for limiting irritant exposures. However, in difficult-to-treat contact dermatitis, unrecognized contact allergy, or unrecognized clinical relevance of identified allergies owing to incomplete or wrong product ingredient information must always be considered.
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Affiliation(s)
- Laura Loman
- Department of DermatologyUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands
| | - Wolfgang Uter
- Department of Medical Informatics, Biometry and EpidemiologyFriedrich‐Alexander‐University Erlangen/NürnbergErlangenGermany
| | - José C. Armario‐Hita
- Department of DermatologyUniversity Hospital of Puerto Real, University of CádizCádizSpain
| | - Fabio Ayala
- Department of DermatologyUniversity of Naples Federico IINaplesItaly
| | - Anna Balato
- Department of Advanced Biomedical SciencesUniversity of Naples Federico IINaplesItaly
| | - Barbara K. Ballmer‐Weber
- Department of DermatologyUniversity Hospital ZürichZürichSwitzerland
- Department of DermatologyUniversity Hospital Zürich and Clinic of Dermatology and Allergology, Kantonsspital St GallenZürichSwitzerland
| | - Andrea Bauer
- Department of DermatologyUniversity Hospital Carl Gustav Carus, Technical University of DresdenDresdenGermany
| | - Andreas J. Bircher
- Department of DermatologyAllergy Unit, University Hospital BaselBaselSwitzerland
| | - Timo Buhl
- Department of Dermatology, Venereology and AllergologyUniversity Medical Center GöttingenGöttingenGermany
| | | | - Heinrich Dickel
- Department of Dermatology, Venereology and AllergologyRuhr University BochumBochumGermany
| | - Thomas Fuchs
- Department of Dermatology, Venereology and AllergologyUniversity Medical Center GöttingenGöttingenGermany
| | - Ana Giménez Arnau
- Department of DermatologyHospital del Mar, Universitat Autònoma de BarcelonaBarcelonaSpain
| | - Swen M. John
- Department of Dermatology and Environmental MedicineInstitute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm), University of Osnabrück, Lower Saxony Institute for Occupational Dermatology (NIB)OsnabrückGermany
| | - Birger Kränke
- Department of Dermatology and VenereologyMedical University of GrazGrazAustria
| | - Beata Kręcisz
- Faculty of Medicine and Health ScienceInstitute of Medical Science, Jan Kochanowski UniversityKielcePoland
- Department of DermatologyNofer Institute of Occupational MedicineŁódźPoland
| | - Vera Mahler
- Department of DermatologyUniversity Hospital of Erlangen, University of Erlangen‐Nuremberg (FAU)ErlangenGermany
- Division of AllergologyPaul‐Ehrlich‐InstitutLangenGermany
| | - Thomas Rustemeyer
- Department of Dermatology‐Allergology and Occupational DermatologyAmsterdam University Medical CentersAmsterdamThe Netherlands
| | | | | | | | - Sibylle Schliemann
- Department of Dermatology and AllergologyUniversity Hospital JenaJenaGermany
| | - Dagmar Simon
- Department of DermatologyInselspital, Bern University Hospital, University of BernBernSwitzerland
| | - Radoslaw Spiewak
- Department of Experimental Dermatology and Cosmetology, Faculty of PharmacyJagiellonian University Medical CollegeKrakowPoland
| | - Philip Spring
- Dermatologie et vénéréologie FMH, Center Médical d'EpalingesEpalingesSwitzerland
| | - Skaidra Valiukevičienė
- Department of Skin and Venereal DiseasesLithuanian University of Health SciencesKaunasLithuania
| | - Nicola Wagner
- Department of DermatologyUniversity Hospital of Erlangen, University of Erlangen‐Nuremberg (FAU)ErlangenGermany
| | - Elke Weisshaar
- Department of Dermatology, Occupational DermatologyUniversity Hospital HeidelbergHeidelbergGermany
| | - Maria Pesonen
- Division Occupational MedicineFinnish Institute of Occupational HealthHelsinkiFinland
| | - Marie L. A. Schuttelaar
- Department of DermatologyUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands
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Kocatürk E, Salman A, Cherrez‐Ojeda I, Criado PR, Peter J, Comert‐Ozer E, Abuzakouk M, Agondi RC, Al‐Ahmad M, Altrichter S, Arnaout R, Arruda LK, Asero R, Bauer A, Ben‐Shoshan M, Bernstein JA, Bizjak M, Boccon‐Gibod I, Bonnekoh H, Bouillet L, Brzoza Z, Busse P, Campos RA, Carne E, Conlon N, Criado RF, Souza Lima EM, Demir S, Dissemond J, Doğan Günaydın S, Dorofeeva I, Ensina LF, Ertaş R, Ferrucci SM, Figueras‐Nart I, Fomina D, Franken SM, Fukunaga A, Giménez‐Arnau AM, Godse K, Gonçalo M, Gotua M, Grattan C, Guillet C, Inomata N, Jakob T, Karakaya G, Kasperska‐Zając A, Katelaris CH, Košnik M, Krasowska D, Kulthanan K, Kumaran MS, Lang C, Larco‐Sousa JI, Lazaridou E, Leslie TA, Lippert U, llosa OC, Makris M, Marsland A, Medina IV, Meshkova R, Palitot EB, Parisi CA, Pickert J, Ramon GD, Rodríguez‐Gonzalez M, Rosario N, Rudenko M, Rutkowski K, Sánchez J, Schliemann S, Sekerel BE, Serpa FS, Serra‐Baldrich E, Song Z, Soria A, Staevska M, Staubach P, Tagka A, Takahagi S, Thomsen SF, Treudler R, Vadasz Z, Valle SOR, Van Doorn MB, Vestergaard C, Wagner N, Wang D, Wang L, Wedi B, Xepapadaki P, Yücel E, Zalewska‐Janowska A, Zhao Z, Zuberbier T, Maurer M. The global impact of the COVID-19 pandemic on the management and course of chronic urticaria. Allergy 2021; 76:816-830. [PMID: 33284457 DOI: 10.1111/all.14687] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 11/09/2020] [Accepted: 11/16/2020] [Indexed: 02/06/2023]
Abstract
INTRODUCTION The COVID-19 pandemic dramatically disrupts health care around the globe. The impact of the pandemic on chronic urticaria (CU) and its management are largely unknown. AIM To understand how CU patients are affected by the COVID-19 pandemic; how specialists alter CU patient management; and the course of CU in patients with COVID-19. MATERIALS AND METHODS Our cross-sectional, international, questionnaire-based, multicenter UCARE COVID-CU study assessed the impact of the pandemic on patient consultations, remote treatment, changes in medications, and clinical consequences. RESULTS The COVID-19 pandemic severely impairs CU patient care, with less than 50% of the weekly numbers of patients treated as compared to before the pandemic. Reduced patient referrals and clinic hours were the major reasons. Almost half of responding UCARE physicians were involved in COVID-19 patient care, which negatively impacted on the care of urticaria patients. The rate of face-to-face consultations decreased by 62%, from 90% to less than half, whereas the rate of remote consultations increased by more than 600%, from one in 10 to more than two thirds. Cyclosporine and systemic corticosteroids, but not antihistamines or omalizumab, are used less during the pandemic. CU does not affect the course of COVID-19, but COVID-19 results in CU exacerbation in one of three patients, with higher rates in patients with severe COVID-19. CONCLUSIONS The COVID-19 pandemic brings major changes and challenges for CU patients and their physicians. The long-term consequences of these changes, especially the increased use of remote consultations, require careful evaluation.
