June 8, 2013

Diagnosis of urticaria

Indian J Dermatol. 2013 May-Jun; 58(3): 211–218.

PMCID: PMC3667285

Diagnosis of urticaria

Nicole Schoepke, Georgios Doumoulakis, and Marcus Maurer

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Abstract

Acute urticaria do not need extensive diagnostic procedures. Urticaria activity score is a useful tool for evaluation of urticaria. Complete blood count, Erythrocyte sedimentation rate and C reactive protein are important investigations for diagnosis of infections in urticaria. Autologous serum skin test is a simple office procedure for diagnosis of auto reactive urticaria. Closed ball point pen tip is a simple test to diagnose dermographism.

Keywords: Autologous serum skin test, dermographism, urticaria activity score

Low Nickel Diet in Dermatology

Indian J Dermatol. 2013 May-Jun; 58(3): 240.

doi: 10.4103/0019-5154.110846

PMCID: PMC3667300

Low Nickel Diet in Dermatology

Ashimav D Sharma

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Abstract

Nickel is a ubiquitous trace element and the commonest cause of metal allergy among the people. Nickel allergy is a chronic, recurring problem; females are affected more commonly than males. Nickel allergy may develop at any age. Once developed, it tends to persist life-long. Nickel is present in most of the dietary items and food is considered to be a major source of nickel exposure for the general population. Nickel in the diet of a nickel-sensitive person can provoke dermatitis. Careful selection of food with relatively low nickel concentration can bring a reduction in the total dietary intake of nickel per day. This can influence the outcome of the disease and can benefit the nickel sensitive patient.

Keywords: Allergy, diet, iron, nickel

The Relationship between Maternal Atopy and Childhood Asthma in Pretoria, South Africa

ISRN Allergy. 2013; 2013: 164063.

Published online 2013 January 27. doi: 10.1155/2013/164063

PMCID: PMC3658429

The Relationship between Maternal Atopy and Childhood Asthma in Pretoria, South Africa

Salome Abbott, 1 ,* Piet Becker, 2 and Robin J. Green 1

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Abstract

Introduction. Asthma is the commonest chronic condition of children. Diagnosis of this condition remains difficult. Many surrogate markers are used, such as documenting evidence of atopy. Method. A random sample of asthmatic children and their mothers attending the Children's Chest and Allergy Clinic at Steve Biko Academic Hospital were enrolled. Children were classified as having atopic or nonatopic asthma. Mothers completed a questionnaire to uncover atopic features. Results. Along with their mothers, 64 children with atopic asthma and 36 with nonatopic asthma were studied. The proportion of children with atopic asthma does not differ for mothers with and without a positive SPT (P = 0.836), a history of asthma (P = 0.045), symptoms suggestive of an allergic disease (P = 1.000), or who were considered to be allergic (P = 0.806). The odds ratio of a child having atopic asthma when having a mother with a doctor diagnosed history of asthma is 4.76, but the sensitivity is low (21.9%).Conclusion. The data demonstrates that all maternal allergic or asthmatic associations are poor predictors of childhood atopic asthma. Despite the increased risk of atopic asthma in a child to a mother that has a doctor diagnosis of asthma (OR 4.76 P = 0.045), this is a poor predictor of atopic asthma (sensitivity 21.9%).

Food Components and the Immune System: From Tonic Agents to Allergens

Front Immunol. 2013; 4: 102.

