Introduction: Mast cell activation syndrome (MCAS) is characterized by recurrent, systemic episodes of mast cell mediator release, often resembling anaphylaxis and involving multiple organ systems. Aim: To describe clinical, laboratory, and therapeutic characteristics of patients with non-clonal mast cell activation syndromes in a real-life cohort. Material and methods: This retrospective study included 21 adult patients fulfilling criteria for non-clonal mast cell activation syndromes, evaluated between 2015 and 2025 at a tertiary allergy and immunology centre in Istanbul, T & uuml;rkiye. Demographic features, clinical manifestations, laboratory findings, and treatment responses were analysed. Results: Eighteen (85.7%) patients were female, with a mean age of 50.1 years. All experienced recurrent acute cutaneous symptoms, with gastrointestinal (42.9%), cardiovascular (61.9%), and respiratory (76.2%) involvement. Baseline serum tryptase levels were normal or mildly elevated, and all patients demonstrated an event-related "20% + 2 ng/ml" increase during follow-up. KIT D816V mutation was negative in peripheral blood in all patients and in bone marrow in 6 evaluated cases. No aberrant mast cell immunophenotype was detected in those undergoing bone marrow assessment. Based on available evaluation, 6 patients were classified as consistent with idiopathic (non-clonal) MCAS, whereas the remaining patients had comorbidities suggestive of secondary MCAS. Conclusions: Non-clonal mast cell activation syndromes remain diagnostically challenging and often require longitudinal evaluation. Omalizumab may serve as an effective adjunct therapy in patients with persistent symptoms. A phenotype-based approach is warranted.
Introduction: In adults, IgE-mediated food allergy is associated with clinically relevant allergic reactions of variable severity. Omalizumab has been shown to reduce food-related reactions in selected populations; however, evidence in adults, particularly those with chronic spontaneous urticaria (CSU), remains limited. Aim: To evaluate whether omalizumab treatment reduces the severity of food-related allergic reactions upon reexposure in adult patients with chronic spontaneous urticaria and concomitant IgE-mediated food allergy. Material and methods: Adult patients with CSU receiving omalizumab and a documented history of IgE-mediated food allergy were retrospectively evaluated with a limited prospective component. Reaction severity before and after omalizumab treatment was assessed using the EAACI, Brown, and Ring-Messmer classification systems. Analyses were restricted to patients who were re-exposed to the culprit food after treatment. Baseline clinical and laboratory parameters were compared between responders and non-responders. Results: Forty adult patients were included (median age: 42 years; 70% were female). Anaphylaxis history was more frequent in patients with chronic spontaneous urticaria and concomitant IgE-mediated food allergy than in CSU patients without food allergy (p = 0.040). Thirty-one patients were re-exposed to the culprit food after initiation of omalizumab treatment. Reaction severity was significantly reduced following treatment across the EAACI, Brown, and Ring-Messmer classification systems (all p < 0.001). Baseline total IgE levels, eosinophil counts, serum tryptase levels, and atopy status were not associated with clinical response. Higher baseline C-reactive protein levels were observed among responders (p = 0.039). Conclusions: Omalizumab treatment was associated with a consistent reduction in the severity of food-related allergic reactions upon re-exposure in adults with CSU and IgE-mediated food allergy. Clinical improvement occurred largely independently of conventional allergic biomarkers.
