Frontiers in allergy最新文献

{"title":"European biologic training course for type 2 inflammation by EUFOREA in 2024: key facts and lessons learned.","authors":"D M Conti, V Backer, W Fokkens, P Gevaert, A Peters, G K Scadding, I Pavord, S Lau, M Wechsler, X Bertels, G Liva, M Doulaptsi, E Prokopakis, P W Hellings","doi":"10.3389/falgy.2024.1517122","DOIUrl":"10.3389/falgy.2024.1517122","url":null,"abstract":"<p><p>The European Forum for Research and Education in Allergy and Airways diseases (EUFOREA) organized the first European Biologic Training Course (EBTC) in Brussels on 1st March 2024. The aim of this hybrid EBTC including both face-to-face and web-based participation was to address the educational needs of physicians dealing with asthma and Chronic Rhinosinusitis with Nasal Polyps (CRSwNP) on the clinically relevant aspects of diagnosing and treatment with biologics. EUFOREA is an international non-for-profit organization forming an alliance of all stakeholders dedicated to reducing the prevalence and burden of chronic respiratory diseases through the implementation of optimal patient care via educational, research, and advocacy activities. The inclusive and multidisciplinary approach of EUFOREA was reflected in faculty coming from the paediatric, allergology, pulmonology, and Ear, Nose and Throat (ENT) speciality and from different continents, with more than 250 participants from over 30 countries in the first EBTC. The current report provides a comprehensive overview of key statements made by the faculty of the EBTC 2024, especially focusing on patient selection for a biologic drug, the communication with patients, the onset of biological treatment and the follow-up in routine clinical practice.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"5 ","pages":"1517122"},"PeriodicalIF":3.3,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11669716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The increasing role of the allergist in the management of infusion reactions at the Oncology Infusion Center.","authors":"Julián Borrás Cuartero, Maria Cruz Torres Górriz, Cristina Isabel Stein Coronado, Adrián Germán Sánchez, Cristina Giovanna Pesántez Méndez, Maria Dolores Latorre Ibáñez, Ernesto Enrique","doi":"10.3389/falgy.2024.1479469","DOIUrl":"10.3389/falgy.2024.1479469","url":null,"abstract":"<p><strong>Background: </strong>Hypersensitivity reactions to chemotherapy disrupt treatment schedules and compromise patient outcomes. Rapid Drug Desensitization (RDD) enables patients to tolerate future treatments after an allergy workup. However, Same-Day Desensitization (SDD) is a novel approach that capitalizes on RDD to allow the continuation of chemotherapy on the same day as the index reaction, preventing treatment delays.</p><p><strong>Objective: </strong>To evaluate the safety and efficacy of SDD in managing hypersensitivity reactions during chemotherapy and emphasize the essential role of allergists in the Oncology Infusion Center (OIC) for accurate drugs hypersensitivity reactions (DHRs) phenotyping and management.</p><p><strong>Methods: </strong>This retrospective cohort included patients experiencing DHRs during chemotherapy. Under allergist supervision, SDD was performed once the index reaction was controlled. At a later date, clinical phenotypes and endotypes of DHRs were assessed through clinical history, skin tests, serum biomarkers (including tryptase and IL-6 levels), and drug provocation testing (DPT) to reach an accurate diagnosis.</p><p><strong>Results: </strong>SDD was successful in 35 cases, even for patients with severe initial reactions. Only 14% experienced breakthrough reactions, all mild. Same-day assessment by allergists ensured a 92% correlation between initial and final diagnoses, optimizing DHR management. Early engagement with Allergy allowed 86% of reactive patients to continue treatment through RDD or after ruling out an allergy.</p><p><strong>Conclusion: </strong>SDD is a safe and effective procedure that ensures that patients don't miss their oncology treatment on the day of a reaction. The presence of an allergist in the OIC is crucial for rapid access to accurate DHR phenotyping and optimal management, supporting personalized precision medicine in oncology.