Abstract
Allergologie select, Vol. 5/2021 (133-139)
Anaphylaxis in middle-aged patients
Wojciech Francuzik1, Magdalena Kraft1,2, Kathrin Scherer Hofmeier3, Franziska Ruëff4, Claudia Pföhler5, Regina Treudler6, Roland Lang7, Thomas Hawranek7, Nicola Wagner8, und Margitta Worm1
1Allergy and Immunology, Department of Dermatology, Venereology and Allergology, Charité – Universitätsmedizin Berlin, Berlin, 2Central Emergency Department, University Hospital Halle (Saale), Martin Luther University Halle-Wittenberg, Halle (Saale), Germany 3Allergology, Clinic for Dermatology, University Hospital Basel, Basel, Switzerland, 4Clinic and Polyclinic for Dermatology and Allergology, University Hospital Munich, Munich, 5Clinic for Dermatology, Venerology and Allergology, Saarland University Hospital and Medical Faculty of Saarland University, Homburg, 6Clinic and Polyclinic for Dermatology, Venerology and Allergology, Leipzig University Hospital, Leipzig, Germany, 7University Clinic for Dermatology and Allergology, Paracelsus Medical Private University Salzburg, Salzburg, Austria and 8Dermatology Clinic, Erlangen University Hospital, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
Age is one of the most important factors influencing the course of anaphylaxis: moreover, the frequency of elicitors of anaphylaxis is age-associated. We analyzed 8,465 anaphylactic episodes in adult patients in three age groups with a focus on patients in the middle-age group (35 – 65 years old). Insect venom was the most frequent trigger in this age group (51.2%) followed by drugs (22.8%) and food (17.3%). Severe reactions were observed in 40.1% of middle-aged patients and occurred more frequently in this age group than in patients below 35 years (27.6%) and less frequently than in patients over 65 years (55.6%). The symptoms and comorbidity profile also changed with age, most significantly regarding the increase in rates of concomitant cardiologic diseases and (severe) cardiovascular symptoms.Correspondence to:
Prof. Dr. med. Margitta Worm, Allergologie und Immunologie, Klinik für Dermatologie, Venerologie, und Allergologie, Charité – Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin
Email: [email protected]
Abstract
Allergologie select, Vol. 9/2025 (28-39)
Recommendations on how to proceed in case of suspected allergy to penicillin/β-lactam antibiotics. Position paper of the German Society for Allergology and Clinical Immunology (DGAKI) in cooperation with the German Society for Pediatric Allergology (
Knut Brockow1, Wolfgang Pfützner2, Bettina Wedi3, Gerda Wurpts4, Axel Trautmann5, Burkhard Kreft6, Timo Buhl7, Mathias Sulk8, Andreas Recke9, Kathrin Scherer10, Stefan Wöhrl11, Irena Neustädter12, Regina Treudler13, Christiane Querbach14, and Margitta Worm15
1Department of Dermatology and Allergology Biederstein, Faculty of Medicine and Health, Technical University of Munich, Munich, 2Department of Dermatology and Allergology, University Hospital Giessen and Marburg, Marburg, 3Hanover Medical School, Department of Dermatology, Allergology and Venereology, Hanover, 4Department of Dermatology and Allergology, Germany, Aachen Comprehensive Allergy Center (ACAC), University Hospital of RWTH Aachen University, Aachen, 5Department of Dermatology and Allergology, Allergy Center Mainfranken, University Hospital Würzburg, Würzburg, 6Department of Dermatology and Venereology, University Hospital Halle, Halle (Saale), 7Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, 8Department of Dermatology, Münster University Hospital, Münster, 9Department of Dermatology, Allergology and Venereology, University Hospital Schleswig-Holstein, Holstein Campus Lübeck, Lübeck, Germany, 10Department of Dermatology, Cantonal Hospital Aarau, Aarau, and Department of Dermatology and Allergology, University Hospital Basel, Switzerland, 11Floridsdorf Allergy Center (FAZ), Vienna, Austria, 12Pediatric Clinic, Diakoneo Klinik Hallerwiese-Cnopfsche Kinderklinik, Nuremberg, 13Institute for Allergy Research, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, 14Hospital Pharmacy, Klinikum rechts der Isar, Technical University of Munich, Munich, and 15Allergology and Immunology, Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany
