Postepy Dermatologii I Alergologii最新文献

Introduction: Cow's milk protein allergy (CMPA) affects up to 3% of the paediatric population. The most reliable diagnostic tool for CMPA is oral food challenge (OFC), which may carry risks for the patient.

Aim: The aim of this study was to assess the usefulness of molecular testing for CMPA in diagnosing and evaluating tolerance acquisition in children with IgE-dependent allergy to this food.

Material and methods: The study included 49 children (average age: 2 years and 8 months) with an IgE-dependent allergy CMPA. Data from medical history was analysed at two time points, including the assessment of allergen-specific IgE (asIgE) against cow's milk extract, α-lactalbumin, β-lactoglobulin, casein, and bovine serum albumin, measured using the fluoroimmunoenzymatic assay (FEIA). Additionally, results from OFC with baked and raw cow's milk were included.

Results: For both baked and raw milk allergies, the best marker for clinical reactivity was the asIgE level for casein (≥ 7.01 kU/l; AUC = 0.869 for baked milk and ≥ 5.96 kU/l; AUC = 0.710 for raw milk). The optimal asIgE level, measured by FEIA, to assess the risk of anaphylaxis during the OFC with baked milk was ≥ 7.01 kU/l for casein (AUC = 0.60). The marker for anaphylaxis in the course of OFC with raw milk was asIgE for β-lactoglobulin ≥ 1.71 kU/l (AUC = 0.724). For monitoring CMPA, the most useful markers were asIgE for casein, milk extract, and both α-lactalbumin and β-lactoglobulin.

Conlusions: For both baked and raw milk allergies, the best marker for clinical reactivity remains casein. Testing for cow's milk allergens using solely molecular methods is insufficient for diagnosing and monitoring CMPA.

Introduction: Severe allergic reactions to mosquito bites are rarely seen.

Aim: To determine the demographic and distinguishing clinical characteristics of Skeeter syndrome, a severe allergic reaction to mosquito allergy, in childhood.

Material and methods: All patients diagnosed with Skeeter syndrome who presented to our Pediatric Allergy and Immunology outpatient clinic between January 2019 and December 2024 were included in the study. The demographic, laboratory, and clinical data of the patients were retrospectively obtained from the hospital's computerized database.

Results: A total of 15 patients with a mean age of 4.4 ±3.2 years were included in the study, of whom 11 (73%) were male. Eight (50%) patients had an additional atopic disease, 13 (86.6%) had recurrent Skeeter syndrome, 8 (50%) had a family history of atopy in first-degree relatives, and 2 (13%) had a family history of a similar disease in first-degree relatives. In 11 (73%) patients, induration was accompanied by a bullous lesion. In 4 (27%) patients, induration resembling cellulitis was present without bullous formation. The induration diameters ranged from 5 to 20 cm, while bullous lesions ranged from 1 to 5 cm. Pruritus was present in 12 (80%) patients, tenderness in 3 (20%), and low-grade fever in 1 patient. The treatment duration ranged from 7 to 14 days. None of the patients had an identified immunodeficiency.

Conclusions: Skeeter syndrome is a recurrent allergic disease. The presence of vesicles/bullae at the center of a large local reaction, along with a detailed medical history, is a distinguishing feature.

Introduction: Body dysmorphic disorder (BDD), originally termed "dysmorphophobia", is a psychiatric condition in which body image concerns become excessive and quite devastating. People with the disorder display a constant preoccupation with an imagined physical defect (ICD-10).

Aim: To evaluate the proportion of body dysmorphic disorder amongst general dermatologic patients and those who seek cosmetic treatments in a tertiary care hospital in Nepal.

Material and methods: This descriptive study duration was 12 months. Proforma was filled up separately and the master chart was created using the latest version of MS Excel; statistical analyses were done using the latest version of Statistical Packages for Social Sciences (SPSS) software.

Results: Twenty five out of 161 patients met the criteria for body dysmorphic disorder. The mean age was 28.02 ±5.89 years. Among 25 patients with BDD, 15 (9.3%) patients had cosmetic problems while 10 (6.2%) patients had other dermatological problems. Most patients had mild (8.32%) and moderate (7.28%) severity in distress, torrent, or pain, similar to the findings for impairment in social, occupational, or other important areas of functioning. While in the c² test, the defect rating scale increased among cosmetic groups (p < 0.05).

Conclusions: Many patients seeking cosmetic and dermatological treatments have been asuffering from BDD, and thereby multiple attempts of treatments may not lead to treatment satisfaction. This dissatisfaction causes worsening of the symptoms in BDD patients and may lead to lawsuits and their legalities to the treating dermatologists.

Introduction: Chronic urticaria is a disease characterized by recurrent itchy wheals and/or angioedema lasting longer than 6 weeks. Its pathogenesis is multifactorial, and there are studies showing that interleukin (IL)-31 and IL-33 cytokines play a role in the pathogenesis.

Material and methods: A total of 79 chronic urticaria patients aged between 18 and 65 years who applied to the allergy outpatient clinic between October and December 2020 were included in the study. While 35 patients were given antihistamine treatment alone, 44 patients were given omalizumab in addition to antihistamines. In addition to routine examination of chronic urticaria patients, serum IL-31 and IL-33 levels were studied in patients and healthy volunteers.

Results: The only variable that was found to be statistically significantly higher in chronic urticaria patients compared with the control group was the IL-31 level. There was no significant difference when the groups were compared in terms of the IL-33 level. There was no significant change in IL-31 and IL-33 levels before and after treatment in patients receiving omalizumab treatment.

Conclusions: IL-31 levels were found to be high in chronic urticaria patients receiving antihistamine treatment, independent of omalizumab treatment.

Keloids are fibrous scars that result from a variety of factors causing skin damage. Botulinum toxin, especially the most widely utilized serotype A, is used for many purposes in both medical and aesthetic practices. Numerous studies indicate the beneficial effects of using botulinum toxin in the treatment of scars, including keloids. The aim of this study was to explore the current evidence behind the use of botulinum toxin in the prevention and treatment of keloids. PubMed was searched using medical subject headings to identify studies on this topic. All analysed studies confirmed the effectiveness of intralesional injections of botulinum toxin in keloid therapy. Significant improvement in the appearance and size of lesions, histopathological findings, patient satisfaction, and reduction in symptoms are observed. Further research is required to ascertain the significance of this therapeutic approach in keloid treatment protocols.