Shitaki ‘shrooms tasty, but linked to streaky, itchy rash

Shitaki ‘shrooms tasty, but linked to streaky, itchy rash

Now, say that fast three times with your mouth full of mushrooms.  Shitake toxicoderma is a very common dermatitis in Asia, especially, China, Japan and Korea.  However, it is being seen more commonly in the U.S. as the popularity of shitake mushrooms increases.  The rash is fairly unique, consisting of a long linear array of urticaria. The skin looks like it has been whipped with cat-o-nine tails having red raised streaks that are very pruritic. The itchy lines can last…

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More reasons to protect with shingles vaccine: Vision-robbing after-effects, even blindness

More reasons to protect with shingles vaccine: Vision-robbing after-effects, even blindness

Since the article in the last issue of Allergic Reaction about Ramsay Hunt Syndrome from shingles, four patients from this office have commented on the much more common problem from shingles. That is eye involvement.  Four individuals either had the complication themselves or knew a relative or friend with the eye involvement. All four of them felt that since the eye issue is so severe, people should know about it so they can protect themselves with the vaccine. So here…

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Mosquito repellant works well, but…

Mosquito repellant works well, but…

The frequent rains this summer have led to a bumper crop of hungry mosquitoes. Although many repellants are available, the most effective compound seems to be DEET. It works because its scent is extremely irritating to biting insects, such as mosquitoes and fleas.  Unfortunately, DEET is fairly allergenic with upwards of 30 percent of individuals developing a rash after repeated use. The types of rash seen are contact dermatitis (looks like poison ivy), eczema and urticaria (hives). The fact that…

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Peanut allergy vaccine – mixed opinions

Peanut allergy vaccine – mixed opinions

Dear Dr. K: Please give us an update on the vaccine for peanut allergy. Your request is very timely as I recently finished reading a pro/con editorial in the journal Asthma and Allergy Proceedings. I think these two editorial viewpoints sum things up quite nicely.  The first of the two is titled, “Oral and Sublingual Peanut Immunotherapy Is Not Ready for General Use.” In this article written by the director of allergy at the University of Michigan, the focus in…

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Meningitis a threat to those with defective or missing spleen

Meningitis a threat to those with defective or missing spleen

Spleenectomy (surgical removal of the spleen), or functional asplenia, is a significant risk factor for meningitis. And curiously, the most common bacteria to cause meningitis in these patients is the germ pneumoccus (most commonly associated with bronchitis and pneumonia).  Patients with splenic dysfunction lose an important site of both antibody production and immune cell production. They also can no longer filter blood-borne bacteria; hence, a germ that normally causes a respiratory infection can get into the bloodstream and land in…

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Q – Tips; Auvi-Q epinephrine injector

Q – Tips; Auvi-Q epinephrine injector

• Auvi-Q is a new, user-friendly epinephrine injector. The auto-injector device has an audio message that verbally walks the patient through administration of the drug. This audio-prompter is built in to the injector as a single unit. This new device has proven useful in patients who otherwise are hesitant to use epinephrine.

Q – Tips; sleep deprivation and vaccines

Q – Tips; sleep deprivation and vaccines

• Sleep deprivation can lessen the immune response to vaccines, report researchers at UCLA. In a controlled study they found that restricting sleep to four hours per night for five days led to only a 50 percent response to vaccination. Take-home message: If your or your child are sleep-deprived put off getting your childhood or adult vaccines until you are well-rested.

Chronic Pruritis

Chronic Pruritis

A recent issue of the New England Journal of Medicine contained an excellent review article on the condition known as chronic pruritis – defined as an itch (either localized or generalized) that lasts longer than six weeks. The problem is more common in women than in men and more common in Asians than other races. The authors of the review article point out that chronic itch can be as debilitating as chronic pain, leading to changes in sleep patterns and…

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Ramsay Hunt Syndrome and chicken pox

Ramsay Hunt Syndrome and chicken pox

Dear Dr. K:  My aunt has Ramsay Hunt syndrome and her doctor said it was a second bout of chicken pox.  Is that true? The answer to your question is yes and no. In the strictest sense the answer is no, because your aunt doesn’t have generalized chicken pox, but rather a very localized rash. The answer is  yes because, in general terms, Ramsay Hunt is a special form of shingles which is a reactivation of the dormant chicken pox…

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Narcolepsy

Narcolepsy

Recent research has discovered that narcolepsy is a genetically controlled autoimmune disease. Individuals with the gene HLA-DRz/DQI have a very high risk that their immune system will attack a part of the brain called the hypothalamus. It is in this brain region that an important neuropeptide called hypocretin is made. Hypocretin is a very important neuropeptide for maintaining alert wakefulness. If the cells in the hypothalamus that produce it are damaged or destroyed, narcolepsy occurs. This condition is characterized by…

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