Revue Francaise d Allergologie最新文献

{"title":"De l’application de teinture capillaire à l’unité de soins intensifs : une réaction sévère à la para-phénylènediamine","authors":"F.Z. El Fatoiki,&nbsp;Z. Mouhsine,&nbsp;Y. Mahdar,&nbsp;F. Hali,&nbsp;S. Chiheb","doi":"10.1016/j.reval.2025.104584","DOIUrl":"10.1016/j.reval.2025.104584","url":null,"abstract":"<div><div>Para-phenylenediamine (PPD), a common allergen in hair dyes and black henna tattoos, is typically responsible for allergic contact dermatitis and, rarely, systemic reactions like anaphylaxis. We report the case of a 22-year-old female with no significant medical history who developed pruritic eyelid edema and respiratory distress 24<!--> <!-->hours after using a PPD-containing hair dye. She had prior exposure to black henna without issues. Clinical examination revealed erythematous plaques with vesicles and eyelid edema. Respiratory symptoms included dyspnea, tachycardia, and dysphonia. The patient required intensive care, receiving nebulized and intramuscular adrenaline, followed by corticosteroids. Patch testing confirmed a positive reaction to PPD. This case highlights the rare but possible coexistence of immediate and delayed hypersensitivity reactions to PPD, reflecting a complex and potentially severe immunologic mechanism. It emphasizes the importance of PPD regulation, patch testing for diagnosis, and prevention of repeated exposures.</div></div>","PeriodicalId":49130,"journal":{"name":"Revue Francaise d Allergologie","volume":"65 5","pages":"Article 104584"},"PeriodicalIF":0.3,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Réaction anaphylactique énigmatique au cabinet dentaire","authors":"E. Seigle-Ferrand ,&nbsp;M. Merveilleau ,&nbsp;P. Bierme ,&nbsp;C. Braun","doi":"10.1016/j.reval.2025.104585","DOIUrl":"10.1016/j.reval.2025.104585","url":null,"abstract":"<div><div>We report the case of a young boy who was referred to us for suspected anaphylaxis to a local anesthetic during a dental procedure. Shortly after the administration of a local anesthesia using adrenaline-laced articaine, he developed a grade 2 anaphylactic reaction, which was treated with an intramuscular injection of adrenaline. Unable to test articaine (which was still mixed with adrenaline), we tested lidocaine as an alternative and then performed a subcutaneous provocation test, which did not elicit any reaction, allowing us to rule out a lidocaine allergy. However, our skin tests, performed after disinfection with chlorhexidine, were positive for latex, which we initially suspected to be responsible for the anaphylactic reaction. But a control prick-test on untreated skin, not disinfected with chlorhexidine, was negative. Upon further questioning, we discovered that the patient had used a mouthwash containing chlorhexidine immediately before the local anesthesia, which had not initially been mentioned either by the dentist or by the family. The chlorhexidine prick-test, as well as specific IgE testing, both returned positive, ultimately confirming sensitization to chlorhexidine. This was therefore an IgE-mediated allergy to chlorhexidine, likely due to mucosal absorption through the breach caused by the gingival local anesthesia. This case serves as a reminder of the need for a systematic and thorough approach in evaluating drug hypersensitivity. Allergy to chlorhexidine should always be considered when investigating perioperative anaphylaxis, even when the product is well tolerated on intact skin or mucous membranes.</div></div>","PeriodicalId":49130,"journal":{"name":"Revue Francaise d Allergologie","volume":"65 5","pages":"Article 104585"},"PeriodicalIF":0.3,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144596521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intérêt des patch tests dans l’exploration des réactions d’hypersensibilité retardée aux antiépileptiques","authors":"I. Bouaziz,&nbsp;R. Atheymen,&nbsp;R. Sahnoun,&nbsp;K. Ksouda,&nbsp;H. Affes,&nbsp;S. Hammami,&nbsp;K. Zghal","doi":"10.1016/j.reval.2025.104568","DOIUrl":"10.1016/j.reval.2025.104568","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of our study was to evaluate the utility of the patch-tests for the diagnosis of the delayed hypersensitivity reactions induced by antiepileptic drugs and to explore cross-reactivity between them.</div></div><div><h3>Patients and methods</h3><div>We included cases of delayed drug addiction to antiepileptics notified to the Sfax regional pharmacovigilance center during the period from January 2019 to June 2023. We used the French Bégaud method for the study of imputability. Patch testing was performed in all patients according to the recommendations of the European Network of Drug Allergy. The interpretation of the results was made according to the rules of the International Contact Dermatitis Research Group.