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Affiliation(s)
- Emek Kocatürk
- Urticaria Center of Reference and Excellence (UCARE) Department of Dermatology Koç University School of Medicine Istanbul Turkey
| | - Andaç Salman
- Urticaria Center of Reference and Excellence (UCARE) Department of Dermatology Marmara University School of Medicine Istanbul Turkey
| | - Ivan Cherrez‐Ojeda
- Urticaria Center of Reference and Excellence (UCARE) School of Medicine Universidad de Especialidades Espíritu Santo, Samborondón, Ecuador and RespiraLab Research, Guayaquil Ecuador
| | - Paulo Ricardo Criado
- Urticaria Center of Reference and Excellence (UCARE)Faculdade de Medicina do ABC Santo André Brazil
- Alergoskin Alergia e Dermatologia SS ltda Santo André Brazil
- UCARE Center São Paulo Brazil
| | - Jonny Peter
- Urticaria Center of Reference and Excellence (UCARE) Division of Allergy and Clinical Immunology Department of Medicine University of Cape Town Cape Town7925South Africa
| | - Elif Comert‐Ozer
- Urticaria Center of Reference and Excellence (UCARE) Department of Dermatology Marmara University School of Medicine Istanbul Turkey
| | - Mohamed Abuzakouk
- Urticaria Center of Reference and Excellence (UCARE) Cleveland Clinic Abu Dhabi UAE
| | - Rosana Câmara Agondi
- Urticaria Center of Reference and Excellence (UCARE) University of São Paulo São Paulo Brazil
| | - Mona Al‐Ahmad
- Urticaria Center of Reference and Excellence (UCARE) Microbiology Department Faculty of Medicine Kuwait University Safat Kuwait
| | - Sabine Altrichter
- Urticaria Center of Reference and Excellence (UCARE) Department of Dermatology and Allergy Charité ‐ Universitätsmedizin Berlin Berlin Germany
| | - Rand Arnaout
- Urticaria Center of Reference and Excellence (UCARE) King Faisal Specialist Hospital & Research Center Al Faisal University Riyadh Saudi Arabia
| | - Luisa Karla Arruda
- Urticaria Center of Reference and Excellence (UCARE) Preto Medical School University of São Paulo São Paulo Brazil
| | - Riccardo Asero
- Urticaria Center of Reference and Excellence (UCARE) Ambulatorio di AllergologiaClinica San Carlo Paderno Dugnano Italy
| | - Andrea Bauer
- Urticaria Center of Reference and Excellence (UCARE) Department of Dermatology University Allergy CenterUniversity Hospital Carl Gustav CarusTechnical University Dresden Germany
| | - Moshe Ben‐Shoshan
- Urticaria Center of Reference and Excellence (UCARE) Division of Allergy, Immunology and Dermatology Department of Pediatrics McGill University Health Center Montreal QC Canada
| | - Jonathan A. Bernstein
- Urticaria Center of Reference and Excellence (UCARE) University of Cincinnati College of MedicineDivision of Immunology, Rheumatology and Allergy Cincinnati USA
| | - Mojca Bizjak
- Urticaria Center of Reference and Excellence (UCARE) Division of Allergy University Clinic of Respiratory and Allergic Diseases Golnik Golnik Slovenia
| | - Isabelle Boccon‐Gibod
- Urticaria Center of Reference and Excellence (UCARE) Clinical Immunology/Internal Medicine Department National Reference Center for AngioedemaGrenoble University Hospital Grenoble France
| | - Hanna Bonnekoh
- Urticaria Center of Reference and Excellence (UCARE) Department of Dermatology and Allergy Allergie‐Centrum‐CharitéCharité ‐ Universitätsmedizin Berlin Berlin Germany
- Autoinflammation Reference Center Charité (ARC2) Charité ‐ Universitätsmedizin Berlin Berlin Germany
| | - Laurence Bouillet
- Urticaria Center of Reference and Excellence (UCARE) Clinical Immunology/Internal Medicine Department National Reference Center for AngioedemaGrenoble University Hospital Grenoble France
| | - Zenon Brzoza
- Urticaria Center of Reference and Excellence (UCARE) Department of Internal Medicine with Division of Allergology Institute of Medical Sciences University of Opole Opole Poland
| | - Paula Busse
- Urticaria Center of Reference and Excellence (UCARE) Division of Clinical Immunology and Allergy Icahn School at Mount Sinai New York NY USA
| | - Regis A Campos
- Urticaria Center of Reference and Excellence (UCARE) Universidade Federal da Bahia Salvador Brazil
- Serviço de Imunologia Hospital das Clínicas Professor Edgard Santos Salvador Brazil
| | - Emily Carne
- Urticaria Center of Reference and Excellence (UCARE) University Hospital of Wales Cardiff UK
| | - Niall Conlon
- Urticaria Center of Reference and Excellence (UCARE) Department of Immunology St James’s Hospital and Trinity College Dublin Ireland
| | - Roberta F. Criado
- Urticaria Center of Reference and Excellence (UCARE)Faculdade de Medicina do ABC (FMABC) Santo André Brazil
| | - Eduardo M. Souza Lima
- Urticaria Center of Reference and Excellence, (UCARE) Faculdade de Ciências Médicas e da Saúde de Juiz de Fora (SUPREMA) Hospital Maternidade Therezinha de Jesus Minas Gerais Brazil
| | - Semra Demir
- Urticaria Center of Reference and Excellence (UCARE) Division of Allergy Department of Internal Medicine Istanbul Faculty of Medicine Istanbul University Istanbul Turkey
| | - Joachim Dissemond
- Urticaria Center of Reference and Excellence (UCARE) Department of Dermatology, Venereology and Allergology University of Essen Essen Germany
| | - Sibel Doğan Günaydın
- Urticaria Center of Reference and Excellence (UCARE) Department of Dermatology and Venereology Faculty of Medicine Hacettepe University Ankara Turkey
| | - Irina Dorofeeva
- Urticaria Center of Reference and Excellence (UCARE) Department of Allergy and Immunotherapy Institute of Immunology FMBA of Russia Moscow Russia
| | - Luis Felipe Ensina
- Urticaria Center of Reference and Excellence (UCARE) Division of Allergy Clinical Immunology and Rheumatology Department of Pediatrics Federal University of São Paulo São Paulo Brazil
| | - Ragıp Ertaş
- Urticaria Center of Reference and Excellence (UCARE) Department of Dermatology Kayseri City Education and Research Hospital Kayseri Turkey
| | - Silvia Mariel Ferrucci
- Urticaria Center of Reference and Excellence (UCARE) Ambulatorio di Dermatologia Allergologica e Professionale Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico Milano Italy
| | - Ignasi Figueras‐Nart
- Urticaria Center of Reference and Excellence (UCARE) The Dermatology Department of the Hospital de Bellvitge Universitat de Barcelona Barcelona Spain
| | - Daria Fomina
- Urticaria Center of Reference and Excellence (UCARE) Center of Allergy and Immunology Moscow Ministry of Healthcare Moscow Russia
- Department of Allergology and Clinical Immunology I.M. Sechenov First Moscow State Medical University Moscow Russia
| | - Sylvie M Franken
- Urticaria Center of Reference and Excellence (UCARE) Department of Dermatology Amsterdam UMC Amsterdam The Netherlands
| | - Atsushi Fukunaga
- Urticaria Center of Reference and Excellence (UCARE) Division of Dermatology Kobe UniversityGraduate School of Medicine Kobe Japan
| | - Ana M. Giménez‐Arnau
- Urticaria Center of Reference and Excellence (UCARE) Department of Dermatology Hospital del MarIMIMUniversitat Autònoma Barcelona Spain
| | - Kiran Godse
- Urticaria Center of Reference and Excellence (UCARE)Department of DermatologyD Y. Patil University School of Medicine Mumbai India
| | - Margarida Gonçalo
- Urticaria Center of Reference and Excellence (UCARE) Centro Hospitalar Universitário Coimbra and Faculty of MedicineUniversity of Coimbra Clinica de Dermatologia Coimbra Portugal
| | - Maia Gotua
- Urticaria Center of Reference and Excellence (UCARECenter of Allergy and Immunology Tbilsi Georgia
| | - Clive Grattan
- Urticaria Center of Reference and Excellence (UCARE) Department of Dermatology Guys & St Thomas' Hospital London UK
| | - Carole Guillet
- Urticaria Center of Reference and Excellence (UCARE) Allergy Unit Department of Dermatology University Hospital of Zurich Zurich Switzerland
| | - Naoko Inomata
- Urticaria Center of Reference and Excellence (UCARE) Department of Environmental Immuno‐Dermatology Yokohama City University Graduate School of Medicine Yokohama Japan
| | - Thilo Jakob
- Urticaria Center of Reference and Excellence (UCARE) Department of Dermatology and Allergy University Medical Center Giessen (UKGMJustus‐Liebig‐University Giessen Giessen Germany
| | - Gul Karakaya
- Urticaria Center of Reference and Excellence (UCARE) School of Medicine Department of Chest Diseases Adult Allergy Unit Hacettepe University Sihhiye Ankara Turkey
| | - Alicja Kasperska‐Zając
- Urticaria Center of Reference and Excellence (UCARE) European Center for Diagnosis and Treatment of Urticaria Medical University of Silesia Zabrze Poland
| | - Constance H Katelaris