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"5 ","pages":"1479469"},"PeriodicalIF":3.3,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: New insights in pediatric gastrointestinal food allergies.","authors":"Laura Carucci, Neil Shah, Roberto Berni Canani","doi":"10.3389/falgy.2024.1531494","DOIUrl":"10.3389/falgy.2024.1531494","url":null,"abstract":"","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"5 ","pages":"1531494"},"PeriodicalIF":3.3,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk and protective factors for coronavirus disease 2019 (COVID-19) in allergic rhinitis patients: a national survey in China.","authors":"Xiaozhe Yang, Yutong Sima, Jinming Zhao, Jing Zhang, Xiangdong Wang, Luo Zhang","doi":"10.3389/falgy.2024.1479493","DOIUrl":"10.3389/falgy.2024.1479493","url":null,"abstract":"<p><strong>Background: </strong>Several epidemiological studies have shown that allergic rhinitis (AR) patients are more susceptible to coronavirus disease 2019 (COVID-19).</p><p><strong>Objective: </strong>We aim to investigate the risk factors for COVID-19 in AR patients.</p><p><strong>Methods: </strong>A retrospective nationwide cohort study was conducted based on a questionnaire survey in China. The baseline characteristics, region of residence, smoking and drinking status, comorbidities, vaccination status and previous infection information were obtained. Allergen test results, the SARS-CoV-2 nucleic acid test, and antigen detection results were collected. Information on AR and comorbid medication use pre-SARS-CoV-2 infection was also collected. Binary logistic regression and analysis of covariance (different adjusted models) were conducted.</p><p><strong>Results: </strong>In all, 830 AR patients were included; 627 patients (75.54%) were infected with SARS-CoV-2. AR comorbid with allergic conjunctivitis (AC) was a protective factor [OR: 0.525 (95% CI = 0.296-0.929), <i>P</i> = 0.027] against SARS-CoV-2 infection, while AR comorbid with food allergy was a risk factor [OR: 6.404 (95% CI = 1.349-30.402), <i>P</i> = 0.0195]. Although fewer patients received four doses of the vaccine, the results showed a significant protective effect against SARS-CoV-2 infection in AR patients [OR: 0.093 (95% CI = 0.025-0.348), <i>P</i> = 0.0004]. Underweight was a protective factor against COVID-19 [OR: 0.287 (95% CI = 0.147-0.562), <i>P</i> = 0.0003] after full multivariable adjustment. Overweight was associated with a 2.071-fold higher risk for COVID-19 compared with normal weight [(95% CI = 1.045-4.105), <i>P</i> = 0.0370]. Additionally, house dust mite (HDM)-specific allergies were also protective against COVID-19 [OR: 0.537 (95% CI = 0.290-0.996), <i>P</i> = 0.0484].</p><p><strong>Conclusions: </strong>This study revealed underlying protective and risk factors, which might be used to improve the management of AR and COVID-19.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"5 ","pages":"1479493"},"PeriodicalIF":3.3,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demographic characteristics associated with a penicillin allergy label during pregnancy.","authors":"Timothy M Buckey, Patrick K Gleeson, Cara M Curley, Scott F Feldman, Andrea J Apter, Olajumoke O Fadugba","doi":"10.3389/falgy.2024.1511392","DOIUrl":"10.3389/falgy.2024.1511392","url":null,"abstract":"<p><strong>Introduction: </strong>Penicillins and other beta-lactam antibiotics are used in greater than one-third of pregnant women as treatment for Group B Streptococcus colonization and prophylaxis for Caesarean sections. Penicillin allergy labels have been associated with increased morbidity in the pregnant population, and penicillin allergy evaluation during pregnancy is now recognized as safe and effective. Yet, demographic characteristics associated with having a penicillin allergy label during pregnancy have not been studied. We aimed to evaluate factors associated with having a penicillin allergy label in a diverse population of pregnant patients.</p><p><strong>Methods: </strong>We performed a retrospective observational study of pregnant patients who had an outpatient visit with Obstetrics and Gynecology and a delivery encounter from 1/1/2020 through 6/30/2022 using electronic health record data in a large health system. We used a multivariable logistic regression model to evaluate factors associated with having a penicillin allergy label.