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1. The DERMACLEAR study: Verification results of a natural language processing system in dermatology

Author

Francisco J. Ortiz de Frutos, Ana M. Giménez‐Arnau, Lluís Puig, Juan F. Silvestre, Esther Serra, Laura Salgado‐Boquete, Vicente García‐Patos, Jose L. L. Estebaranz, Jaime Notario, Ana Martin‐Santiago, Gabriel M. Pontevia, Víctor Martín, Guillermo Guinea, Pau Terradas, and Esteban Daudén

Subjects
deep learning, dermatology, machine learning, natural language processing, OMOP CSM, real world data, Dermatology, RL1-803, Diseases of the genitourinary system. Urology, RC870-923
Abstract

Abstract Background Accurately determining the epidemiology of dermatological diseases such as hidradenitis suppurativa (HS), psoriasis (PsO), chronic urticaria (CU) and/or atopic dermatitis (AD) is challenging due to variations in prevalence and disease severity in the reported literature. Objectives The DERMACLEAR study aims to use natural language processing (NLP) to assess the proportions of patients with HS, PsO, CU and/or AD, and obtain information on patient profiles, patient journeys, and disease and healthcare burden in Spain. Here, the study design and objectives of the DERMACLEAR study are described and the precision of the NLP system used is assessed. Methods This study will retrospectively collect patient information from electronic health records (EHRs) at dermatology departments from seven tertiary hospitals in Spain. The NLP system was developed by IOMED Medical Solutions and was verified internally (IOMED scientific team) and externally (principal investigators of each hospital) to determine its precision in identifying patients with HS, PsO, CU and/or AD. Furthermore, internal verification was performed on other medical variables relevant to the study. Results To date, the DERMACLEAR study has retrospectively collected data from 54,458 patients with HS, PsO, CU and/or AD (HS: 5045; PsO: 32,559; CU: 8397; AD: 12,492). The average precision of the NLP system to identify patients diagnosed with HS, PsO, CU, and/or AD across all hospitals exceeded 95% via external and internal verification. Conclusions Results from the DERMACLEAR study will increase the real‐world evidence of clinical practice, obtaining a large amount of information on patients with the studied diseases. The NLP system used is precise in identifying patients diagnosed with HS, PsO, CU and/or AD, and other medical variables from EHRs, highlighting that it is a valid system to use in the DERMACLEAR study.

Published
2023
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2. A global perspective on stepping down chronic spontaneous urticaria treatment: Results of the Urticaria Centers of Reference and Excellence SDown‐CSU study

Author

Murat Türk, Emek Kocatürk, Ragıp Ertaş, Luis Felipe Ensina, Silvia Mariel Ferrucci, Clive Grattan, Christian Vestergaard, Torsten Zuberbier, Marcus Maurer, and Ana Maria Giménez‐Arnau

Subjects
antihistamine, chronic urticaria, cyclosporine, guideline, omalizumab, step down, Immunologic diseases. Allergy, RC581-607
Abstract

Abstract Background Although there have been significant advances in the treatment of chronic spontaneous urticaria (CSU) in recent years, there remains a lack of clear guidance on when and how to step down treatment in responders. This study aims to investigate stepping down approaches of different steps of CSU treatment from a global perspective. Methods “Stepping down chronic spontaneous urticaria treatment” (SDown‐CSU) is an international, multicenter, observational, cross‐sectional, survey‐based study of the Urticaria Centers of Reference and Excellence (UCARE) network. The questionnaire included 48 questions completed by physicians in the UCARE network. Results Surveys completed by 103 physicians from 81 UCAREs and 34 countries were analyzed. Seventy‐eight percent of the participants responded that they had a national urticaria management guideline written by their professional societies and 28% responded that they had to operate under a regulatory guideline proposed by central health funding organizations. Seventy‐two and 58.7% of these national recommendations do not contain any detailed information on when and/or how CSU treatment should be discontinued. There was a lack of detailed information on antihistamines and cyclosporine in particular. A predefined maximum duration was generally not applicable to omalizumab and cyclosporine (81% and 82%, respectively). Nearly all UCAREs step down omalizumab within 6 months from the first controlled status and 42% discontinue cyclosporine after 6 months regardless of the control status. Conclusions The findings from the SDown‐CSU study clearly highlight a global need for guidance on the process of stepping down treatment in CSU. Additionally, the study offers a step‐down algorithm applicable to all stages of CSU treatment.

Published
2024
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3. A concept for integrated care pathways for atopic dermatitis—A GA2LEN ADCARE initiative

Author

Torsten Zuberbier, Amir Abdul Latiff, Xenofon Aggelidis, Matthias Augustin, Radu‐Gheorghe Balan, Christine Bangert, Lisa Beck, Thomas Bieber, Jonathan A. Bernstein, Marta Bertolin Colilla, Alejandro Berardi, Anna Bedbrook, Carsten Bindslev‐Jensen, Jean Bousquet, Marjolein deBruin‐Weller, Dayanne Bruscky, Betul Buyuktiryaki, Giorgio Walter Canonica, Carla Castro, Natia Chanturidze, Herberto Jose Chong‐Neto, Chia‐Yu Chu, Leena Chularojanamontri, Michael Cork, Roberta F. J. Criado, Laia Curto Barredo, Adnan Custovic, Ulf Darsow, Arben Emurlai, Ana dePablo, Stefano DelGiacco, Giampiero Girolomoni, Tanja Deleva Jovanova, Mette Deleuran, Nikolaos Douladiris, Bruno Duarte, Ruta Dubakiene, Esben Eller, Batya Engel‐Yeger, Luis Felipe Ensina, Nelson Rosario Filho, Carsten Flohr, Daria Fomina, Wojciech Francuzik, Maria Laura Galimberti, Ana M. Giménez‐Arnau, Kiran Godse, Charlotte Gotthard Mortz, Maia Gotua, Michihiro Hide, Wolfram Hoetzenecker, Nicolas Hunzelmann, Alan Irvine, Carolyn Jack, Ioanna Kanavarou, Norito Katoh, Tamar Kinaciyan, Emek Kocatürk, Kanokvalai Kulthanan, Hilde Lapeere, Susanne Lau, Mariana Machado Forti Nastri, Michael Makris, Eli Mansour, Alexander Marsland, Mara Morelo Rocha Felix, Ana Paula Moschione Castro, Eustachio Nettis, J. F. Nicolas, Audrey Nosbaum, Mikaela Odemyr, Niki Papapostolou, Claudio A. S. Parisi, Sushil Paudel, Jonny Peter, Prakash Pokharel, Luis Puig, Tamara Quint, German Dario Ramon, Frederico Regateiro, Giampaolo Ricci, Cristine Rosario, Cansin Sackesen, Peter Schmid‐Grendelmeier, Esther Serra‐Baldrich, Kristina Siemens, Cathrine Smith, Petra Staubach, Katarina Stevanovic, Özlem Su‐Kücük, Gordon Sussman, Simona Tavecchio, Natasa Teovska Mitrevska, Diamant Thaci, Elias Toubi, Claudia Traidl‐Hoffmann, Regina Treudler, Zahava Vadasz, Ingrid vanHofman, Maria Teresa Ventura, Zhao Wang, Thomas Werfel, Andreas Wollenberg, Ariana Yang, Yik Weng Yew, Zuotao Zhao, Ricardo Zwiener, and Margitta Worm

Subjects
atopic dermatitis, eczema, guidance, ICP, integrated care pathways, multidisciplinary, Immunologic diseases. Allergy, RC581-607
Abstract

Abstract Introduction The integrated care pathways for atopic dermatitis (AD‐ICPs) aim to bridge the gap between existing AD treatment evidence‐based guidelines and expert opinion based on daily practice by offering a structured multidisciplinary plan for patient management of AD. ICPs have the potential to enhance guideline recommendations by combining interventions and aspects from different guidelines, integrating quality assurance, and describing co‐ordination of care. Most importantly, patients can enter the ICPs at any level depending on AD severity, resources available in their country, and economic factors such as differences in insurance reimbursement systems. Methods The GA2LEN ADCARE network and partners as well as all stakeholders, abbreviated as the AD‐ICPs working group, were involved in the discussion and preparation of the AD ICPs during a series of subgroup workshops and meetings in years 2020 and 2021, after which the document was circulated within all GAL2EN ADCARE centres. Results The AD‐ICPs outline the diagnostic procedures, possible co‐morbidities, different available treatment options including differential approaches for the pediatric population, and the role of the pharmacists and other stakeholders, as well as remaining unmet needs in the management of AD. Conclusion The AD‐ICPs provide a multidisciplinary plan for improved diagnosis, treatment, and patient feedback in AD management, as well as addressing critical unmet needs, including improved access to care, training specialists, implementation of educational programs, assessment on the impact of climate change, and fostering a personalised treatment approach. By focusing on these key areas, the initiative aims to pave the way for a brighter future in the management of AD.