- Urticaria Center of Reference and Excellence (UCARE) Immunology & Allergy Unit Department of Medicine Campbelltown Hospital Campbelltown NSW Australia
| | - Mitja Košnik
- Urticaria Center of Reference and Excellence (UCARE) Division of Allergy University Clinic of Respiratory and Allergic Diseases Golnik Golnik Slovenia
| | - Dorota Krasowska
- Urticaria Center of Reference and Excellence (UCARE) Department of Dermatology, Venereology and Pediatric Dermatology Medical University of Lublin Lublin Poland
| | - Kanokvalai Kulthanan
- Urticaria Center of Reference and Excellence (UCARE) Department of Dermatology Faculty of Medicine Siriraj Hospital Mahidol University Bangkok Thailand
| | - M. Sendhil Kumaran
- Urticaria Center of Reference and Excellence (UCARE) Department of Dermatology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Claudia Lang
- Urticaria Center of Reference and Excellence (UCARE) Allergy Unit Department of Dermatology University Hospital of Zurich Zurich Switzerland
| | | | - Elisavet Lazaridou
- Urticaria Center of Reference and Excellence (UCARE) Second department of Dermatology and Venereology Aristotle University of ThessalonikiGeneral Hospital Papageorgiou Thessaloniki Greece
| | - Tabi Anika Leslie
- Urticaria Center of Reference and Excellence (UCARE) Department of Dermatology Royal Free Hospital London UK
| | - Undine Lippert
- Urticaria Center of Reference and Excellence (UCAREDepartment of DermatologyMedical Center of University Goettingen Venerology und Allergology Goettingen Germany
| | - Oscar Calderón llosa
- Urticaria Center of Reference and Excellence (UCARE) Department of Allergy SANNA el Golf San Isidro, Lima
| | - Michael Makris
- Urticaria Center of Reference and Excellence (UCARE) Second Department of Dermatology and Venereology National and Kapodistrian University of AthensUniversity General Hospital “Attikon” Athens Greece
| | - Alexander Marsland
- Urticaria Center of Reference and Excellence (UCARE) Department of Dermatology The Urticaria ClinicSalford Royal Foundation TrustUniversity of Manchester Manchester UK
| | - Iris V. Medina
- Urticaria Center of Reference and Excellence (UCARE) Allergy and Clinical Immunology Department Centro Médico Vitae, de Julio Argentina
| | - Raisa Meshkova
- Urticaria Center of Reference and Excellence (UCARE) Department of Clinical Immunology and Allergology Smolensk State Medical University Smolensk Russia
| | - Esther Bastos Palitot
- Urticaria Center of Reference and Excellence (UCARE) Department of Dermatology Hospital Universitário Lauro Wanderley João Pessoa PB Brazil
| | - Claudio A.S. Parisi
- Urticaria Center of Reference and Excellence (UCARE) Adults and Pediatrics Allergy Unit Hospital Italiano de Buenos Aires Buenos Aires Argentina
| | - Julia Pickert
- Urticaria Center of Reference and Excellence (UCARE) Clinical & Experimental Allergology Department of Dermatology and Allergology Philipps University Marburg Marburg Germany
| | - German D. Ramon
- Urticaria Center of Reference and Excellence (UCARE) Instituto de Alergia e Inmunologia del Sur Buenos Aires Argentina
| | - Mónica Rodríguez‐Gonzalez
- Urticaria Center of Reference and Excellence (UCARE) Department of Allergy Hospital Español de México Mexico City Mexico
| | - Nelson Rosario
- Urticaria Center of Reference and Excellence (UCARE) Federal University of ParanaRua General Carneiro Curitiba Brazil
| | - Michael Rudenko
- Urticaria Center of Reference and Excellence (UCARE) London Allergy and Immunology Centre London UK
| | - Krzysztof Rutkowski
- Urticaria Center of Reference and Excellence (UCARE) Department of Allergy Guy's and St Thomas’ Hospital NHS Foundation Trust London UK
| | - Jorge Sánchez
- Urticaria Center of Reference and Excellence (UCARE) Department of Pediatrics Graduate Program on Allergology University of Antioquia Medellín Colombia
| | - Sibylle Schliemann
- Urticaria Center of Reference and Excellence (UCARE) Department of Dermatology University Hospital Jena Germany
| | - Bulent Enis Sekerel
- Urticaria Center of Reference and Excellence (UCARE) Department of Pediatric Allergy Hacettepe University Faculty of Medicine Ankara Turkey
| | - Faradiba S. Serpa
- Urticaria Center of Reference and Excellence (UCARE) Hospital Santa Casa de Misericórdia de Vitória Espírito Santo Brazil
| | - Esther Serra‐Baldrich
- Urticaria Center of Reference and Excellence (UCARE) Dermatology Department Hospital Sant Pau Barcelona Spain
| | - Zhiqiang Song
- Urticaria Center of Reference and Excellence (UCARE) Department of Dermatology Southwest HospitalArmy Medical University Chongqing China
| | - Angèle Soria
- Urticaria Center of Reference and Excellence (UCARE) Service de Dermatologie et Allergologie Hopital TenonAPHPUniversité Paris Sorbonne France
| | - Maria Staevska
- Urticaria Center of Reference and Excellence (UCARE) Department of Allergy Sofia Medical University Sofia Bulgaria
| | - Petra Staubach
- Urticaria Center of Reference and Excellence (UCARE) Department of Dermatology University Medical Center Mainz Germany
| | - Anna Tagka
- Urticaria Center of Reference and Excellence (UCARE) First Department of Dermatology and Venereology National and Kapodistrian University of Athens, "A. Syggros" HospitalReferral Center of Occupational Dermatological Diseases Athens Greece
| | - Shunsuke Takahagi
- Urticaria Center of Reference and Excellence (UCARE) Department of Dermatology Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan
| | - Simon Francis Thomsen
- Urticaria Center of Reference and Excellence (UCARE) Department of Dermatology Bispebjerg Hospital Copenhagen Denmark
| | - Regina Treudler
- Urticaria Center of Reference and Excellence (UCARE) Department of Dermatology, Venerology and Allergology and Leipzig Interdisciplinary Center of Allergology Comprehensive Allergy Center UMC Leipzig Leipzig Germany
| | - Zahava Vadasz
- Urticaria Center of Reference and Excellence (UCARE) Division of Allergy and Clinical Immunology Bnai‐Zion Medical CenterTechnion Faculty of Medicine Haifa Israel
| | - Solange Oliveira Rodrigues Valle
- Urticaria Center of Reference and Excellence (UCARE) Federal University of Rio de JaneiroDepartment of Internal Medicine, Immunology Service Rio de Janeiro Brazil
| | - Martijn B.A. Van Doorn
- Urticaria Center of Reference and Excellence (UCARE) Department of Dermatology Erasmus MC Rotterdam The Netherlands
| | - Christian Vestergaard
- Urticaria Center of Reference and Excellence (UCARE) Aarhus University Hospital Aarhus Denmark
| | - Nicola Wagner
- Urticaria Center of Reference and Excellence (UCARE) Department of Dermatology University of Erlangen Erlangen Germany
| | - Dahu Wang
- Urticaria Center of Reference and Excellence (UCARE) Dermatovenerological Department The Second Hospital of HeBei Medical University Shijiazhuang, HeBei Province China
| | - Liangchun Wang
- Urticaria Center of Reference and Excellence (UCAREDermatology Department of Sun Yat‐sen Memorial Hospital Guangzhou China
| | - Bettina Wedi
- Urticaria Center of Reference and Excellence (UCAREDepartment of Dermatology and AllergologyHannover Medical School Allergology Division Hannover Germany
| | - Paraskevi Xepapadaki
- Urticaria Center of Reference and Excellence (UCARE) Department of Allergy 2nd Pediatric Clinic, National and Kapodistrian University of Athens Athens Greece
| | - Esra Yücel
- Urticaria Center of Reference and Excellence (UCARE) Department of Pediatric Allergy and Immunology Istanbul Faculty of Medicine Istanbul University Istanbul Turkey
| | - Anna Zalewska‐Janowska
- Urticaria Center of Reference and Excellence (UCARE) Chair of Clinical Immunology and Rheumatology Department of Psychodermatology Medical University of Lodz Lodz Poland
| | - Zuotao Zhao
- Urticaria Center of Reference and Excellence (UCARE) Department of Dermatology and Venerology Peking University First HospitalBeijing Key Laboratory of molecular Diagnosis on Dermatoses and National Clinical Research Center for Skin and Immune Diseases Beijing China
| | - Torsten Zuberbier
- Autoinflammation Reference Center Charité (ARC2) Charité ‐ Universitätsmedizin Berlin Berlin Germany
| | - Marcus Maurer
- Urticaria Center of Reference and Excellence (UCARE) Dermatological Allergology Allergie‐Centrum‐CharitéDepartment of Dermatology and AllergyCharité – Universitätsmedizin Berlin Germany
