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Monographs of fragrance chemicals and extracts that have caused contact allergy / allergic contact dermatitis
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
In a study in the mid-1970’s in Sweden, closed patch tests with BP in concentrations ranging from 1.56% to 50% and 11 of its components (benzoic acid 5%, benzaldehyde 5%, cinnamal 2% [not an ingredient of MP], cinnamyl alcohol 2%, cinnamic acid 5%, methyl cinnamate 0.5%, benzyl benzoate 5%, benzyl salicylate 2%, benzyl cinnamate 5%, eugenol 5%, vanillin 10%) were applied to the upper part of the back for a period of 30 minutes. The result was read immediately after removal and after every hour until the reaction disappeared. The tests were performed on 121 patients with different dermatoses and on 57 patients with chronic urticaria, the components only in 5 patients (not specified). MP gave rise to 9/121 (7.4%) and 16/57 (28%) patients, respectively. Most reactions were caused by the higher concentrations, with 12.5% < 25% < 50% pet. The reaction appeared earliest 10 minutes after application of MP and normally after 20 minutes and would fade within 2 hours. Conventional patch tests were negative.
Urticaria and Angioedema
Published in Pudupakkam K Vedanthan, Harold S Nelson, Shripad N Agashe, PA Mahesh, Rohit Katial, Textbook of Allergy for the Clinician, 2021
Jenny M Stitt, Stephen C Dreskin
Chronic urticaria is characterized by hives that occur daily or almost daily for 6 weeks or more. Chronic Spontaneous Urticaria (CSU) is the most common type of chronic urticaria. CSU was previously called Chronic ‘Idiopathic’ Urticaria (CIU), but recent nomenclature has shifted to the term ‘spontaneous’ to reflect that urticaria occurs spontaneously without an apparent trigger. This lack of an identifiable cause of urticaria is sometimes difficult for both patients and health care providers to accept. Search for a cause of CSU can lead to expensive, potentially invasive and often fruitless investigations (Tarbox et al. 2011). The best diagnostic tool in the evaluation of chronic spontaneous urticaria is a thorough history and physical, performed by a board certified specialist knowledgeable in urticarial disease. Figure 24.3 outlines a diagnostic algorithm for chronic urticaria.
Immunologically mediated skin disorders
Published in Ronald Marks, Richard Motley, Common Skin Diseases, 2019
Urticaria and angioedema can last for a few days or some years. A common pattern is for the disorder to recur in a series of attacks. Chronic urticaria is a common and sometimes disabling disorder, which in most cases is of unknown origin.
Emerging treatments for chronic urticaria
Published in Expert Opinion on Investigational Drugs, 2022
For patients and clinicians, the pipeline for the treatment of chronic urticaria is very promising. While omalizumab biosimilars are investigated in clinical trials, the expected approval of ligelizumab will soon expand the so far very effective and safe anti-IgE approach observed with omalizumab. For other anti-IgE mAbs like UB-221, the development is considerably behind. Data are too limited so far to clearly define the role of anti-cytokine and anti-cytokine receptor biologics such as dupilumab, tezepelumab, mepolizumab, benralizumab and CDX-0159, of which only dupilumab is actually investigated in phase 3. Regarding small molecules, three selective oral BTK inhibitors are considered in CU, remibrutinib, rilzabrutinib, and fenebrutinib, of which the development of remibrutinib is most advanced, namely in phase 3. As the pipeline interventions address different targets, the results of the studies will give new insights into the pathomechanism of CSU and of CINDU and might identify additional endotypes. It is welcome that for the first time, CINDU subtypes are addressed in RCTs. Hopefully, in the next future, we will have additional approved and also more targeted approaches to adequately treat chronic urticaria.
Assessment of thiol/disulphide homoeostasis and ischaemia-modified albumin and their relationship with disease severity in children with chronic urticaria
Published in Cutaneous and Ocular Toxicology, 2020
Songul Akdag, Serap Ozmen, Nazli Ercan, Ilknur Bostanci, Salim Neselioglu
In patients with chronic urticaria, autologous serum skin tests (ASSTs) were performed as described by Sabroe et al.8 Skin prick tests were performed at volar surface of both forearms or lesion-free areas at back with Dermatophagoides farinae, Dermatophagoides pteronyssinus, grass-pollen mixture, mixture of Aspergillus (Aspergillus fumigatus, Aspergillus nidulans, Aspergillus niger)], cat epithelia, dog epithelia, Blatella germanica, peanut, mixture of tree, artemisia and suspicious food allergens (Stallergenes; Paris, France) using Stallerpoint® based on history. Histamine and normal saline were used as positive and negative controls, respectively. Positive reaction is defined as wheal or induration 3 mm greater than negative control after 15 min. Positive reaction against at least one allergen was considered as sensitisation.
Haematological parameters in patients with chronic spontaneous urticaria
Published in Cutaneous and Ocular Toxicology, 2020
Chronic urticaria is a common skin disorder defined by recurrent wheals and pruritus of at least a 6-week duration2. Previous studies have deemed chronic spontaneous urticaria to be associated with an altered immune response related to chronic systemic inflammation3,4. Moreover, these studies have demonstrated the infiltration of eosinophils, neutrophils, monocytes and T cells in the skin of patients with chronic spontaneous urticaria5. As you mentioned in the study, in recent years, haematological parameters have been used as inflammatory markers in various diseases. It is known that monocytes increase in diseases in which inflammatory response is involved such as psoriasis and urticaria. In addition, these cells decrease with suppression of inflammation after treatment. In the present study authors found a significant decrease in the neutrophil/monocyte ratio due to increased monocyte count after omalizumab treatment. However, both neutrophils and monocytes are expected to decrease after treatment. This unexpected increase in the count of monocytes may be due to other possible causes. Moreover, neutrophil/monocyte ratio was not shown as an inflammatory parameter in previous studies. Therefore, I think that neutrophil/monocyte ratio decreases by chance after the treatment, and should not be shown as an inflammatory marker. The clinical relevance should be validated in more rigorous studies with larger participant numbers.