This review highlights some of the research advances in allergic
skin disease,
anaphylaxis, and
hypersensitivity reactions to foods, drugs, and
insect venom that were reported primarily in the Journal of
Allergy and Clinical Immunology from 2002 through 2003. Among the topics highlighted are new insights into the pathogenesis of
atopic dermatitis and potential strategies for more effective treatment of the atopic march. Patients should remain supine with raised legs during
anaphylactic shock because upper body elevation could result in
sudden death from loss of venous return to the heart. A major advance in
food allergy was that humanized, monoclonal
anti-IgE antibody showed protection against peanut-induced
anaphylaxis. In addition to studies elucidating mechanisms of
drug hypersensitivity, a clinical study showed patients with a history of prior
penicillin allergy with negative
penicillin allergy test results are unlikely to experience reactions or resensitization on subsequent oral courses of
penicillin. Lastly, there are new recommendations for patients with convincing
insect sting reaction histories but negative skin test responses to
venom.