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Bauer A, Dickel H, Jakob T, Kleinheinz A, Lippert U, Metz M, Schliemann S, Schwichtenberg U, Staubach P, Valesky E, Wagner N, Wedi B, Maurer M. Expert consensus on practical aspects in the treatment of chronic urticaria. ACTA ACUST UNITED AC 2021; 30:64-75. [PMID: 33643777 PMCID: PMC7903036 DOI: 10.1007/s40629-021-00162-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 12/30/2020] [Indexed: 12/13/2022]
Abstract
Background Chronic urticaria (CU) is a common disease which represents a considerable burden for many patients. The current urticaria guideline describes the evidence-based diagnosis and treatment of CU. In addition, however, questions often arise in everyday practice that are not addressed by the guideline. Methods In May 2020, a digital meeting with German urticaria experts was held, in which practical aspects of CU treatment were discussed and supporting aids for everyday clinical treatment formulated. The resulting advice in this document focus on practical questions and the available literature and experiences of the participants. Results The diagnosis of CU can be made in a short time by means of a thorough anamnesis, a physical examination, and a basic laboratory chemical diagnosis. For this purpose, practical recommendations for everyday practice are given in this paper. An extended diagnosis is only indicated in a few cases and should always be carried out in parallel with an effective therapy. In general, CU should always be treated in the same way, regardless of whether wheals, angioedema or both occur. Symptomatic therapy should be carried out according to the treatment steps recommended by the guidelines. This publication provides practical advice on issues in everyday practice, such as the procedure in the current coronavirus disease 2019 (COVID-19) pandemic, the cardiac risk under higher dosed H1 antihistamines, the self-administration of omalizumab as well as vaccination under omalizumab therapy. In addition to treatment recommendations, topics such as documentation in the practice and family planning with urticaria will be discussed. Discussion These supporting treatment recommendations serve as an addendum to the current CU guideline and provide support in dealing with CU patients in everyday practice. The aim is to ensure that patients suffering from CU achieve complete freedom of symptoms with the help of an optimal therapy. Supplementary Information The online version of this article (10.1007/s40629-021-00162-w) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Andrea Bauer
- University Hospital Carl Gustav Carus, Department of Dermatology, University Allergy Center, Urticaria Center of Reference and Excellence (UCARE), Technical University, Dresden, Germany
| | - Heinrich Dickel
- Department of Dermatology, Venereology and Allergology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
| | - Thilo Jakob
- University Medical Center Giessen (UKGM), Department of Dermatology and Allergy, Justus-Liebig-University Giessen, Giessen, Germany
| | - Andreas Kleinheinz
- Department of Dermatology, Urticaria Center of Reference and Excellence (UCARE), Elbe Medical Centre, Buxtehude, Germany
| | - Undine Lippert
- Department of Dermatology and Allergology, Urticaria Center of Reference and Excellence (UCARE), University Medical Center Göttingen, Göttingen, Germany
| | - Martin Metz
- Department of Dermatology and Allergy, Urticaria Center of Reference and Excellence (UCARE), Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Sibylle Schliemann
- Department of Dermatology, Urticaria Center of Reference and Excellence (UCARE), University Hospital Jena, Jena, Germany
| | | | - Petra Staubach
- Department of Dermatology, Urticaria Center of Reference and Excellence (UCARE), University Medical Center Mainz, Mainz, Germany
| | - Eva Valesky
- University Hospital Frankfurt, Department of Dermatology, Venerology and Allergology, Goethe University, Frankfurt, Germany
| | - Nicola Wagner
- Department of Dermatology, Urticaria Center of Reference and Excellence (UCARE), University Medical Center Erlangen, Erlangen, Germany
| | - Bettina Wedi
- Department of Dermatology and Allergy, Urticaria Center of Reference and Excellence (UCARE), Comprehensive Allergy Center, Hannover Medical School, Hannover, Germany
| | - Marcus Maurer
- Department of Dermatology and Allergy, Urticaria Center of Reference and Excellence (UCARE), Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
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Francuzik W, Ruëff F, Bauer A, Bilò MB, Cardona V, Christoff G, Dölle-Bierke S, Ensina L, Fernández Rivas M, Hawranek T, O'B Hourihane J, Jakob T, Papadopoulos NG, Pföhler C, Poziomkowska-Gęsicka I, Van der Brempt X, Scherer Hofmeier K, Treudler R, Wagner N, Wedi B, Worm M. Phenotype and risk factors of venom-induced anaphylaxis: A case-control study of the European Anaphylaxis Registry. J Allergy Clin Immunol 2021; 147:653-662.e9. [DOI: 10.1016/j.jaci.2020.06.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 05/27/2020] [Accepted: 06/02/2020] [Indexed: 12/12/2022]
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Uter W, Worm M, Brans R, Wagner N, Bauer A, Geier J. Patch test results with caine mix III and its three constituents in consecutive patients of the IVDK. Contact Dermatitis 2021; 84:481-483. [PMID: 33400817 DOI: 10.1111/cod.13778] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/30/2020] [Accepted: 01/02/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, Erlangen, Germany
| | - Margitta Worm
- Division of Allergy and Immunology, Department of Dermatology, Venereology and Allergy, Charité -Universitätsmedizin Berlin, Berlin, Germany
| | - Richard Brans
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany.,Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | - Nicola Wagner
- Department of Dermatology, University Hospital Erlangen, Medical Faculty Friedrich-Alexander University, Erlangen/Nürnberg, Germany
| | - Andrea Bauer
- Department of Dermatology, University Hospital Carl Gustav Carus, Technical University of Dresden, Dresden, Germany
| | - Johannes Geier
- Information Network of Departments of Dermatology (IVDK), Institute at the University Medical Center Göttingen, Göttingen, Germany
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Schielein MC, Tizek L, Baeumer D, Hillmann E, Romer K, Wagner N, Zink A. People-centered care for psoriasis and urticaria: Are we overlooking Internet addiction while only considering patients and physician settings? J Dermatol 2021; 48:825-834. [PMID: 33406282 DOI: 10.1111/1346-8138.15740] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 11/29/2020] [Accepted: 12/06/2020] [Indexed: 11/27/2022]
Abstract
Psoriasis and chronic urticaria (CU) are chronic skin diseases with a high impact on individuals' life and mental health. Some studies indicate a high prevalence of Internet addiction and many affected individuals seem not to utilize healthcare, but rather search for health-related information online. The aims of the study were to assess Internet addiction as a potential comorbidity in both diseases as well as identify differences in healthcare utilization between individuals with psoriasis and CU. This cross-sectional study is based on self-reported data from individuals with psoriasis and CU living throughout Germany using the framework of an online survey from 12/2018 to 01/2019. Advertisements on Google and Facebook were used to address Internet users who searched online for information on psoriasis or CU. The study questionnaire comprised questions on demographics, current contact with physicians, and disease history as well as validated screening tools for well-being and Internet addiction. Overall, 1686 participants (74.0% female, 38.5% psoriasis) with a mean age of 36.9 ± 12.9 years were analyzed. Participants with CU were more likely female (89.2% vs 49.8%, P < 0.001) and not in medical care compared to participants with psoriasis (60.3% vs 45.9%, P < 0.001). Sixteen percent of the participants overall were screened positive for Internet addiction. Furthermore, not utilizing medical care showed a significant association with being screened positive for Internet addiction in participants with CU (adjusted odds ratio [aOR] = 1.49, 95% confidence interval [CI] 1.10-2.02), but not in those with psoriasis. The study revealed a high proportion of affected individuals not being in medical care and a high prevalence of Internet addiction, with individuals with CU not utilizing medical resources having a higher chance of being screened positive for Internet addiction. This underlines the approach of people-centered care and highlights its importance for further research.
