Perceived efficacy and satisfaction of patients with subcutaneous hypoallergenic high-dose house dust mite extract.

SUMMARY: The efficacy and safety of subcutaneous immunotherapy with modified, high-dose, major allergen house dust mite extract is widely supported by double-blind, placebo-controlled studies. However, little is known regarding patient-perceived efficacy and satisfaction. An observational, retrospective, multicentre study in patients treated with Acaroid® was conducted to assess the efficacy and degree of satisfaction of the patients after the first six months of treatment with it. All the clinical study procedures were performed according to the routine clinical practice. This study demonstrates that Acaroid® is effective and well tolerated. The patients' condition demonstrated a clear and marked improvement in the first 6 months after treatment initiation. Patients treated with Acaroid® were very satisfied, with a correlation to improvement in patient-perceived symptoms and the administration of treatment by a healthcare professional.

Estandarización de pruebas epicutáneas con aeroalergenos en la dermatitis atópica. Estudio multicéntrico / Patch test standarization with aeroallergens in atopic dermatitis. A multicentre study

En algunos pacientes con dermatitis atópica se ha demostrado que la aplicación directa de aeroalergenos sobre la piel es capaz de reproducir las lesiones características de la enfermedad. Por ello, si las pruebas epicutáneas fueran una técnica bien estandarizada, podrían constituir el modelo ideal de estudio alergológico en estos pacientes. El objetivo de este estudio fue determinar la concentración óptima para pruebas epicutáneas con varios aeroalergenos. Material y métodos: Se seleccionaron 137 pacientes con dermatitis atópica y 32 controles atópicos > 12 años en los 10 centros participantes en el estudio. Se realizaron pruebas del prick y pruebas epicutáneas con extractos de D. pteronyssinus, P. pratense, O. europaea, Alternaria alternata y epitelio de gato en concentraciones de 10, 5 y 1 HEP (Laboratorios DIATER®) y se determinó la IgE específica en el suero frente a aquellos alergenos positivos en el prick. Resultados: Los grupos de pacientes y controles fueron homogéneos. Obtuvimos un 25,7% y 9% de parches positivos con 10 HEP de D. pteronyssinus en pacientes y controles, respectivamente. Con O. europaea sólo hubo un 3% de pacientes y controles con un parche positivo. Con el resto de los alergenos la frecuencia de parches positivos en los pacientes fue del 11,2%, 8,8% y 7,5% frente a P. pratense, A. alternata y gato, respectivamente, y del 3% en los controles. Conclusión: La concentración más alta utilizada de 10 HEP con D. pteronyssinus puede considerarse adecuada para las pruebas epicutáneas. Respecto a los otros alergenos, esta concentración parece encontrarse por debajo de la óptima, sobre todo en el caso de O. europaea

In some patients with atopic dermatitis, characteristic eczematous skin lesions can be induced by patch testing with aeroallergens. However, atopy patch test is not well standardised. The aim of this study was to stablish the optimal concentration of aeroallergens for patch testing. Material and methods: We selected 137 patients with atopic dermatitis and 32 atopic controls in the 10 participant centres. Prick test and atopy patch test with D. pteronyssinus, P. pratense, O. europaea, A. alternata and cat dander extracts at 10, 5 and 1 HEP (DIATER S.A.) as well as specific IgE determination were performed. Results: The groups of patients and controls were homogeneous. A 25,7% and 9% of patients and controls, respectively, had a positive result when patch testing with D. pteronyssinus extract at 10 HEP. Only a 3% of positive patch tests were obtained with O. europaea in patients and controls. The frequency of positive patch tests with the other allergens in patients was 11,2%, 8,8% y 7,5% for P. pratense, A. alternata and cat dander, respectively, and 3% in controls. Conclusions: The highest concentration of 10 HEP could be considered optimal for the atopy patch test with D. pteronyssinus. Such concentration seems to be lower than the optimal one when patch testing the other allergens

Topical dexketoprofen as a cause of photocontact dermatitis.