Published
2023
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4. Remibrutinib inhibits hives effector cells stimulated by serum from chronic urticaria patients independently of FcεR1 expression level and omalizumab clinical response

Author

Ramón Gimeno, Clara Ribas‐Llauradó, David Pesque, Evelyn Andrades, Bruno Cenni, Barbara Ambros, Ramon Pujol, and Ana M. Giménez‐Arnau

Subjects
basophils, Bruton's tyrosine kinase, chronic urticaria, IgE, mast cells, omalizumab, Immunologic diseases. Allergy, RC581-607
Abstract

Abstract Background Despite advances in the treatment of chronic urticaria, in a significant percentage of the patients symptoms are not fully controlled with conventional approaches. New strategies under development include blocking intracellular mediators of mast cell and basophil activation. Objective We aim to investigate the effects of the Bruton's tyrosine kinase (BTK) inhibitor remibrutinib on human blood basophils and CD34+‐derived mast cells activation induced by serum obtained from chronic urticaria patients. Methods Twenty‐two patients with chronic spontaneous urticaria (mean age 52 years, 27% women) and 22 patients with chronic inducible urticaria (46 years, 27% women) were included in the study together with a sex‐matched control group. Patients were classified as responders or non‐responders to anti‐IgE therapy on the basis of their clinical data, FcεR1a expression on blood basophils and total IgE levels. Changes on CD63 expression—as an activation marker‐, were used to evaluate in vitro the response of basophils and mast cells to serum exposure and the inhibitory effects of remibrutinib. Results Remibrutinib inhibits degranulation induced by IgE cross‐linking in mast cells and basophils and also the activation triggered by factors present in the sera of spontaneous and inducible chronic urticaria patients. Patient's serum induces a greater degranulation of effector cells than controls. Activation of mast cells and basophils by patient sera and remibrutinib effects were not related to omalizumab responsiveness. Conclusion Remibrutinib inhibits activation of human basophils and mast cells induced in vitro by exposure to the serum of chronic urticaria patients independently of their response to omalizumab.

Published
2023
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5. Differential diagnosis of contact dermatitis: A practical‐approach review by the EADV Task Force on contact dermatitis

Author

Pesqué, David, primary, Aerts, Olivier, additional, Bizjak, Mojca, additional, Gonçalo, Margarida, additional, Dugonik, Aleksandra, additional, Simon, Dagmar, additional, Ljubojević‐Hadzavdić, Suzana, additional, Malinauskiene, Laura, additional, Wilkinson, Mark, additional, Czarnecka‐Operacz, Magdalena, additional, Krecisz, Beata, additional, John, Swen M., additional, Balato, Anna, additional, Ayala, Fabio, additional, Rustemeyer, Thomas, additional, and Giménez‐Arnau, Ana M., additional

Published
2024
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6. Polysensitization in the Spanish Contact Dermatitis Registry (REIDAC): A 2019–2022 prospective study with cluster and network analysis

Author

Pesqué, David, primary, Borrego, Leopoldo, additional, Zaragoza‐Ninet, Violeta, additional, Sanz‐Sánchez, Tatiana, additional, Miquel‐Miquel, Francisco Javier, additional, González‐Pérez, Ricardo, additional, Silvestre, Juan Francisco, additional, Córdoba‐Guijarro, Susana, additional, Carrascosa, José Manuel, additional, Gatica‐Ortega, María Elena, additional, Ruiz‐González, Inmaculada, additional, Mercader‐García, Pedro, additional, Tous‐Romero, Fátima, additional, Ortiz de Frutos, Francisco Javier, additional, Serra‐Baldrich, Esther, additional, Pastor‐Nieto, María Antonia, additional, Rodríguez‐Serna, Mercedes, additional, Sánchez‐Pérez, Javier, additional, Sánchez‐Gilo, Araceli, additional, Melé‐Ninot, Gemma, additional, Sánchez‐Pedreño Guillén, Paloma, additional, Pujol, Ramon Maria, additional, and Giménez‐Arnau, Ana María, additional

Published
2024
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7. Sensitisation to textile dyes in Spain: Epidemiological situation (2019–2022)

Author

Hernández Fernández, Carlos Pelayo, primary, Borrego, Leopoldo, additional, Giménez Arnau, Ana María, additional, Zaragoza Ninet, Violeta, additional, Sanz Sánchez, Tatiana, additional, Miquel Miquel, Francisco Javier, additional, González Pérez, Ricardo, additional, Silvestre Salvador, Juan Francisco, additional, Córdoba Guijarro, Susana, additional, Carrascosa Carrillo, José Manuel, additional, Gatica Ortega, María Elena, additional, Ruiz González, Inmaculada, additional, Mercader García, Pedro, additional, Tous Romero, Fátima, additional, Serra Baldrich, Esther, additional, Pastor‐Nieto, María Antonia, additional, Rodríguez Serna, Mercedes, additional, Sánchez Pérez, Javier, additional, Sánchez Gilo, Araceli, additional, Melé Ninot, Gemma, additional, Sánchez‐Pedreño Guillén, Paloma, additional, de Vega Martínez, Marina, additional, Descalzo, Miguel Ángel Gallego, additional, and Doval, Ignacio García, additional

Published
2024
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8. A global perspective on stepping down chronic spontaneous urticaria treatment: Results of the Urticaria Centers of Reference and Excellence SDown‐CSU study

Author

Türk, Murat, primary, Kocatürk, Emek, additional, Ertaş, Ragıp, additional, Ensina, Luis Felipe, additional, Mariel Ferrucci, Silvia, additional, Grattan, Clive, additional, Vestergaard, Christian, additional, Zuberbier, Torsten, additional, Maurer, Marcus, additional, and Giménez‐Arnau, Ana Maria, additional

Published
2024
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9. Ligelizumab improves sleep interference and disease burden in patients with chronic spontaneous urticaria

Author

Ana Giménez‐Arnau, Marcus Maurer, Jonathan Bernstein, Petra Staubach, Nathalie Barbier, Eva Hua, Thomas Severin, Yolandi Joubert, Reinhold Janocha, and Maria‐Magdalena Balp

Subjects
chronische spontane Urtikaria, Lebensqualität, Schlafstörung, tägliches Funktionieren, Immunologic diseases. Allergy, RC581-607
Abstract

Abstract Background Chronic spontaneous urticaria (CSU) negatively impacts patients' sleep, thereby reducing health‐related quality of life (HRQoL). Half of patients with inadequately controlled CSU report sleep interference often or every night, which can lead to depression, anxiety, social, and work‐related problems. Methods This randomized, double‐blind, placebo‐controlled Phase 2b core study (NCT02477332) included adult patients ≥18 years with moderate to severe CSU inadequately controlled with H1‐antihistamines. The current analysis includes patients randomized to receive ligelizumab 72 or 240 mg, omalizumab 300 mg or placebo every 4 weeks (q4w) for five injections over 20 weeks with treatment‐free follow‐up for 24 weeks. Patients could enter the open‐label extension study (NCT02649218) from Week 32 onwards if their weekly urticaria activity score was ≥12, which included an open‐label treatment (52 weeks of ligelizumab 240 mg q4w) and a 48‐week post‐treatment follow‐up. Weekly Sleep Interference Scores (SIS7, range 0 [no interference]–21 [substantial interference]), Weekly Activity Interference Score (AIS7), Dermatology Life Quality Index (DLQI) scores, and Overall Work Impairment were assessed. Results Mean baseline SIS7 scores were balanced between the treatment arms for ligelizumab 72 mg (n = 84) and 240 mg (n = 85), omalizumab 300 mg (n = 85), and placebo (n = 43). By Week 12, patients experienced large improvements in sleep interference, with least square mean (standard error) changes from baseline (CFB) in SIS7 of −7.84 (0.58), −7.55 (0.61), −6.98 (0.60), and −5.85 (0.81), respectively. By Week 12, CFB in AIS7 were −8.25 (0.57), −8.25 (0.59), −7.30 (0.60), and −5.62 (0.79), DLQI scores were −9.79 (0.77), −9.93 (0.81), −8.35 (0.79), and −6.99 (1.11), and Overall Work Impairment scores were −28.96 (3.73), −30.76 (3.71), −25.74 (3.91), and −20.13 (5.10) for ligelizumab 72 and 240 mg, omalizumab 300 mg and placebo, respectively. Improvements in each patient‐reported outcome were sustained with ligelizumab 240 mg treatment during the extension study. Conclusions Ligelizumab showed effective and sustained responses in managing sleep interference in patients with CSU, and numerically higher responses than with omalizumab and placebo. Treating the symptoms of CSU with ligelizumab improved disease burden, HRQoL, and markedly improved sleep quality.

Published
2022
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10. IgE and high‐affinity IgE receptor in chronic inducible urticaria, pathogenic, and management relevance

Author

Ana M. Giménez‐Arnau, Clara Ribas‐Llauradó, Nasser Mohammad‐Porras, Gustavo Deza, Ramón M. Pujol, and Ramón Gimeno

Subjects
basophils, chronic inducible urticaria, FcεRI receptor, IgE, omalizumab, Immunologic diseases. Allergy, RC581-607
Abstract

Abstract Background IgE and high‐affinity IgE receptor (FcεRI) expression on basophils have been scarcely explored in patients with chronic inducible urticaria (CIndU). Objectives To investigate baseline serum IgE and FcεRI expression on blood basophils in a large cohort of CIndU patients and its relationship to treatment response. Methods Baseline total serum IgE and basophil FcεRI expression measured by flow cytometry in 165 patients with CIndU was studied. The relationship of both parameters with the response to antihistamine and anti‐IgE (omalizumab) treatment was considered in a subsample of CIndU patients. FcεRI expression in basophils was assessed by mean fluorescence intensity (MFI) and basophil FcεRI standardized density (receptors/cell). Results The median FcεRI expression standardized per density in blood basophils was found significantly higher in patients with CIndU compared to HCs. A positive correlation was found between IgE serum levels and basophil FcεRI expression. Basal FcεRI expression was not related to antihistamine treatment response. However, it was related to omalizumab, and patients responding to omalizumab showed higher basal basophil expression of FcεRI levels. Non‐responders to the antihistamine showed significantly higher IgE serum levels. Conclusions FcεRI receptor overexpression in patients with CIndU shows almost the same pattern than chronic spontaneous urticaria. It seems to be independent of CIndU subtypes. Although additional studies would be welcome, our work highlights the relevance of FcεRI receptor regulation in CIndU supporting autoimmune basophil and mast cell activation and may be a biomarker for response to anti‐IgE therapy.