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Affiliation(s)
- Maximilian Christian Schielein
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany.,Department of Medical Informatics, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University Munich, Munich, Germany.,Pettenkofer School of Public Health, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Linda Tizek
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany.,Department of Medical Informatics, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University Munich, Munich, Germany.,Pettenkofer School of Public Health, Ludwig-Maximilians-University Munich, Munich, Germany
| | | | | | | | - Nicola Wagner
- Department of Dermatology, University Hospital Erlangen-Nürnberg, Erlangen, Germany
| | - Alexander Zink
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
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43
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Löwe A, Bienen F, Kopljar D, Wagner N, Klemm E. Electrochemical production of formic acid from alkaline CO
2
reduction by coupling with bipolar membrane electro dialysis. CHEM-ING-TECH 2020. [DOI: 10.1002/cite.202055358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- A. Löwe
- University of Stuttgart Institute of Chemical Technology Pfaffenwaldring 55 70569 Stuttgart Germany
| | - F. Bienen
- German Aerospace Center Institut für Technische Thermodynamik Pfaffenwaldring 38–40 70569 Stuttgart Germany
| | - D. Kopljar
- German Aerospace Center Institut für Technische Thermodynamik Pfaffenwaldring 38–40 70569 Stuttgart Germany
| | - N. Wagner
- German Aerospace Center Institut für Technische Thermodynamik Pfaffenwaldring 38–40 70569 Stuttgart Germany
| | - E. Klemm
- University of Stuttgart Institute of Chemical Technology Pfaffenwaldring 55 70569 Stuttgart Germany
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44
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Maurer M, Aberer W, Agondi R, Al‐Ahmad M, Al‐Nesf MA, Ansotegui I, Arnaout R, Arruda LK, Asero R, Aygören‐Pürsün E, Banerji A, Bauer A, Ben‐Shoshan M, Berardi A, Bernstein JA, Betschel S, Bindslev‐Jensen C, Bizjak M, Boccon‐Gibod I, Bork K, Bouillet L, Boysen HB, Brodszki N, Broesby‐Olsen S, Busse P, Buttgereit T, Bygum A, Caballero T, Campos RA, Cancian M, Cherrez‐Ojeda I, Cohn DM, Costa C, Craig T, Criado PR, Criado RF, Csuka D, Dissemond J, Du‐Thanh A, Ensina LF, Ertaş R, Fabiani JE, Fantini C, Farkas H, Ferrucci SM, Figueras‐Nart I, Fili NL, Fomina D, Fukunaga A, Gelincik A, Giménez‐Arnau A, Godse K, Gompels M, Gonçalo M, Gotua M, Gower R, Grumach AS, Guidos‐Fogelbach G, Hide M, Ilina N, Inomata N, Jakob T, Josviack DO, Kang H, Kaplan A, Kasperska‐Zając A, Katelaris C, Kessel A, Kleinheinz A, Kocatürk E, Košnik M, Krasowska D, Kulthanan K, Kumaran MS, Larco Sousa JI, Longhurst HJ, Lumry W, MacGinnitie A, Magerl M, Makris MP, Malbrán A, Marsland A, Martinez‐Saguer I, Medina IV, Meshkova R, Metz M, Nasr I, Nicolay J, Nishigori C, Ohsawa I, Özyurt K, Papadopoulos NG, Parisi CAS, Peter JG, Pfützner W, Popov T, Prior N, Ramon GD, Reich A, Reshef A, Riedl MA, Ritchie B, Röckmann‐Helmbach H, Rudenko M, Salman A, Sanchez‐Borges M, Schmid‐Grendelmeier P, Serpa FS, Serra‐Baldrich E, Sheikh FR, Smith W, Soria A, Staubach P, Steiner UC, Stobiecki M, Sussman G, Tagka A, Thomsen SF, Treudler R, Valle S, Doorn M, Varga L, Vázquez DO, Wagner N, Wang L, Weber‐Chrysochoou C, Ye Y, Zalewska‐Janowska A, Zanichelli A, Zhao Z, Zhi Y, Zuberbier T, Zwiener RD, Castaldo A. Definition, aims, and implementation of GA 2 LEN/HAEi Angioedema Centers of Reference and Excellence. Allergy 2020; 75:2115-2123. [PMID: 32248571 DOI: 10.1111/all.14293] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 03/16/2020] [Accepted: 03/18/2020] [Indexed: 01/12/2023]
Affiliation(s)
- Marcus Maurer
- Department of Dermatology and Allergy Dermatological Allergology Allergie‐Centrum‐Charité Charité—Universitätsmedizin Berlin Berlin Germany
| | - Werner Aberer
- Department of Dermatology Medical University of Graz Graz Austria
| | | | - Mona Al‐Ahmad
- Microbiology Department Faculty of Medicine Kuwait University Safat Kuwait
| | - Maryam Ali Al‐Nesf
- Allergy and Immunology Section Department of Medicine Hamad General Hospital Doha Qatar
| | - Ignacio Ansotegui
- Department of Allergy and Immunology Hospital Quiron Bizkaia Bizkaia Spain
| | - Rand Arnaout
- King Faisal Specialist Hospital & Research Center Al Faisal University Riyadh Saudi Arabia
| | | | - Riccardo Asero
- Ambulatorio di Allergologia Clinica San Carlo Paderno Dugnano (MI) Italy
| | - Emel Aygören‐Pürsün
- Center for Children and Adolescents University Hospital Frankfurt Frankfurt Germany
| | - Aleena Banerji
- Division of Rheumatology, Allergy and Immunology Massachusetts General Hospital Boston MA USA
| | - Andrea Bauer
- Department of Dermatology University Allergy Center University Hospital Carl Gustav Carus Technical University Dresden Germany
| | - Moshe Ben‐Shoshan
- Division of Allergy, Immunology and Dermatology Department of Pediatrics McGill University Health Center Montreal QC Canada
| | - Alejandro Berardi
- Instituto de Asma Alergia y Enfermedades Respiratorias Corrientes Argentina
| | - Jonathan A. Bernstein
- Allergy Section Division of Immunology Department of Internal Medicine Partner Bernstein Allergy Group Partner Bernstein Clinical Research Center University of Cincinnati Cincinnati OH USA
| | - Stephen Betschel
- Division of Clinical Immunology and Allergy St. Michael’s Hospital University of Toronto Toronto ON Canada
| | | | - Mojca Bizjak
- Division of Allergy University Clinic of Respiratory and Allergic Diseases Golnik Golnik Slovenia
| | - Isabelle Boccon‐Gibod
- Clinical Immunology/Internal Medicine Department National Reference Center for Angioedema Grenoble University Hospital Grenoble France
| | - Konrad Bork
- Department of Dermatology Johannes Gutenberg University Mainz Mainz Germany
| | - Laurence Bouillet
- Clinical Immunology/Internal Medicine Department National Reference Center for Angioedema Grenoble University Hospital Grenoble France
| | | | | | - Sigurd Broesby‐Olsen
- Department of Dermatology and Allergy Center Odense University Hospital Odense Denmark
| | - Paula Busse
- Division of Clinical Immunology Icahn School at Mount Sinai New York NY USA
| | - Thomas Buttgereit
- Department of Dermatology and Allergy Dermatological Allergology Allergie‐Centrum‐Charité Charité—Universitätsmedizin Berlin Berlin Germany
| | - Anette Bygum
- HAE Centre Odense University Hospital Odense Denmark
| | - Teresa Caballero
- Allergy Department Hospital Universitario La Paz IdiPaz, CIBERER U754 Madrid Spain
| | - Régis A. Campos
- Universidade Federal da Bahia Salvador Brazil
- Serviço de Imunologia Hospital das Clínicas Professor Edgard Santos Salvador Brazil
| | - Mauro Cancian
- Department of Systems Medicine University Hospital of Padua Padua Italy
| | - Ivan Cherrez‐Ojeda
- School of Medicine Universidad de Especialidades Espíritu Santo Samborondón Ecuador
- RespiraLab, Research Guayaquil Ecuador
| | - Danny M. Cohn
- Department of Vascular Medicine Amsterdam UMC University of Amsterdam Amsterdam The Netherlands
| | - Célia Costa
- Immunoallergology Department Hospital de Santa Maria Centro Hospitalar Universitário de Lisboa Norte (CHLN) EPE Lisbon Portugal
| | - Timothy Craig
- Department of Medicine and Pediatrics Penn State University Hershey PA USA
| | - Paulo Ricardo Criado
- Faculdade de Medicina do ABC Santo André Brazil
- Alergoskin Alergia e Dermatologia SS ltda Santo André Brazil
- UCARE Center São Paulo Brazil
| | | | - Dorottya Csuka
- 3rd Department of Internal Medicine Hungarian Angioedema Reference Center Semmelweis University Budapest Hungary
| | - Joachim Dissemond
- Department of Dermatology, Venereology and Allergology University of Essen Essen Germany
| | - Aurélie Du‐Thanh