</p><p><strong>Results: </strong>We identified 10,969 pregnant women of whom 940 (8.6%) had a penicillin allergy label. In the multivariable analysis, having a penicillin allergy label was positively associated with age 32-34 years [odds ratio (OR) = 1.31 vs. 18-27 years, <i>p</i> = 0.02], 35-51 years (OR = 1.41 vs. 18-27 years, <i>p</i> = 0.002) and having rhinitis, asthma, or eczema (OR = 1.55 vs. none, <i>p</i> < 0.0005); and negatively associated with Black race (OR = 0.59 vs. White, <i>p</i> < 0.0005).</p><p><strong>Discussion: </strong>This study found that Black race was associated with lower likelihood of penicillin allergy label, while older age and atopic conditions were associated with a higher likelihood. This finding may impact health outcomes and interventions related to penicillin allergy in pregnant women.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"5 ","pages":"1511392"},"PeriodicalIF":3.3,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11663910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acupuncture for allergic rhinitis: protocol for a systematic review and network meta-analysis.","authors":"YanNi Chen, ChenFei Song, JiaQin Wang, XinMin Han","doi":"10.3389/falgy.2024.1499406","DOIUrl":"10.3389/falgy.2024.1499406","url":null,"abstract":"<p><strong>Introduction: </strong>Allergic rhinitis (AR) is a widespread inflammatory disorder of the nasal mucosa affecting millions globally. The increasing prevalence of AR underscores the need for effective treatment modalities. Acupuncture has been identified as a potential non-pharmacological intervention for AR due to its effects on autonomic nerve functions and neuroendocrine and immune networks. However, a comprehensive evaluation of different acupuncture techniques through high-quality, evidence-based research is still needed.</p><p><strong>Methods and analysis: </strong>Randomised controlled trials of different acupuncture-related therapies for postmenopausal osteoporosis will be searched in the following databases from 1 January 2002 to 31 December 2022, including PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, VIP Database, Wanfang Database and China Biomedical Literature Database. Overall, clinical efficacy rate, bone mineral density and a Visual Analogue Scale score are used as the primary outcome indicators. In addition, the secondary outcome indicator is adverse reactions. Meanwhile, Stata (V.14.0) and RevMan (V.5.4) will be used to conduct the network meta-analysis. If the data are permissible and feasible, we will also perform meta-regression and subgroup analyses to address the underlying causes of data inconsistency and heterogeneity in the statistical analyses. To improve the credibility of this network meta-analysis, we will evaluate the quality of evidence in this research according to the GRADE assessment. <b>Prospero Registration Number</b>: identifier (CRD 42024579713).</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"5 ","pages":"1499406"},"PeriodicalIF":3.3,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of humidity and precipitation with asthma: a systematic review and meta-analysis.","authors":"Wangyang Gu, Dan Xie, Qinpeng Li, Huike Feng, Yihao Xue, Yang Chen, Jingyi Tang, Yushi Zhou, Dan Wang, Shilu Tong, Shijian Liu","doi":"10.3389/falgy.2024.1483430","DOIUrl":"10.3389/falgy.2024.1483430","url":null,"abstract":"<p><strong>Introduction: </strong>The relationship of asthma with humidity and precipitation remains controversial. The objective of this study was to investigate the association of increased humidity and precipitation with asthma risk.</p><p><strong>Methods: </strong>A comprehensive systematic search was conducted across various databases, including PubMed, Embase, Cochrane Library, Web of Science, Chinese Wanfang, CQVIP, and CNKI. A total of 21 studies with 1,052,960 participants from 9 countries or regions were included. The fixed and random effect model were used to analyze the data.</p><p><strong>Results: </strong>The study revealed a pooled odds ratio (OR) of 1.0489 [95% confidence interval (CI): 1.0061, 1.0935] for the association between humidity and asthma risk. Specifically, among individuals under 18 years of age, the OR (95% CI) was 1.0898 (1.0290, 1.1541). Furthermore, the OR (95% CI) for developing countries or regions was 1.0927 (1.0220, 1.1684), while it was 1.1298 (0.9502, 1.3433) for regions with a high latitude (41°-51°). The pooled OR for precipitation and asthma risk was 0.9991 (0.9987, 0.9995). The OR (95%CI) values were 0.9991 (0.9987, 0.9995), 0.9991 (0.9987, 0.9995) and 0.9990 (0.9986, 0.9994) in people above the age of 18, developing countries or regions, and middle latitudes (31°-41°), respectively.