Review
Atopic dermatitis and psychosocial comorbidities – What’s new?
Paula Kage, Julia Zarnowski, Jan-Christoph Simon, and Regina Treudler
Volume 4 (2020) p. 86 - 96
Abstract
Allergologie select, Volume 4/2020 (86-96)
Atopic dermatitis and psychosocial comorbidities – What’s new?
Paula Kage, Julia Zarnowski, Jan-Christoph Simon, and Regina Treudler
Department of Dermatology, Venereology and Allergology, Leipzig Interdisciplinary Center for Allergology – LICA-CAC, University of Leipzig, Germany
Atopic dermatitis (AD) is a chronic inflammatory disease. During the last years, researchers have focused on a variety of associated comorbidities, especially psychosocial disease. This article aims at giving an overview over recent data. A systematic literature research was performed in PubMed including data from the time period January 1, 2018 until March 1, 2020. Patients with AD frequently suffer from cocomitant depression, anxiety, and attention deficit hyperactivity disorder. There is less evidence about the relation between AD and schizophrenia, eating disorder, and obsessive compulsive disorder. There is still great need for research in the connection between AD and psychosocial disease, particularly about the pathogenesis and the influence of new therapies.Correspondence to:
Dr. med. Paula Kage, Department of Dermatology, Venereology and Allergology, Leipzig Interdisciplinary Center for Allergology – LICA-CAC, University of Leipzig, Philipp-Rosenthal-Straße 23, 04103 Leipzig, Germany
Email: [email protected]
Original
Dietary and physical trigger factors in hereditary angioedema: Self-conducted investigation and literature overview
Julia Zarnowski and Regina Treudler
Volume 8 (2024) p. 358 - 364
Abstract
Allergologie select, Vol. 8/2024 (358-364)
Dietary and physical trigger factors in hereditary angioedema: Self-conducted investigation and literature overview
Julia Zarnowski1 and Regina Treudler1,2
1Department of Dermatology, Venereology and Allergology, University Hospital Leipzig, Leipzig, and 2Institute of Allergology, Charité University Hospital Berlin, Campus Benjamin Franklin, Berlin, Germany
Background: In hereditary angioedema (HAE), numerous factors are known to trigger an attack. The possible influence of diet or recreational sports has been given little consideration in studies. The aim of our work was to investigate the influence of nutrition and physical activity in patients with HAE at the Leipzig ACARE Center. Materials and methods: Patients with HAE were given a self-designed questionnaire inquiring for family history, disease progression, and encountered burden due to HAE, current therapy, and disease control (angioedema control test (AECT)) as well as the influence of diet and/or recreational sports on HAE attacks. Results: Inclusion of 30 patients (23 female, 77%) with a mean age of 49.5 ± 16.9 years and mean body mass index of 25.1 ± 6.4 kg/m2. 60% received prophylactic treatment, and 37% received exclusively on-demand therapy. The mean AECT score was 10.9 ± 5.1 and patients reported 15.5 ± 26.9 days of absence due to HAE attacks in the last 12 months. 33% reported an association with food intake, in particular worsening of abdominal symptoms (n = 7), swelling of the extremities (n = 3), face, larynx, or genital area (n = 1 each). 70% reported regular exercise, most commonly cycling (n = 11), running or walking (n = 10), or strength training (n = 10). 62% reported a worsening of HAE due to recreational exercise. Conclusion: Dietary factors and physical activity frequently led to an aggravation of HAE in our cohort and should be taken into consideration when counseling patients with regard to trigger avoidance.Correspondence to:
Dr. med. Julia Zarnowski, Department of Dermatology, Venereology and Allergology, University Hospital Leipzig, Philipp-Rosenthal-Straße 69, 04103 Leipzig, Germany
Email: [email protected]
Position Paper
Occupational anaphylaxis: A Position Paper of the German Society of Allergology and Clinical Immunology (DGAKI)
Regina Treudler, Margitta Worm, Andrea Bauer, Heinrich Dickel, Guido Heine, Uta Jappe, Ludger Klimek, Monika Raulf, Bettina Wedi, Dorothea Wieczorek, Wojciech Francuzik, Thilo Jakob, Oliver Pfaar, Johannes Ring, Franziska Rueff, Sabine Schnadt, Thomas Werfel, Gerda Wurpts, Julia Zarnowski, Torsten Zuberbier, and Knut Brockow
Volume 8 (2024) p. 407 - 424
Abstract
Allergologie select, Vol. 8/2024 (407-424)