Published online 2013 May 17. doi: 10.3389/fimmu.2013.00102

PMCID: PMC3656403

Food Components and the Immune System: From Tonic Agents to Allergens

Ana Maria Caetano Faria,1,2 Ana Cristina Gomes-Santos,1,2 Juliana Lauar Gonçalves,1,2 Thais Garcias Moreira,1,2Samara Rabelo Medeiros,1,2 Luana Pereira Antunes Dourado,2,3,4 and Denise Carmona Cara2,5,*

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Abstract

The intestinal mucosa is the major site of contact with antigens, and it houses the largest lymphoid tissue in the body. In physiological conditions, microbiota and dietary antigens are the natural sources of stimulation for the gut-associated lymphoid tissues (GALT) and for the immune system as a whole. Germ-free models have provided some insights on the immunological role of gut antigens. However, most of the GALT is not located in the large intestine, where gut microbiota is prominent. It is concentrated in the small intestine where protein absorption takes place. In this review, we will address the involvement of food components in the development and the function of the immune system. Studies in mice have already shown that dietary proteins are critical elements for the developmental shift of the immature neonatal immune profile into a fully developed immune system. The immunological effects of other food components (such as vitamins and lipids) will also be addressed. Most of the cells in the GALT are activated and local pro-inflammatory mediators are abundant. Regulatory elements are known to provide a delicate yet robust balance that maintains gut homeostasis. Usually antigenic contact in the gut induces two major immune responses, oral tolerance and production of secretory IgA. However, under pathological conditions mucosal homeostasis is disturbed resulting in inflammatory reactions such as food hypersensitivity. Food allergy development depends on many factors such as genetic predisposition, biochemical features of allergens, and a growing array of environmental elements. Neuroimmune interactions are also implicated in food allergy and they are examples of the high complexity of the phenomenon. Recent findings on the gut circuits triggered by food components will be reviewed to show that, far beyond their role as nutrients, they are critical players in the operation of the immune system in health and disease.

Keywords: nutrition, oral tolerance, food allergy, diet, CLA, vitamin A, food aversion

June 7, 2013

Classification of Urticaria

Indian J Dermatol. 2013 May-Jun; 58(3): 208–210.

doi: 10.4103/0019-5154.110830

PMCID: PMC3667284

Classification of Urticaria

Torsten Zuberbier

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Abstract

Classification is based on GA2LEN/EAACI/WAO/EDF guidelines (2009). These guidelines classify urticaria according to clinical manifestations. Urticaria is mediated by mast cells. According to level of mast cell degranulation clinical signs are superficial (Urticaria) or deep swelling (Angioedema).

Keywords: Spontaneous urticaria, Physical urticaria, Angioedema

Lack of Association of Plasma Histamine with Diamine Oxidase in Chronic Idiopathic Urticaria

Annals of Dermatology 2013 May; 25(2): 189~195

Annals of Dermatology 2013 May; 25(2): 189~195

Lack of Association of Plasma Histamine with Diamine Oxidase in Chronic Idiopathic Urticaria

Hee Jin Cho, Soo Ick Cho, Hye One Kim, Chun Wook Park, Cheol Heon Lee

Department of Dermatology, Kangnam Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Background: Chronic idiopathic urticaria (CIU) is considered a complex and multifactorial disease. Excessive histamine intake may induce an attack of urticaria. The main enzyme for histamine metabolism is diamine oxidase (DAO). Objective: Plasma histamine concentrations and DAO activities were evaluated to determine whether there are abnormalities in the histamine metabolism of CIU patients. Methods: Seventy-five CIU patients and twenty-five healthy control subjects were included in the study. Blood was taken from all subjects to measure plasma levels of the histamine and DAO. Results: Mean plasma histamine levels were significantly higher in CIU patients (11.59±10.98 nM) than in the control subjects (8.75±2.55 nM) (p=0.04). Mean DAO activities were lower in patients of CIU (80.86±26.81 histamine degrading unit [HDU]/ml) than in the controls (81.60±9.67 HDU/ml), but without significant difference. In 15 CIU patients with gastrointestinal symptoms, the mean histamine concentration was higher (12.43±7.97 nM) and DAO activity was lower (77.93±27.53 HDU/ml) than in the remaining 60 CIU patients without gastrointestinal symptoms (11.38±11.67 nM and 81.58±26.82 HDU/ml), without significant difference. The relationship between DAO activity and plasma histamine concentrations showed a significant negative linear value (p=0.001). There were no significant relationships between plasma histamine concentrations and symptom severity score. Conclusion: In CIU patients, a high plasma histamine concentration may not be explained by DAO activity. CIU patients with gastrointestinal (GI) symptoms showed no significantly lower DAO activity. Larger group studies are required to elucidate the relationship between plasma histamine concentrations and DAO activity, especially of CIU patients with GI symptomsto understand the difference in CIU patients with and without GI symptoms. (Ann Dermatol 25(2) 189∼195, 2013)