- Service de Dermatologie‐allergologie CHU Montpellier Montpellier Cedex 5 France
| | - Luis Felipe Ensina
- Division of Allergy, Clinical Immunology and Rheumatology Department of Pediatrics Federal University of São Paulo São Paulo Brazil
| | - Ragıp Ertaş
- Department of Dermatology Kayseri City Education and Research Hospital Kayseri Turkey
| | | | - Claudio Fantini
- Servicio de Alergia e Inmunología—Hospital Alende y Clínica Colón Mar del Plata Argentina
| | - Henriette Farkas
- 3rd Department of Internal Medicine Hungarian Angioedema Reference Center Semmelweis University Budapest Hungary
| | - Silvia Mariel Ferrucci
- Ambulatorio di Dermatologia Allergologica e Professionale Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico Milano (MI) Italy
| | - Ignasi Figueras‐Nart
- The Dermatology Department of the Hospital de Bellvitge Universitat de Barcelona Barcelona Spain
| | - Natalia L. Fili
- Unidad Alergia e Inmunología Clínica Hospital Público Materno Infantil Salta Argentina
| | - Daria Fomina
- Center of Allergy and Immunology City Clinical Hospital No. 52 Moscow Ministry of Healthcare Moscow Russian Federation
- Department of Allergology and Clinical Immunology I.M. Sechenov First Moscow State Medical University Moscow Russian Federation
| | - Atsushi Fukunaga
- Division of Dermatology Graduate School of Medicine Kobe University Kobe Japan
| | - Asli Gelincik
- Division of Immunology and Allergic Diseases Department of Internal Medicine Istanbul Faculty of Medicine Istanbul University Istanbul Turkey
| | - Ana Giménez‐Arnau
- Department of Dermatology Hospital del Mar IMIM Universitat Autònoma Barcelona Spain
| | - Kiran Godse
- Department of Dermatology D Y. Patil University School of Medicine Mumbai India
| | - Mark Gompels
- Department of Immunology North Bristol NHS Trust Southmead Hospital Bristol UK
| | - Margarida Gonçalo
- Clinica de Dermatologia Centro Hospitalar Universitário Coimbra Coimbra Portugal
| | - Maia Gotua
- Center of Allergy and Immunology Tbilsi Georgia
| | | | - Anete S. Grumach
- Clinical Immunology Medical School University Center Health ABC Santo Andre Brazil
| | | | - Michihiro Hide
- Department of Dermatology Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan
| | | | - Naoko Inomata
- Department of Environmental Immuno‐Dermatology Yokohama City University Graduate School of Medicine Yokohama Japan
| | - Thilo Jakob
- Department of Dermatology and Allergy University Medical Center Giessen (UKGM) Justus‐Liebig‐University Giessen Giessen Germany
| | | | - Hye‐Ryun Kang
- Institute of Allergy and Clinical Immunology Seoul National University Medical Research Center Seoul Korea
| | - Allen Kaplan
- Medical University of South Carolina Charleston SC USA
| | | | - Constance Katelaris
- Immunology & Allergy Unit Department of Medicine Campbelltown Hospital Campbelltown NSW Australia
| | - Aharon Kessel
- Division of Allergy & Clinical Immunology Rappaport Faculty of Medicine Bnai Zion Medical Center Technion Haifa Israel
| | | | - Emek Kocatürk
- Department of Dermatology School of Medicine Koç University Koc Turkey
| | - Mitja Košnik
- Division of Allergy University Clinic of Respiratory and Allergic Diseases Golnik Golnik Slovenia
| | - Dorota Krasowska
- Department of Dermatology, Venerology and Pediatric Dermatology Medical University of Lublin Lublin Poland
| | - Kanokvalai Kulthanan
- Department of Dermatology Faculty of Medicine Siriraj Hospital Mahidol University Bangkok Thailand
| | - M. Sendhil Kumaran
- Department of Dermatology Postgraduate Institute of Medical Education and Research Chandigarh India
| | | | - Hilary J. Longhurst
- Department of Immunology Addenbrookes Hospital Cambridge University NHS Foundation Trust Cambridge UK
- UCLH London UK
- Addenbrooke's Hospital Cambridge and University College Hospital London UK
| | - William Lumry
- Allergy/Immunology Division Department of Internal Medicine University of Texas Southwestern Medical School Dallas TX USA
| | - Andrew MacGinnitie
- Division of Immunology Department of Pediatrics Boston Children’s Hospital Harvard Medical School Boston MA USA
| | - Markus Magerl
- Department of Dermatology and Allergy Dermatological Allergology Allergie‐Centrum‐Charité Charité—Universitätsmedizin Berlin Berlin Germany
| | - Michael P. Makris
- Allergy Unit “D. Kalogeromitros” 2nd Department of Dermatology and Venereology University Hospital “Attikon”, National and Kapodistrian University of Athens Athens Greece
| | | | - Alexander Marsland
- Department of Dermatology The Urticaria Clinic Salford Royal Foundation Trust University of Manchester Manchester UK
| | | | - Iris V. Medina
- Allergy and Clinical Immunology Department Centro Médico Vitae de Julio Argentina
| | - Raisa Meshkova
- Department of Clinical Immunology and Allergology Smolensk State Medical University Smolensk Russian Federation
| | - Martin Metz
- Department of Dermatology and Allergy Dermatological Allergology Allergie‐Centrum‐Charité Charité—Universitätsmedizin Berlin Berlin Germany
| | - Iman Nasr
- Adult Immunology and Allergy Unit Department of Medicine Royal Hospital Muscat Oman
| | - Jan Nicolay
- Klinik für Dermatologie Universitätsklinikum Mannheim Mannheim Germany
| | - Chikako Nishigori
- Division of Dermatology Kobe University Graduate School of Medicine Kobe Japan
| | - Isao Ohsawa
- Department of Internal Medicine Saiyu Soka Hospital Soka Japan
| | - Kemal Özyurt
- Department of Dermatology Faculty of Medicine Kırşehir Ahi Evran University Kırşehir Turkey
| | | | - Claudio A. S. Parisi
- Adults and Pediatrics Allergy Unit Hospital Italiano de Buenos Aires Buenos Aires Argentina
| | | | - Wolfgang Pfützner
- Department of Dermatology and Allergology Allergy Center Hessen University Clinic Marburg Marburg Germany
| | - Todor Popov
- University Hospital Sv. Ivan Rilski Sofia Bulgaria
| | - Nieves Prior
- Allergy Department Hospital Universitario Severo Ochoa Madrid Spain
| | - German D. Ramon
- Instituto de Alergia e Inmunologia del Sur Buenos Aires Argentina
| | - Adam Reich
- Department of Dermatology University of Rzeszow Rzeszów Poland
| | - Avner Reshef
- Angioedema Center Barzilai Medical Center Ashkelon Israel
| | - Marc A. Riedl
- Department of Medicine University of California—San Diego La Jolla CA USA
| | - Bruce Ritchie
- Departments of Medicine and Medical Oncology University of Alberta Edmonton AB Canada
| | - Heike Röckmann‐Helmbach
- Department of Dermatology and Allergology University Medical Center Utrecht Utrecht The Netherlands
| | | | - Andaç Salman
- Dermatology Department Marmara University School of Medicine Pendik Research and Training Hospital Istanbul Turkey
| | - Mario Sanchez‐Borges
- Allergy and Clinical Immunology Department Centro Medico Docente La Trinidad Caracas Venezuela
| | | | - Faradiba S. Serpa
- Hospital Santa Casa de Misericórdia de Vitória Espírito Santo Brazil
| | | | - Farrukh R. Sheikh
- Department of Medicine King Faisal Specialist Hospital & Research Center Riyadh Saudi Arabia
| | - William Smith
- Clinical Immunology and Allergy Royal Adelaide Hospital Adelaide SA Australia
| | - Angèle Soria
- Service de Dermatologie et Allergologie Hopital Tenon APHP Sorbonne Université Paris France
| | - Petra Staubach
- Department of Dermatology University Medical Center Mainz Germany
| | - Urs C. Steiner
- Department of Clinical Immunology University Hospital Zurich Zurich Switzerland
| | - Marcin Stobiecki
- Department of Environmental Allergology Jagiellonian University Medical College Kraków HAE Center University Hospital Kraków Poland
| | - Gordon Sussman
- Division of Allergy and Immunology University of Toronto Toronto ON Canada
| | - Anna Tagka
- First Department of Dermatology and Venereology National and Kapodistrian University of Athens, "A. Syggros" Hospital Referral Center of Occupational Dermatological Diseases Athens Greece
| | | | - Regina Treudler