β-lactam antibiotics (BLAs) are still the antibiotics of first choice for the treatment of many bacterial infections. Treatment with a BLA is often hindered by a suspected allergy, up to 10% of the population report an allergy to penicillin. After Position Paper allergological evaluation of the suspected allergic reaction to a BLA, most patients show a low probability of a BLA allergy; only in a minority of cases an allergic reaction to the repeated administration of a BLA appear likely in view of the previous history. In > 90% of cases, the suspected BLA allergy can be ruled out by allergy diagnostics. We recommend a risk-stratified approach in the context of an urgent need for BLA, which should enable most patients to receive a BLA therapy. After acute therapy, allergy diagnostics have to be done to clearly prove or reliably rule out a BLA allergy.Correspondence to:
Prof. Dr. med. Knut Brockow, Department of Dermatology and Allergology Biederstein, Faculty of Medicine and Health, Technical University of Munich, Biedersteiner Strasse 29, 80802 Munich, Germany
Email: [email protected]
Abstract
Allergologie select, Vol. 10/2026 (262-267)
Fixed drug eruption to propofol: Case series and clinical implications
Carole Guillet1,2,3,4,5, Elisabeth Gössinger1,2,3, Lukas Joerg6, Barbara Ballmer-Weber4,7, Felicitas Bellutti-Enders3,8, Valentina N.S. Hongler1,2,3, Hazem A. Juratli2,3,9,10, Karin Hartmann1,2,3,11, Thierry Girard2,3,12, Anne Leuppi-Taegtmeyer3,11,13,14, Kathrin Scherer3,15, Minaya Beigi1,2,3, and Esther Helen Steveling-Klein1,2,3,15
1Division of Allergy, Department of Dermatology, 2Department of Biomedicine, University Hospital Basel and University of Basel, Basel, 3Faculty of Medicine, University Basel, Basel, 4Department of Dermatology, University Hospital Zurich, Zurich, 5Faculty of Medicine, University of Zurich, Zurich, 6Division of Allergology and Clinical Immunology, Department of Pulmonary Medicine, Allergology and Clinical Immunology, Inselspital, Bern University Hospital, University of Bern, Bern, 7Division of Allergy, Clinic for Dermatology and Allergology, Kantonsspital St. Gallen, St. Gallen, 8Allergy Unit, University Children’s Hospital Basel, Basel, 9Department of Dermatology, Universityhospital Basel, Basel, 10Department of Pathology, University Hospital Basel, Basel, 11Department of Clinical Research, University Hospital Basel and University of Basel, Basel, 12Clinic for Anaesthesia, Intermediate Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel and University of Basel, Basel, 13Department of Patient Safety, Medical Directorate, University Hospital Basel, Basel, 14Clinical Pharmacology and Clinical Pharmacy Service, Cantonal Hospital Baselland, Liestal, and 15Dermatology and Allergology, Cantonal Hospital Aarau, Aarau, Switzerland
Background: Fixed drug eruption (FDE) is a type IV delayed hypersensitivity reaction characterized by recurrent lesions at the same site upon drug re-exposure. Propofol-induced FDE is extremely rare. Case Report: We report four cases of FDE following propofol administration, presenting with erythematous or bullous lesions at fixed sites, sometimes with mucosal involvement. Standard skin tests and lymphocyte transformation tests were frequently negative, particularly when performed outside previously affected areas. Diagnosis was confirmed by controlled intravenous provocation in one adult case. Histology supported the diagnosis when available. Discussion: FDE to propofol is likely under-recognized due to delayed onset of lesions. Diagnostic testing can be challenging, and controlled re-exposure may be required. Awareness of this rare reaction is important given propofol’s widespread use and limited alternative anaesthetic options. Reporting such cases improves recognition and guides safe management.Correspondence to:
Esther Steveling-Klein, MD, Division of Allergy, Department of Dermatology, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland
Email: [email protected]
