Diagnosis and treatment of urticaria and angioedema: a worldwide perspective

Urticaria and angioedema are common clinical conditions representing a major concern for physicians and patients alike. The World Allergy Organization (WAO), recognizing the importance of these diseases, has contributed to previous guidelines for the diagnosis and management of urticaria. The Scientific and Clinical Issues Council of WAO proposed the development of this global Position Paper to further enhance the clinical management of these disorders through the participation of renowned experts from all WAO regions of the world. Sections on definition and classification, prevalence, etiology and pathogenesis, diagnosis, treatment, and prognosis are based on the best scientific evidence presently available. Additional sections devoted to urticaria and angioedema in children and pregnant women, quality of life and patient-reported outcomes, and physical urticarias have been incorporated into this document. It is expected that this article will supplement recent international guidelines with the contribution of an expert panel designated by the WAO, increasing awareness of the importance of urticaria and angioedema in medical practice and will become a useful source of information for optimum patient management worldwide

Atypical familial Papillon-Lefevre syndrome

The Papillon-Lefevre syndrome is a rare autosomal recessive disorder. Consanguinity seems a notable prerequisite. Papillon-Lefevre syndrome manifests in the first 6 months of life with rapidly progressive periodontitis and severe alveolar bone destruction leading to early loss of both the deciduous and permanent teeth in association with palmo-plantar hyperkeratosis. We present two unusual cases of familial Papillon-Lefevre syndrome, one of whom has only late onset of mild skin lesions and the other has severe skin lesions and relatively mild periodontal disease. A number of other cases recently described have also had atypical features

The significance of immunohistochemistry in the skin pathergy reaction of patients with Behcet's syndrome

Background Behcet's syndrome is a chronic systemic immuno-inflammatory disorder affecting multiple organs with generalized vasculitis of arteries and veins. Although the actiology is still unknown, endothelial dysfunction is one of the most prominent features in Behcet's syndrome. The skin pathergy reaction (SPR) is a non-specific hyperreactive lesion formation that is one of the major features and diagnostic criteria of the disease. It develops after 24-48 h at the site of the needle-prick, especially in the exacerbation period, and it is very similar to the erythematous papules or pustules that appear spontaneously in patients with Behcet's syndrome. Therefore, an investigation into the formation of the SPR lesion may contribute to the pathophysiology of skin lesions of this unique disorder

Effects of Saint John’s wort on the fetus in pregnant rats

Introduction: Because of the toxic and teratologic side effects that might develop into the fetus, the number of drugs that can be used in the treatment of depression seen in pregnancy is very limited. In this study, we investigated whether the Saint John’s wort used during pregnancy has side effects on the liver of fetus.Methods: Thirteen Wistar albino female rats were used in this study. The animals divided into two groups as 8 rats for the experimental group and 5 rats for the control group.  The animals detected for pregnancy in the experimental group were fed with the Saint John’s wort extract as 100 mg/kg/day through orogastric probe from the first day of the pregnancy. The animals in the control group were fed with 2 ml distiled water through an orogastric probe every day begining from the first day of the pregnancy. The newborn pups were taken. Their liver tissues were harvested and investigated after the tissue processing and staining procedure.Results: Microvesicular lipidosis and hydropic degeneration were observed in histopathological evaluation of the harvested tissues of experimental group. Conclusion: As a result, there is not enough data in the literature in order to claim that Saint John’s worth is reliable for the pregnant women or fetus. It is important for the physician to evaluate the complaints related to the use of pregnancy and to raise the awareness of the physicians in the first stage of the pregnancy follow-up. For the usage of this herb as an alternative or addition to antidepressive drugs more preclinical (basic) and clinical studies need to be performed