- Department of Dermatology, Venerology and Allergology and Leipzig Interdisciplinary Center of Allergology—Comprehensive Allergy Center UMC Leipzig Leipzig Germany
| | - Solange Valle
- Federal University of Rio de Janeiro Rio de Janeiro Brazil
| | - Martijn Doorn
- Department of Dermatology Erasmus MC Rotterdam The Netherlands
| | - Lilian Varga
- 3rd Department of Internal Medicine Hungarian Angioedema Reference Center Semmelweis University Budapest Hungary
| | | | - Nicola Wagner
- Department of Dermatology University of Erlangen Erlangen Germany
| | - Liangchun Wang
- Dermatology Department of Sun Yat‐sen Memorial Hospital Guangzhou China
| | | | - Young‐Min Ye
- Department of Allergy and Clinical Immunology Ajou University School of Medicine Suwon Korea
| | - Anna Zalewska‐Janowska
- Chair of Clinical Immunology and Rheumatology Department of Psychodermatology Medical University of Lodz Lodz Poland
| | - Andrea Zanichelli
- Department of Biomedical and Clinical Sciences Luigi Sacco Hospital University of Milan Milan Italy
| | - Zuotao Zhao
- Department of Dermatology and Venereology First Hospital Peking University Beijing China
- Beijing Key Laboratory of Molecular Diagnosis on Dermatoses Beijing China
| | - Yuxiang Zhi
- Department of Allergy Peking Union Medical College Hospital & Chinese Academy of Medical Sciences Beijing China
| | - Torsten Zuberbier
- Department of Dermatology and Allergy Allergie‐Centrum‐Charité Charité—Universitätsmedizin Berlin Berlin Germany
| | - Ricardo D. Zwiener
- Servicio de Alergia e Inmunología Hospital Universitario Austral Buenos Aires Argentina
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45
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Kraft M, Knop MP, Renaudin J, Scherer Hofmeier K, Pföhler C, Bilò MB, Lang R, Treudler R, Wagner N, Spindler T, Hourihane JO, Maris I, Koehli A, Bauer A, Lange L, Müller S, Papadopoulos NG, Wedi B, Moeser A, Ensina LF, Fernandez‐Rivas M, Cichocka‐Jarosz E, Christoff G, Garcia BE, Poziomkowska‐Gęsicka I, Cardona V, Mustakov TB, Rabe U, Mahler V, Grabenhenrich L, Dölle‐Bierke S, Worm M. Secondary prevention measures in anaphylaxis patients: Data from the anaphylaxis registry. Allergy 2020; 75:901-910. [PMID: 31584692 DOI: 10.1111/all.14069] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 08/09/2019] [Accepted: 08/22/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Patients with a history of anaphylaxis are at risk of future anaphylactic reactions. Thus, secondary prevention measures are recommended for these patients to prevent or attenuate the next reaction. METHODS Data from the Anaphylaxis Registry were analyzed to identify secondary prevention measures offered to patients who experienced anaphylaxis. Our analysis included 7788 cases from 10 European countries and Brazil. RESULTS The secondary prevention measures offered varied across the elicitors. A remarkable discrepancy was observed between prevention measures offered in specialized allergy centers (84% of patients were prescribed adrenaline autoinjectors following EAACI guidelines) and outside the centers: Here, EAACI guideline adherence was only 37%. In the multivariate analysis, the elicitor of the reaction, age of the patient, mastocytosis as comorbidity, severity of the reaction, and reimbursement/availability of the autoinjector influence physician's decision to prescribe one. CONCLUSIONS Based on the low implementation of guidelines concerning secondary prevention measures outside of specialized allergy centers, our findings highlight the importance of these specialized centers and the requirement of better education for primary healthcare and emergency physicians.
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Affiliation(s)
- Magdalena Kraft
- Division of Allergy and Immunology Department of Dermatology Venerology and Allergology Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| | - Macarena Pia Knop
- Department of Dermatology and Allergy University Hospital LMU Munich Munich Germany
| | | | - Kathrin Scherer Hofmeier
- Division of Allergy Department of Dermatology University Hospital Basel University of Basel Basel Switzerland
| | - Claudia Pföhler
- Department of Dermatology The Saarland University Medical Center Homburg/Saar Germany
| | - Maria Beatrice Bilò
- Allergy Unit Department of Internal Medicine University Hospital Ospedali Riuniti di Ancona Ancona Italy
- Department of Clinical and Molecular Sciences Polytechnic University of Marche Ancona Italy
| | - Roland Lang
- Department of Dermatology University Hospital Salzburg Paracelsus Medical University Salzburg Austria
| | - Regina Treudler
- Department of Dermatology, Venereology and Allergology Leipzig Interdisciplinary Allergy Center (LICA)‐Comprehensive Allergy Center University Hospital Leipzig Germany
| | - Nicola Wagner
- Department of Dermatology University Hospital of Erlangen‐Nürnberg Erlangen Germany
| | | | | | - Ioana Maris
- Bon Secours Hospital Cork/Department of Paediatrics and Child Health University College Cork Cork Ireland
| | - Alice Koehli
- Division of Allergology University Children's Hospital Zurich Zurich Switzerland
| | - Andrea Bauer
- University Allergy Center University Hospital Carl Gustav Carus Technical University Dresden Dresden Germany
| | - Lars Lange
- Department for Pediatrics St. Marien‐Hospital Bonn Germany
| | - Sabine Müller
- Department of Dermatology Medical Center‐University of Freiburg Freiburg Germany
| | - Nikolaos G. Papadopoulos
- Allergy Department 2nd Pediatric Clinic, National and Kapodistrian University of Athens Athens Greece
- Division of Infection, Immunity & Respiratory Medicine University of Manchester Manchester UK
| | - Bettina Wedi
- Department of Dermatology and Allergy Comprehensive Allergy CenterHannover Medical SchoolHannover Germany
| | - Anne Moeser
- Institute for Infectious Diseases and Infection Control Jena University Hospital Jena Germany
| | - Luis F. Ensina
- Division of Allergy Clinical Immunology and Rheumatology Department of Pediatrics Federal University of São Paulo São Paulo Brazil
| | - Montserrat Fernandez‐Rivas
- Department of Allergy Hospital Clinico San Carlos Universidad Complutense, IdISSC Madrid Spain
- ARADyAL Research Network
| | - Ewa Cichocka‐Jarosz
- Department of Pediatrics, Pulmonology, Allergy and Dermatology Clinic Jagiellonian University Medical College Krakow Poland
| | - George Christoff
- Faculty of Public Health Medical University‐Sofia Sofia Bulgaria
- Allergy Out‐patient Department Acibadem CityClinic Tokuda Medical Centre Sofia Bulgaria
| | - Blanca E. Garcia
- Service of Allergology Complejo Hospitalario de Navarra Pamplona Spain
| | | | - Victoria Cardona
- ARADyAL Research Network
- Allergy Section Department of Internal Medicine Hospital Vall d'Hebron Barcelona Spain
| | | | - Uta Rabe
- Department for Allergy and Asthma Johanniter Hospital Treuenbrietzen Germany
| | | | - Linus Grabenhenrich
- Division of Allergy and Immunology Department of Dermatology Venerology and Allergology Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health Berlin Germany
- Department for Infectious Disease Epidemiology Robert Koch‐Institut Berlin Germany
| | - Sabine Dölle‐Bierke
- Division of Allergy and Immunology Department of Dermatology Venerology and Allergology Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| | - Margitta Worm
- Division of Allergy and Immunology Department of Dermatology Venerology and Allergology Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health Berlin Germany
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Heppt F, Meder C, Wagner N. Sinus Pericranii. Dtsch Arztebl Int 2020; 116:136. [PMID: 32181738 PMCID: PMC7081364 DOI: 10.3238/arztebl.2020.0136a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Franz Heppt
- *Hautklinik, Universitätsklinikum, Friedrich-Alexander-Universität Erlangen-Nürnberg,
| | - Christine Meder
- *Hautklinik, Universitätsklinikum, Friedrich-Alexander-Universität Erlangen-Nürnberg,