</p><p><strong>Discussion: </strong>The impact of humidity on asthma risk is particularly pronounced among individuals below 18 years of age, people living in developing countries or regions and in regions located in high latitudes. And the influence of precipitation on asthma persons over the age of 18, developing countries or regions, and middle latitudes significantly. Increased humidity appears to elevate asthma risk, and increased precipitation may reduce the risk. In addition, there appears to be a combined effect of humidity and precipitation on asthma.</p><p><strong>Systematic review registration: </strong>PROSPERO, identifier, CRD42023482446.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"5 ","pages":"1483430"},"PeriodicalIF":3.3,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11659254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Milk ladder: Who? When? How? Where? with the lowest risk of reaction.","authors":"Betul Buyuktiryaki, Ozge Soyer, Gulbin Bingol, Ceren Can, Hikmet Tekin Nacaroglu, Aysen Bingol, Ebru Arik Yilmaz, Metin Aydogan, Cansin Sackesen","doi":"10.3389/falgy.2024.1516774","DOIUrl":"10.3389/falgy.2024.1516774","url":null,"abstract":"<p><p>The milk ladder (ML) approach, which is the gradual reintroduction of the milk allergen from the least allergenic forms to the most allergenic forms into the diet of the patients, has been utilized mostly in non-IgE-mediated but in some countries also in IgE-mediated-CMPA due to its possible benefits which include nutrition, quality of life and tolerance induction. Despite increasing interest, so far, there is no guideline on ML; thus, the use of this approach shows discrepancies among healthcare professionals as many factors such as dietary habits, patient history, test results, workload, and facilities of the hospitals, the anxiety of the parents/patients may affect the decision on how, when, where and whom to use ML. Here, we reviewed current data on implementing the ML, suggested a 4-step ML including receipts and amounts, and shared our experience on optimal patient selection, appropriate time and steps for initiating ML, and time intervals between the steps targeting the lowest risk of reaction. We also added the newly developed twice-baked biscotti cake to the ML. We presented the analyses of this product, showing its low allergenicity compared to conventional cake, which provides a safer introduction of milk into the diet.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"5 ","pages":"1516774"},"PeriodicalIF":3.3,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11659236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and sensitization profile in peach allergy due to LTP sensitization.","authors":"Zambrano Ibarra Gabriela, Rodríguez Mazariego M Elena, López Tovar Carlos, Blanco López Marta, Baeza Ochoa M Luisa","doi":"10.3389/falgy.2024.1477364","DOIUrl":"10.3389/falgy.2024.1477364","url":null,"abstract":"<p><strong>Background: </strong>Lipid transfer proteins (LTP) are associated with a wide range of severity of allergic reactions. However, the risk factors associated with this severity are not fully understood.</p><p><strong>Objectives: </strong>To describe the clinical characteristics of peach-allergic patients due to LTP sensitization and analyze the relationship between the severity of the reactions and patients' sensitization profiles.</p><p><strong>Methods: </strong>A retrospective study of peach-allergic patients was performed. Patients were classified into LTP-monoallergic (only peach allergy) or LTP-Syndrome (peach allergy and allergy to other plants-foods related with LTP). Symptoms with Rosaceae family and other related plant foods, skin prick tests (SPTs), and IgE values were recorded.</p><p><strong>Results: </strong>Seventy-one patients were included, 46.5% suffering from anaphylaxis, 32.3% from urticaria angioedema, and 21.2% from oral allergy syndrome. Six had monoallergy to LTP and 65 LTP syndrome. Clinical severity showed no differences according to peach SPT wheal size or <i>Pru p 3</i> IgE levels. We also found no differences between the components of LTP-containing foods analyzed, the number of LTPs recognized, and the severity of symptoms. However, anaphylaxis was more frequent in patients with concomitant allergies to ≥3 groups of plant foods.