Types, Symptoms, Causes & Treatments

Overview

What are allergies?

Allergies are your body’s reaction to a substance it views as a harmful “invader.” For example, coming into contact with what is normally a harmless substance, such as pollen, might cause your immune system (your body’s defense system) to react. Substances that cause these reactions are called allergens.

What is an allergic reaction?

An “allergic reaction” is the way your body responds to the allergen. A chain of events occur that result in an allergic reaction.

If you are prone to allergies, the first time you’re exposed to a specific allergen (such as pollen), your body responds by producing allergic (IgE) antibodies. The job of these antibodies is to find the allergens and help remove them from your system. As a result, a chemical called histamine is released and causes symptoms of allergies.

What are the types of allergies and how are they treated?

You can be allergic to a wide variety of substances – including pollen, animal dander, mold and dust mites.

Pollen

Seasonal allergic rhinitis, or hay fever, is an allergic response to pollen. It causes inflammation and swelling of the lining of your nose and of the protective tissue of your eyes (conjunctiva).

Symptoms include sneezing, congestion (feeling stuffy), and itchy, watery eyes, nose and mouth. Treatment options include over-the-counter and prescription oral antihistamines, anti-leukotrienes, nasal steroids, nasal antihistamines, and nasal cromolyn. In some people, allergic asthma symptoms (wheezing, shortness of breath, coughing, and/ or chest tightness) can be caused by exposure to pollen.

Your symptoms can be reduced by avoiding pollen. Stay indoors when pollen counts are high, close your windows, and use air conditioning. Ask your healthcare provider about immunotherapy (“allergy shots”) to treat pollen allergy.

Dust mites

Dust mites are tiny organisms that live in dust and in the fibers of household objects, such as pillows, mattresses, carpet, and upholstery. Dust mites grow in warm, humid areas.

The symptoms of dust mite allergy are similar to those of pollen allergy. To help manage dust mite allergies, try using dust mite encasements (airtight plastic/polyurethane covers) over pillows, mattresses, and box springs. Also, remove carpet, or vacuum frequently with a high-efficiency filter vacuum cleaner. Treatment may include medications to control your nasal/eye and chest symptoms. Immunotherapy may be recommended if your symptoms are not adequately controlled with avoidance methods and medications.

Molds

Molds are tiny fungi (like Penicillium) with spores that float in the air like pollen. Mold is a common trigger for allergies. Mold can be found indoors in damp areas, such as the basement, kitchen, or bathroom, as well as outdoors in grass, leaf piles, hay, mulch or under mushrooms. Mold spores reach a peak during hot, humid weather.

Treatment may include medications to control your nasal/eye and chest symptoms. Immunotherapy may be recommended if your symptoms are not adequately controlled with avoidance and medications.

Animal dander

Allergic reactions can be caused by the proteins secreted by sweat glands in an animal’s skin, which are shed in dander, and by the proteins in an animal’s saliva. Avoidance measures don’t work as well as simply removing the pet from your home. However, because many people are reluctant to do this, second-best measures include keeping your pet out of your bedroom, using air cleaners with HEPA filtration and washing your pet (cat or dog) frequently.

Treatment may include medications to control your nasal/eye and chest symptoms. Immunotherapy may be recommended if your symptoms are not adequately controlled with avoidance methods and medications.

Latex

Some people develop a latex allergy after repeated contact with latex. Rubber gloves, such as those used in surgery or home cleaning, are a major source for causing this type of reaction. Skin rash, hives, eye tearing and irritation, wheezing and itching of the skin may occur if you have a latex allergy.

Allergic reactions to latex can be mild, such as skin redness and itching. More severe reactions can occur if your mucosal membranes are exposed, such as during an operation or a dental or gynecologic exam.

Treatment of latex reactions begins by removing the offending latex product. If you have latex allergy, it is important for you to wear a Medic Alert® bracelet and carry an emergency epinephrine kit. All procedures should be carried out in a “latex-safe” fashion. There is no cure for latex allergy, so the best treatment for this condition is prevention and avoidance.

Certain foods

Food allergies develop when your body develops a specific antibody to a specific food. An allergic reaction occurs within minutes of eating the food, and symptoms can be severe. In adults, the most common food allergies are shellfish, peanuts and tree nuts. In children, they include milk, egg, soy, wheat, shellfish, peanuts and tree nuts.

If you have a food allergy, your symptoms include itching, hives, nausea, vomiting, diarrhea, breathing difficulties and swelling around your mouth.

It is extremely important to avoid the foods that cause allergy symptoms. If you (or your child) have a food allergy, your doctor may prescribe injectable epinephrine (adrenaline) for you to carry at all times. This is needed in case you accidentally eat foods that cause allergies. There are new therapies for peanut allergies called oral immunotherapy.

Insect venom (stings)

If you get a bee sting, a normal reaction includes pain, swelling and redness around the sting site. A large, local reaction includes swelling that extends beyond the sting site. For example, if you are stung on the ankle, you may see swelling in your leg.

The most serious reaction to an insect sting is an allergic one, which needs immediate medical attention. Symptoms of an allergic reaction to an insect sting include:

• Difficulty breathing.
• Generalized (widespread) hives that appear as a red, itchy rash that spreads to areas other than the area that was stung.
• Swelling of your face, throat or mouth tissue.
• Wheezing or difficulty swallowing.
• Restlessness and anxiety.
• Rapid pulse.
• Dizziness or a sharp drop in your blood pressure.

If you have a reaction like this, a re-sting can cause a serious reaction that can be life-threatening.

An allergic reaction is treated with epinephrine (adrenaline). If you’ve had an allergic reaction to bee stings, see a board-certified allergy/immunologist to get a skin and/or blood test to confirm your allergy to bee venom. Venom immunotherapy is recommended if venom allergy is confirmed. This will help reduce the possibility that a re-sting will cause a serious reaction.

What is allergic rhinitis?

Nasal allergy symptoms and hay fever are referred to as “allergic rhinitis. ” Seasonal allergic rhinitis is nasal allergies that change with the seasons because of pollen from plants (trees, grasses, or weeds). Seasonal symptoms arise during the pollinating seasons for particular plants. Because you can be allergic to more than one thing, your symptoms may get worse at different times throughout the year, or may be constant.

Does everyone get allergies?

No. Most allergies are inherited, which means they are passed on to children by their parents. People inherit a tendency to be allergic, although not to any specific allergen. If your child develops an allergy, it is very likely that you or your partner has allergies.

How common are allergies?

More than 50 million Americans (1 in 6) experience all types of allergies, including indoor/outdoor allergies, food and drug, latex, insect, skin and eye allergies. The number of people who have allergies continues to increase across all ages, sex and racial groups.

10 Worst Cities for Spring Allergies

Is Your Town on the List?

Spring has sprung, and so have the sneezes and sniffles that come along with it. Every year, the Asthma and Allergy Foundation of America (AAFA) ranks the 100 largest U.S. metro areas by pollen count, allergy medicine use, and allergy doctors. Has your town made the list for the 10 worst “spring allergy capitals”? You might be surprised: They aren’t all in the South!

No. 10: Buffalo, N.Y.

The second largest city in New York leaps into the top 10 from No. 36 in 2015. Super-high pollen scores and above-average use of allergy meds secured its place. This Niagara Falls neighbor has the sunniest and driest springs in the Northeast. That means pollen sticks around longer — and has more time to make your eyes water. Buffalo has flirted with higher rankings before. It placed 15th 3 years ago.