Published
2022
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11. Chronic urticaria patients are interested in apps to monitor their disease activity and control: A UCARE CURICT analysis

Author

Ivan Cherrez‐Ojeda, Emanuel Vanegas, Annia Cherrez, Miguel Felix, Karsten Weller, Markus Magerl, Rasmus Robin Maurer, Valeria L. Mata, Alicja Kasperska‐Zajac, Agnieszka Sikora, Daria Fomina, Elena Kovalkova, Kiran Godse, Nimmagadda Dheeraj Rao, Maryam Khoshkhui, Sahar Rastgoo, Roberta F. J. Criado, Mohamed Abuzakouk, Deepa Grandon, Martijn B. A. Van Doorn, Solange Oliveira Rodrigues Valle, Eduardo Magalhães De Souza Lima, Simon Francis Thomsen, German D. Ramón, Edgar E. Matos Benavides, Andrea Bauer, Ana M. Giménez‐Arnau, Emek Kocatürk, Carole Guillet, Jose Ignacio Larco, Zuo‐Tao Zhao, Michael Makris, Carla Ritchie, Paraskevi Xepapadaki, Luis Felipe Ensina, Sofia Cherrez, and Marcus Maurer

Subjects
apps, chronische induzierbare urtikaria, chronische spontane urtikaria, chronische urtikaria, UCARE, Immunologic diseases. Allergy, RC581-607
Abstract

Abstract Background Information/communication technologies such as mobile phone applications (apps) would enable chronic urticaria (CU) patients to self‐evaluate their disease activity and control. Yet, recently Antó et al (2021) reported a global paucity of such apps for patients with CU. In this analysis, we assessed patient interest in using apps to monitor CU disease activity and control using questions from the chronic urticaria information and communication technologies (CURICT) study. Methods The methodology for CURICT has been reported. Briefly, a 23‐item questionnaire was completed by 1841 CU patients from 17 UCAREs across 17 countries. Here, we analyzed patient responses to the CURICT questions on the use of apps for urticaria‐related purposes. Results As previously published, the majority of respondents had chronic spontaneous urticaria (CSU; 63%; 18% chronic inducible urticaria (CIndU) [CIndu]; 19% with both), were female (70%) and in urban areas (75%). Over half of patients were very/extremely interested in an app to monitor disease activity (51%) and control (53%), while only ∼1/10 were not. Patients with both urticaria types versus those with CSU only (odds ratio [OR], 1.36 [1.03–1.79]) and females versus males (OR [95% CI], 1.47 [1.17–1.85]) were more likely to be very to extremely interested in an app to assess disease control. Conclusions Overall, half of the patients with CU were very to extremely interested in using an app to assess their disease activity and control. Development of well‐designed apps, specific to disease types (CSU, CIndU, CSU + CIndU, etc), validated by experts across platforms would help improve the management and possibly outcomes of CU treatment while providing important patient information to be used in future research.

Published
2021
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12. A concept for integrated care pathways for atopic dermatitis—A GA2LEN ADCARE initiative

Author

Zuberbier, Torsten, primary, Abdul Latiff, Amir, additional, Aggelidis, Xenofon, additional, Augustin, Matthias, additional, Balan, Radu‐Gheorghe, additional, Bangert, Christine, additional, Beck, Lisa, additional, Bieber, Thomas, additional, Bernstein, Jonathan A., additional, Bertolin Colilla, Marta, additional, Berardi, Alejandro, additional, Bedbrook, Anna, additional, Bindslev‐Jensen, Carsten, additional, Bousquet, Jean, additional, de Bruin‐Weller, Marjolein, additional, Bruscky, Dayanne, additional, Buyuktiryaki, Betul, additional, Canonica, Giorgio Walter, additional, Castro, Carla, additional, Chanturidze, Natia, additional, Chong‐Neto, Herberto Jose, additional, Chu, Chia‐Yu, additional, Chularojanamontri, Leena, additional, Cork, Michael, additional, Criado, Roberta F. J., additional, Barredo, Laia Curto, additional, Custovic, Adnan, additional, Darsow, Ulf, additional, Emurlai, Arben, additional, de Pablo, Ana, additional, Del Giacco, Stefano, additional, Girolomoni, Giampiero, additional, Deleva Jovanova, Tanja, additional, Deleuran, Mette, additional, Douladiris, Nikolaos, additional, Duarte, Bruno, additional, Dubakiene, Ruta, additional, Eller, Esben, additional, Engel‐Yeger, Batya, additional, Ensina, Luis Felipe, additional, Filho, Nelson Rosario, additional, Flohr, Carsten, additional, Fomina, Daria, additional, Francuzik, Wojciech, additional, Galimberti, Maria Laura, additional, Giménez‐Arnau, Ana M., additional, Godse, Kiran, additional, Mortz, Charlotte Gotthard, additional, Gotua, Maia, additional, Hide, Michihiro, additional, Hoetzenecker, Wolfram, additional, Hunzelmann, Nicolas, additional, Irvine, Alan, additional, Jack, Carolyn, additional, Kanavarou, Ioanna, additional, Katoh, Norito, additional, Kinaciyan, Tamar, additional, Kocatürk, Emek, additional, Kulthanan, Kanokvalai, additional, Lapeere, Hilde, additional, Lau, Susanne, additional, Machado Forti Nastri, Mariana, additional, Makris, Michael, additional, Mansour, Eli, additional, Marsland, Alexander, additional, Morelo Rocha Felix, Mara, additional, Moschione Castro, Ana Paula, additional, Nettis, Eustachio, additional, Nicolas, J. F., additional, Nosbaum, Audrey, additional, Odemyr, Mikaela, additional, Papapostolou, Niki, additional, Parisi, Claudio A. S., additional, Paudel, Sushil, additional, Peter, Jonny, additional, Pokharel, Prakash, additional, Puig, Luis, additional, Quint, Tamara, additional, Ramon, German Dario, additional, Regateiro, Frederico, additional, Ricci, Giampaolo, additional, Rosario, Cristine, additional, Sackesen, Cansin, additional, Schmid‐Grendelmeier, Peter, additional, Serra‐Baldrich, Esther, additional, Siemens, Kristina, additional, Smith, Cathrine, additional, Staubach, Petra, additional, Stevanovic, Katarina, additional, Su‐Kücük, Özlem, additional, Sussman, Gordon, additional, Tavecchio, Simona, additional, Teovska Mitrevska, Natasa, additional, Thaci, Diamant, additional, Toubi, Elias, additional, Traidl‐Hoffmann, Claudia, additional, Treudler, Regina, additional, Vadasz, Zahava, additional, van Hofman, Ingrid, additional, Ventura, Maria Teresa, additional, Wang, Zhao, additional, Werfel, Thomas, additional, Wollenberg, Andreas, additional, Yang, Ariana, additional, Weng Yew, Yik, additional, Zhao, Zuotao, additional, Zwiener, Ricardo, additional, and Worm, Margitta, additional

Published
2023
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13. Skin microdialysis: methods, applications and future opportunities—an EAACI position paper

Author

Katrine Y. Baumann, Martin K. Church, Geraldine F. Clough, Sven Roy Quist, Martin Schmelz, Per Stahl Skov, Chris D. Anderson, Line Kring Tannert, Ana Maria Giménez-Arnau, Stefan Frischbutter, Jörg Scheffel, and Marcus Maurer

Subjects
Microdialysis, Cutaneous, Inflammation, Interstitial, Dermal, Immunologic diseases. Allergy, RC581-607
Abstract

Abstract Skin microdialysis (SMD) is a versatile sampling technique that can be used to recover soluble endogenous and exogenous molecules from the extracellular compartment of human skin. Due to its minimally invasive character, SMD can be applied in both clinical and preclinical settings. Despite being available since the 1990s, the technique has still not reached its full potential use as a tool to explore pathophysiological mechanisms of allergic and inflammatory reactions in the skin. Therefore, an EAACI Task Force on SMD was formed to disseminate knowledge about the technique and its many applications. This position paper from the task force provides an overview of the current use of SMD in the investigation of the pathogenesis of chronic inflammatory skin diseases, such as atopic dermatitis, chronic urticaria, psoriasis, and in studies of cutaneous events during type 1 hypersensitivity reactions. Furthermore, this paper covers drug hypersensitivity, UVB-induced- and neurogenic inflammation, and drug penetration investigated by SMD. The aim of this paper is to encourage the use of SMD and to make the technique easily accessible by providing an overview of methodology and applications, supported by standardized operating procedures for SMD in vivo and ex vivo.