Introduction: Globules in pigmented lesions represent clusters of melanocytes or melanin deposits and are generally interpreted as a sign of active growth. While these structures are frequently observed in physiological naevi, they can also manifest in melanomas. Aim: The objective of this study was to retrospectively analyse the clinical significance of globules as a single factor by correlating their specific dermoscopic characteristics, including distribution, colour and shape, with the final histopathological diagnosis. Material and methods: We analysed 209 melanocytic lesions with globules from 159 patients examined via dermoscopy between 2017 and 2025. All lesions were surgically excised and underwent histopathological verification. Statistical analysis compared dermoscopic features against the diagnosis using the c2 and Fisher's exact test, with predictive values quantified using odds ratios. Results: Histopathological examination of all lesions revealed 192 benign naevi and 17 melanomas. In benign lesions, globules were most common in compound naevi (34.3%), junctional naevi (28.6%), and lentiginous naevi (15.6%). Benign lesions were significantly characterised by overall symmetry (72.9%) and the regularity of the globule shape and size (24.5%), which was absent in all analysed melanomas. On the other hand, malignant lesions were strongly associated with the presence of red globules (11.8% vs. 1.0% in benign cases). Univariate analysis identified red globules as the most significant predictor of malignancy (OR = 12.67; p = 0.0340), while symmetry (OR = 0.26) and globule uniformity (OR = 0.09) were strong protective factors. Conclusions: The morphology of globules is more diagnostically relevant than their presence alone. Uniformity and symmetry reliably indicate benign naevi, whereas red globules are a strong predictor of melanoma.
Introduction:Latex allergy remains a significant occupational and clinical challenge in healthcare environments. Aim:The aim of this review study was to systematically analyse existing scientific data on the allergenic potential of latex, the clinical typology of allergic reactions, diagnostic capabilities, and preventive strategies in the medical environment. Methods:The review included systematic reviews, clinical and epidemiological studies as well as case reports. All publications appeared in peer-reviewed journals between 2013 and 2025. Results:The analysis showed that latex allergy is predominantly immunoglobulin E-mediated hypersensitivity to latex proteins (Hevea brasiliensis allergen b 1-15) and chemical compounds used in its production. Hevea brasiliensis allergens b 5 and b 6.02 demonstrate the highest allergenic potency among healthcare workers. In patients with congenital abnormalities, particularly those undergoing multiple surgical procedures, sensitization is more frequently associated with Hevea brasiliensis allergens b 1 and b 3. Sensitization may occur through dermal contact, inhalation exposure, or parenteral routes. Clinical manifestations range from urticaria and rhinitis to anaphylaxis. Diagnosis is based on skin prick tests, specific immunoglobulin E determination, and molecular diagnostics. The frequency of sensitization among healthcare workers reaches 22%, especially with frequent contact with gloves with a high protein content and aerosol latex (up to 9.4 ng/m3). A reliable relationship between the level of exposure and the risk of sensitization has been established (p-trend = 0.03). Prevention includes switching to gloves with reduced protein content, avoiding powdered products, using latex-alternative materials, training staff, and applying latex-free protocols in patients at risk. Conclusions:The results confirm the need for a comprehensive strategy for the prevention of latex allergy in healthcare settings, with an emphasis on protecting staff health, reducing allergen exposure, and ensuring patient safety.
Introduction:Vitiligo is a chronic skin condition characterised by progressive depigmentation. The visibility of skin lesions, their location, and perceived social stigma can exacerbate emotional stress and reduce life satisfaction. For this reason, the condition can significantly affect mental well-being and social functioning. Aim:The aim of the study was to assess the relationship between life satisfaction in individuals with vitiligo and the level of social support and degree of acceptance of illness. Material and methods:The study involved 215 individuals diagnosed with vitiligo. The Standardised Satisfaction with Life Scale (SWLS) was used to assess life satisfaction, the Acceptance of Illness Scale (AIS) was used to assess illness acceptance and the Multidimensional Scale of Perceived Social Support (MSPSS) was used to assess the perceptions of social support. Results:Women (88.8%), city dwellers (82.8%) and people with higher education (65.6%) constituted the majority of the study group. The majority of participants demonstrated a high level of acceptance of their disease and satisfaction with life. Suicidal thoughts and feelings of ostracism were rare, but 41.8% of participants reported long-term low mood. A higher level of social support and acceptance of illness was significantly associated with greater life satisfaction. Conclusions:Despite their declared acceptance of their own appearance, patients with vitiligo often experience low mood and undertake strategies to hide their skin lesions. The results emphasise the need for holistic care, combining dermatological treatment with psychological and social support to increase patients' life satisfaction.