No. 9: Knoxville, TN

Its pollen levels are on par with most other cities, but people here use more allergy meds than average. That’s kept this Tennessee River city in the top 10 this year. If spring makes you sneeze here, pollen from oak, birch, and maple box elder trees are likely to blame. To make things worse, the surrounding mountains trap pollen in the valley.

No. 8: Providence, RI

This northeastern city has once again earned a top 10 spot. (In 2015, it was No. 9.) Oddly, the American Academy of Allergy, Asthma & Immunology doesn’t have a pollen counter stationed here. But the city’s daily average temps are heading up. This helps plants grow and make more pollen. This year’s report found average levels of the sneeze-worthy yellow dust. But the city had higher use of allergy meds and a lower number of allergy doctors.

No. 7: Oklahoma City, OK

The Sooner State capital drops several slots from No. 3 last year. Yet it still has high pollen scores, thanks to lots of sunshine and trees. Blame your springtime sneezes here on oak, mulberry, poplar, aspen, and sycamore, among others. Warm, dry, breezy days send pollen counts up. The tiny grains can float for miles in the wind. If you’ve been outside when the count is high, quickly shed your clothes and hit the shower when you get home.

No. 6: Wichita, KS

The largest city in Kansas inches up one spot on this year’s list. Weeds and grasses trigger itchy, watery eyes and sneezing in this Midwestern town. Wichita’s ranking is based on higher-than-average pollen counts and increased use of allergy medicines. The city also has a lower-than-average number of allergy doctors.

No. 5: McAllen, TX

This city perched in the Rio Grande Valley has teetered mid-list for the last few years. Pollen from mountain cedar trees hundreds of miles away rides in on the breeze to kick off sneeze season early here. Later on, grasses and other native plants like mesquite and huisache join in. Dry weather adds to the sniffle factor. McAllen gets only about 26 inches of rain a year. That doesn’t do much to help wash away the pollen.

No. 4: Louisville, KY

Kentucky’s famous bluegrass creates more pollen than any other grass in the U. S. That makes it a world-class allergy trigger. If you have grass allergies, your symptoms will spike here in late spring and early summer. There’s some good news for spring sneezers: Louisville’s status as an allergy capital is improving. Last year it ranked as the second-worst place in the country for spring allergies. In 2014, it was the top offender.

No. 3: Syracuse, N.Y.

It’s known as the Crossroads of New York State, and it vaults into the top 3 after ranking 20th last year. Super-high pollen scores played a role in its surprise appearance. The region is home to tons of hardwood trees, many used to make furniture. Pollen from oak and elm lead to seasonal sniffles and itchy, watery eyes.

No. 2: Memphis, TN

Got allergies? You’ll be singin’ the blues here during springtime. After a short stint at 4th place last year, Memphis returns to the No. 2 spot once again. Trees that give off spring pollen thrive in this city’s warm days and cool nights. The area also makes the list for worst places to live for people with asthma. Close the windows and turn on the AC to breathe easier.

No. 1: Jackson, MS

For the second year, the City with Soul is the worst place in the U.S. for spring allergies. Oak, ash, elm, and hickory trees cover more than half of this southern state. The result: layers of springtime pollen that’ll keep you reaching for the tissues. Jackson kept its first-place spot due to soaring pollen counts and use of allergy meds. Unlike others in the top 10, this city has a higher-than-average number of allergy doctors.

Systemic Reaction Throughout the Body

When a reaction stays with one area of the body, it’s known as a localized reaction. When inflammation spreads from a localized area of one organ (like the skin) to other organ systems in the body, it’s known as a systemic reaction. The inflammation can be from toxins, allergies or infections.

RyanKing999 / Getty Images

Anaphylaxis (Allergies)

Anaphylaxis is a systemic reaction related to allergies. It occurs when an allergic reaction moves from a single organ system (most commonly the integumentary system, which is the skin) to include at least one other system. Anaphylaxis often affects the respiratory system (shortness of breath) or the circulatory system (low blood pressure/shock) in addition to the integumentary system (itching, redness, and ​hives). Anaphylactic shock is a life-threatening, systemic allergic reaction characterized by dangerously low blood pressure.

Sepsis (Infection)

When an otherwise low-key bacterial infection develops into a full-body failure of organs, it’s known as sepsis or septic shock. As healthcare providers learn more about sepsis and more about how we can treat it, recognition of this systemic disorder becomes increasingly important.Sepsis usually starts out as a common infection with typical signs and symptoms. Eventually, sepsis evolves into fatigue, confusion, no fever, weakness and progresses to low blood pressure.

Toxins

Poisons or toxins often cause localized rashes or swelling. However, if they are picked up in the bloodstream or otherwise transported around the body, some toxins can cause reactions in areas far away from where the substance entered the body. Carbon monoxide poisoning, for example, shows signs and symptoms throughout the body. Fatigue, weakness, confusion, headaches, and nausea are all symptoms. In extreme cases, carbon monoxide poisoning can make the patient’s skin very red.

Treatment

There is no specific treatment for a systemic reaction. It is dependent on the type of reaction (allergic, toxic or septic). The important thing is to recognize a systemic reaction quickly and to seek help immediately. Not all systemic reactions are life-threatening, but when infection or a substance can affect so many different organ systems at the same time, chances are the outcome will not be desirable. It is important to avoid the known causes of reaction.

If you suspect a patient (or you) is experiencing a systemic reaction, head to the doctor or call 911 immediately. Try not to drive if you are experiencing symptoms of fatigue, confusion, dizziness or weakness. You might discover that you’re not able to operate a motor vehicle safely for you or for others on the road.

Allergy and Immunology : Allergy

What is an allergic reaction?

An allergy develops when the immune system recognises and responds to something in the environment that is normally harmless: e.g. food proteins, pollens or dust mite.  An allergic reaction occurs when a child is exposed to that substance and the body’s immune system reacts to that substance.  Symptoms may be localised or generalised, and range from mild to severe.

The most common causes of allergic reactions in young children are foods. In particular:

• Egg
• Cow’s milk
• Peanut
• Tree nut
• Soy
• Wheat
• Fish
• Shellfish
• Sesame
• Lupin

Other causes are bee or other insect stings (wasps, jack jumper ants), medication and latex (rubber).

What is anaphylaxis?

This term is used to describe a severe allergic reaction that involves the respiratory and/or cardiovascular systems.  Anaphylaxis is the most severe form of an allergic reaction and is life threatening.

A reaction can develop within minutes of exposure to the allergen, but with planning and training, a reaction can be treated effectively by using an adrenaline autoinjector (Epinephrine). An important aspect of anaphylaxis management is prevention and avoidance of the cause.

Signs and symptoms of an allergic reaction:

Mild to moderate allergic reaction 

A mild to moderate reaction will include one or more of these symptoms, and it is possible that a number of them will occur simultaneously:

• Swelling of lips, face & eyes
• Hives or welts
• Tingling mouth
• Abdominal pain, vomiting (these are signs of anaphylaxis for insect allergy)

Mild to moderate allergic reactions may not always occur before anaphylaxis

Anaphylaxis 

Anaphylaxis is the term used to describe a severe systemic allergic reaction that involves the respiratory and/or cardiovascular system.

Presentation of any one of the following symptoms below indicates anaphylaxis:

• Difficult/noisy breathing
• Swelling of tongue
• Swelling/tightness in throat
• Difficulty talking and/or hoarse voice
• Wheeze or persistent cough
• Persistent dizziness or collapse
• Pale and floppy (young children)

Management of anaphylaxis

Treatment of anaphylaxis

The first line emergency treatment for anaphylaxis is adrenaline (Epinephrine), all children who have experienced anaphylaxis should be prescribed an adrenaline autoinjector. EpiPen® is currently the only adrenaline autoinjector available for use in Australia. EpiPen Jr® is prescribed for children weighing between 7.5 – 20 kg, EpiPen® is prescribed for children weighing 20 kg or more. EpiPen® is a single use single dose of adrenaline, and needs to be prescribed initially by an allergist. 

