Patch testing has an evolving and expanding role in fixed drug eruption, FDE. Repeated application may be needed = repeated open application test, ROAT, for example, twice a day for seven days. There are contraindications to the test in severe FDE

A single day challenge with a penicillin antibiotic is just fine. No clear benefit to extending the challenge to a second day as of now. This review was done in the setting of beta lactam hypersensitivity.

Symbicort is one of the most effective and versatile asthma medication but it’s now generic and it’s being replaced by Breyna (nice green fountain logo, btw). If I may quote Andrew Murphy here, “asthma is not a monoclonal antibody deficiency”, consider ics/laba as per guidelines

Omalizumab as a treatment for food allergies increases the threshold at which the foods may cause an allergic reaction, it only works as long as you take it, and it may be needed as a lifelong treatment open.spotify.com/episode/6FFmDH…

Omalizumab is a valuable alternative to oral immunotherapy (OIT) for treatment of food allergies. OIT studies show breaks in efficacy, complications such as EOE, and high dropout rates open.spotify.com/episode/6FFmDH…

Food allergy to cashew tree nut is among the most dangerous food allergies because cashew is prone to causing major reactions at a very low dose. All food allergy researchers who work with patients allergic to cashew learn to respect it. open.spotify.com/episode/6FFmDH…

The new Flonase tablet has nothing to do with Flonase nasal spray. It’s a totally different medication, different active ingredients. Flonase nasal spray may reduce nasal congestion vs Flonase tablet will not affect nasal congestion. OTC marketing can get confusing.

Food allergy to Ackee fruit is rare, but it was described in 1996. Ackee is poisonous, if eaten unripe. There are several mature trees in Fruit&spice park in the Redlands, Miami area, and the guides there always warn against eating the fruit if you don’t know how to prepare it.

Repeat open application testing (ROAT) may be considered for fixed drug eruptions (FDE)

Atopic dermatitis in children is linked to a higher risk of asthma exacerbations. Atopic dermatitis is part of the classically described atopic march - several allergic diseases linked together

The first trial of allergy shots, being injected in the tonsils, showed efficacy. This is another approach to intra lymphatic immunotherapy. In prior trials allergy shots were injected in inguinal lymph nodes. The proposed advantage of this therapy is shorter duration.

Food ladders in food allergy don’t have a clearly defined use yet. The idea is to introduce the foods at a faster pace, as opposed to oral immunotherapy.

Uncontrolled asthma is even deadlier in the setting of food allergy. One study described 21 cases of fatal reactions to foods. Asthma was present in all but one patient. If you have food allergy and asthma , make sure your asthma is under excellent control.

The authors propose the use of currently available over-the-counter epinephrine inhaler for treatment of anaphylaxis. They also suggest that Symbicort should be available over-the-counter too. More research is needed of course, especially in the case of the epinephrine inhaler

SNOT 5 may replace SNOT 22 for diagnosis of chronic sinusitis. As per the current guidelines, chronic sinusitis does not cause headaches. Acute sinusitis may cause headaches. That’s difficult to say, of course, as any chronic disease is prone to exacerbations.

Non-specific lipid-transfer protein (nsLTP) allergy is considered the most common cause of food allergy and food induced anaphylaxis in southern Europe. It’s emerging in other parts in the world via sensitization to cannabis.

BAT and MAT : New cellular test for food allergy include basophil activation test (BAT) and mast cell activation test (MAT). BAT has been validated for peanut and sesame allergy

Why people develop food allergy? Dishwater detergents may damage gut epithelial barrier, thus possibly playing a role in the increase in food allergy over the past few decades.

open.spotify.com/episode/5Q27pE…

statnews.com/2024/09/25/chr… new chronic urticaria therapy: 25% of patients who started the study on barzolvolimab stopped treatment during the trial, changes in hair and skin color reported