Published
2019
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14. Chronic spontaneous urticaria: Focus on pathophysiology to unlock treatment advances

Author

Allen Kaplan, Mark Lebwohl, Ana M. Giménez‐Arnau, Michihiro Hide, April W. Armstrong, and Marcus Maurer

Subjects
Urticaria, Immunology, Mast cells, Immunology and Allergy, IgE, Dermatology, Angioedema
Abstract

Chronic spontaneous urticaria (CSU) is a debilitating skin disease characterized by intensely itchy wheals, angioedema, or both. Symptoms recur spontaneously, on a near-daily basis, over >6 weeks; many patients experience flare-ups over several years and, consequently, reduced quality of life. Differences between the inflammatory profiles of the skin of CSU patients (wheals and nonlesional sites) and healthy controls indicate that key drivers such as mast cells, eosinophils, and basophils interact, release vasoactive mediators, and prime the skin, leaving patients predisposed to symptoms. Many cytokines and chemokines involved in these inflammatory networks and their corresponding intracellular signaling cascades have been identified. These insights informed the development of therapies such as omalizumab, dupilumab, and Bruton's tyrosine kinase (BTK) inhibitors, marking a renewed focus on pathogenesis in CSU clinical research. Despite progress, current therapies provide symptomatic control but do not appear to redress the inflammatory balance in the skin permanently. A deeper understanding of CSU pathogenesis will permit a more targeted approach to developing novel treatments with curative intent. Here, we review what is known about the pathogenesis of CSU and consider how this can be used to identify rational targets to improve patient care further.

Published
2022

15. MI (2-methyl-4-isothiazolin-3-one) contained in detergents is not detectable in machine washed textiles

Author

Maja A. Hofmann, Ana Giménez-Arnau, Werner Aberer, Carsten Bindslev-Jensen, and Torsten Zuberbier

Subjects
MI, Laundry detergent, Preservative, Contact allergy, Immunologic diseases. Allergy, RC581-607
Abstract

Abstract Background European legislation has banned the preservative methylisothiazolinone (MI) from inclusion in leave-on cosmetics. However, the risk for allergic reactions depends on exposure. The aim of this study was to determine the risk of MI in laundry detergents for household machine washing. Methods Different formulations of laundry detergents with commercial MI levels, up to one thousand ppm were used and three different types of clothes were washed in a normal household machine setting one time and 10 times. The level of MI was measured by HPLC. Results While MI could be retrieved in the positive control of clothes drenched with washing powder but not washed afterwards, MI could not be detected in any specimen of clothes washed under household conditions. The detection limit was 0.5 ppm. Conclusion It is important to discuss the difference of risk and hazard. While MI clearly is a high hazard as a strong contact allergen, the risk depends on exposure. Regarding the risk of exposure levels for the consumer to MI in clothes it can be stated that the use of MI in laundry detergents is safe for the consumer if these products are used according to the instructions in the normal household setting machine wash.

Published
2018
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16. The DERMACLEAR study: Verification results of a natural language processing system in dermatology

Author

Ortiz de Frutos, Francisco J., primary, Giménez‐Arnau, Ana M., additional, Puig, Lluís, additional, Silvestre, Juan F., additional, Serra, Esther, additional, Salgado‐Boquete, Laura, additional, García‐Patos, Vicente, additional, Estebaranz, Jose L. L., additional, Notario, Jaime, additional, Martin‐Santiago, Ana, additional, Pontevia, Gabriel M., additional, Martín, Víctor, additional, Guinea, Guillermo, additional, Terradas, Pau, additional, and Daudén, Esteban, additional

Published
2023
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18. Chronic hand eczema in Europe: Patient experiences and perspectives ( CHEPEP ) in qualitative interviews

Author

Rönsch, H., primary, Schiffers, F., additional, Ofenloch, R., additional, Weisshaar, E., additional, Buse, A. S., additional, Hansen, A., additional, John, S. M., additional, Giménez Arnau, A. M., additional, Pesqué, D., additional, Agner, T., additional, Nørreslet, L. B., additional, Loman, L., additional, Romeijn, G. L. E., additional, Schuttellaar, M. L. A., additional, Košćec Bjelajac, A., additional, Macan, J., additional, Apfelbacher, C., additional, and Bauer, A., additional

Published
2023
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20. Sensitization to isothiazolinones in the Spanish Contact Dermatitis Registry (REIDAC): 2019–2021 epidemiological situation

Author

Dermatología, oftalmología y otorrinolaringología, Dermatologia, oftalmologia eta otorrinolaringologia, Hernández Fernández, Carlos Pelayo, Borrego Hernando, Leopoldo, Mercader García, Pedro, Giménez Arnau, Anna María, Sánchez Pérez, Javier, Silvestre Salvador, Juan Francisco, González Pérez, Ricardo, Sanz Sánchez, Tatiana, Sánchez Gilo, Araceli, Melé Ninot, Gemma, Zaragoza Ninet, Violeta, Miquel Miquel, Francisco Javier, Carrascosa Carrillo, José Manuel, Córdoba Guijarro, Susana, Gatica Ortega, María Elena, Ruiz González, Inmaculada, Serra Baldrich, Esther, Tous Romero, Fátima, Rodríguez Serna, Mercedes, Pastor Nieto, María Antonia, Pérez Feal, Patricia, Hervella Garcés, Marcos, De Vega Martínez, Marina, García Doval, Ignacio, Dermatología, oftalmología y otorrinolaringología, Dermatologia, oftalmologia eta otorrinolaringologia, Hernández Fernández, Carlos Pelayo, Borrego Hernando, Leopoldo, Mercader García, Pedro, Giménez Arnau, Anna María, Sánchez Pérez, Javier, Silvestre Salvador, Juan Francisco, González Pérez, Ricardo, Sanz Sánchez, Tatiana, Sánchez Gilo, Araceli, Melé Ninot, Gemma, Zaragoza Ninet, Violeta, Miquel Miquel, Francisco Javier, Carrascosa Carrillo, José Manuel, Córdoba Guijarro, Susana, Gatica Ortega, María Elena, Ruiz González, Inmaculada, Serra Baldrich, Esther, Tous Romero, Fátima, Rodríguez Serna, Mercedes, Pastor Nieto, María Antonia, Pérez Feal, Patricia, Hervella Garcés, Marcos, De Vega Martínez, Marina, and García Doval, Ignacio

Abstract

Background: Current frequency and risk factors for sensitization to methylisothiazolinone (MI), methylchloroisothiazolinone/methylisothiazolinone (MCI/MI), benzisothiazolinone (BIT) and octylisothiazolinone (OIT) in Spain are not well known. Objectives: To study the frequency of sensitization, risk factors and simultaneous sensitization between the four isothiazolinones. Materials and Methods: We analysed all 2019-2021 consecutive patients patch-tested with MI (0.2% aq.), MCI/MI (0.02% aq.), BIT (0.1% pet.) and OIT (0.1% pet) within the Spanish Contact Dermatitis Registry (REIDAC). Results: A total of 2511 patients were analysed. Frequencies of sensitization were: any isothiazolinone 15.7%, MI 6.8%, MCI/MI 4.8%, BIT 3.5% and OIT 0.5%. MI and MCI/MI sensitization was associated with being occupationally active, hand dermatitis, detergents and age over 40. BIT sensitization was associated with leg dermatitis and age over 40. About one in nine MI-positive patients were positive to BIT, whereas one in five BIT-positive patients were positive to MI. Conclusions: Sensitization to MI, MCI/MI and BIT is still common in Spain, while sensitization to OIT is rare. Currently, sensitization to MI and MCI/MI seems to be occupationally related. Although its origin is unknown, sensitization to BIT is more frequent in patients aged over 40 years. Simultaneous sensitization between MI and BIT is uncommon.

Published
2023

22. European Surveillance System on Contact Allergies (ESSCA)

Author

Loman, Laura, Uter, Wolfgang, Armario-Hita, José C., Ayala, Fabio, Balato, Anna, Ballmer-Weber, Barbara K., Bauer, Andrea, Bircher, Andreas J., Buhl, Timo, Czarnecka-Operacz, Magdalena, Dickel, Heinrich, Fuchs, Thomas, Giménez Arnau, Ana, John, Swen M., Kränke, Birger, Kręcisz, Beata, Mahler, Vera, Rustemeyer, Thomas, Sadowska-Przytocka, Anna, Sánchez-Pérez, Javier, Scherer Hofmeier, Kathrin, Schliemann, Sibylle, Simon, Dagmar, Spiewak, Radoslaw, Spring, Philip, Valiukevičienė, Skaidra, Wagner, Nicola, Weisshaar, Elke, Pesonen, Maria, Schuttelaar, Marie L. A., Aberer, Werner, Beiteke, Ulrike, Frosch, Peter, Werfel, Thomas, Elsner, Peter, Becker, Detlef, Sliuziaviciene, Gondinga, Kiec-Swierczynska, Marta, Silvestre, Juan F., Ruiz, Inmaculada, Mercader, Pedro, Fernández-Redondo, Virginia, García-Gavín, Juan, Grabbe, J. rgen, Navarini, Alexander, Loman, Laura, Uter, Wolfgang, Armario-Hita, José C, Ayala, Fabio, Balato, Anna, Ballmer-Weber, Barbara K, Bauer, Andrea, Bircher, Andreas J, Buhl, Timo, Czarnecka-Operacz, Magdalena, Dickel, Heinrich, Fuchs, Thoma, Giménez Arnau, Ana, John, Swen M, Kränke, Birger, Kręcisz, Beata, Mahler, Vera, Rustemeyer, Thoma, Sadowska-Przytocka, Anna, Sánchez-Pérez, Javier, Scherer Hofmeier, Kathrin, Schliemann, Sibylle, Simon, Dagmar, Spiewak, Radoslaw, Spring, Philip, Valiukevičienė, Skaidra, Wagner, Nicola, Weisshaar, Elke, Pesonen, Maria, Schuttelaar, Marie L A, Medicina, Dermatology, and Public Health Research (PHR)