Once prescribed by an allergist, a GP can prescribe adrenaline autoinjector and update the ASCIA action plan for anaphylaxis .

Care of the EpiPen®/EpiPen® Jr 

• Clearly label storage container with child’s name and photo
• Check expiry date regularly
• Store at room temperature
• Store in a safe, easily accessible location
• A copy of the ASCIA action plan for anaphylaxis should be stored with the EpiPen®/EpiPen® Jr,  which must be followed in the case of emergency.
• The ASCIA action plan for anaphylaxis also contains contact details for parents/guardian, and medical services

Each child who has been prescribed an EpiPen®/EpiPen® Jr, requires an ASCIA action plan for anaphylaxis , completed by a doctor or clinical nurse practitioner. A copy of the ASCIA action plan for anaphylaxis should be provided to schools and children’s services by the parents, together with an EpiPen®/EpiPen® Jr.

• School & Children’s Services staff are required to have  anaphylaxis training and be competent in the use of an adrenaline autoinjector (EpiPen®)
• If a reaction is suspected, the ASCIA action plan for anaphylaxis must be followed
• If an EpiPen®/EpiPen® Jr, is given, an ambulance must be requested by phoning 000 * Medical observation in hospital for at least 4 hours is recommended after anaphylaxis
• If in doubt, give adrenaline autoinjector

Prevention of subsequent allergic reactions:

• Know and avoid the causes
• Do not allow food sharing or swapping
• Only give foods approved by the child’s parents
• Use non-food treats where possible, but if food treats are used, give only those provided by the parents (encourage parents to provide a container of safe treats from home)
• Practise routine hygiene and good food safety practices. Children and staff should always wash their hands after play and before and after eating.

Banning of products

Banning of products that contain the allergen is NOT recommended.

Banning will not succeed in creating an “allergy free zone”.  It is difficult to achieve a 100% ban, for a variety of reasons.  For example, product labels can be confusing, parents of non-allergic children may not comply with the ban, and lastly, staff and students become complacent.

Food sharing

The child at risk of food allergies should not share food.  These children must only have food provided from home or given with the parent’s permission.

Food preparation

Any staff, including relief staff, who are responsible for cooking or delivering food to children should know about the child’s allergies.  They should be aware of alternative words used to describe the particular allergy food.  For example, cow’s milk may be called casein, and egg may be called ovalbumin.   They should also be aware of potential contamination of other foods when preparing, handling or displaying food.

Art/craft

Food containers or packages that contain the allergen should not be used.  

Separate tables should be used for art/craft and food.  Where this is not possible, tables must be cleaned thoroughly between use.

Excursions/camps

The EpiPen®/EpiPen® Jr must be taken on all excursions and staff must have had anaphylaxis training and be competent in use of an adrenaline autoinjector (EpiPen®)

The EpiPen®/EpiPen® Jr must be readily available. An adrenaline autoinjector for general use should be taken on all excursion/camps

Allergies to Insect Stings | Michigan Medicine

Topic Overview

What are allergies to insect stings?

When you are stung by an insect, poisons and other toxins enter your skin. It’s normal to have some swelling, redness, pain, and itching around the sting. But you may have an allergic reaction if your immune system reacts strongly to allergens in the sting.

You probably won’t have a severe allergic reaction the first time you are stung. But even if your first reaction to a sting is mild, allergic reactions can get worse with each sting. Your next reaction may be more severe or even deadly.

What causes an allergic reaction to insect stings?

An allergic reaction occurs when your immune system reacts strongly to the allergens in the sting.

A few types of stinging insects cause most allergic reactions. They are:

• Bees.
• Wasps.
• Hornets.
• Yellow jackets.
• Fire ants.

What are the symptoms?

Symptoms of an allergic reaction can range from mild to severe.

Mild reactions may cause:

• Redness, pain, and swelling around the sting.
• Itching around the sting or anywhere on your body.

Large, local reactions may cause the same symptoms as mild reactions, plus:

• Redness and swelling that affects an entire arm, leg, or large part of your body.
• Swelling that continues to increase for up to 48 hours.

A large local reaction can take up to 10 days to go away.^{footnote 1}

Severe reactions may cause:

• Hives.
• Swelling of your tongue, throat, or other body parts.
• Nausea, vomiting, or diarrhea.
• Anaphylaxis, which is a severe, life-threatening reaction that requires emergency treatment. It causes confusion, trouble breathing, and other symptoms.

How are allergies to insect stings diagnosed?

Your doctor may do a physical exam and ask you questions about your symptoms and past health. He or she also may want you to have allergy tests after you get better from the allergic reaction. Allergy tests, such as skin prick tests or blood tests, can help you find out which types of insect stings you are most allergic to.

How are they treated?

When you are stung

• For a severe reaction, such as hives, confusion, or trouble breathing:
  • If you think you are having a severe allergic reaction, give yourself an epinephrine shot in your thigh muscle.
  • Also take an oral antihistamine.
  • Then call 911 and go to the emergency room, even if you feel better.
• For a large, local reaction or a mild reaction, you can typically treat it at home.
  • Use an ice pack to reduce swelling. If you can, raise the body part where you were stung.
  • Take an over-the-counter pain reliever, such as acetaminophen (Tylenol, for example) or ibuprofen (Advil, for example).
  • Take an antihistamine to help with the itching. Read and follow the warnings on the label. And don’t give antihistamines to your child unless you’ve checked with the doctor first.

Other treatment

If you or your child has severe reactions, your doctor may prescribe an epinephrine shot that you keep with you or your child at all times. Teach others, such as teachers, friends, or coworkers, what to do if you’re stung and how to give the shot. Also, be sure to wear a medical alert bracelet or other jewelry that lists your allergies. During an emergency, these can save your life.

You may also want to try allergy shots, called immunotherapy, to help prevent worse allergic reactions in the future.

Preventing stings

To reduce your chances of being stung:

• Stay away from places where insects nest.
• Wear shoes, long sleeves, and long pants when you are outdoors.
• Don’t wear perfume or scented lotions.

If you are stung, stay as calm and quiet as you can. Then move away from the insect and leave the area, because the nest may be close by.

Remove the stinger from your skin. It may be best to scrape or flick the stinger off your skin—squeezing or gripping the stinger to pull it out may inject more venom into your wound. If you were stung in your arm or leg, lower it to slow the spread of venom. Then treat the insect sting based on the type of reaction you have.

Are You Allergic To Insect Stings? Types Of Reactions, Symptoms And Treatments

If you get stung by a bee, wasp, yellow jacket, hornet, or fire ant, would you know if you had an allergic reaction?

Those are the insect stings that most often trigger allergies. Most people aren’t allergic. By knowing the difference, you can decide if you need to see a doctor.

3 Types of Reactions

The severity of symptoms from a sting varies from person to person. But in general:

A normal reaction sets off pain, swelling, and redness around the sting site.

A large local reaction causes swelling that extends beyond the sting site. For example, a person stung on the ankle may have swelling of the entire leg. While it often looks alarming, it’s usually no more serious than a normal reaction. Large local reactions peak at about 48 hours and then gradually get better over 5 to 10 days.

The most serious reaction is an allergic one (described below). You’ll need to get it treated right away.

What Are the Symptoms of an Insect Sting Allergy?

