Toxicon, Journal Year: 2022, Volume and Issue: 217, P. 41 - 45
Published: Aug. 5, 2022
Language: Английский
Nature Reviews Disease Primers, Journal Year: 2022, Volume and Issue: 8(1)
Published: Sept. 15, 2022
Language: Английский
Citations
214
Current Treatment Options in Allergy, Journal Year: 2025, Volume and Issue: 12(1)
Published: Jan. 17, 2025
Abstract Purpose of Review Despite global incidence, considerable morbidity, and diverse triggers, CU is poorly characterized amongst African populations. This systematic review aims to describe available studies unmet needs. Recent Findings Overall 221 publications were screened 29 eligible for full review. These represented only 12 54 countries, with 38% from Nigeria. Most described within the context dermatology out-patient clinics(21/29), a prevalence 0.03–10.4%. Two detailed demographics, female predominance median age 30–40 years. patients reported variable associations infections, including T.canis (Egypt), H.pylori (Nigeria South Africa), other risk factors foods, food additives, low vitamin D levels. UAS was < 100 patients, two co-morbidities, while none addressed patient-reported outcome or quality-of-life measures, treatment access and/or efficacy. Summary disease prevalence, in Further are required detail phenotypes, severity use
Language: Английский
Citations
1
The Journal of Allergy and Clinical Immunology In Practice, Journal Year: 2024, Volume and Issue: 12(9), P. 2268 - 2277
Published: July 6, 2024
Cutaneous adverse drug reactions collectively are delayed such as morbilliform eruption and severe cutaneous (SCARs). Morbilliform may wane over time, be the result of viral interactions, amenable to slow reintroduction or rechallenge, whereas SCARs HLA class I restricted, T-cell-mediated that demonstrate durable immunity warrant lifelong avoidance. reaction with eosinophilia systemic symptoms, Stevens-Johnson syndrome toxic epidermal necrolysis, acute generalized exanthematous pustulosis, bullous fixed often occur in setting multiple drugs dosed together. Collectively, they lead significant morbidity, mortality, safety concerns could severely limit future treatment options. Currently, no single combination diagnostic tests for ex vivo vitro testing, (skin) other adjunctive typing have 100% negative predictive value. In this "Controversies Allergy Review" article, we review current literature on skin testing (patch prick/intradermal test) critically assess evidence base its utility across different clinical phenotypes hypersensitivity reactions.
Language: Английский
Citations
4
Allergy, Journal Year: 2025, Volume and Issue: unknown
Published: March 31, 2025
There is a paucity of information on Chronic Urticaria (CU) in Africa and the global south [1]. We have conducted retrospective folder review Cape Town UCARE centre (https://ga2len-ucare.com/)—the only one continent—and dermatology services two tertiary hospitals Town, South Africa. All patients that were coded L50 (the ICD10 code for urticaria) reviewed (see Figure S1) this study was approved by University Human Research Ethics Committee (HREC 603/2023), all provided informed consent use photographs. This multicentre largest cohort reported to date (n = 939)—and, despite limitations missing data, it provides several valuable insights. The prevalence CU ranges from 1%–4.4% [2], with international allergy clinics reporting rates 1.3%–1.7% [3, 4]. In Tygerberg Hospital Dermatology clinic, accounted 0.6% patients, while at Groote Schuur Allergy/Dermatology clinics, 1.8% S1). Our population multiethnic, 85.8% (806/939) having darker Fitzpatrick skin tones (III-VI). Given underrepresentation dermatology/allergy literature [5] 1 collection photographs showing morphologies chronic urticaria against background skin. CIndU group had higher I-II (paler skin) angioedema without high V-VI (darker tones) (p < 0.001) Table 1). Spontaneous (CSU) Inducible (CIndU) commonest (81% [761/939]), 8.6% (81/939) combined CSU/CIndU. Isolated found less than 5% (42/939), heat delayed pressure being most common; symptomatic dermatographism 19) cholinergic urticarias 9) rare. Only 2.2% (21/939) recurrent urticaria. Source: Day et al. Clinical characteristics, associated co-morbidities, exacerbating factors our similar other cohorts different regions (Table 1, Tables S1 S3) [2]. typically has more severe course [6], showed 65% rate angioedema, which averages [6]. Consistent reports about Mast cell-isolated older, food additive sensitivities, mental illness, hypertension gastrointestinal symptoms groups Patient Reported Outcome Measures (PROMs) poor (8.6%–14.9%) restricted patients. Similarly, third endotyping or screening co-morbid thyroid autoantibodies. However, those endotyped, 237/293 (81%) total IgE > 43ku/l 34/266 (12.7%) elevated anti-TPO antibodies S2) supporting predominance autoallergy CSU indicative spectrum likely Despite significant burden disease (indicated median UAS7 21 [IQR 8; 32] PROMs), 46.3% accessed high-dose antihistamines, just 13 third-line therapies highlights although may be lower countries, there sizable data diversity ethnicities generalisable African countries. underscore urgent need greater awareness better education around PROMS even amongst specialist healthcare providers, example, dermatologists allergists. Greater increased PROMs needed guide appropriate treatment escalation. huge access gap—due cost—to highly effective biologics middle-income country like Africa, when compared high-income also needs attention advocacy. recent article suggests picture across continent, meaning unmet considerable impact quality life Innovative strategies improve targeted therapies, as well ongoing alternative, affordable treatments methotrexate, dapsone, UVA auxiliary such pseudoallergen-free diets stress control merit [7]. Furthermore, novel enter guidelines, industry, governments academia work together suffering low/middle-income J.P. developed research concept. C.D., M.D., Y.J., Q.G.M., S.N., B.H., E.K., N.A. reviews entry. C.D. L.M. did statistical analysis. wrote manuscript. authors themanuscript. Dr. Cascia received funding her PhD Discovery Foundation Medical Council Division Capacity Development Programme. degree emanated funded through its under Clinician Researcher Programme National Department Health. content hereof sole responsibility does not necessarily represent official views SAMRC funders. J Peter speaker's fees honoraria CSL Behring, Novartis, Sanofi Regeneron, Takeda. He educational grants Astria, Cipla, Glenmark Pharmaceuticals, Kalvista, Pharvaris, serves advisory board Astria Pharvaris. support findings are available corresponding author upon reasonable request. Data S1. Supporting Information. Please note: publisher responsible functionality any supplied authors. Any queries (other content) should directed article.