| | - Nicola Wagner
- *Hautklinik, Universitätsklinikum, Friedrich-Alexander-Universität Erlangen-Nürnberg,
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Krause K, Bonnekoh H, Ellrich A, Tsianakas A, Wagner N, Fischer J, Maurer M. Long-term efficacy of canakinumab in the treatment of Schnitzler syndrome. J Allergy Clin Immunol 2020; 145:1681-1686.e5. [PMID: 31940469 DOI: 10.1016/j.jaci.2019.12.909] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 12/12/2019] [Accepted: 12/19/2019] [Indexed: 11/19/2022]
Affiliation(s)
- Karoline Krause
- Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
| | - Hanna Bonnekoh
- Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - André Ellrich
- Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Athanasios Tsianakas
- Department of Dermatology, Universitätsklinikum Münster, Germany; Department of Dermatology, Fachklinik Bad Bentheim, Bentheim, Germany
| | - Nicola Wagner
- Department of Dermatology, Klinikum Erlangen, Erlangen, Germany
| | - Jörg Fischer
- Department of Dermatology and Allergy, Universitätsklinik Tübingen, Tübingen, Germany
| | - Marcus Maurer
- Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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Schnuch A, Schubert S, Lessmann H, Geier J, Beiteke U, Dissemond J, Buhl T, Schäkel K, Pföhler C, Dietrich C, Worm M, Bauer A, Kreft B, Schliemann S, Brockow K, Becker D, Forchhammer S, Recke A, Witte J, Pfützner W, Coras‐Stepanek B, Skudlik C, Wagner N, Aberer W, Emmert S, Baron JM, Siedlecki K, Baur V, Schmieder A, Weisshaar E, Grunwald‐Delitz H, Trautmann A, Hofmeier KS, Szliska C, Weiß J, Effendy I, Jünger M, Brehler R, Rueff F, Werfel T, Dickel H, Rieker‐Schwienbacher J, Vieluf D, Stadler R, Simon D, Fartasch M, Micaletto S, Treudler R, Nestoris S, Mechtel D, Schröder‐Kraft C, Löffler H, Gina M, Koch A, Raap U, Grabbe J, Spring P, Prager W, Wilfinger D. The methylisothiazolinone epidemic goes along with changing patients' characteristics – After cosmetics, industrial applications are the focus. Contact Dermatitis 2019; 82:87-93. [DOI: 10.1111/cod.13414] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 10/07/2019] [Accepted: 10/07/2019] [Indexed: 12/11/2022]
Affiliation(s)
- Axel Schnuch
- Information Network of Department of Dermatology (IVDK)Institute at the University Medical Center Göttingen Göttingen Germany
| | - Steffen Schubert
- Information Network of Department of Dermatology (IVDK)Institute at the University Medical Center Göttingen Göttingen Germany
| | - Holger Lessmann
- Information Network of Department of Dermatology (IVDK)Institute at the University Medical Center Göttingen Göttingen Germany
| | - Johannes Geier
- Information Network of Department of Dermatology (IVDK)Institute at the University Medical Center Göttingen Göttingen Germany
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Abstract
BACKGROUND Every year up to 35,000 people in Germany are severely injured in accidents in traffic, during work or leisure activities. The 24-h availability of the trauma room as well as surgical and intensive care unit capacities are essential to provide optimal acute care. This study analyzed the frequency of utilization of the resource trauma room in a level I trauma center in the past. METHODS Data of a level I trauma center from 2005 to 2016 including trauma room alerts deployed by the rescue coordination center and the number of patients found to be severely injured (ISS ≥ 16) during trauma room diagnostics were analyzed retrospectively. Additionally, alerts due to trauma mechanism, accompanying by the emergency physician, ventilation and resuscitation were evaluated via a web-based interdisciplinary care capacity system (IVENA) from 2012 to 2016. Therefore, a comparison between the number of trauma room alerts and the number of severely injured patients was performed for the time after 2012. RESULTS For the time from 2012 to 2016, data obtained by IVENA showed a continuous increase in the number of trauma room alerts (n = 367 to n = 623). At the same time, the number of patients admitted under resuscitation (n = 15 to n = 45) as well as ventilated patients (n = 78 to n = 139) increased significantly; however, there was also an increase in the number of trauma alerts due to trauma mechanisms (n = 84 to n = 194) as well as the number of patients admitted to the trauma room not accompanied by an emergency physician (n = 38 to n = 132). The ratio between the number of trauma room alerts and severely injured patients (ISS ≥ 16) increased from 3.1 in 2012 to 5.4 in 2015 and 4.6 in 2016. CONCLUSION The data at hand showed a constant number of severely injured trauma patients admitted to a level I trauma center over the past few years. At the same time, there was a significant increase in utilization of the trauma room; however, in a considerable number of patients admitted to the trauma room the diagnostic process resulted in non-traumatic diagnostic findings. In the analyzed cohort, especially patients admitted to the trauma room due to trauma mechanism or without an accompanying emergency physician contributed to this development, necessitating an increased operational readiness of the trauma room team.
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Affiliation(s)
- I Marzi
- Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Klinikum der Johann Wolfgang Goethe-Universität Frankfurt am Main, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Deutschland
| | - T Lustenberger
- Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Klinikum der Johann Wolfgang Goethe-Universität Frankfurt am Main, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Deutschland
| | - P Störmann
- Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Klinikum der Johann Wolfgang Goethe-Universität Frankfurt am Main, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Deutschland
| | - K Mörs
- Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Klinikum der Johann Wolfgang Goethe-Universität Frankfurt am Main, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Deutschland.
| | - N Wagner
- Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Klinikum der Johann Wolfgang Goethe-Universität Frankfurt am Main, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Deutschland
| | - S Wutzler
- Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Klinikum der Johann Wolfgang Goethe-Universität Frankfurt am Main, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Deutschland
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Wagner N, Staubach P. Mastocytosis - pathogenesis, clinical manifestation and treatment. J Dtsch Dermatol Ges 2019; 16:42-57. [PMID: 29314691 DOI: 10.1111/ddg.13418] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 11/14/2017] [Indexed: 01/08/2023]
Abstract
The term mastocytosis designates a group of rare disorders characterized by typical skin lesions, frequently associated episodes of anaphylaxis, and clinical symptoms related to the release of various mediators. Dermatologists/allergists are frequently the first to establish the diagnosis. The condition is based on clonal mast cell proliferation, usually in the skin or bone marrow and only rarely in the gastrointestinal tract or other tissues. In general, mastocytosis has a good prognosis in terms of life expectancy. Rare variants - including mast cell leukemia, aggressive mastocytosis, and the exceedingly rare mast cell sarcoma - require cytoreductive therapy. In cases associated with hematological neoplasms, the prognosis depends on the underlying hematologic disorder.
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Affiliation(s)
- Nicola Wagner
- Department of Dermatology, University Medical Center, Erlangen, Germany
| | - Petra Staubach
- Department of Dermatology, University Medical Center, Mainz, Germany
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