A mild allergic reaction may cause one or more of these symptoms at the site of the sting:

• Pain
• Redness
• Pimple-like spots
• Mild to moderate swelling
• Warmth
• Itching

Severe allergic reactions (also called an anaphylactic reaction) are not that common. But when they happen, they’re emergencies.

Symptoms can include:

Get emergency treatment as soon as possible.

How Common Are Insect Sting Allergies?

About 2 million Americans have allergies to the venom of stinging bugs. If you’re allergic to bee stings, you may also be allergic to yellow jackets, wasps, and hornets. Many of these people are at risk for life-threatening allergic reactions.

Treatment if You’re Not Allergic

First, if you’re stung on the hand, remove any rings from your fingers immediately.

If stung by a bee, the bee usually leaves a sac of venom and a stinger in your skin. Remove the stinger within 30 seconds to avoid receiving more venom. Gently scrape the sac and stinger out with a fingernail or a stiff-edged object like a credit card. Don’t squeeze the sac or pull on the stinger, or more venom will get into you.

Wash the stung area with soap and water, then apply an antiseptic.

Apply a soothing ointment, like a hydrocortisone cream or calamine lotion, and cover the area with a dry, sterile bandage.

If swelling is a problem, apply an ice pack or cold compress to the area.

Take an over-the-counter oral antihistamine to ease itching, swelling, and hives. Don’t give this medication to children under 2 years old or to pregnant women unless your doctor says it’s OK. (If you’re pregnant, it’s best to talk to your doctor before you take any medicine.)

You can also take an “NSAID” pain reliever such as ibuprofen.

Read the label on any medicines first. Parents of children and people with medical conditions should talk with a pharmacist if they have questions about a medicine’s use.

Treatment if You’re Allergic

If you have a severe allergic sting reaction, you’ll need epinephrine, which you can inject yourself before you call 911. Usually, this shot will stop a more severe allergic reaction from happening.

You’ll still need emergency medical care, even if the symptoms seem to stop. You may need to stay overnight at the hospital. If you’ve ever had allergic reactions to an insect sting, carry epinephrine with you wherever you go.

How Can I Avoid Being Stung?

You can’t completely. But these steps make it less likely.

1. Learn to recognize insect nests and avoid them. Yellow jackets nest in the ground in dirt mounds or old logs and walls. Honeybees camp out in beehives. Hornets and wasps make their homes in bushes, trees, and on buildings.

2. Wear shoes and socks when outdoors.

3. Wear long-sleeved shirts, long pants, socks, and shoes when in rural or wooded areas.

4. Avoid wearing perfumes or brightly colored clothing. They tend to attract insects.

5. If you have severe allergies, make sure you have someone with you if you hike, boat, swim, golf, or do other things outdoors, just in case.

6. Consider using screens on windows and doors at home. You may also want to use insect repellents when you’re outside.

7. Spray garbage cans regularly with insecticide, and keep the cans covered.

8. Avoid or remove insect-attracting plants and vines growing in and around the home.

Also, if you’re severely allergic, always wear identification that says you have an allergy. Keep an epinephrine kit on hand in case of an emergency, too. For more information on where to get a MedicAlert bracelet, you can call 800-ID-ALERT.

What Are Epinephrine Kits?

These let you give yourself medicine (epinephrine) right away if you’re stung, before you get to a doctor for treatment. The most common brand is an EpiPen. You should still see a doctor ASAP after being stung.

You’ll need a prescription from your doctor to buy one of these kits. Carry two with you at all times. In order to prevent drug interactions, tell your doctor about any medicine you take.

How Can I Prevent an Allergic Reaction?

Allergy shots may help. They’re about 97% effective. Allergy shots for insect stings put tiny amounts of the allergen (you may hear it called insect venom) into your body over time. Your body gets used to the allergen, and if you get stung again, you won’t have such a bad reaction.

Your doctor will first test you to find out what insects you’re allergic to. Then you’ll typically get the shots once or twice a week. The dose will go up slightly over time until you reach a maintenance dose, usually in about 3 to 6 months.

For most people, allergy shots are safe. You may have side effects like redness and warmth at the injection site. You could also have a mild or serious allergic reaction to the shot itself. They may be more risky for people who have heart or lung disease or who take certain medications.

Allergic Reaction
Overview – CancerConnect

An allergic reaction occurs when the body becomes hypersensitive to a substance, such as a drug, dust, or pollen. The reaction can be localized, in an isolated place in the body, or wide spread. A severe allergic reaction, called anaphylaxis or anaphylactic reaction, can be life-threatening. Notify your doctor immediately if you develop any symptoms of an allergic reaction.

• What is an allergic reaction?
• Which cancer drugs are likely to cause an allergic reaction?
• What are the symptoms of an allergic reaction?
• How is a drug allergy treated?

What is an allergic reaction

An allergic reaction is an overactive or misdirected immune response to a foreign substance that does not cause a response in most people. An immune response involves activation of white blood cells in order to protect the body from foreign substances, such as viruses and bacteria. However, the body can become hypersensitive to a foreign substance that it has been exposed to in the past, such as drugs, pollen or dust. Subsequent exposure will produce an exaggerated immune response.

An allergic reaction may be characterized by itching, hives, skin rash, shortness of breath or wheezing within minutes to two hours after contact with an allergy-causing substance, and in rare instances may occur up to four hours later.  A severe allergic reaction, called anaphylaxis, is a rapid reaction that affects the whole body and can be life-threatening.  Symptoms include red, blotchy skin, increased breathing and heart rate, swelling around the mouth and throat, and difficulty breathing.  Common causes of anaphylaxis include food, medication, insect stings and latex. First exposure to a foreign substance does not cause an anaphylactic reaction, but subsequent exposure may.

If you experience these symptoms or think you are experiencing an allergic reaction, notify your healthcare provider immediately.  Allergic reactionscan occur after taking almost any drug.

Which cancer drugs are likely to cause an allergic reaction

Allergic reactions have been reported with most cancer drugs, although they are generally infrequent and localized. Chemotherapy drugs that have been reported to cause a systemic allergic reaction in more than 10% of patients include:

• Melphalan (Alkeran®)
• Procarbazine (Matulane®)
• Asparaginase (Elspar®)—occurs in more than 30% of patients
• Pegaspargase (Oncaspar®)—occurs in more than 30% of patients

What are the symptoms of an allergic reaction

Most drug allergies are local reactions, causing minor skin rashes and hives. However, other symptoms occasionally develop into a life-threatening acute allergic reaction involving the whole body (anaphylaxis). A common type of local allergic reaction that occurs with intravenous (into your vein) drug administration is called an injection site reaction. Symptoms occur around the site where the drug was injected.

The symptoms of a local allergic reaction include the following:

• Hives are raised, itchy, red blotches, which may be pale in the center and red around the outside. Hives are a common drug reaction usually occurring within 36 hours of drug exposure. Hives rarely last for more than 24 hours. However, on exposure to the drug again, the hives may develop within minutes.
• Swelling
• Rash
• Runny nose
• Asthma symptoms (minor wheezing, cough)
• Itching

The symptoms of an anaphylactic reaction include:

• Difficulty breathing due to constriction of the throat
• Faintness and lightheadedness that does not improve dramatically with lying down (due to very low blood pressure)
• Rapid heart rate
• Swelling, including in the tongue, lips, or mouth causing difficulty in swallowing or breathing
• Nausea, vomiting
• Abdominal pain (cramping)

How is a drug allergy treated

Most local drug allergies can be treated. Antihistamines usually relieve mild symptoms (rash, hives, itching). Corticosteroid cream may be applied to the skin to relieve itching and swelling. Bronchodilators such as albuterol may be prescribed to reduce asthma-like symptoms (moderate wheezing or cough).