</p><p><strong>Conclusions: </strong>LTP syndrome was the most common presentation in patients with Rosaceae food allergy. The severity of the reactions was not related to peach SPT wheal size or sIgE levels to Pru p 3, but concomitant allergies to ≥3 plant food groups could be a good marker of severity.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"5 ","pages":"1477364"},"PeriodicalIF":3.3,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11649636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spectrum of offending drugs and cutaneous adverse drug reactions requiring hospitalisation in a tertiary South African hospital in TB/HIV endemic setting.","authors":"S P P Konyana, N F Teixeira, L Pirjol, B Thwala, W Nkoyane, M Porter, F Gxolo, E Phillips, R Lehloenya, A Mankahla, J Peter","doi":"10.3389/falgy.2024.1481281","DOIUrl":"10.3389/falgy.2024.1481281","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Cutaneous immune-mediated adverse drug reactions are more prevalent in people with human immunodeficiency virus (PWH). Severe cutaneous adverse drug reactions (SCAR) are a life-threatening subset of cutaneous adverse drug reactions (CADRs) and a significant public health issue in settings endemic for human immunodeficiency virus and tuberculosis. However, limited data are available on CADR requiring hospitalisation in African settings. The aim of this study is to describe the epidemiology, offending drugs and outcomes of CADRs requiring admission to a South African tertiary dermatology service.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Retrospective folder review was conducted on all CADRs requiring hospitalisation at Nelson Mandela Academic Hospital in Mthatha, Eastern Cape, South Africa between 30 July 2015 and 15 December 2022. This data was compared to prospective inclusion of CADR admissions between 03 March 2021 and 09 April 2024 as part of the Immune-Mediated Adverse Drug Reactions (IMARI) Registry and Biorepository and AFRISCAR consortium. Where possible, phenotype and drug causality assessment was performed through RegiSCAR, or Naranjo and/or ALDEN scoring respectively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;CADR admissions included 122 cases: 89 and 33 in the retrospective and prospective cohorts respectively. The commonest SCAR phenotype was Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) at 59.8% (73/122), although other validated SCAR phenotypes included drug reaction with eosinophilia and systemic symptoms (DRESS), acute generalized exanthematous pustulosis (AGEP) and generalized fixed bullous drug eruption (GBFDE). Cutaneous presentations included typical and atypical SCAR features against a background Fitzpatrick skin tones of type IV and above. Amongst the retrospective cohort 16.9% (15/89) of phenotypes were unclassifiable due to lack of photographs. The overall median (IQR) age was 38 (25-50) years, 50.8% (62/122) were male and 60.7% (74/122) were PWH [median (IQR) CD4T-cell count of 267 (76-470) cells/mm&lt;sup&gt;3&lt;/sup&gt;]. The commonest offending drugs included cotrimoxazole in 24.6% (30/122); and anti-retroviral therapy (ART) in 13.9% (17/122). No offending drug could be identified in 24.7% (22/89) of the retrospective cohort. The median (IQR) length of hospital stay for validated SCAR was 13 (8-21) days for the retrospective cohort and 19 (13-28) days for the prospective cohort (&lt;i&gt;p&lt;/i&gt; = 0.03). The median (IQR) length of hospital stay for non-SCAR was 9 (5-13) days for the retrospective cohort and 11 (9-16) days for the prospective cohort.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Typical and atypical presentations of SCAR were represented in this vulnerable South African cohort of predominantly PWH. SJS/TEN was the commonest phenotype, and cotrimoxazole the most frequent offending drug. This data emphasises the need for prospective data collection across a diverse African population for valid SCAR pheno","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"5 ","pages":"1481281"},"PeriodicalIF":3.3,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}