ABSTRACT
Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a severe adverse drug-induced hypersensitivity reaction. We report a case of DRESS syndrome in a 17-year-old female caused by itraconazole, confirmed by patch testing, that required treatment with both corticotherapy and cyclosporine. Our case highlights the importance of clinical suspicion of this syndrome in pediatric age and the novelty of an antifungal drug being identified as the culprit.
Subject(s)
Drug Hypersensitivity Syndrome , Eosinophilia , Exanthema , Female , Humans , Child , Adolescent , Drug Hypersensitivity Syndrome/diagnosis , Drug Hypersensitivity Syndrome/etiology , Drug Hypersensitivity Syndrome/drug therapy , Itraconazole/adverse effects , Eosinophilia/chemically induced , Eosinophilia/diagnosis , Cyclosporine/adverse effects , Exanthema/chemically induced , Exanthema/diagnosisABSTRACT
The COVID-19 pandemic has forced the development of vaccines to fight SARS-CoV-2. After vaccination began, reports of adverse reactions, including anaphylaxis, emerged. This raised concerns about the safety of COVID-19 vaccines in patients diagnosed with mastocytosis. The authors share their experience in administering different COVID-19 vaccines to patients diagnosed with mastocytosis.
A pandemia por COVID-19 obrigou ao rápido desenvolvimento de vacinas para combate ao SARS-CoV-2. Após o início da vacinação começaram a surgir relatos de reações adversas às vacinas, incluindo reações anafiláticas, surgindo dúvidas sobre a segurança das vacinas em doentes com mastocitose. Os autores apresentam a sua experiência em relação à administração de diferentes vacinas contra a COVID-19 em doentes com diagnóstico de mastocitose.
Subject(s)
HumansABSTRACT
Temporary henna tattoos have become increasingly popular, particularly among children and teenagers. The word "henna" is of Persian origin, and it is prepared from the plant Lawsonia inermis belonging to the family Lythraceae. Concerning allergic reactions, natural henna paste is rarely responsible for contact dermatitis, which is more frequent if paraphenylenediamine (PPD) is added to the paste. The authors present a case of female child with erythematous exanthems that appeared after the application of black henna tattoo. A diagnosis of contact dermatitis to black henna tattoo was hypothesised. Epicutaneous tests were performed at the Immunoalergology Department of the Coimbra University Hospital using standard European battery and natural henna paste. The tests revealed positive reaction to PPD.
Subject(s)
Dermatitis, Allergic Contact , Tattooing , Child , Adolescent , Humans , Tattooing/adverse effects , Dermatitis, Allergic Contact/diagnosis , Dermatitis, Allergic Contact/etiology , Coloring Agents/adverse effects , Phenylenediamines/adverse effectsABSTRACT
The first reports of hypersensitivity reactions following the rollout of COVID-19 vaccination programs have raised public concern. Given the recent availability and novel mechanisms of COVID-19 vaccines, there is limited data on possible hypersensitivity reactions. Although it seems rare, the incidence of anaphylaxis for approved COVID-19 vaccines has been suggested as being higher when compared to previous vaccines. Adequate risk assessment, recognition, classification, and management of hypersensitivity reactions is crucial to ensure safe immunization and avoid misinformation and vaccine hesitancy. In this review, we present an overview of the types of hypersensitivity reactions that can potentially occur due to vaccination and the possible allergenic components of COVID-19 vaccines, as well as a suggestion for causality and risk assessment for the BNT162b2, mRNA-1273 and AZD1222 vaccines.
Após o início dos programas de vacinação contra a COVID-19, os primeiros relatos de reações de hipersensibilidade suscitaram alguma preocupação. Dada a recente disponibilidade e os novos mecanismos das vacinas contra a COVID-19, existem poucos dados relativos a possíveis reações de hipersensibilidade. A incidência de anafilaxia às vacinas COVID-19 parece ser mais elevada comparativamente a vacinas anteriores, embora seja igualmente rara. Uma avaliação adequada dos riscos, reconhecimento, classificação e correta abordagem das reações de hipersensibilidade é crucial para garantir uma imunização segura e evitar desinformação e hesitação na vacinação. Nesta revisão, apresentamos uma visão geral das potenciais reações de hipersensibilidade que podem ocorrer após a vacinação com as vacinas BNT162b2, mRNA-1273 e AZD1222, os seus possíveis constituintes alergénicos, bem como uma sugestão de avaliação do risco em doentes alérgicos e causalidade.