Anaphylaxis is treated with an injection of epinephrine. Epinephrine (adrenalin) is a natural hormone that is produced by the body. It causes relaxation of the bronchioles (throat) and constricts blood vessels to increase blood pressure. A drug that has caused anaphylaxis in the past should be avoided.

90,000 Urgent allergology. Types of allergic reactions and treatment regimen

All upper respiratory tract is involved in the process. From the side of the eyes, acute conjunctivitis can be observed, from the side of the nasal mucosa – sneezing and profuse rhinorrhea, from the side of the throat – cough (bronchospasm).

Quincke’s edema can be acute and single , i.e. manifest once in a lifetime, or maybe recurrent . Recurrent Quincke’s edema is divided into familial (the patient says that there were similar cases in his family) and non-familial.In the case of familial Quincke’s edema, a pathology in the compliment system is detected, treatment is prescribed up to transfusion of plasma and donor blood. If Quincke’s edema is non-familial, it is necessary to identify the pathology (the underlying disease is treated and standard emergency care is carried out).

Consider also such an allergic reaction as anaphylactic shock.
This is an extreme degree of hypersensitivity, it can be both allergic and non-allergic.

Causes of anaphylactic shock:
– Most often: nuts, fish, seafood, fruits, sesame seeds, berries, protein, legumes.
– In second place: preservatives, dyes, stabilizers, antiseptics, enzymes.
– In third place is the drug list: penicillins, cephalosporins, sulfonamides, serums, vaccines, iodine.

Additionally, anaphylactic shock can be provoked by physical activity, cold stress and insect bites.

Clinic of anaphylactic shock
Shock may be accompanied by urticaria with systemic manifestations. With a mild degree, symptoms appear 2 hours after contact (itching, lacrimation, sneezing, swelling of the eyelids, mucous membranes).With a moderate degree – shortness of breath, cough, choking, anxiety, accompanied by lethal fears. In severe cases, asphyxia may develop – a fulminant anaphylactic reaction.

Treatment
– First of all, you need to stop the administration of the allergen!
– The patient needs to be given oxygen, in case of bites, apply a tourniquet, ice.
– Introduce adrenaline 0.1% 0.3-0.5. After 15 minutes – re-introduction, then – every 4 hours.
– The patient should receive antihistamines for at least two days every 6 hours (parenterally).
– If the case is more severe, use GCS (prednisolone 50-100 mg intravenously) for 4-6 days.
– All patients with anaphylactic shock must be hospitalized for 10 days!

Consider also the classification of antihistamines.

1st generation drugs (sedative antihistamines): Suprastin, Tavegil. Diphenhydramine, Pipolfen, Ketotifen, Fenkarol, Diazolin, Peritol.

2nd generation drugs (non-sedative antihistamines): Cetirizine (Zyrtec, Parlazin, Zodak), Fexofenadine (Telfast), Desloratadine (Erius), Ebastin (Kestin), Loratadine (Claritin).

The clinical advantages of 1st generation antihistamines are that these drugs effectively eliminate sneezing and rhinorrhea when a rhinovirus infection occurs; help to eliminate the feeling of itching and normalize disturbed sleep, therefore, they are more often prescribed at night. Lipophilic properties of drugs in this group provide penetration to the histamine receptors of the skin better than hydrophilic ones.

Side effects of 1st generation drugs
This group of drugs penetrates the BBB, has a pronounced sedative effect.They are also capable of causing impaired coordination, dizziness, decreased ability to concentrate, dryness of mucous membranes. Perhaps the development of tachyphylaxis – a decrease in therapeutic activity with prolonged use. It is important to remember that 1st generation drugs do not leave the medical arsenal, but are used only for a few days! When it comes to basic therapy, 2nd generation antihistamines are used in the treatment.

Criteria for an ideal 2nd generation antihistamine:
– Rapid onset of action
– Convenient dosing regimen in children
– Many drugs have anti-inflammatory activity
– Rapid absorption and no drug interactions
– No sedation at all
– No cardiotoxicity

The optimal treatment regimen for patients with allergic reactions is as follows: at the peak of the acute state (with anaphylactic shock) adrenaline is prescribed, after which 1st generation antihistamines are prescribed for several days.When the severity of the allergic condition is removed, the patient must be transferred to 2nd generation antihistamines, which are used for a long time, taking into account their criteria. If the allergic reaction is excessive, GCS should be used.

How does skin allergy manifest?

Some changes in the skin may be a manifestation of an allergic reaction. Rashes after eating, itching from mosquito bites – there are many variations in symptoms. We will tell you what to do with it.

allergy sufferers on average have skin manifestations of allergy, and in childhood – in 50–66% ¹.

They can occur on almost any irritant, but usually insect venom or drugs are the culprit. Food allergies can also cause changes in the skin³. And the symptoms quite often combine external and internal reactions. Thus, in 31–33% of children with bronchial asthma, signs of atopic dermatitis are noted in the course of the disease.

How to understand that unpleasant external symptoms are just an allergy? Usually, the so-called primary morphological elements appear on the skin – blisters, papules, etc.

They are accompanied by redness and swelling. At the same time, for some diseases, the characteristic symptom is itching (for example, dermatitis and urticaria), while for others – pain, burning sensation and a feeling of tightness (erythema and some allergic syndromes) ¹ .

Depending on the prevalence of the process, several forms of the disease are distinguished (this classification is applicable for atopic dermatitis). The first is localized lesions that do not exceed 10% of the skin.They usually appear on the skin of the hands, face and neck ¹ . The next severity form is a common allergic process, when the lesion is 10-50% of the skin surface and affects the limbs, back, chest ¹ . And with a diffuse form, the lesion area is already more than 50% of the skin ¹ .

It is interesting that psychosomatics can affect the skin manifestations of allergies. So, for some people, before a difficult exam or interview, their hands or eyes begin to itch.

Negative emotions can really lead to the development of hypersensitization – increased sensitivity of the body to the allergen⁵. A number of studies confirm that skin allergic manifestations are often associated with neurotic disorders⁵, ⁶.

The complexity of the treatment of skin manifestations arises already at the stage of diagnosis. The fact is that it is first necessary to understand what caused the reaction in general. It is important for a doctor not to confuse allergies with many other diseases: dermatitis, shingles, eczema, and so on ¹ .

Treatment of allergies with skin manifestations should be comprehensive⁷. Compliance with a hypoallergenic regimen plays an important role. It includes limiting the intake of airborne allergens and pollutants into the home. It is also necessary to follow a hypoallergenic diet – this significantly improves the prognosis and outcome of the disease8. External therapy is required to relieve itching, prevent secondary infection, moisturize, control skin inflammation and stimulate skin healing1. For this, emollients and nourishing agents, external corticosteroids, and sometimes (with the addition of a secondary infection) and antibacterial medicines are used, since the affected skin is more susceptible to the action of pathogens ¹ .The complex therapy of systemic agents includes antihistamines, detoxification and sedative drugs.

Antihistamines are classified into first and second generation drugs. The preference is usually given to second-generation products due to the more favorable safety profile⁹. More information about antihistamines can be found in article “ How to choose an antihistamine ” .

Skin allergies are one of the most common manifestations of atopy, especially in children.If you suspect an allergic reaction, you should consult a doctor, because these are not just unpleasant symptoms, but a disease!

Text: Zoya Andreeva

Illustrations: Nina Magradze

Drug allergy: symptoms, first aid :: Is an allergy to Kagocel possible in children and adults :: Articles

Drug allergy occurs in 10–20% of people. In 5% of cases, it becomes the cause of hospitalization, in 1% – leads to death ¹ .In the vast majority of cases, the development of an allergic reaction to drugs is predictable and avoidable.