Occupational anaphylaxis: A Position Paper of the German Society of Allergology and Clinical Immunology (DGAKI)
Regina Treudler1, Margitta Worm2, Andrea Bauer3, Heinrich Dickel4, Guido Heine5, Uta Jappe6, Ludger Klimek7, Monika Raulf8, Bettina Wedi9, Dorothea Wieczorek9, Wojciech Francuzik2, Thilo Jakob10, Oliver Pfaar11, Johannes Ring12, Franziska Rueff13, Sabine Schnadt14, Thomas Werfel9, Gerda Wurpts15, Julia Zarnowski16, Torsten Zuberbier1,17, and Knut Brockow12
1Institute of Allergology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, 2Department of Dermatology, Venereology and Allergology, Charité – Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, 3Department of Dermatology, University AllergyCenter, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, 4Department of Dermatology, Venereology and Allergology, St. Josef Hospital, University Medical Center, Ruhr University Bochum, Bochum, 5Department of Dermatology, Venereology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, 6Division of Clinical and Molecular Allergology, Research Center Borstel, Airway Research, Center North (ARCN), Member of the German Center for Lung Research, Borstel, Interdisciplinary Allergy Outpatient Clinic, Department of Pneumology, University of Luebeck, 7Department of Otolaryngology, Head and Neck Surgery, Universitätsmedizin Mainz, Mainz and Center for Rhinology and Allergology, Wiesbaden, 8Department of Allergology/Immunology; Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bochum, Germany, 9Department of Dermatology and Allergy, Comprehensive Allergy Center, Hannover Medical School, Hannover, 10Department of Dermatology and Allergology, University Medical Center Giessen (UKGM), Justus-Liebig-University Giessen, Giessen, 11Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Philipps-Universität Marburg, Marburg, 12Department of Dermatology and Allergy Biederstein, School of Medicine and Health, Technical University of Munich TUM), 13Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, 14German Allergy and Asthma Association (DAAB), Mönchengladbach, 15Clinic for Dermatology and Allergology, Aachen Comprehensive Allergy Center (ACAC), University Hospital of RWTH Aachen University, Aachen, 16Department of Dermatology, Venerology and Allergology, University of Leipzig Medical Center, Leipzig, and 17Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
Background: Anaphylaxis is a systemic allergic reaction that is potentially life-threatening. Occupational anaphylaxis is an anaphylaxis that occurs in an occupational context. In this position paper, we propose diagnostic criteria for occupational anaphylaxis and provide an overview of the current state of knowledge in terms of prevalence, triggers, prevention, and management. Results: The most common triggers of occupational anaphylaxis include Hymenoptera venoms, followed by food and drugs. Chemicals, bites or contact with animals (mammals/snakes/insects) and natural rubber latex are far less common. Occupations at risk for occupational anaphylaxis are therefore beekeepers, outdoor workers, or those who handle food as well as healthcare workers. The route of contact, intensity, and frequency of exposure, type of allergen, and the simultaneous occurrence of co-factors determine the clinical manifestation. A detailed medical history is required to confirm the diagnosis of anaphylaxis and to identify the trigger. Both skin tests and the determination of specific IgE are recommended, but only very few commercially available and quality-tested allergens are available that can be examined using both test methods. Preventive measures are based on avoiding further exposure or, if necessary, replacing a working substance. A written emergency plan and the prescription of an adrenaline autoinjector as well as instructions for its use are mandatory. Allergen immunotherapy is recommended for systemic Hymenoptera venom allergy. Depending on the national healthcare systems, patients with occupational anaphylaxis must be reported to the accident insurance. Conclusion: Occupational anaphylaxis is very rare. We recommend educational measures and generally standardized recording of occupational anaphylaxis for occupations with an increased risk of anaphylaxis.Correspondence to:
Prof. Dr. Regina Treudler, Charité – Universitätsmedizin Berlin, Campus Benjamin Franklin, Institute of Allergology, Hindenburgdamm 30, 12203 Berlin, Germany