Annals of Dermatology 2013 May; 25(2): 189~195

Keyword : Chronic urticaria, Diamine oxidase, Gastrointestinal, Histamine, Pseudoallergic reaction

Autologous Serum Therapy in Chronic Urticaria

Indian J Dermatol. 2013 May-Jun; 58(3): 225–226.

doi: 10.4103/0019-5154.110833

PMCID: PMC3667287

Autologous Serum Therapy in Chronic Urticaria

Sharmila Patil, Nidhi Sharma, and Kiran Godse

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Abstract

Autologous serum therapy is a promising therapy for treatment resistant urticaria. This is useful in developing countries as this is economical option. Minimum instruments like centrifuge, syringe and needles are required for the procedure.

Keywords: Centrifuge, intra muscular, injections

Chronic rhinitis in South Africa: Update 2013

Guidelines

Chronic rhinitis in South Africa: Update 2013

Robin John Green, Maurice Hockman, Raymond Friedman, Martin Davis, Marinda McDonald, Riaz Seedat, Carla Els, Michael Levin, Paul C Potter, Charles Feldman

Abstract

The term rhinitis implies inflammation of the lining of the nose. Characteristic symptoms are a blocked nose, anterior and posterior rhinorrhea, sneezing and itching. Not all cases of chronic rhinitis have an allergic basis. Chronic non-allergic rhinitis is defined as a condition where ongoing rhinitic symptoms are present for many months (as for persistent allergic rhinitis) but there is no IgE basis. Many common conditions may present as chronic rhinitis, which will need to be investigated and managed on their own merits. Not all cases of chronic rhinitis respond to allergic rhinitis therapy: continued attempts to manage chronic rhinitis as allergic rhinitis may be hampered by pathophysiological conditions where other specific therapy may be required. Chronic rhinitis impacts on patient quality of life, and therefore therapy is important. Managing patients with chronic rhinitis requires attention to patient education in order to achieve the maximal therapeutic benefit of medication. This update is intended to provide clinicians with a sound basis for management of a common condition.

Authors' affiliations

Robin John Green, Department of Paediatrics and Child Health, University of Pretoria, South Africa

Maurice Hockman, Department of ENT Surgery, Netcare Linksfield Clinic, Johannesburg, South Africa

Raymond Friedman, Department of ENT Surgery, Netcare Linksfield Clinic, Johannesburg, South Africa; Mediclinic Sandton, Johannesburg, South Africa

Martin Davis, Department of Paediatrics, Netcare Linksfield Clinic, Johannesburg, South Africa

Marinda McDonald, Mediclinic Sandton, Johannesburg, South Africa

Riaz Seedat, Department of Otorhinolaryngology, University of the Free State, South Africa

Carla Els, Department of Paediatric Pulmonology and Allergy, Linksfield Clinic, Johannesburg, South Africa

Michael Levin, Department of Paediatrics and Adolescent Health, University of Cape Town, South Africa

Paul C Potter, Department of Medicine, University of Cape Town, South Africa

Charles Feldman, Division of Pulmonology, Department of Internal Medicine, University of the Witwatersrand, Johannesburg, South Africa

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Keywords

Allergic rhinitis; chronic rhinitis; management; guidelines

Cite this article

South African Medical Journal 2013;103(6):419-422. DOI:10.7196/samj.6972

Article History

Date submitted: 2013-04-18
Date published: 2013-04-30

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June 8, 2013