Subjects
medicine.medical_specialty, Allergy, IMPACT, Population, 610 Medicine & health, Dermatology, Disease, occupational contact dermatiti, sensitization, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, irritant contact dermatitis, Epidemiology, medicine, Immunology and Allergy, ATOPIC-DERMATITIS, Clinical significance, 030212 general & internal medicine, NETWORK, education, RRID, Allergic contact dermatitis, patch testing, education.field_of_study, patch test, Kontaktallergie, allergic contact dermatitis, body site, contact allergy, business.industry, SCR_001905 [RRID], BASE-LINE SERIES, Original Articles, medicine.disease, RRID:SCR_001905, 3. Good health, occupational contact dermatitis, irritant contact dermatiti, DISEASES, Irritant contact dermatitis, Original Article, epidemiology, eczema, SCR_001905, business, Contact dermatitis, SKIN
Abstract

Background Irritant contact dermatitis (ICD) is caused by the acute locally toxic effect of a strong irritant, or the cumulative exposure to various weaker physical and/or chemical irritants. Objectives To describe characteristics of patients with ICD in the population patch tested in the European Surveillance System on Contact Allergies (ESSCA; www.essca-dc.org) database. Methods Data collected by the ESSCA in consecutively patch tested patients from January 2009 to December 2018 were analyzed. Results Of the 68 072 patients, 8702 patients were diagnosed with ICD (without concomitant allergic contact dermatitis [ACD]). Hand and face were the most reported anatomical sites, and 45.7% of the ICD was occupational ICD (OICD). The highest proportions of OICD were found in metal turners, bakers, pastry-cooks and confectionery makers. Among patients diagnosed with ICD, 45% were found sensitized with no relevance for the current disease. Conclusions The hands were mainly involved in OICD also in the subgroup of contact dermatitis patients, in whom relevant contact sensitization had been ruled out, emphasizing the need for limiting irritant exposures. However, in difficult to treat contact dermatitis, unrecognized contact allergy, or unrecognized clinical relevance of identified allergies owing to incomplete or wrong product ingredient information must always be considered. This article is protected by copyright. All rights reserved.

Published
2021

23. Which outcomes should be measured in hand eczema trials? Results from patient interviews and an expert survey

Author

Rönsch, H., primary, Schiffers, F., additional, Ofenloch, R., additional, Weisshaar, E., additional, Buse, A. S., additional, Hansen, A., additional, John, S. M., additional, Giménez Arnau, A. M., additional, Pesqué, D., additional, Agner, T., additional, Nørreslet, L. B., additional, Loman, L., additional, Romeijn, G. L. E., additional, Schuttelaar, M. L. A., additional, Košćec Bjelajac, A., additional, Macan, J., additional, Bauer, A., additional, and Apfelbacher, C., additional

Published
2023
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24. The European baseline series and recommended additions: 2023

Author

Wilkinson, S. Mark, primary, Gonçalo, Margarida, additional, Aerts, Olivier, additional, Badulici, Sonia, additional, Dickel, Heinrich, additional, Gallo, Rosella, additional, Garcia‐Abujeta, Jose L., additional, Giménez‐Arnau, Ana M., additional, Hamman, Curt, additional, Hervella, Marcos, additional, Isaksson, Marléne, additional, Johansen, Jeanne D., additional, Mahler, Vera, additional, Niklasson, Bo, additional, Pigatto, Paolo, additional, Ponyai, Gyorgyi, additional, Rustemeyer, Thomas, additional, Schuttelaar, Marie L. A., additional, Spiewak, Radoslaw, additional, Stingeni, Luca, additional, Thyssen, Jacob P., additional, and Uter, Wolfgang, additional

Published
2022
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26. Sensitization to isothiazolinones in the Spanish Contact Dermatitis Registry (REIDAC): 2019–2021 epidemiological situation

Author

Hernández Fernández, Carlos Pelayo, primary, Borrego, Leopoldo, additional, Mercader García, Pedro, additional, Giménez Arnau, Ana María, additional, Sánchez Pérez, Javier, additional, Silvestre Salvador, Juan Francisco, additional, González Pérez, Ricardo, additional, Sanz Sánchez, Tatiana, additional, Sánchez Gilo, Araceli, additional, Melé Ninot, Gemma, additional, Zaragoza Ninet, Violeta, additional, Miquel Miquel, Francisco Javier, additional, Carrascosa Carrillo, José Manuel, additional, Córdoba Guijarro, Susana, additional, Gatica Ortega, María Elena, additional, Ruiz González, Inmaculada, additional, Serra Baldrich, Esther, additional, Tous Romero, Fátima, additional, Rodríguez Serna, Mercedes, additional, Pastor Nieto, María Antonia, additional, Pérez Feal, Patricia, additional, Hervella Garcés, Marcos, additional, de Vega Martínez, Marina, additional, and García Doval, Ignacio, additional

Published
2022
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28. Allergic contact dermatitis to alkyl glucosides: Epidemiological situation in Spain

Author

Fátima Tous‐Romero, Ana María Giménez‐Arnau, Tatiana Sanz‐Sánchez, Ricardo González Pérez, Jose Manuel Carrascosa‐Carrillo, Violeta Zaragoza‐Ninet, Susana Córdoba‐Guijarro, María Elena Gática‐Ortega, Javier Miquel‐Miquel, Leopoldo Borrego‐Hernando, Inmaculada Ruíz‐González, Esther Serra‐Baldrich, Juan Francisco Silvester‐Salvador, Pedro Mercader‐García, Javier Sánchez‐Pérez, Mercedes Rodríguez‐Serna, Antonia Pastor‐Nieto, Marcos Hervella‐García, Ignacio García‐Doval, and Francisco Javier Ortiz‐de Frutos

Subjects
Infectious Diseases, Dermatology
Published
2022

31. Allergic contact dermatitis to alkyl glucosides: Epidemiological situation in Spain

Author

Tous‐Romero, Fátima, primary, Giménez‐Arnau, Ana María, additional, Sanz‐Sánchez, Tatiana, additional, González Pérez, Ricardo, additional, Carrascosa‐Carrillo, Jose Manuel, additional, Zaragoza‐Ninet, Violeta, additional, Córdoba‐Guijarro, Susana, additional, Gática‐Ortega, María Elena, additional, Miquel‐Miquel, Javier, additional, Borrego‐Hernando, Leopoldo, additional, Ruíz‐González, Inmaculada, additional, Serra‐Baldrich, Esther, additional, Silvester‐Salvador, Juan Francisco, additional, Mercader‐García, Pedro, additional, Sánchez‐Pérez, Javier, additional, Rodríguez‐Serna, Mercedes, additional, Pastor‐Nieto, Antonia, additional, Hervella‐García, Marcos, additional, García‐Doval, Ignacio, additional, and Ortiz‐de Frutos, Francisco Javier, additional

Published
2022
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32. Contact dermatitis from glucose sensors in <scp>Spain</scp> : A multicentric approach

Author

Leopoldo Borrego, María E. Gatica-Ortega, Enrique Gómez-de-la-Fuente, Virginia Fernández-Redondo, Ana Giménez-Arnau, Martin Mowitz, María A Pastor-Nieto, Miguel Torralba, N Hernandezcano, Francisco J. Navarro‐Triviño, and Cecilia Svedman

Subjects
Adult, Male, medicine.medical_specialty, Dermatology, Patch test, N,N dimethylacrylamide (CAS no. 2680-03-7), Young Adult, Insulin Infusion Systems, Isobornyl acrylate (CAS 5888-33-5), Humans, Immunology and Allergy, Medicine, Contact allergens, Insulin pump, Glucose sensors, Child, Allergic contact dermatitis, Camphanes, Glucose sensor, business.industry, Blood Glucose Self-Monitoring, Mean age, Allergens, Patch Tests, medicine.disease, Diabetes Mellitus, Type 1, Acrylates, Spain, Dermatitis, Allergic Contact, Medical devices, Isobornyl acrylate, Female, business, Contact dermatitis
Abstract

Background: Allergic contact dermatitis from glucose sensors may interfere with their ongoing application. Objective: To evaluate a series of Spanish patients with contact dermatitis to glucose sensors regarding former sources of contact allergens, patch test results, and outcomes from the ongoing use of the device. Methods: A series of patients with contact dermatitis from glucose sensors was investigated in eight dermatology departments across Spain (epidemiological features, brands, latency time to develop dermatitis, the ability to continue using the devices as well as the patch test results). Results: Thirty patients were evaluated (mean age 20.9 years). A total of 66.7% were children and 66.7% female. Ninety per cent used Freestyle Libre (FSL). Eight of 26 (30.8%) reacted to isobornyl acrylate (IBOA) and two of 20 (10.0%) to N,N dimethylacrylamide (DMAA). The mean latency time to develop dermatitis was 9 months. Sixteen of 29 (55.2%) patients continued using the same sensor causing the reaction. Thirteen of 29 (44.8%) patients were unable to continue using the sensor because of severe reactions. Of these, five were positive to IBOA, one to IBOA and DMAA, one to DMAA, one to colophony, and one to isopropyl alcohol wipes. In one patient, the outcome was unknown. Conclusion: The frequency of sensitisation to IBOA and DMAA, was lower than in other European series, but similar to a previously published Spanish article. Legislation requiring manufacturers to provide information regarding the composition of medical devices and cooperate with the investigations into contact dermatitis is urgently needed.

