Asia Pacific Allergy最新文献

{"title":"Erythrodermic psoriasis in post-coronavirus disease 2019 patient","authors":"Irwanida Batubara, W. Budianti","doi":"10.5415/apallergy.2022.12.e16","DOIUrl":"https://doi.org/10.5415/apallergy.2022.12.e16","url":null,"abstract":"Erythrodermic psoriasis (EP) is characterized by generalized erythema and desquamation affecting more than 75% of body surface area and usually accompanied by systemic symptoms. The triggers are medication withdrawal, drugs reactions, and systemic infections including coronavirus disease 2019 (COVID-19). A 46-year-old man with plaque psoriasis suffered from EP following the sudden discontinuation of medications. He was diagnosed with COVID-19 one month before erythroderma appeared. The body surface area involvement was 96% and psoriasis area severity index was 49.8. His general condition and laboratory examination were within normal limits. He was treated with cyclosporine-A for one month after being healed from COVID-19 with significant improvement. Excessive production of proinflammatory cytokines in COVID-19 plays a role in the pathogenesis of psoriasis. This condition should be managed appropriately to minimize the complication. Cyclosporine-A is the first-line therapy for EP because of its effectiveness and good safety profile. It is also shown a beneficial effect in COVID-19 infection in vitro.","PeriodicalId":8488,"journal":{"name":"Asia Pacific Allergy","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45756426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment-resistant atopic dermatitis: novel therapeutics, digital tools, and precision medicine","authors":"P. Naik","doi":"10.5415/apallergy.2022.12.e20","DOIUrl":"https://doi.org/10.5415/apallergy.2022.12.e20","url":null,"abstract":"Atopic dermatitis (AD) is a prevalent condition impacting up to 25% of children and 8% of adults worldwide. An estimated 20% of those with AD comprise a subset of patients with treatment-resistant AD, for whom traditional therapeutics and management strategies are unsuccessful. Physical symptoms significantly impact quality of life for patients and caregivers. The condition is chronic and may persist throughout the lifespan with recurrent episodes. Novel AD therapeutics offer new opportunities to resolve symptoms of treatment-resistant more effectively AD. Recently developed pharmacological agents were developed with an appreciation of AD as a heterogeneous condition. New advances include topical, oral, and injectable therapeutics with novel mechanisms of action. In addition, advances in clinical practice, including the application of digital tools, can promote a personalized medicine approach. For example, teledermatology for chronic conditions such as AD have been embraced by clinicians and patients; communicating symptoms via photographs can augment patient symptom trackers and aid trigger identification. Digital tools can also be used to increase medication adherence and improve patient/caregiver engagement. Integrating the above is a personalized medicine approach. Advanced therapeutics with novel mechanisms of action, integrated with digital tools, and trends toward patient-centered medicine can assist this chronic, heterogeneous condition via precision medicine and better treat treatment-resistant AD.","PeriodicalId":8488,"journal":{"name":"Asia Pacific Allergy","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46125987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Senile erythroderma with hyper IgE: an independent and novel disease form","authors":"Y. Horiuchi","doi":"10.5415/apallergy.2022.12.e12","DOIUrl":"https://doi.org/10.5415/apallergy.2022.12.e12","url":null,"abstract":"Erythroderma is a rare exfoliative dermatitis with various causes [1, 2]. The exact pathophysiology of this disease has not received much attention. Moreover, while it has been reviewed many times [1, 2], there is little mention of senile erythroderma. The accumulated findings [1, 2] reveal 3 factors involved in its etiology: drugs such as carbamazepine, preexisting skin diseases such as psoriasis [1], and stages of malignancies such as cutaneous T-cell lymphomas. Li and Zheng [2] reported the most prevalent causative factors—preexisting dermatoses (70.77%), followed by idiopathic causes (14.23%), drug-induced reactions (12.69%), and malignancies (2.31%). Among the pre-existing dermatoses, psoriasis was the most common etiology (55%). Several case analyses show that males are 4 times more likely to be affected by erythroderma than females [1, 2]. The average age is 52 to 57 years, including those in 80s [1, 2]. One study reported a unique case of erythroderma caused by propolis [3]—a food product produced by