[Specific immunotherapy]. / Spezifische Immuntherapie.

SCIT (subcutaneous immunotherapy) and SLIT (sublingual immunotherapy) are the only routinely available therapies, which modify allergic diseases sustainably. The ongoing reduction of symptoms and the lower need of symptomatic medication are able to improve the quality of life over a long period of time. However, allergic patients are underprovided due to low use of SIT (specific immunotherapy). After thorough diagnostic workup, the indication has to be checked carefully especially in patients with allergic rhinitis and allergic asthma, to insure that SIT is standard therapy. Allergen extracts are manufacturer-specific preparations, therefore their effects cannot be compared directly, just as SCIT and SLIT efficacy cannot be compared directly. In general, preparations with proven efficacy and safety profile should be preferred. Allergens listed in the TAV (Therapeutic Allergen Regulation) fulfill these requirements. However, it is important to ensure adherence for 3 years of therapy, independent of the route of application. SIT has proven socioeconomic benefit already after a short time of therapy.

Chronic pruritus.

Chronic pruritus is one of the most frequent complaints of the skin associated with a high disease burden and markedly impaired quality of life. Chronic pruritus (>6 weeks of duration) may occur in a broad variety of diseases including dermatological, systemic, neurological, psychosomatic/psychiatric and gynaecological ones and in every age group (children, adults, pregnant women, elderly patients). The medical care of patients with chronic pruritus has improved significantly in the past few years (14). Though research into the neurobiology of chronic pruritus has failed to resolve the mechanisms underlying this disease, it has led to the awareness that management of patients with chronic pruritus needs a separate strategy that is different from therapy of the underlying disease. The antipruritic therapy is still based on symptomatic regimens and target-specific therapies urgently needed.