</div></div><div><h3>Results</h3><div>We included 17 delayed drug reactions: Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) syndrome (<em>n</em> <!-->=<!--> <!-->10), maculopapular rash (<em>n</em> <!-->=<!--> <!-->6), Stevens-Johnson syndrome (<em>n</em> <!-->=<!--> <!-->1). Patch tests were positive in 76.47% of cases: 66.66% for maculopapular rash with cross-reactivity between carbamazepine and phenobarbital (<em>n</em> <!-->=<!--> <!-->1) and 90% in DRESS syndrome with cross-reactivity between 2 or more antiepileptics (<em>n</em> <!-->=<!--> <!-->5). For the patient with Stevens-Johnson syndrome, the tests were interpreted as irritating.</div></div><div><h3>Conclusion</h3><div>Patch tests are safe and useful to confirm the imputability of antiepileptic drugs in the genesis of delayed drug hypersensibility reaction and to detect possible cross-reactivity.</div></div>","PeriodicalId":49130,"journal":{"name":"Revue Francaise d Allergologie","volume":"65 5","pages":"Article 104568"},"PeriodicalIF":0.3,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"La téléexpertise en allergologie","authors":"E. Seve ,&nbsp;V. Baggio ,&nbsp;M. Hosotte ,&nbsp;J. Herry ,&nbsp;N. Guerzider ,&nbsp;C. Palussière ,&nbsp;W. Assemat","doi":"10.1016/j.reval.2025.104569","DOIUrl":"10.1016/j.reval.2025.104569","url":null,"abstract":"<div><div>Teleexpertise is a recent telemedicine tool for communicating between healthcare professionals about a patient's problem, in a secure and asynchronous manner. We studied data from a platform, Omnidoc©, on all allergology activity during the first half of 2024, i.e. 444 procedures, and on data from the 5 most active allergists. An allergist performs on average one TE per month with a response time of less than 48 hours. Opinions are mainly requested by general practitioners, for stories of skin rashes or suspected drug allergies. However, uses vary greatly from one doctor to another.</div></div>","PeriodicalId":49130,"journal":{"name":"Revue Francaise d Allergologie","volume":"65 5","pages":"Article 104569"},"PeriodicalIF":0.3,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Allergie croisée entre paclitaxel et éribuline ?","authors":"M. Delin ,&nbsp;H. Gadoin ,&nbsp;E. Ewig ,&nbsp;F. Rocher-Moreau ,&nbsp;L. Lipszyc ,&nbsp;L. Thomas ,&nbsp;A. Creisson ,&nbsp;B. Gerard ,&nbsp;S. Leroy","doi":"10.1016/j.reval.2025.104581","DOIUrl":"10.1016/j.reval.2025.104581","url":null,"abstract":"<div><h3>Background</h3><div>Eribulin is a drug that is currently used in metastatic breast cancer as an alternative to taxanes. No allergy has been described yet to this molecule.</div></div><div><h3>Patients and methods</h3><div>We described two cases in France that present delayed allergy to eribulin after a first cycle. Both of patients received paclitaxel before.</div></div><div><h3>Results</h3><div>A possible cross-allergy to eribulin with paclitaxel is possible. Our case describes skin testing to eribulin.</div></div><div><h3>Conclusions</h3><div>Cross-allergy between paclitaxel and eribulin is conceivable. This would be a rare undesirable effect, but one that requires particular attention. The mode of action of these two molecules (inhibition of microtubules) could provide a pathophysiological explanation.</div></div>","PeriodicalId":49130,"journal":{"name":"Revue Francaise d Allergologie","volume":"65 5","pages":"Article 104581"},"PeriodicalIF":0.3,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"L’angiœdème à travers les âges : considérations pratiques","authors":"A. Bocquet ,&nbsp;C. Hoarau ,&nbsp;L. Carriat ,&nbsp;L. Bouillet ,&nbsp;S. Guez ,&nbsp;I. Boccon-Gibod ,&nbsp;N. Marmion","doi":"10.1016/j.reval.2025.104583","DOIUrl":"10.1016/j.reval.2025.104583","url":null,"abstract":"<div><div>Challenges associated with angioedema differ with patient's age. In children, the most frequent one is bradykinin-related hereditary angioedema (HAE). Diagnosis might be difficult when signs and symptoms are not evocative, such as isolated abdominal crises, in the absence of familial context. Management by multidisciplinary team should be organized rapidly, preferably in an expert center, to allow children living a normal life and experiencing satisfactory development. Adolescence, often characterized by an increase in frequency and severity of crises, must be the period of patient's empowerment in disease management. But it is also a period of instability and turbulences with a possible decreased compliance to treatment. Contraception must be discussed in young female patients due to the relationship between estrogen secretion and