honeybees. Steroid withdrawal erythroderma [4] has been reported; as it is caused by medical care, it is called iatrogenic. Patients with systemic eczema have received steroids for external use at various medical institutions for many years due to the intractability of their conditions. In cases of steroid withdrawal, erythroderma occasionally occurs. As the cases caused by an underlying disease are diverse, dermatologists and clinicians should first determine the possible cause in patients with erythroderma.","PeriodicalId":8488,"journal":{"name":"Asia Pacific Allergy","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47809836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between self-reported drug hypersensitivity reactions and psychological disorders.","authors":"Inês Machado Cunha,&nbsp;Joana Gouveia,&nbsp;Eva Gomes","doi":"10.5415/apallergy.2022.12.e15","DOIUrl":"https://doi.org/10.5415/apallergy.2022.12.e15","url":null,"abstract":"<p><strong>Background: </strong>Medically unexplained physical symptoms are a well-recognized problem and, in some cases, there is a well-established relationship between behavior and psychopathological disturbances. However, the association between drug hypersensitivity reactions and psychoactive disorders stills under discussion.</p><p><strong>Objective: </strong>Our main goal was to establish if there is an association between self-reported drug hypersensitivity reaction and psychopathology with need for psychoactive drug consumption.</p><p><strong>Methods: </strong>Retrospective study of adult patients evaluated in a first Immunoallergology appointment because of self-reported drug hypersensitivity over 1 year and register of data concerning psychoactive drugs use. Compare the study group with patients observed for allergic respiratory disease along the same year.</p><p><strong>Results: </strong>The study group included 70 patients that referred a total of 92 self-reported drug hypersensitivity reactions. Twenty-nine (41.4%) were under treatment with psychoactive drugs: 20 (70%) were treated with anxiolytics, 13 (18.6%) with antidepressants, 15 (21.4%) with sedatives, and 1 (1.4%) with antipsychotics. The control group included 160 patients and 38 patients (23.8%) were under treatment with psychoactive drugs: 31 (19.4%) where treated with antidepressants, 29 (18.1%) with anxiolytics, and 3 (1.9%) with sedatives. The use of psychoactive drugs in the study group is higher than in the control group (<i>p</i> = 0.007), the difference is especially important for sedative drugs (<i>p</i> < 0.001). Besides a higher use of psychoactive drugs, the study group also has a higher frequency of use of several psychoactive drug (<i>p</i> = 0.002).</p><p><strong>Conclusion: </strong>Patients with a self-report drug hypersensitivity have more tendency to be under treatment with psychoactive drugs and could have more tendency to somatization. Personality traces and psychopathology must be taken into account during an allergy workup.</p>","PeriodicalId":8488,"journal":{"name":"Asia Pacific Allergy","volume":"12 2","pages":"e15"},"PeriodicalIF":1.7,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/24/1b/apa-12-e15.PMC9066087.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10242728","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":"PSAAI@50: Celebrating gold… and beyond!","authors":"Maria Carmela Kasala","doi":"10.5415/apallergy.2022.12.e18","DOIUrl":"https://doi.org/10.5415/apallergy.2022.12.e18","url":null,"abstract":"","PeriodicalId":8488,"journal":{"name":"Asia Pacific Allergy","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45901443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronavirus disease 2019 (COVID-19) and Long COVID","authors":"Yoon-Seok Chang","doi":"10.5415/apallergy.2022.12.e22","DOIUrl":"https://doi.org/10.5415/apallergy.2022.12.e22","url":null,"abstract":"https://apallergy.org The coronavirus disease 2019 (COVID-19) pandemic has impacted every aspect of our lives. We lost our patients, colleagues, friends, and family members. Most countries experienced lockdowns. Wearing a face mask, physical distance, washing hands, and vaccination are the essential components of the preventive measure. We got used to have online or virtual meetings. It is still an ongoing global pandemic. However, after the Omicron, a variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), became dominant, some countries are starting to lift the regulations with the policy of “living with COVID.” For example, at the moment, it is no longer mandatory to wear a face mask in United Kingdom (UK) where the WAO-BASCI 2022 UK Conference was held (Edinburgh, Scotland, April 25–27, 2022). It was a very successful face to face