Chronic irritant contact dermatitis (CICD) results from repeated exposure to skin irritants causing progressive deterioration of the epidermal barrier function with release of pro-inflammatory mediators from the skin residential cells. In this mini-review, we address key aspects of the epidermal barrier response to irritant exposure in healthy skin and in individuals with an increased risk of developing CICD and emphasize the need for validated, robust biomarkers for accurate differentiation of irritant from atopic dermatitis or allergic contact dermatitis reactions.
Abstract Background With a global prevalence of 9.4%, penicillin allergy (PenA) is the most commonly documented drug allergy in hospitalized patients. Since over 90% of these labels cannot be confirmed, structured evaluation is crucial to optimize patient care. Prevalence data are available from several European countries, but data for Germany are lacking. This study provides data on the prevalence of PenA and cephalosporin allergy (CephA) as well as documentation quality from a large German university hospital. Methods Adult inpatients were screened on 10 days between November 2023 and February 2024, and pediatric inpatients were screened on five days in 2025; 29 adult and seven pediatric wards across various specialties were included. Primary outcome was the average point prevalence of documented PenA or CephA labels across predefined screening days. Secondary outcomes included documentation quality, reported reactions, and beta-lactam use. Results The mean point prevalence in adults was 8.1% for PenA alone and 8.7% for PenA or CephA (418 allergy labels/4777 screened records). Point prevalence was highest in general internal medicine (12.8%) and lowest in cardiac intensive care units (4.2%). In 65% of cases, no reaction was documented, and 70% of labels were unspecific. In the pediatric cohort, the mean point prevalence was 1.7% (8/477). Conclusion Our findings demonstrate substantial potential for improved allergy assessment and highlight the relevance of PenA evaluation in German hospitals. Targeting low-risk patients in higher prevalence wards may offer a practical approach, particularly when allocating resources to delabeling programs. Improved clinical awareness and consistent documentation could further support safe and sustainable PenA delabeling strategies.
Chronic inflammatory airway diseases are conditions that can affect both the lower and upper airways. Their pathophysiology is associated with epithelial barrier dysfunction and skewed immune response, predominantly toward a type 2 profile. The detailed underlying cellular and molecular mechanisms remain incompletely understood, highlighting the need for high-dimensional approaches to comprehensively characterize structural and immune cells in these diseases. Mass cytometry enables simultaneous assessment of over 50 cellular markers, providing deeper insight into cellular phenotypes in the airways. The scientific literature was searched using databases (PubMed), artificial intelligence tools (Consensus and Copilot), and the reference lists of relevant studies. The findings were synthesized and discussed to provide an overview of the application of mass cytometry in chronic inflammatory airway diseases. Mass cytometry has been applied to investigate immune profiles in patients with chronic rhinosinusitis, asthma, and chronic obstructive pulmonary disease using peripheral blood and lower and upper airway samples. Compared with peripheral blood, analysis of samples from the airways is less common, and standardized protocols remain limited. Mass cytometry-based analysis of chronic airway diseases revealed phenotypic disturbances in various adaptive and innate immune cell populations, shedding light on disease mechanisms. Advancing the development of novel therapies and guiding personalized treatment strategies require precise definition of disease endotypes through the identification of altered cellular players and molecular pathways. High-dimensional techniques such as mass cytometry can address this need by enabling detailed investigation of structural and immune cells in airway diseases and beyond.
The processing of personal data is one of the key challenges of digitized healthcare. In allergology in particular—a field with an interdisciplinary focus and often long-term treatment processes—the handling of sensitive health data is of special importance. This review examines the relevance of data protection in allergological practice and research. The focus is on the legal framework, particularly the General Data Protection Regulation (GDPR) and the Federal Data Protection Act (BDSG), as well as their practical implications for allergological care. Key data protection principles—such as data minimization, purpose limitation, transparency, storage limitation, and access control—may conflict with the medical need for continuous, long-term, and interdisciplinary data use. This applies in particular to electronic health records, telemedicine procedures, mobile health applications, cloud services, and the documentation of long-term therapies such as allergen-specific immunotherapy. Further challenges arise from a lack of interoperability, insufficient staff training, and increased requirements for differentiated access management. Based on current studies and real-world examples, this review presents legal, technical, and organizational measures. These include differentiated access rights, pseudonymization for research purposes, end-to-end encryption, and digital consent tools that enable flexible and patient-centered consent. Data protection in allergology is not only a legal obligation but also a central prerequisite for quality, trust, and innovation in patient care. Future developments such as big data, artificial intelligence, and international collaborations require robust data protection concepts that bridge the gap between the reality of medical care and regulatory requirements.
Climate change is clearly evident in Germany. Yet what changes does a 1 °C increase in the annual average maximum temperature bring about in the natural environment, for example? Pollen serves as an excellent bioindicator for determining these changes. However, since pollen counts are subject to natural fluctuations, long time series are required to detect effects such as those caused by climate change. Studies in other European countries demonstrated an earlier onset of the pollen season for nearly all pollen types and found that pollen levels have increased. In Germany, data for birch pollen, for example, are currently limited. In Bavaria, an automated pollen monitoring network was established in 2019, running in parallel with existing manual monitors. For Bavaria, it is evident that pollen is appearing progressively earlier in terms of start, end, and peak dates. Compared to start dates over the past 30 years, the birch pollen season now begins approximately 1 month earlier. The amount of birch pollen has also increased in recent decades. For hazel and alder, the manual system—which has the longest data series—does not collect data in winter, resulting in gaps in pollen dispersal data and making it more difficult to detect changes. However, indicator parameters such as hazel pollen in December (normally in February) show the same pattern as for birch. In the future, however, birch pollen levels in Bavaria will decline as tree populations shrink due to climate change. Similar trends are expected for the rest of Germany. For most people with pollen allergies, daily pollen levels—which are subject to significant natural variability—are more important than long-term trends. The new automatic pollen monitors with data available online display current pollen levels (e.g., Pollenscience.eu). Although the automatic network is not yet distributed evenly across Germany, the German Weather Service is currently expanding the network and expects to complete this by 2027.