Published
2021

34. Sustained safety and efficacy of ligelizumab in patients with chronic spontaneous urticaria: A one‐year extension study

Author

Sinisa Savic, I V Danilycheva, Alis Burciu, Avantika Barve, Ana Giménez-Arnau, Petra Staubach, Karl Sitz, Thomas Severin, Chia-Yu Chu, Michael Makris, Gordon Sussman, Jonathan A. Bernstein, Martin Metz, Marcus Maurer, Michihiro Hide, Eva Hua, Reinhold Janocha, and Weily Soong

Subjects
medicine.medical_specialty, Urticaria, Immunology, Ligelizumab, Omalizumab, Immunoglobulin E, Placebo, Antibodies, Monoclonal, Humanized, Internal medicine, Active disease, medicine, Immunology and Allergy, Humans, In patient, Chronic Urticaria, Adverse effect, biology, business.industry, Extension study, Chronic spontaneous urticaria, Treatment Outcome, biology.protein, IgE, business, 600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit, medicine.drug
Abstract

Background: Ligelizumab, a next-generation, humanized anti-immunoglobulin E (IgE) monoclonal antibody is in development as a treatment for patients with chronic spontaneous urticaria, whose symptoms are inadequately controlled with standard-of-care therapy. Objective: To evaluate the long-term safety and re-treatment efficacy of ligelizumab 240 mg in patients who completed the core study and extension study. Methods: This open-label, single-arm, long-term Phase 2b extension study was designed to assess patients who were previously administered various doses of ligelizumab, omalizumab or placebo in the Phase 2b, dose-finding core study and who presented with active disease after Week 32. In the extension study, patients received ligelizumab 240 mg subcutaneously every 4 weeks, for 52 weeks and were monitored post-treatment for 48 weeks. Results: Overall, ligelizumab was well-tolerated with no newly identified safety signals. A total of 95.4% (226/237) screened patients received ligelizumab 240 mg in the extension study; 84.1% (190/226) of patients experienced at least one treatment-emergent adverse event. Most reported events were mild (41.6%) or moderate (35.8%) and mostly unrelated to the study treatment. At Week 12, 46.5% of patients had a complete response increasing to 53.1% after 52 weeks. Following 52 weeks of extension study treatment, 75.8% (95% confidence interval, 69.9, 81.3) of patients had cumulative complete responses. The median time to relapse in complete responders was 38 weeks. Conclusion: The long-term safety profile of ligelizumab 240 mg in patients with chronic spontaneous urticaria was consistent with the core study and re-treatment efficacy was shown. Trial registration: ClinicalTrials.gov Identifier: NCT02477332 and NCT02649218.

Published
2022

35. New transcriptome and clinical findings of platelet‐activating factor in chronic spontaneous urticaria: Pathogenic and treatment relevance

Author

Andrades, Evelyn, primary, Clarós, Miquel, additional, Torres, Juan Vicente, additional, Nonell, Lara, additional, González, Mónica, additional, Curto‐Barredo, Laia, additional, Rozas‐Muñoz, Eduardo, additional, Gimeno, Ramon, additional, Barranco, Carlos, additional, Pujol, Ramon M., additional, Izquierdo, Iñaki, additional, and Giménez‐Arnau, Ana M., additional

Published
2022
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37. Adrenaline autoinjector is underprescribed in typical cold urticaria patients

Author

Bizjak, Mojca, primary, Košnik, Mitja, additional, Dinevski, Dejan, additional, Thomsen, Simon Francis, additional, Fomina, Daria, additional, Borzova, Elena, additional, Kulthanan, Kanokvalai, additional, Meshkova, Raisa, additional, Aarestrup, Fernando Monteiro, additional, Ahsan, Dalia Melina, additional, Al‐Ahmad, Mona, additional, Altrichter, Sabine, additional, Bauer, Andrea, additional, Brockstädt, Maxi, additional, Costa, Célia, additional, Demir, Semra, additional, Criado, Roberta Fachini, additional, Ensina, Luis Felipe, additional, Gelincik, Asli, additional, Giménez‐Arnau, Ana Maria, additional, Gonçalo, Margarida, additional, Gotua, Maia, additional, Holm, Jesper Grønlund, additional, Inomata, Naoko, additional, Kasperska‐Zajac, Alicja, additional, Khoshkhui, Maryam, additional, Klyucharova, Aliya, additional, Kocatürk, Emek, additional, Lu, Rongbiao, additional, Makris, Michael, additional, Maltseva, Natalya, additional, Pasali, Maria, additional, Paulino, Marisa, additional, Pesqué, David, additional, Peter, Jonny, additional, Ramón, German Dario, additional, Ritchie, Carla, additional, Rodrigues Valle, Solange Oliveira, additional, Rudenko, Michael, additional, Sikora, Agnieszka, additional, Wagner, Nicola, additional, Xepapadaki, Paraskevi, additional, Xue, Xiaoyang, additional, Zhao, Zuotao, additional, Terhorst‐Molawi, Dorothea, additional, and Maurer, Marcus, additional

Published
2022
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38. Guidelines for diagnosis, prevention, and treatment of hand eczema

Author

Thyssen, Jacob P., primary, Schuttelaar, Marie L. A., additional, Alfonso, Jose H., additional, Andersen, Klaus E., additional, Angelova‐Fischer, Irena, additional, Arents, Bernd W. M., additional, Bauer, Andrea, additional, Brans, Richard, additional, Cannavo, Alicia, additional, Christoffers, Wianda A., additional, Crépy, Marie‐Noelle, additional, Elsner, Peter, additional, Fartasch, Manigé, additional, Filon, Francesca Larese, additional, Giménez‐Arnau, Ana M., additional, Gonçalo, Margarida, additional, Guzmán‐Perera, Maria G., additional, Hamann, Carsten R., additional, Hoetzenecker, Wolfram, additional, Johansen, Jeanne Duus, additional, John, Swen M., additional, Kunkeler, Amalia C. M., additional, Hadzavdic, Suzana Ljubojevic, additional, Molin, Sonja, additional, Nixon, Rosemary, additional, Oosterhaven, Jart A. F., additional, Rustemeyer, Thomas, additional, Serra‐Baldrich, Esther, additional, Shah, Mili, additional, Simon, Dagmar, additional, Skudlik, Christoph, additional, Spiewak, Radoslaw, additional, Valiukevičienė, Skaidra, additional, Voorberg, Angelique N., additional, Weisshaar, Elke, additional, and Agner, Tove, additional

Published
2022
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39. Value of photo assessment in late patch test readings—A multicenter study from six European patch test clinics

Author

Cecilia Svedman, Caterina Foti, Ana Giménez-Arnau, Evy Paulsen, Tove Agner, Farnam Barati Sedeh, Yasemin Topal Yüksel, and Richard Brans

Subjects
Adult, Male, Pediatrics, medicine.medical_specialty, Office Visits, contact dermatitis, Dermatology, Patch testing, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, True test, Photography, medicine, Humans, Immunology and Allergy, tele-dermatology, False Positive Reactions, Prospective Studies, 030212 general & internal medicine, patch testing, Delayed reaction, delayed reaction, business.industry, Patch test, Middle Aged, Patch Tests, late reaction, Multicenter study, Contact allergy, Dermatitis, Allergic Contact, contact allergy, Female, allergic contact dermatitis, business
Abstract

Background: It is recommended that patch-test readings include a day (D)7 reading. Substitution of the D7 reading with a photo may be a valid option. Objectives: To compare the sensitivity of digital photos at D7 to clinical readings, to assess the number of positive reactions appearing at D7 only (late reactions), and after D7 only (delayed reactions). Methods: Patients patch tested in six European clinics were instructed to forward photos of the patch test reactions to the respective clinics at D7 (before attending the clinic) and at D21. Only allergens in the baseline series or TRUE Test were included in the data analysis. Results: Two hundred ninety-three of 629 patients had a total of 599 positive reactions, with 6.3% occurring at D7 only. When substituting the D7 reading with a photo (90% submitted), 26.3% of late reactions were missed and nine false-positive reactions were found. Delayed reactions were detected in four patients at D21 (65.3% submitted). Conclusion: Our data show that if the D7 reading is not performed, 6.3% of positive reactions from the baseline series would be missed, and if substituting the D7 reading by digital photo, 26.3% late reactions would be missed. Delayed reactions seemed rare.