international congress with a lot of learning and networking.","PeriodicalId":8488,"journal":{"name":"Asia Pacific Allergy","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46610817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of the European Thoracic Society/American Thoracic Society severe asthma definition as a determinant of future use of biologics/bronchial thermoplasty","authors":"H. Nishiyama, Y. Kanemitsu, Kensuke Fukumitsu, N. Takeda, Ryota Kurokawa, T. Tajiri, K. Ito, Jenifer Maries Go Yap, S. Fukuda, T. Uemura, H. Ohkubo, K. Maeno, Y. Ito, T. Oguri, M. Takemura, A. Niimi","doi":"10.5415/apallergy.2022.12.e13","DOIUrl":"https://doi.org/10.5415/apallergy.2022.12.e13","url":null,"abstract":"Background International guidelines define severe uncontrolled asthma. Biologics or bronchial thermoplasty (Bio/BT) are recommended for such patients. Objectives To determine which definitions of severe uncontrolled asthma are associated with an additional Bio/BT treatment in patients with severe uncontrolled asthma. Methods Consecutive 107 asthmatics (including 15 patients for whom Bio/BT was introduced within 3 months after examination), classified as treatment step 4 according to the Global Initiative for Asthma 2015 guideline, were eligible for this analysis. Patients were assessed using the European Thoracic Society/American Thoracic Society (ERS/ATS) severe uncontrolled asthma guideline as defined by these 4 characteristics: poor control (ACT < 20), frequent exacerbations (≥2/yr), admissions (≥1/yr), and airflow limitation (forced expiratory volume in 1 second < 80% of predicted), along with comorbidities, and biomarkers, including blood granulocytes, fractional nitric oxide, and capsaicin cough reflex sensitivity (C-CS). These indices were compared between patients with and without Bio/BT introduction, and multivariate logistic regression analysis was performed to determine the association of the 4 definitions with treatment needs for Bio/BT. Results Patients who were introduced to Bio/BT had heightened C-CS, heavier smoking history, and a greater prevalence of diabetes mellitus than those without (p < 0.05). Poor asthma control (ACT < 20), frequent exacerbations (≥2/yr), and admissions (≥1/yr) were relevant to the future use of Bio/BT in the multivariate regression analysis. Type 2-related biomarkers including absolute eosinophil counts were higher in patients in the Bio introduction group than in the BT introduction group. Meanwhile, there was no significant difference of the 4 characteristics of severe uncontrolled asthma definition between patients in the Bio and those in the BT groups. Conclusion Although multiple factors such as treatment cost and asthma phenotypes affect treatment decision-making, the definition of poor asthma control, frequent exacerbations and admission by the ERS/ATS guidelines were important factors for an additional intensive treatment for severe uncontrolled asthma. Trial Registration UMIN Clinical Trials Registry: UMIN000024734","PeriodicalId":8488,"journal":{"name":"Asia Pacific Allergy","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47719119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics of drug-induced Stevens-Johnson syndrome and toxic epidermal necrolysis: A single-center study.","authors":"Hye Won Yoo,&nbsp;Hye-Young Kim,&nbsp;Kihyuk Shin,&nbsp;Seong Heon Kim","doi":"10.5415/apallergy.2022.12.e17","DOIUrl":"https://doi.org/10.5415/apallergy.2022.12.e17","url":null,"abstract":"<p><strong>Background: </strong>Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe adverse cutaneous reactions, most commonly triggered by medications, characterized by extensive necrosis and detachment of the epidermis.</p><p><strong>Objective: </strong>We investigated the differences in clinical characteristics of drug-induced SJS/TEN depending on the type of drug in a single center.</p><p><strong>Methods: </strong>The relevance of sex, age, culprit drugs, clinical features, courses, treatment options, and follow-up results were retrospectively evaluated in patients diagnosed with drug-induced SJS/TEN at Pusan National University Hospital between 2008 and 2019.</p><p><strong>Results: </strong>Ninety-two patients with a mean age of 58.7 ± 20.2 years (range, 10-93 years) were included in the study. Those aged 60-80 years accounted for the largest number of patients (42.4%). Patients with drug-induced SJS/TEN comprised 40 women (43.5%) and 52 men (56.5%). We categorized drug-induced SJS/TEN cases by culprit drugs into 6 groups: antibiotics, allopurinol, antiepileptic (AED), nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, and other drugs. The rate of NSAID-induced disease significantly increased from SJS to TEN (<i>p</i> = 0.016). Among the patients in the NSAID group, the proportion of TEN (40%) was higher than that in the other groups (<i>p</i> = 0.021). The mean body surface area was significantly lower in the AED group than in the non-AED groups (7.1 ± 9.8 vs. 23.1 ± 27.3, <i>p</i> = 0.020) and higher in the NSAID group than in the non-NSAID groups (47.5 ± 39.5 vs. 15.7 ± 20.0, <i>p</i> = 0.010).