We reported on the case of a patient who developed a cutaneous eruption in a photoexposed area 1 week after a continous topical treatment with dexketoprofen (Enangel). Photopatch tests were positive for dexketoprofen, ketoprofen and piketoprofen and patch test was positive for piketoprofen. Control photopatch testing with dexketoprofen in 15 healthy volunteers was negative. Dexketoprofen, ketoprofen and piketoprofen are non-steroidal anti-inflamatory drugs (arylpropionic acid derivatives) often used as topical anti-inflammatory agents. It appears that the benzophenone moiety of their chemical structure is the cause of their photosensitivity and cross-photoreaction.

[Application of immunotherapy in Catalonia (Spain)]. / Aplicación de la inmunoterapia en Cataluña.

BACKGROUND: The aim of this study was to determine the use of specific immunotherapy (SIT) in public and private hospitals in Catalonia (Spain) in the management of respiratory allergic diseases and opinions about this treatment through a questionnaire. SIT dosage schedules and the creation of immunotherapy units were also investigated. METHODS AND RESULTS: A questionnaire containing eight items was sent by post and/or electronic mail to the heads of allergy units in 24 public and private hospitals in Catalonia.A total of 18 hospitals responded. The most commonly used route of administration was subcutaneous (89.4 %, SD 9.05) and the most widely used dosage schedule was the classical schedule (77.2 %, SD 24.9). Most of the hospitals (83.3 %) believed that immunotherapy units were an advantage but only 44 % of them believed that their creation was feasible. CONCLUSIONS: The results of this survey identify the application of SIT in Catalonia and reveal certain features of this treatment that remain to be established such as the optimal dosage schedule and the precautions that should be followed when administering SIT.

Aplicación de la inmunoterapia en Cataluña / Application of immunotherapy in Catalonia (Spain)

Objetivos: Encuesta realizada con el objetivo de conocer la situación actual y la opinión de los hospitales públicos y privados de Cataluña en relación a la utilización de la inmunoterapia específica (ITE) en el tratamiento de las enfermedades alérgicas, la pauta de administración de la ITE y la creación de Unidades de ITE. Métodos y resultados: Se envió por correo postal y/o electrónico una encuesta con 8 preguntas que estaba dirigida a los responsables de la unidad de alergología de 24 hospitales públicos y privados de Cataluña. Han contestado un total de 18 hospitales. La vía de administración de ITE más utilizada es la subcutánea (89,4 por ciento, D.E. 9,05) y la pauta de administración más seguida es la clásica (77,2 por ciento, D.E. 24,9). La mayoría de los hospitales (83,3 por ciento) consideran como una ventaja la creación de Unidades de ITE, pero sólo un 44 por ciento de los hospitales contestaron que en su centro sería posible crearlas. Conclusiones: Los resultados de la encuesta permiten conocer la aplicación de la ITE en Cataluña y poner de manifiesto algunos aspectos pendientes de establecer en este tipo de tratamiento como es la pauta de dosificación ideal y la vigilancia que requiere la administración de ITE (AU)

Background: The aim of this study was to determine the use of specific immunotherapy (SIT) in public and private hospitals in Catalonia (Spain) in the management of respiratory allergic diseases and opinions about this treatment through a questionnaire. SIT dosage schedules and the creation of immunotherapy units were also investigated. Methods and results: A questionnaire containing eight items was sent by post and/or electronic mail to the heads of allergy units in 24 public and private hospitals in Catalonia. A total of 18 hospitals responded. The most commonly used route of administration was subcutaneous (89.4 %, SD 9.05) and the most widely used dosage schedule was the classical schedule (77.2 %, SD 24.9). Most of the hospitals (83.3 %) believed that immunotherapy units were an advantage but only 44 % of them believed that their creation was feasible. Conclusions: The results of this survey identify the application of SIT in Catalonia and reveal certain features of this treatment that remain to be established such as the optimal dosage schedule and the precautions that should be followed when administering SIT (AU)

Myocardial ischemia due to severe amoxicillin allergy.

A patient suffered a myocardial injury as a manifestation of anaphylactic reaction to amoxicillin-clavulanic acid administration. A cardiologic study (ergometry and catheterization) showed no obstructive coronary disease and prick test to amoxicillin was positive. Anaphylaxis may cause myocardial injury and the mechanism is likely to be vasospasm induced by mast cells and basophil mediators.

Reacción de hipersensibilidad retardada en el postoperatorio de una histerectomía / Retarded hypersensitivity reaction after hysterectomy

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