Despite the fact that almost any medicine can cause an allergy, it most often happens after the use of antibiotics, vaccines, opiates, drugs for local and general anesthesia, insulin, heparin, neuromuscular blockers, corticosteroids, X-ray contrast agents, latex. Women are more prone to drug allergies than men ² .

Types of drug allergies

In terms of prevalence, allergic reactions are divided as follows ² :

• Generalized (applies to the entire body). These include
  anaphylactic shock, serum sickness, fever, extensive inflammation of the vascular system.

• Localized (affect individual organs and systems).These are lesions of the skin, nervous system, internal organs, mucous membranes and the respiratory system, small vascular inflammation.

According to the severity, drug allergic reactions are divided into mild, moderate and severe. They can occur in acute, subacute and chronic forms, as well as be complicated and uncomplicated ² .

Allergic reactions from the skin are most often observed, in second place is the respiratory tract, in third place is the cardiovascular system.In rare cases, mixed reactions are possible [2].

Diagnosis of drug allergy

Before prescribing any therapy, the attending physician always asks questions about the tolerability of drugs in order to exclude allergic reactions. If such episodes have already happened, you should find out what caused them, how they manifested themselves, whether treatment was prescribed, how effective it was.

The likelihood of developing allergic reactions to medications increases with the following factors ² :

• heredity;
• the presence of allergic diseases;
• bronchial asthma;
• work in hazardous industries, professional contact with medicines;
• fungal diseases;
• the use of a large number of drugs;
• self-medication.

Laboratory blood tests, skin testing, and challenge tests are used to diagnose drug allergies. Blood tests are the safest, but their reliability is only 60-85% ³ .

Skin testing is only suitable for detecting allergic contact dermatitis and is the application of a small amount of the drug diluted with white petrolatum or other viscous inert substance to the patient’s clean, intact skin in the interscapular region.

The response is assessed 20 minutes after the start of testing. If there are no changes in the skin, the application is left for 48-72 hours, periodically monitoring the condition of the skin. If the patient has an allergy, redness, rash, itching appears at the site of contact of the drug with the skin ² .

Provocative tests are carried out by an allergist in a specialized office under conditions of resuscitation readiness. The existing types of provocative tests ² are described below:

• Sublingual test. The patient is allowed to hold a tablet or lump of sugar with a liquid preparation under his tongue. In the presence of an allergy, after 5-15 minutes, itching begins in the mouth, lips swell, and urticaria appears.

• Dosed provocation. The study medication is sequentially administered to the patient, starting with the smallest doses: first on the skin, then intradermally and subcutaneously. After each injection of the drug, you should observe the condition for at least 20 minutes.This method is the most informative.

If an allergy to a drug is identified, the doctor puts a red mark on the cover of the patient’s medical history or outpatient card. It is impossible to prescribe this drug in the future.

Taking a drug allergic to

Allergic diseases in general and drug allergies in particular are characterized by progression and complications.Therefore, taking drugs that are allergic, even if it manifested itself in a mild form, is prohibited. In cases where the withdrawal of a drug poses a threat to the patient’s life (for example, insulin in diabetes), it is used under the supervision of an allergist and accompanied by special therapy ² .

Symptoms for drug allergies 90 150

Clinical manifestations of drug allergy can be ⁵ :

• Rhinitis. Difficulty in nasal breathing, feeling of stuffiness, sneezing, swelling of the mucous membrane and profuse mucous discharge from the nose.

• Conjunctivitis. Narrowing of the palpebral fissure, itchy eyes, lacrimation, photophobia, swelling of the eyelids.

• Urticaria. Itchy skin rash.

• Quincke’s edema. Edema of the skin, subcutaneous tissue or mucous membranes. The most dangerous is laryngeal edema, leading to suffocation.

• Anaphylactic shock. The most dangerous condition, which is characterized by a sharp drop in blood pressure, urticaria, laryngeal edema, fainting. In addition to suffocation from edema, life-threatening injuries from a fall from loss of consciousness – for example, a fracture of the base of the skull – can pose a threat to life.

If such manifestations occur, you should immediately consult a doctor.

First aid for drug allergies

In the acute course of allergies, emergency medical care is provided in the following areas ⁵ :

1. Cessation of ingestion of an allergen. If there is any allergic reaction to the injection, a hot water bottle with cold water or ice is applied to the injection site for 15 minutes, a tourniquet is applied above. 5–6 points may be required and the injection site should be infiltrated with epinephrine solution.

2. Taking antihistamines or glucocorticosteroids. Indicated for allergic rhinitis, allergic conjunctivitis, urticaria, Quincke’s edema. Usually, taking pills is enough; in severe cases, injections are required.

3. Symptomatic drug therapy. Aimed at relieving bronchospasm, correcting arterial hypotension, bradycardia.

4. Anti-shock measures. The patient is positioned so that the head is below the legs and turned to the side to avoid aspiration of vomit. The lower jaw should be extended, removable dentures (if any) – removed. Adrenaline is injected subcutaneously, if necessary, every 20 minutes for an hour under the control of blood pressure. If the condition does not improve and a threat to life develops, intravenous adrenaline is possible.

You should be aware that death from an allergic reaction to drugs usually occurs from anaphylaxis. It develops within five minutes, causing laryngeal edema and death by suffocation. In such a situation, an urgent injection of adrenaline is required. People who have already had similar episodes need to constantly carry with them a passport of an anaphylaxis patient. They should also keep adrenaline with them at all times so that it can be injected immediately ⁴ .

Prevention of drug allergy

Those who suffer from drug allergies should take the following preventive measures:

• Avoid recurrence of allergic attacks, as they can get worse each time.

• Alert your doctor about allergies before any medical procedure.

• Read the annotations to medicinal products in order to prevent the intake of an allergen drug under a different name or similar in composition.

• Exclude self-medication.

• If clinical symptoms of drug allergy appear, call an ambulance.

• Avoid prolonged contact with medications, especially on a professional basis. According to statistics, drug allergy causes difficulties in performing professional duties in 45.5% of dressing nurses, 42.9% of resuscitators, 38.9% of procedural nurses, 30.2% of resuscitation nurses, 29.6% of surgeons, 29% of psychiatrists, 23 , 3% of ward nurses and 17.2% of nurses.Some of them have to change their profession ^{2, 6} .

If you or your family members are allergic to medications, inform your loved ones about this: they should be aware of the problem and, if necessary, be able to provide first aid.

Allergy to Kagocel

Possible adverse reactions ⁷ when using the drug are given in the instructions for medical use, depending on the frequency of occurrence (WHO classification): often (≥1 / 100,

Allergic reactions: the frequency is unknown – rash, urticaria, itching of the skin, Quincke’s edema.

From the digestive system: the frequency is unknown – nausea, diarrhea, gastralgia.

If any of the adverse reactions indicated in the instructions are aggravated, or you notice any other adverse reactions not listed in the instructions, inform your doctor.

Allergy to Kagocel can occur in both an adult and a child. The reason for the reactions is individual intolerance to the components of the drug. It is worth noting that over 16 years of circulation of the drug on the market, only 160 adverse reactions were registered.During this time, about 200 million packages of Kagocel were sold (more than 100 million patients received treatment with the drug). This means that the number of cases of side effects is negligible – only 0, 00008% of the number of packages sold.

At the first manifestations of allergy, you should immediately interrupt the drug intake, as soon as possible consult a general practitioner at your place of residence and report the occurrence of an undesirable action to the Pharmacovigilance service of Nearmedic.