</p><p><strong>Conclusion: </strong>This study showed that the clinical characteristics of each causative drug group may be different in drug-induced SJS/TEN. Our findings may help clinicians better understand drug-induced SJS/TEN.</p>","PeriodicalId":8488,"journal":{"name":"Asia Pacific Allergy","volume":"12 2","pages":"e17"},"PeriodicalIF":1.7,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2c/6a/apa-12-e17.PMC9066085.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10249438","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":"Changes in clinical features of food-related anaphylaxis in children during 5 years","authors":"C. Motomura, Koki Okabe, H. Matsuzaki, T. Kawano, Yuko Akamine, Daisuke Yasunari, Masatoshi Wakatsuki, N. Taba, S. Honjo, H. Odajima","doi":"10.5415/apallergy.2022.12.e14","DOIUrl":"https://doi.org/10.5415/apallergy.2022.12.e14","url":null,"abstract":"Background Despite being frequently recommended, adrenaline auto-injectors (AAIs) are insufficiently prescribed and used for the prehospital management of anaphylaxis. Objective This study aimed to investigate recent changes in the clinical features and prehospital management of food-related anaphylaxis in children. Methods We retrospectively compared the clinical features of children who were hospitalized for food-related anaphylaxis in 2013 and 2018. The patients’ medical records were reviewed for causative foods, triggers, location, AAI prescription, and/or use, wheezing on admission, and treatment. Results Overall, 62 consecutive patients (43 males; median age, 5.6 years) hospitalized in 2018 were compared with 57 patients (37 males; median age, 4.3 years) hospitalized in 2013. There were no significant differences between the cohorts in age, gender, causative foods, or wheezing on admission. Cow’s milk, wheat, and egg represented over half of the causative foods in both groups. Compared with 2013, the incidence of anaphylaxis decreased at home but increased at nurseries and schools in 2018. Exercise was a significantly more common trigger for anaphylaxis in 2018. Furthermore, a significant increase was observed in AAI administration by lay helpers or the patients themselves and in ambulance transportation. After admission, intramuscular adrenaline was administered to 26 patients in 2013 and 12 patients in 2018. Patients receiving prehospital adrenaline were significantly less likely to require in-hospital adrenaline injections. Conclusion Food-related anaphylaxis triggered by exercise and AAI use have increased. Hence, raising awareness and educating caregivers, patients, teachers, and medical professionals are essential for the optimal management of this disorder.","PeriodicalId":8488,"journal":{"name":"Asia Pacific Allergy","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41426349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-COVID severe refractory cough: discussion of a case with 6-week longitudinal cough characterization","authors":"Yu Ri Kang, Ji-Yoon Oh, Ji-Hyang Lee, Peter M. Small, K. Chung, W. Song","doi":"10.5415/apallergy.2022.12.e19","DOIUrl":"https://doi.org/10.5415/apallergy.2022.12.e19","url":null,"abstract":"Long coronavirus disease (COVID) refers to an array of variable and fluctuating symptoms experienced after acute illness, with signs and symptoms that persist for 8–12 weeks and are not otherwise explicable. Cough is the most common symptom of acute COVID-19, but cough may persist in some individuals for weeks or months after recovery from acute phase. Long-COVID cough patients may get stigmatised because of the public fear of contagion and reinfection. However, clinical characteristics and longitudinal course of long-COVID cough have not been reported in detail, and evidence-based treatment is also lacking. In this paper, we describe a case of long-COVID severe refractory cough with features of laryngeal hypersensitivity and dysfunction. We characterized cough using patient-reported outcomes and engaged in continuous cough frequency monitoring. Through the case study, we discuss potential mechanisms, managements, and clinical implications of long-COVID refractory cough problems.","PeriodicalId":8488,"journal":{"name":"Asia Pacific Allergy","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45699345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}