HAE attacks. In adults, follow-up and treatment are pursued without any remarkable feature. If HAE appears during adulthood, differential diagnoses should be considered, such as acquired C1 inhibitor deficiency, and associated hemopathies should be detected (monoclonal gammopathy or lymphoproliferative syndrome). Pregnancy requires increased surveillance because of specific risks arising in this situation. Finally, in elderly patients, preexisting HAE is often associated with other comorbidities that can interfere with its evolution, especially because of drug intake. Attacks management may become more difficult and compliance may decrease. Occurrence of HAE after 65 years of age being exceptional, it is important to diagnose iatrogenic angioedema (related in particular to conversion enzyme inhibitors) or thrombolysis of a stroke.</div></div>","PeriodicalId":49130,"journal":{"name":"Revue Francaise d Allergologie","volume":"65 5","pages":"Article 104583"},"PeriodicalIF":0.3,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144099234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of neutrophil-lymphocyte, platelet-lymphocyte ratio changes in patients with acute and chronic urticaria","authors":"S. Çevik ,&nbsp;U. Altaş ,&nbsp;H. Alkaya ,&nbsp;A. Sarısaltık ,&nbsp;M.Y. Özkars","doi":"10.1016/j.reval.2025.104552","DOIUrl":"10.1016/j.reval.2025.104552","url":null,"abstract":"<div><h3>Study objective</h3><div>This study aimed to evaluate the changes in inflammatory markers, specifically neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), in pediatric patients with acute and chronic urticaria. The objective was to compare these inflammatory indices between patients with acute urticaria, chronic urticaria, and healthy controls to determine whether they can be used as potential biomarkers for the evaluation of urticaria.</div></div><div><h3>Patients and methods</h3><div>The study included 200 participants: 100 with acute urticaria, 50 with chronic urticaria, and 50 healthy controls, all aged 0–18<!--> <!-->years. Blood samples were taken to calculate NLR, PLR, systemic immune-inflammation index (SII), and other related indices. Specific allergen sensitivities were also evaluated using specific IgE tests and skin prick tests.</div></div><div><h3>Results</h3><div>The study found significant differences in NLR, PLR, and SII between the acute and chronic urticaria groups and the control group. NLR and PLR were significantly higher in the chronic urticaria group, suggesting ongoing inflammation. No significant difference was found in monocyte, platelet, eosinophil, and basophil counts.</div></div><div><h3>Conclusion</h3><div>The findings suggest that NLR, PLR, and SII could be potential biomarkers for assessing the inflammatory response in urticaria, particularly in differentiating between acute and chronic forms. However, further research is needed to confirm the clinical utility of these markers for routine evaluation in urticaria patients.</div></div>","PeriodicalId":49130,"journal":{"name":"Revue Francaise d Allergologie","volume":"65 4","pages":"Article 104552"},"PeriodicalIF":0.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143746275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dermite de contact à l’huile de cade","authors":"K. Kaddar ,&nbsp;N. Tahri ,&nbsp;O. Hormi ,&nbsp;N. Zizi ,&nbsp;S. Dikhaye","doi":"10.1016/j.reval.2025.104553","DOIUrl":"10.1016/j.reval.2025.104553","url":null,"abstract":"<div><div>Cade oil has long been used in herbal medicine for its antifungal and antiseptic properties. These properties make it an oil of choice for scaly scalp conditions. We report the case of a 32-year-old woman who presented with contact dermatitis few hours after application of cade oil as a hair mask treatment. A patch test performed revealed a strong positive reaction to cade oil after 48 hours. The patient was treated with topical corticosteroids, showing significant improvement after 3 days.</div></div>","PeriodicalId":49130,"journal":{"name":"Revue Francaise d Allergologie","volume":"65 4","pages":"Article 104553"},"PeriodicalIF":0.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Érythème pigmenté fixe bulleux généralisé : à propos d’un cas","authors":"L. Elyamani ,&nbsp;N. Benaini ,&nbsp;O. Hormi ,&nbsp;N. Zerrouki ,&nbsp;N. Zizi","doi":"10.1016/j.reval.2025.104554","DOIUrl":"10.1016/j.reval.2025.104554","url":null,"abstract":"<div><h3>Introduction</h3><div>Generalized bullous fixed drug eruption is a rare and severe form of fixed drug eruption, often induced by cotrimoxazole, which may be confused with Stevens-Johnson syndrome.</div></div><div><h3>Observation</h3><div>A 45-year-old patient with no relevant history developed Generalized bullous fixed drug eruption 8<!