List of sources:

1. Drug allergy. / Zhukova N.V., Krivosheeva I.M. – Crimean therapeutic journal. – 2012. – No. 2 (19). – URL: https://cyberleninka.ru/article/n/medikamentoznaya-allergiya/viewer (date accessed: 11/23/2020)

2. Allergic reactions to drugs and medicines. Benefit. / D. K. Novikov, V. I. Novikova, P. D. Novikov. – Vitebsk. – VSMU. – 2012. – URL: https://core.ac.uk/download/pdf/80151511.pdf (date accessed: 11/23/2020)

3. Modern aspects of diagnosis and treatment of drug allergy. / E.V. Stepanov. – Therapist. – # 04/09. – URL: https://www.lvrach.ru/2009/04/7620391 (date of access: 23.11.

4. Dangerous medicine. How do you know if you are allergic to a drug? Interview with an allergist-immunologist Anna Shulyaeva. – AIF. – 17.04.2017. – URL: https://aif.ru/health/life/opasnoe_lekarstvo_kak_uznat_o_nalichii_u_vas_allergii_na_preparat (date of access: 23.11.2020)

5. Provision of emergency medical care for acute allergic diseases. / I. I. Balabolkin, L. S. Namazova, I. V. Sidorenko, I. S. Elkis, A. V. Topolyansky, A. L. Vertkin. – Russian medical journal. – # 20/2001. – URL: https://www.rmj.ru/articles/neotlozhnaya_terapiya/Okazanie_skoroy_medicinskoy_pomoschi_pri_ostryh_allergicheskih_zabolevaniyah/ (date of access: 23.11.

6. Drug allergy. / GBUZ “City hospital of the resort town of Gelendzhik” MH KK.- URL: https://gbgel.ru/2017-06-23-06-48-34/229-2018-07-09-11-25-29 (date accessed: 23.11.

7.URL: https://kagocel.ru/about_drug/instrukciya

Drug hypersensitivity (drug allergy) with various clinical manifestations> Clinical protocols of the Ministry of Health of the Republic of Kazakhstan

However, despite all the drawbacks, skin tests, due to their simplicity and speed of obtaining a result, are recommended for use in the diagnosis of PH (UD – V).

Drip test – This is the simplest and safest in vivo test in terms of the risk of complications. That is why, despite the less informativeness of the test, it is recommended to precede them with other tests in vivo [6,9,13].

Technique:
Before testing, the skin in the forearm is treated with alcohol, a small drop of the test solution is applied. Next, negative (saline) and positive (a drop of histamine solution) controls are applied to the skin.Places of application should be noted. The results are evaluated after 15-20 minutes, the diameter of the blister (the most important sign) and erythema should be recorded in millimeters, as well as the result of the control injections. The saline control should be negative, and the positive result should be 3mm more than the saline test. After the test, the patient should remain under observation for at least 20 minutes after taking the results.

Prick test ( prick – test , prick test) is an affordable, fast, minimally invasive test.It is recommended to conduct skin testing (skin and intradermal tests) if IgE-mediated reactions to penicillins and β-lactam antibiotics, muscle relaxants, X-ray contrast agents, and anesthetics are suspected. For NSAID allergies, skin tests are usually not helpful. Clinical guidelines of the European Academy of Allergology and Clinical Immunology, WHO recommend prick test as the main diagnostic method for detecting IgE-associated reactions in conjunction with history and physical examination [7].

Technique:
Before testing, the skin in the forearm is treated with alcohol, a small drop of the test solution is applied. Next, a test control (saline solution) and a drop of a histamine solution are applied to the skin. Places of application should be noted. After that, a disposable scarifier at an angle of 45-60 degrees damages the epidermis in each drop. Use a new scarifier for every drop. After 1 min, the drop is gently washed with a napkin.
The results are evaluated after 15-20 minutes, the diameter of the blister (the most important sign) and erythema should be recorded in millimeters, as well as the result of the control injections. The saline control should be negative, and the positive result should be 3mm more than the saline test. After the test, the patient should remain under observation for at least 20 minutes after taking the results.
Start testing with less invasive (drip, prick test) tests and move on to more invasive (intradermal) tests if the previous ones are negative.
Scarification tests are not currently recommended for use.

Intradermal test is more sensitive, but less specific than the prick test. When it is carried out, increasing tenfold concentrations from 10 ^-5 are used to a positive result or until a therapeutic dose is reached. The intradermal test is assessed after 15–20 minutes, but a positive reaction after 48 hours may indicate the development of HRT. Intradermal test is more dangerous by the development of a systemic reaction and should be carried out only by a trained allergist in a specialized department.
For most drugs for skin tests, therapeutic concentrations of drugs are used, however, in some cases, it is recommended to use dilutions to exclude local irritation and histamine-liberating effects. In some cases, it is necessary to test the concentration of drugs that do not cause irritation on healthy skin on healthy volunteers. It is recommended to use solutions for parenteral administration for skin testing; as an exception, it is allowed to use solutions of tablet forms and oral liquid forms, but the reliability of the sample is reduced in this case [8,9,18,19,20].

Application tests (patch tests, patch – test ) are designed to detect delayed-type hypersensitivity. The use of standardized test patches for testing is recommended. Evaluation of the result is carried out after 48 and 96 hours. It is necessary to collect information in the literature on the validity of this testing for each specific drug. There is evidence of the possibility of using this test to diagnose the cause of maculopapular rash, fixed erythema, contact dermatitis caused by antibiotics, antimicrobial drugs, anticonvulsants, antihypertensive drugs [21,22].

Provocative tests and trial treatment can only be performed if there is an intensive care unit (or at least an intensive care unit) and the possibility of round-the-clock monitoring of the patient for several days due to the high risks of PH (see section 10 of this protocol).

NB! In vivo tests must be performed in strict accordance with standards of performance and exclusively by trained professionals.

Provocative tests and trial treatment are indicated in case of inconsistency between the data of the allergic anamnesis and the results of skin tests. These tests are based on the reproduction of allergic reactions by introducing an allergen into an organ or tissue, the lesion of which is leading in the picture of the disease (oral, intramuscular, subcutaneous administration). They are the most informative, but they are not recognized by the “Gold Standard” due to the high degree of danger to the patient. Provocative tests should be performed only by a specialist allergist in a hospital setting with an intensive care unit.International guidelines indicate the use of a placebo in a series of provocative tests as a negative control, since the patient’s psychogenic status and anxiety can affect the interpretation of the test.
Provocative tests are carried out when all other studies have already been carried out, but the diagnosis remains unclear, and the use of the drug is extremely necessary and there is no alternative to it. The European Commission on Drug Allergy also recommends provocative testing after negative skin tests for β-lactam antibiotics in individuals with a history of penicillin and cephalosporin antibiotics, since up to 30% of patients with a negative skin test but with a history of an antibiotic reaction from of this group, a clinically significant allergic reaction develops.The purpose of provocative tests: to exclude hypersensitivity to the drug, the intake of which is important for the patient, to find a suitable alternative drug. It is recommended to use a series of gradually increasing concentration tests using a placebo. The informed consent of the patient is mandatory. Provocative tests are not performed if the patient has a history of life-threatening reactions (AS, Lyell’s syndrome) to drugs, as well as if the patient has severe concomitant diseases.It is necessary to measure the benefit / risk when prescribing challenge testing [7,18].
Provocative metered-dose tests (PDT) with the introduction of a drug in a full therapeutic dose, and, if necessary, a full therapeutic course (trial treatment), are the gold standard for identifying a causally significant drug (C) and are carried out in a hospital setting with an intensive care unit if replacement is impossible Alternative drugs. An oral challenge test is safer (D). PDT should be carried out no earlier than 1 month after the reaction (D).