Published
2020

40. Developing a cosmetic series: Results from the <scp>ESSCA</scp> network, 2009‐2018

Author

Marie L A Schuttelaar, Vera Mahler, Heinrich Dickel, Margarida Gonçalo, Barbara Ballmer-Weber, Andrea Bauer, Javier Sánchez-Pérez, Thomas Rustemeyer, Ana Giménez-Arnau, Andreas J. Bircher, Dagmar Simon, Johannes Geier, Wolfgang Uter, S. Mark Wilkinson, Swen Malte John, Emma Horton, Elke Weisshaar, University of Zurich, Horton, Emma, Public Health Research (PHR), Dermatology, and AII - Inflammatory diseases

Subjects
antioxidant, IRRITANT DERMATITIS, MULTICENTER, Cosmetics, Antioxidants, 030207 dermatology & venereal diseases, ANHYDRIDE/TRIMELLITIC ANHYDRIDE/GLYCOLS COPOLYMER, 0302 clinical medicine, preservative, Prevalence, Immunology and Allergy, Medicine, 030212 general & internal medicine, 610 Medicine & health, cosmetic, media_common, 10177 Dermatology Clinic, Patch test, Patch Tests, STEARYL ALCOHOL, Europe, Population Surveillance, antiseptic, ALLERGIC CONTACT-DERMATITIS, Dermatology clinic, Dermatitis, Allergic Contact, EUROPEAN SURVEILLANCE SYSTEM, 2723 Immunology and Allergy, RUBBER SERIES, medicine.medical_specialty, CETYL ALCOHOL, surfactant, media_common.quotation_subject, Dermatology, Patch testing, 2708 Dermatology, 03 medical and health sciences, emollient, Humans, PANTHENOL, Irritant dermatitis, emulsifier, Contact allergens, patch testing, Allergic contact dermatitis, PHOTOPATCH TEST, Emollients, business.industry, Preservatives, Pharmaceutical, Allergens, medicine.disease, Contact allergy, Emulsifying Agents, Anti-Infective Agents, Local, contact allergy, business
Abstract

Background There is considerable variability across European patch test centres as to which allergens are included in local and national cosmetics series. Objectives To propose a standardised, evidence-based cosmetic series for Europe based on up-to-date analysis of relevant contact allergens. Methods We collated data from the European Surveillance System on Contact Allergies (ESSCA) from 2009-2018 to determine which cosmetic allergens produce a high yield of contact allergy. Contact allergens with a prevalence of >0.3% that were considered relevant were included. Rare contact allergens were excluded if deemed no longer relevant or added to a supplemental cosmetic series for further analysis. Results Sensitisation prevalence rates of 39 cosmetic contact allergens are tabulated. Thirty of these allergens yield >0.3% positive reactions and are therefore included in our proposed European Cosmetic Series. Six are considered no longer relevant and therefore excluded. Three are included in a supplementary European cosmetic series. An additional 9 allergens are included in either the core or supplemental European cosmetic series following literature review. Conclusion We have derived a potential European cosmetic series based upon the above methods. This will require ongoing investigation based upon the changing exposure profiles of cosmetic allergens as well as new and evolving substances. This article is protected by copyright. All rights reserved.

Published
2020

41. Sensitization to isothiazolinones in the Spanish Contact Dermatitis Registry (REIDAC). 2019-2021 epidemiological situation

Author

Carlos Pelayo Hernández Fernández, Leopoldo Borrego, Pedro Mercader García, Ana María Giménez Arnau, Javier Sánchez Pérez, Juan Francisco Silvestre Salvador, Ricardo González Pérez, Tatiana Sanz Sánchez, Araceli Sánchez Gilo, Gemma Melé Ninot, Violeta Zaragoza Ninet, Francisco Javier Miquel Miquel, José Manuel Carrascosa Carrillo, Susana Córdoba Guijarro, María Elena Gatica Ortega, Inmaculada Ruiz González, Esther Serra Baldrich, Fátima Tous Romero, Mercedes Rodríguez Serna, María Antonia Pastor Nieto, Patricia Pérez Feal, Marcos Hervella Garcés, Marina de Vega Martínez, and Ignacio García Doval

Subjects
Spain, Contact dermatitis, Immunology and Allergy, Benzisothiazolinone, Methylchloroisothiazolinone/methylisothiazolinone, Methylisothiazolinone, Dermatology, Octylisothiazolinone, Patch tests, Standard series
Abstract

Background: Current frequency and risk factors for sensitization to methylisothiazolinone (MI), methylchloroisothiazolinone/methylisothiazolinone (MCI/MI), benzisothiazolinone (BIT) and octylisothiazolinone (OIT) in Spain are not well known. Objectives: To study the frequency of sensitization, risk factors and simultaneous sensitization between the four isothiazolinones. Materials and Methods: We analysed all 2019-2021 consecutive patients patch-tested with MI (0.2% aq.), MCI/MI (0.02% aq.), BIT (0.1% pet.) and OIT (0.1% pet) within the Spanish Contact Dermatitis Registry (REIDAC). Results: A total of 2511 patients were analysed. Frequencies of sensitization were: any isothiazolinone 15.7%, MI 6.8%, MCI/MI 4.8%, BIT 3.5% and OIT 0.5%. MI and MCI/MI sensitization was associated with being occupationally active, hand dermatitis, detergents and age over 40. BIT sensitization was associated with leg dermatitis and age over 40. About one in nine MI-positive patients were positive to BIT, whereas one in five BIT-positive patients were positive to MI. Conclusions: Sensitization to MI, MCI/MI and BIT is still common in Spain, while sensitization to OIT is rare. Currently, sensitization to MI and MCI/MI seems to be occupationally related. Although its origin is unknown, sensitization to BIT is more frequent in patients aged over 40 years. Simultaneous sensitization between MI and BIT is uncommon. The Spanish Registry of Contact Dermatitis (REIDAC) is promoted by the Fundación Piel Sana (Academia Española de Dermatología y Venereología), which has received financial support from the Spanish Medicines and Health Products Agency (Agencia Española de Medicamentos y Productos Sanitarios. https://www.boe.es/boe/dias/2022/04/11/pdfs/BOE-A-2022-5975.pdf) and Sanofi. The funders were not involved in the design and conduct of the study, collection, management, analysis and interpretation of data, preparation, review, approval of the manuscript, or decision to submit the manuscript for publication.

Published
2022

42. Adrenaline autoinjector is underprescribed in typical cold urticaria patients

Author

Mojca Bizjak, Mitja Košnik, Dejan Dinevski, Simon Francis Thomsen, Daria Fomina, Elena Borzova, Kanokvalai Kulthanan, Raisa Meshkova, Fernando Monteiro Aarestrup, Dalia Melina Ahsan, Mona Al‐Ahmad, Sabine Altrichter, Andrea Bauer, Maxi Brockstädt, Célia Costa, Semra Demir, Roberta Fachini Criado, Luis Felipe Ensina, Asli Gelincik, Ana Maria Giménez‐Arnau, Margarida Gonçalo, Maia Gotua, Jesper Grønlund Holm, Naoko Inomata, Alicja Kasperska‐Zajac, Maryam Khoshkhui, Aliya Klyucharova, Emek Kocatürk, Rongbiao Lu, Michael Makris, Natalya Maltseva, Maria Pasali, Marisa Paulino, David Pesqué, Jonny Peter, German Dario Ramón, Carla Ritchie, Solange Oliveira Rodrigues Valle, Michael Rudenko, Agnieszka Sikora, Nicola Wagner, Paraskevi Xepapadaki, Xiaoyang Xue, Zuotao Zhao, Dorothea Terhorst‐Molawi, and Marcus Maurer

Subjects
Epinephrine, Urticaria, adrenaline autoinjector, Cold-induced anaphylaxis, Immunology, cold urticaria, Cold Temperature, COLD-CE, cold-induced anaphylaxis, Cold urticaria, Immunology and Allergy, Humans, Adrenaline autoinjector, Anaphylaxis
Published
2022

43. European patch test results with audit allergens as candidates for inclusion in the European Baseline Series, 2019/20: Joint results of the ESSCA A and the EBS B working groups of the ESCD, and the GEIDAC C

Author

Uter, Wolfgang, Giménez Arnau, Anna Maria, and GEIDAC

Subjects
Sodium metabisulfite, Surveillance, Clinical epidemiology, Contact allergy, Baseline series, Benzisothiazolinone, Decyl glucoside, RRID:SCR_001905, Patch testing
Abstract

Background: In 2019, a number of allergens (haptens), henceforth, "the audit allergens," were considered as potential additions to the European Baseline Series (EBS), namely, sodium metabisulfite, 2-bromo-2-nitropropane-1,3-diol, diazolidinyl urea, imidazolidinyl urea, Compositae mix II (2.5% or 5% pet), linalool hydroperoxides (lin-OOH), limonene hydroperoxides (lim-OOH), benzisothiazolinone (BIT), octylisothiazolinone (OIT), decyl glucoside, and lauryl glucoside; Evernia furfuracea (tree moss), was additionally tested by some departments as well. Objectives: To collect further data on patch test reactivity and clinical relevance of the audit allergens in consecutive patients across Europe. Methods: Patch test data covering the audit allergens in 2019 and 2020 were collected by those departments of the European Surveillance System on Contact Allergies testing these, as well as further collaborators from the EBS working group of the European Society of Contact Dermatitis (ESCD), and the Spanish Grupo Español de Investigación en Dermatitis de Contacto y Alergia Cutánea. As patch test outcome, reactions between day (D) 3 and D5 were considered. Results: Altogether n = 12 403 patients were tested with any of the audit allergen. Positive reactions were most common to lin-OOH 1% pet. (8.74% [95%CI: 8.14-9.37%]), followed by lin-OOH 0.5% pet., and lim-OOH 0.3% pet (5.41% [95% CI: 4.95-5.89%]). Beyond these terpene hydroperoxides, BIT 0.1% pet. was the second most common allergen with 4.72% (95% CI: 4.2-5.28%), followed by sodium metabisulfite 1% pet. (3.75% [95%CI: 3.32-4.23%]) and Compositae mix 5% pet. (2.31% [95% CI: 1.84-2.87%]). For some allergens, clinical relevance was frequently difficult to ascertain. Conclusions: Despite many positive patch test reactions, it remains controversial whether lin- and lim-OOH should be tested routinely, while at least the two preservatives BIT and sodium metabisulfite appear suitable. The present results are a basis for further discussion and ultimately decision on their implementation into routine testing among the ESCD members.