Email: [email protected]
Original
Significant handling errors and education gaps regarding the use of the emergency kit among adult patients with Hymenoptera venom allergy
Julia Zarnowski, Louise Wilkens, and Regina Treudler
Volume 9 (2025) p. 1 - 7
Abstract
Allergologie select, Vol. 9/2025 (1-7)
Significant handling errors and education gaps regarding the use of the emergency kit among adult patients with Hymenoptera venom allergy
Julia Zarnowski1, Louise Wilkens1, and Regina Treudler1,2
1Department of Dermatology, Venereology and Allergology, University Hospital Leipzig, Leipzig, and 2Institute of Allergology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
Aim: In case of systemic anaphylactic reactions after Hymenoptera stings, patients should be provided with an adrenaline autoinjector (AAI). We aimed to evaluate the education and handling competence of patients in a real-world setting. Materials and methods: Patients with Hymenoptera venom allergy presenting for the first time in our clinic with a previously prescribed emergency kit including an AAI were interviewed using a standardized questionnaire and were asked to demonstrate the AAI use with a dummy. Results: 82 patients (62.2% female, mean age 52.0 ± 17.3 years) with allergy to wasp venom (85.3%), bee venom (9.8%), or hornet venom (4.9%) were included. 37.8% reported to have received a practical training on the AAI upon prescription. 59.8% of all patients showed significant handling errors which would have led to misinjections in 30.6%. Conclusion: Our data demonstrate a considerable lack of education, significant handling errors of the emergency kit, and a high risk of misinjections of the AAI. As the emergency kit is potentially lifesaving, the awareness for a sufficient education and training needs to be risen.Correspondence to:
Dr. med. Julia Zarnowski, Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig, Philipp-Rosenthal-Straße 69, 04103 Leipzig, Germany
Email: [email protected]
Original
Substantial psychosocial impairments in patients with chronic urticaria are associated with delayed referral to urticaria centers, non-academic treatments, and dietary changes
Julia Zarnowski, Paula Kage, and Regina Treudler
Volume 9 (2025) p. 8 - 15
Abstract
Allergologie select, Vol. 9/2025 (8-15)
Substantial psychosocial impairments in patients with chronic urticaria are associated with delayed referral to urticaria centers, non-academic treatments, and dietary changes
Julia Zarnowski1, Paula Kage1,2, and Regina Treudler1,3
1Department of Dermatology, Venereology and Allergology, University Hospital Leipzig, Leipzig, 2Dermatological practice, Dr. med. Paula Kage, Freiberg, and 3Institute for Allergology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
Background: Chronic idiopathic urticaria (CIU) is common in allergological practice. Although therapeutic options have improved in the past decade, patients still suffer from a significant burden of disease and are often treated insufficiently. Objective: We aimed at analyzing the psychiatric comorbidities, social impairments, and treatment gap in a real-world setting. Materials and methods: Adult patients with CIU were investigated for demographical data, medical history, and psychosocial burden. Validated questionnaires were used to assess urticaria activity, control of disease, quality-of-life impairment, and psychiatric comorbidities. Results: 82 patients (78% female; 47.5 ± 14.8 years) were included. 65.9% had insufficient disease control, 11% reported on prior self-medication with drugs, 19.5% were seeking help from non-academic medicine, and 54.9% tried a change of diet. The use of non-academic treatment was significantly associated with higher disease activity. Self-initiated dietary changes were significantly associated with less control of disease. Delayed referrals to a urticaria-specialized center were significantly linked to self-reported psychiatric diseases, self-medication with drugs and self-initiated dietary changes. Conclusion: Our data show an unsatisfactory control of CIU in many patients and substantial psychosocial impairments which are also associated with a delayed referral to urticaria centers, self-initiated non-academic treatments, and dietary changes.Correspondence to:
Dr. med. Julia Zarnowski, Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig, Philipp-Rosenthal-Straße 69, 04103 Leipzig, Germany
Email: [email protected]