Irritated skin: how to deal with it

Today, several thousand skin diseases are known. Often the most unpleasant side of them is
that the problem cannot be hidden from prying eyes, not to mention the excruciating symptoms. Is it possible to
quickly get rid of them and enjoy life again? Consider the most common manifestations of skin
diseases.

Redness

This symptom accompanies many skin diseases and, as a rule, is combined with other manifestations: edema,
rash and itching.The cause of redness is most often an allergic reaction (for example, hives), but it
can also be a sign of an infectious skin lesion (eg, streptoderma).

Redness occurs due to the expansion of the subcutaneous vessels, capillaries, in which blood flow accelerates. To
remove the symptom, reduce vascular permeability and narrow the capillaries, the local remedy should have a pronounced
anti-inflammatory effect.

Itching

Skin irritation is most often accompanied by an intolerable desire to scratch the inflamed areas.Exhausting and
excruciating itching can lead not only to insomnia, but also to severe depression. He accompanies such
common skin conditions like scabies, eczema and dermatitis, but often also a sign of common
diseases of the body – hepatitis, diabetes and others. Itching can be generalized, i.e.
cover the entire surface of the body, but for skin pathology, localized itching, focused on
one or more of its sites.

Mechanical damage to the skin, microcracks arising
due to scratching with itching, they become a gateway for infection.

The infectious agent enters the thickness of the skin, destroying its cells. This causes inflammation with the appearance of
the intercellular space of biologically active substances that lead to itching. Insofar as
the addition of infection is very likely, it is important that the drug has an antimicrobial effect
for direct control of an infectious agent.

Rash

The appearance of a rash can be both a local reaction of the skin to an external stimulus, and a symptom of internal
disturbances in the work of the body. Since the rash accompanies several hundred different diseases, put the correct
the diagnosis can only be made by a dermatologist, based on the shape and size of the rash, as well as the presence of inflammatory and
infectious component.

Diseases in which these symptoms often develop are, for example, “diathesis” (red cheeks in a child),
skin allergy to metals (such as jewelry), or skin irritation when using cosmetics or
perfumery.Unfortunately, these conditions are very often complicated by a secondary infection.

How to beat symptoms

Since skin diseases are accompanied by a whole group of diverse symptoms, an effective remedy for
the fight against them should affect the skin in a complex manner. Due to the combination of active ingredients, the combined
the drug Pimafukort® has anti-inflammatory, antimicrobial,
antifungal and antipruritic
action*.

Pimafucort® contains the antibiotic neomycin, as well as natamycin, which has
pronounced antifungal
properties. This combination of components in the preparation makes it easy to eliminate the associated infection. Here
why Pimafukort® is effective in inflammatory skin diseases complicated by infection.

Due to the content of hydrocortisone, the drug inhibits the activity of bradykinin and histamine, as a result of which it subsides
local inflammatory reaction and itching, as well as reducing swelling due to vasoconstriction.

Don’t let skin troubles spoil your mood,
after all, a simple and affordable solution is always at hand.

Information about the drug, its properties and characteristics, indications for use and contraindications, and
also other information is set out in the instructions for the medicinal product.

How to prevent the development of an allergic reaction

Allergies can manifest themselves gradually, and usually becomes an unpleasant surprise at the first manifestation.Often, people, especially those who have a predisposition (hereditary, or associated with the duties of the immune system), may experience an allergic reaction to any product, pollen, household chemicals or other substances. Many people live with allergies throughout their lives and know how to deal with them at home.

Home first aid kit for allergy sufferers

At the first manifestation of signs of allergies, including redness and itching of the skin, sneezing, itching in the nose and eyes, it is worth contacting paid medical organizations to establish the cause and know how to act in such situations.The danger lies in the possibility of developing anaphylactic shock, which requires urgent help.

If the symptoms are local, you can cope with them yourself. Sorbents help to cope well with symptoms. They are available in different forms:

• Powder for suspension preparation;
• Paste;
• Tablets.

They differ in ease of use in each specific case and the effectiveness of the action at different localization of symptoms:

For action in the intestinal cavity, capsules and tablets are better suited;

Suspensions and solutions will help to localize the focus of irritation in the stomach;

Pastes and gels will more effectively cope with irritation of mucous membranes.

In addition to sorbents, the following medications should be in the home medicine cabinet for people with allergies:

• Antihistamines that help eliminate symptoms such as sneezing, itchy eyes and heavy nasal discharge;
• Moisturizing eye drops to help clear allergens from the eyes;
• Nasal sprays;
• Cream or ointment as prescribed by a physician.

These drugs help to cope only with symptoms, eliminating discomfort.To deal with the problem, you need to contact a good paid allergist. The specialists of the Heratsi Medical Center have extensive experience in solving allergy problems. After admission, you need to pass tests at a medical center in order to establish the cause and identify the allergen.

After the cause of the allergic reaction is understood, the doctor will prescribe the appropriate therapy. First of all, it is necessary to avoid contact with the allergen as much as possible and to have drugs with you that will help to cope with the onset of allergy manifestations.

Clinic “Heratsi” is a place where you can take tests in Rostov-on-Don with a guarantee of an accurate result thanks to experienced laboratory specialists and modern equipment. Accuracy is especially important when identifying the causes of allergies, as it can make life much easier for people suffering from its manifestations. The center has a house call service for a paid therapist, which can be used if the first symptoms appear. The doctor will conduct an examination and establish whether these are really manifestations of an allergy, or there is another reason.

You can find out the prices of paid medical services in the “Price” section, doctors’ schedule and other necessary information can be found on the website or by calling the round-the-clock hotline 8-863-333-20-11.

| Sarah Bush Lincoln

Limited Response

Limited (localized) response only affects the area of ​​contact. Some reactions may not appear for several days. Others may appear almost immediately.

Step 1. Remove the allergen source

• If the person has been bitten, scrape off the sting with the edge of a credit card or the blunt edge of a knife.Do not use your fingers or tweezers to remove the sting. If the sting is squeezed, it can release poison into the skin.

• If the reaction is caused by eating a certain food or medication, the person should not eat or take this substance again.

Step 2. Treat the skin

• Wash insect bites with soap and water.

• Remove and wash in hot water all clothing that may contain vegetable oils or any other reacting substance.Shower with plenty of soap to remove vegetable oils or other allergens from your skin.

• Ask your doctor what to do with itchy or irritated skin.

Strong reaction

Strong (systemic) reaction affects the entire body. In severe cases, the airways between the mouth and lungs may swell (anaphylaxis). The reaction can occur immediately or after a few hours.

Step 1. Calm the person

• Help the person get into a comfortable position.Support your head to facilitate breathing.

• Tell the person to stay still and restrict the conversation.

• If the person carries a medication (adrenaline) for anaphylaxis, help him or her take it.

• Prevent any further contact or exposure to the allergen.

Step 2 Breathing Control

• Watch for signs of airway swelling such as wheezing or swollen lips.In severe cases, the person may have breathing problems.

• Give artificial respiration if necessary. In severe cases, air cannot enter the lungs.

Call 911. While waiting for help:

Immediately call 911 if the person has any of the following symptoms:

• Difficulty breathing,

• Airway edema (anaphylaxis) has already occurred.

• Calm the person down.

• Provide first aid for shock or artificial respiration or CPR as needed.

When to seek medical attention

An allergic reaction may worsen over time. Seek medical attention if any of the following occurs:

• Rash or hives cover the face, genitals, or most of the body.

• A part of the body such as an arm or a leg is swollen.