Published
2022

44. Cutaneous reactions after SARS-CoV-2 vaccination: a cross-sectional Spanish nationwide study of 405 cases

Author

Ricardo Ruiz-Villaverde, O Marcantonio, I. Polimón Olabarrieta, T Masat-Ticó, Cristina Galván-Casas, Priscila Giavedoni, J Tercedor-Sanchez, X García-Navarro, Antonio Guilabert, A G Angulo Menéndez, M Utrera-Busquets, M. Roncero Riesco, Xavier Cubiró, A. Català, D Pesqué, L Bou Camps, I Hiltun, M P Gil Mateo, Jorge Romaní, N Iglesias Pena, C Muñoz-Santos, S. Marinero Escobedo, E San Juan Lasser, E Vargas Laguna, T Toledo-Pastrana, Diego Fernandez-Nieto, D Revilla Nebreda, L Alonso Naranjo, A Solá-Truyols, Ana Giménez-Arnau, G Baeza-Hernández, M J Calderón Gutiérrez, E Cutillas Marco, Gregorio Carretero, L Carnero Gonzalez, Pedro Rodriguez-Jimenez, M Iglesias-Sancho, Carlos González-Cruz, S Gómez-Armayones, and Mar Llamas-Velasco

Subjects
medicine.medical_specialty, COVID-19 Vaccines, viruses, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Dermatology, medicine.disease_cause, Patient age, ChAdOx1 nCoV-19, Injection site, medicine, Humans, BNT162 Vaccine, business.industry, SARS-CoV-2, Vaccination, Varicella zoster virus, COVID-19, Pityriasis, Original Articles, Middle Aged, medicine.disease, Morbilliform, Cross-Sectional Studies, Commentary, Mass vaccination, Original Article, Female, business, 2019-nCoV Vaccine mRNA-1273
Abstract

Summary Background Cutaneous reactions after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines are poorly characterized. Objective To describe and classify cutaneous reactions after SARS-CoV-2 vaccination. Methods A nationwide Spanish cross-sectional study was conducted. We included patients with cutaneous reactions within 21 days of any dose of the approved vaccines at the time of the study. After a face-to-face visit with a dermatologist, information on cutaneous reactions was collected via an online professional survey and clinical photographs were sent by email. Investigators searched for consensus on clinical patterns and classification. Results From 16 February to 15 May 2021, we collected 405 reactions after vaccination with the BNT162b2 (Pfizer-BioNTech; 40·2%), mRNA-1273 (Moderna; 36·3%) and AZD1222 (AstraZeneca; 23·5%) vaccines. Mean patient age was 50·7 years and 80·2% were female. Cutaneous reactions were classified as injection site (‘COVID arm’, 32·1%), urticaria (14·6%), morbilliform (8·9%), papulovesicular (6·4%), pityriasis rosea-like (4·9%) and purpuric (4%) reactions. Varicella zoster and herpes simplex virus reactivations accounted for 13·8% of reactions. The COVID arm was almost exclusive to women (95·4%). The most reported reactions in each vaccine group were COVID arm (mRNA-1273, Moderna, 61·9%), varicella zoster virus reactivation (BNT162b2, Pfizer-BioNTech, 17·2%) and urticaria (AZD1222, AstraZeneca, 21·1%). Most reactions to the mRNA-1273 (Moderna) vaccine were described in women (90·5%). Eighty reactions (21%) were classified as severe/very severe and 81% required treatment. Conclusions Cutaneous reactions after SARS-CoV-2 vaccination are heterogeneous. Most are mild-to-moderate and self-limiting, although severe/very severe reactions are reported. Knowledge of these reactions during mass vaccination may help healthcare professionals and reassure patients.

Published
2022

46. Bikini textile contact dermatitis: a sherlockian approach revealing 2,4-dichlorophenol as a potential textile contact allergen

Author

Jakob Dahlin, Elena Giménez-Arnau, Marléne Isaksson, Ramon M. Pujol, David Pesqué, Alvaro March-Rodriguez, Ana Giménez-Arnau, Universitat Autònoma de Barcelona (UAB), Lund University [Lund], Institut de Chimie de Strasbourg, and Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS)-Institut de Chimie du CNRS (INC)

Subjects
Polidocanol, 2,4-dichlorophenol, Ether, Dermatology, 010501 environmental sciences, Patch test, 01 natural sciences, Clothing, 030207 dermatology & venereal diseases, 03 medical and health sciences, chemistry.chemical_compound, 2.4-dichlorophenol, 0302 clinical medicine, medicine, Immunology and Allergy, Humans, [SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology, Thin-layer chromatography, Allergic contact dermatitis, 0105 earth and related environmental sciences, Irritant contact dermatitis, Chromatography, Ethanol, Chemistry, Textiles, Ethylene glycol monododecyl ether, Middle Aged, Patch Tests, medicine.disease, Textile contact dermatitis, Dermatitis, Allergic Contact, Gas chromatography-mass spectrometry, Female, Contact dermatitis, Ethylene glycol, [SDV.MHEP.DERM]Life Sciences [q-bio]/Human health and pathology/Dermatology, Chlorophenols
Abstract

International audience; Background: Different textile constituents may act as allergens and/or irritants and provoke textile contact dermatitis (TCD).Objectives: To report a case of TCD caused by ethylene glycol monododecyl ether and 2.4-dichlorophenol present in a bikini.Methods: A woman presented with an eczematous, pruritic rash in the area of the straps and back. Patch testing was performed with the European baseline, textile, sunscreen and photo-patch series, the bikini “as is”, and ethanol and acetone extracts of the bikini. Thin-layer chromatography (TLC) of the extracts and gas chromatography-mass spectrometry (GC-MS) analysis were used to elucidate the culprit agents.Result: Positive reactions were found to the bikini “as is”, and to the ethanol and acetone extracts. Patch testing with TLC strips showed a strong reaction to particular fractions (3 and 4). GC-MS was performed to identify substances in each fraction, and those suspected to be skin sensitizers were patch tested. On day 4 (D4) positive reactions to ethylene glycol monododecyl ether (IR) and 2.4-dichlorophenol (++) were observed.Conclusion: A myriad of chemical compounds can be found in clothing. Ethylene glycol monododecyl ether and 2.4-dichlorophenol were identified as the potential culprits of this bikini TCD.

Published
2021

50. Risk factors for systemic reactions in typical cold urticaria: Results from the COLD‐CE study

Author

Bizjak, Mojca, primary, Košnik, Mitja, additional, Dinevski, Dejan, additional, Thomsen, Simon Francis, additional, Fomina, Daria, additional, Borzova, Elena, additional, Kulthanan, Kanokvalai, additional, Meshkova, Raisa, additional, Ahsan, Dalia Melina, additional, Al‐Ahmad, Mona, additional, Altrichter, Sabine, additional, Bauer, Andrea, additional, Brockstädt, Maxi, additional, Costa, Célia, additional, Demir, Semra, additional, Fachini Criado, Roberta, additional, Ensina, Luis Felipe, additional, Gelincik, Asli, additional, Giménez‐Arnau, Ana Maria, additional, Gonçalo, Margarida, additional, Gotua, Maia, additional, Holm, Jesper Grønlund, additional, Inomata, Naoko, additional, Kasperska‐Zajac, Alicja, additional, Khoshkhui, Maryam, additional, Klyucharova, Aliya, additional, Kocatürk, Emek, additional, Lu, Rongbiao, additional, Makris, Michael, additional, Maltseva, Natalya, additional, Miljković, Jovan, additional, Pasali, Maria, additional, Paulino, Marisa, additional, Pesqué, David, additional, Peter, Jonny, additional, Ramón, German Dario, additional, Ritchie, Carla, additional, Rodrigues Valle, Solange Oliveira, additional, Rudenko, Michael, additional, Sikora, Agnieszka, additional, de Souza Lima, Eduardo M., additional, Wagner, Nicola, additional, Xepapadaki, Paraskevi, additional, Xue, Xiaoyang, additional, Zhao, Zuotao, additional, Terhorst‐Molawi, Dorothea, additional, and Maurer, Marcus, additional

Published
2021
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