Language: Английский
Citations
0
Current Allergy and Asthma Reports, Journal Year: 2024, Volume and Issue: 24(6), P. 317 - 322
Published: May 22, 2024
Language: Английский
Citations
3
Inflammation Research, Journal Year: 2024, Volume and Issue: 73(5), P. 877 - 896
Published: March 31, 2024
Language: Английский
Citations
2
Frontiers in Allergy, Journal Year: 2023, Volume and Issue: 4
Published: May 4, 2023
Photosensitive dermatoses are seen in 5% of HIV-infected persons. These include drug- and chemical-induced photoallergic phototoxic reactions, chronic actinic dermatitis HIV, photo lichenoid drug eruptions, porphyria. Data on photodermatitis HIV limited to case reports series. The pathogenesis is not completely understood includes a th2 phenotype which results impaired barrier function resultant allergen sensitisation as well immune dysregulation. objective this manuscript review the literature clinical phenotype, pathogenesis, role patch testing, outcomes, treatment an African population.
Language: Английский
Citations
4
JAC-Antimicrobial Resistance, Journal Year: 2022, Volume and Issue: 5(1)
Published: Dec. 29, 2022
In high-income countries, up to 25% of inpatients have a self-reported penicillin allergy (PA). After testing, 95% these PAs are incorrect. These incorrectly labelled increase the use broad-spectrum antibiotics, and drive bacterial resistance. The epidemiology PA in low- middle-income countries is unknown. We aimed describe delabelling outcomes South African (SA) inpatients.We conducted point prevalence surveys between April 2019 June 2021 at seven hospitals Cape Town, Africa. A team trained PEN-FAST decision tool in-person interviews, reviewed patient notes identify risk stratify with PA. patients were referred Groote Schuur Hospital (GSH) clinic for delabelling.A total 1486 hospital surveyed 3.2% (n = 48) carried label. Importantly, 64.6% 31) classified by as low true hypersensitivity. Overall, received β-lactam antibiotic directly delabelled. Delabelling attrition was very high, 6.3% (3/48) attending GSH clinic, only one proceeding negative oral challenge.Inpatient lower Africa compared other upper-middle-income majority low-risk Linkage poor, thus strategies improve access delivery remains an urgent public health issue.
Language: Английский
Citations
7
Frontiers in Medicine, Journal Year: 2022, Volume and Issue: 9
Published: Sept. 12, 2022
Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) are on a spectrum of cutaneous drug reactions characterized by pan-epidermal necrosis with SJS affecting < 10% body surface area (BSA), TEN > 30%, SJS/TEN overlap between 10 30%. Severity-of-illness score for (SCORTEN) is validated tool to predict mortality rates based age, heart rate, BSA, malignancy serum urea, bicarbonate, glucose. Despite improved understanding, remains constant therapeutic interventions not universally accepted number reasons, including rarity SJS/TEN; inconsistent definition cases, disease severity, endpoints in studies; low efficacy interventions; variations treatment protocols. Apart from mortality, none the other used evaluate interventions, duration hospitalization, sufficiently standardized be reproducible across cases centers. Some gaps research can narrowed through international collaboration harmonize endpoints. A case made an urgent collaborative effort develop consensus definitions such as status, progression, cessation, complete re-epithelialization interventional studies. The deficiencies using BSA sole determinant excluding internal organ involvement extension skin beyond epidermis, discussed role these factors play time healing acute stage highlighted. potential artificial intelligence, biomarkers, PET/CT scan radiolabeled glucose markers activity, response also discussed.
Language: Английский
Citations
5
South African Medical Journal, Journal Year: 2023, Volume and Issue: unknown, P. 69 - 74
Published: Feb. 1, 2023
Up to a quarter of inpatients in high-income countries (HICs) self-report beta-lactam allergy (BLA), which if incorrect,increases the use alternative antibiotics, worsening individual health outcomes and driving bacterial resistance. In HICs, up 95% ofself-reported BLAs are incorrect. The epidemiology BLA low- middle-income African is unknown.To describe de-labelling self-reported hospitalised South (SA) patients.Point-prevalence surveys were conducted at seven hospitals (adult, paediatric, government privately funded, district andtertiary level) Cape Town, SA, between April 2019 June 2021. Ward prescription records in-person interviews conductedto identify risk-stratify patients using validated PEN-FAST tool. De-labelling was attempted tertiary clinic atGroote Schuur Hospital.A total 1 486 hospital surveyed (1 166 adults 320 children). Only 48 (3.2%) BLA,with higher rate private than government-funded (6.3% v. 2.8%; p=0.014). Using tool, only 10.4% (n=5/48)of classified as high risk for true penicillin hypersensitivity. Antibiotics prescribed 70.8% (n=34/48)of patients, with 64.7% (n=22/34) receiving beta-lactam. Despite three attempts contact atthe clinic, 3/36 underwent vivo testing, no positive results, patient proceeded negative oral challenge.Unlike low among SA. majority those who fortype hypersensitivity, but outpatient efforts largely unsuccessful.
Language: Английский
Citations
2