Goals: The intranasal Schirmer test (INS) is a quick method to objectify nasal secretion. This study aims to use the INS to assess nasal secretion change through direct nasal allergen provocation (NPT). Material and Methods: This prospective single-center study included patients who received allergy diagnostics using NPT and anterior rhinomanometry (aRMM). The Schirmer filter paper was attached to the nasal septum bilaterally pre- and post-allergen provocation. Additionally, all participants completed the sinonasal outcome test 22 (SNOT-22). The difference in wetting length before and after allergen provocation was investigated. Moreover, a cut-off value for allergic rhinitis were calculated. Results: A total of n = 25 patients and n = 25 in the control group were included. Patients with a positive result in NPT showed a significantly higher secretion in the provoked nasal cavity (mean difference = 13.95 mm; p = 0.01). The increased moisture level through provocation resulted in an area under the curve (AUC) of 0.814. A cut-off value of 2.75 mm wetting length increase (Youden index = 0.532) was calculated (sensitivity = 81.8% and specificity = 71.4%). Allergy diagnostic patients scored significantly higher in the SNOT-22 than the control group (25.04 score difference; p < 0.001). Conclusion: The INS represents a straightforward and cost-effective test to assess intranasal secretion changes in allergy diagnostics. The incorporation of the INS in the NPT protocol could particularly enhance treatment efficacy for patients with inconclusive NPT results or it could serve as a substitute for other objective measurements like aRMM or acoustic rhinometry.

Aim: The 4th Davos Declaration, convened during the Global Allergy Forum (GAF) in Davos, aimed to elevate patient care for patients with atopic dermatitis (AD) by uniting experts and stakeholders. The forum addressed the high prevalence of AD, with a strategic focus on advancing research, treatment, and management to meet the evolving challenges in the field. Methods: This multidisciplinary forum brought together top leaders from research, clinical practice, policy, and patient advocacy to discuss the critical aspects of AD, including neuroimmunology, environmental factors, comorbidities, and breakthroughs in prevention, diagnosis, and treatment. The discussions were geared towards fostering a collaborative approach to integrate these advancements into practical, patient-centric care. Results The forum underlined the mounting burden of AD, attributing it to significant environmental and lifestyle changes. It acknowledged the progress in understanding AD and in developing targeted therapies but recognized a gap in translating these innovations into clinical practice. Emphasis was placed on the need for enhanced awareness, education, and stakeholder engagement to address this gap effectively and to consider environmental and lifestyle factors in a comprehensive disease management strategy. Conclusion: The 4th Davos Declaration marks a significant milestone in the journey to improve care for people with AD. By promoting a holistic approach that combines research, education, and clinical application, the Forum sets a roadmap for stakeholders to work together to improve patient outcomes in AD, reflecting a commitment to adapt and respond to the dynamic challenges of AD in a changing world.

Title:

The pandemic condition Coronavirus-disease (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can take asymptomatic, mild, moderate, and severe courses. COVID-19 affects primarily the respiratory airways leading to dry cough, fever, myalgia, headache, fatigue, and diarrhea and can end up in interstitial pneumonia and severe respiratory failure. Different clinical symptoms caused by involvement of organs outside the respiratory system have been also described. Interestingly, reports about the manifestation of various skin lesions and lesions of the vascular system in some subgroups of SARS-CoV-2 positive patients as such features outside the respiratory sphere, are rapidly emerging. However, knowledge about prevalence and pattern of skin involvement, time of onset, predilection, and its direct or indirect relation to SARS-CoV-2 is still limited. In order to update information gained, we provide a systematic overview of the skin lesions described in COVID-19 patients, discuss potential causative factors and describe differential diagnostic evaluations.