--> <!-->hours after taking cotrimoxazole for gastroenteritis. A similar episode localized to the extremities had been reported 5 years earlier, occurring 4 days after taking the same drug. Clinico-pathological correlation led to the diagnosis of Generalized bullous fixed drug eruption. Treatment consisted of discontinuation of cotrimoxazole and local care, resulting in healing of all lesions, with post-inflammatory hyperpigmentation. Reintroduction of the drug was prohibited, and a pharmacovigilance report was made.</div></div><div><h3>Discussion</h3><div>Fixed drug eruption is a drug-induced toxidermia characterized by well-limited skin lesions, recurring at the same site after re-exposure to the causative drug. Generalized bullous fixed drug eruption is a rare and severe form, which can mimic Stevens-Johnson syndrome/toxic epidermal necrolysis, particularly in cases of extensive mucosal involvement. Diagnosis is based on clinico-pathological correlation and a detailed drug history. Treatment consists of discontinuing the causative drug, combined with local care. Topical or systemic corticosteroids may be necessary in severe forms.</div></div><div><h3>Conclusion</h3><div>Erythema pigmentosum fixed bullosa generalizada (EPFBG) is a rare and misunderstood condition. Further efforts are needed to develop more reliable and safer methods for identifying the drugs involved in equivocal situations.</div></div>","PeriodicalId":49130,"journal":{"name":"Revue Francaise d Allergologie","volume":"65 5","pages":"Article 104554"},"PeriodicalIF":0.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Étude de vraie vie des patients traités par TEZEPELUMAB : résultats à 6 et 12 mois d’une cohorte lyonnaise","authors":"M. Bouguennec ,&nbsp;P. Pradat ,&nbsp;N. Freymond ,&nbsp;G. Devouassoux","doi":"10.1016/j.reval.2025.104300","DOIUrl":"10.1016/j.reval.2025.104300","url":null,"abstract":"<div><h3>Prérequis/contexte</h3><div>TEZEPELUMAB est la dernière biothérapie autorisée pour le traitement de l’asthme sévère en France. Il s’agit d’un anticorps monoclonal ciblant thymic stromal lymplopoietin (TSLP).</div><div>Dans l’essai de phase III NAVIGATOR, TEZEPELUMAB a montré vs placebo une réduction significative du risque d’exacerbation annuelle de 56 %, un gain moyen de VEMS de 130<!--> <!-->mL. La réduction des exacerbations était obtenue quel que soit l’éosinophilie sanguine et de l’ordre de 40 % si<!--> <!-->&lt;<!--> <!-->0,3<!--> <!-->g/L. L’amélioration des scores AQLQ, ACQ 6, n’atteignait pas la pertinence clinique vs placebo. Avec ces résultats, le libellé d’AMM autorise son utilisation chez l’asthmatique sévère, quel que soit le profil inflammatoire.</div></div><div><h3>Objectifs</h3><div>Description de la population asthmatique exposée au TEZEPELUMAB aux hospices civils de Lyon, évaluer à 6 et 12 mois l’impact sur les exacerbations, le contrôle de l’asthme, la qualité de vie, la polypose nasosinusienne, les marqueurs inflammatoires, la sécurité d’emploi et identifier des facteurs prédictifs de réponse au traitement.</div></div><div><h3>Méthodes</h3><div>Il s’agit d’une étude de cohorte historico-prospective incluant tous les asthmatiques sévères traités par TEZEPELUMAB en pneumologie, à l’hôpital de la Croix-Rousse (centre intégré, d’expertise et de recherche en asthme CIERA) et au centre hospitalier de Lyon-Sud. Les données sont recueillies à 6 et 12 mois après introduction du traitement.</div></div><div><h3>Résultats/discussions</h3><div>Quatre-vingt-huit patients ont été inclus et suivis à 6 mois, les données à 1 an de traitement sont disponibles pour 22 patients. La population est exacerbatrice fréquente avec un taux annualisé d’exacerbation (TEA) médian à 3. Parmi les patients, 21 % sont bionaifs.</div><div>À 6 mois, on observe une réduction du TEA de 0,91 (<em>p</em> <!-->&lt;<!--> <!-->0,001), une amélioration du mini AQLQ de 0,52 (<em>p</em> <!-->&lt;<!--> <!-->0,05). Parmi les patients, 63,46 % présentent une réponse selon le score composite BARS.</div><div>À 12 mois, on observe une réduction du TEA de 1,78 (<em>p</em> <!-->&lt;<!--> <!-->0,005). Aucune caractéristique n’est prédictive de la réponse au traitement dans cette cohorte.</div></div><div><h3>Conclusion</h3><div>On observe au sein de notre cohorte d’asthmatiques sévères une baisse statistiquement significative du taux annualisé d’exacerbation à 6 et 12 mois, en phase avec les études comparables et pour certains aspects, meilleurs que les résultats de NAVIGATOR.</div></div>","PeriodicalId":49130,"journal":{"name":"Revue Francaise d Allergologie","volume":"65 ","pages":"Article 104300"},"PeriodicalIF":0.3,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}