Die mobile Teledermatoskopie ist eine vielversprechende Technik zur Ergänzung oder Substitution einer dermatologischen Untersuchung.

Among the many attempts to classify urticaria, 2 categories have been accepted worldwide, namely according to time course into acute (shorter than 6 weeks) and chronic urticaria (longer than 6 weeks) and a classification according to etiopathophysiology. A special subgroup is the physical urticarias where wheals are elicited via specific physical (mechanical, temperature, radiation) stimuli. In many forms of chronic urticaria, psychosomatic influences play a role. Despite great progress in modern immunology and allergology, chronic urticaria still remains a challenge for doctors and patients.

Foods are common elicitors of allergic reactions. Whereas the majority of symptoms are mild, fatal reactions do occur. Foods represent the most common elicitor of anaphylaxis treated in emergency departments. Fatal anaphylaxis is caused by food in 1/3 of the cases, especially by peanuts, tree nuts, cows milk, shellfish and fish. Asthma bronchiale is the principal risk factor for a fatal reaction. Whereas a large inter- and intraindividual variability does exist, often minute amounts of food are sufficient to result in serious reactions. Although the majority of patients do know about their food anaphylaxis, many are not able to avoid the offending food completely. Education and training of patients and treating physicians is necessary. Thus, an anaphylaxis training and educational program is being constructed by the Arbeits-gemeinschaft Anaphylaxie Training and Education (AGATE) to better protect patients with prior anaphylaxis.

Sublingual immunotherapy (SLIT) was developed to improve the safety of specific immunotherapy; however, its effectiveness is still subject to discussion although the balance sheet for SLIT is improving. In SLIT laboratory parameters and objective measures of allergen reactivity are nonuniform even in studies showing clinical effectiveness, thus subjective symptom scores remain the principal end points. For allergic rhinitis an expert panel collaborating with the WHO recently proposed that SLIT was a viable alternative for injectable immunotherapy (SIT) since a multitude of double-blind placebo-controlled studies had proved the effectiveness of SLIT. Unfortunately, there are only a small number of studies comparing effectiveness of SLIT directly with subcutaneous SIT. These studies demonstrated comparable effectiveness of both therapies. According to the data so far SLIT can be recommended for the therapy of allergic rhinitis in adults and children refusing injectable therapy. For the treatment of allergic asthma both positive and disappointing results have been published. Effectiveness in preventing the onset of allergic asthma in patients with allergic rhinitis has been demonstrated for SIT, while for SLIT this question cannot yet be answered. Copyright (C) 2003 S. Karger AG, Basel.

Objective: Little is known on psychosocial characteristics of subjects with allergies who use or do not use alternative medicine (AM). We aimed to assess health-related quality of life (QoL), life satisfaction and health locus of control of adults with allergies and to compare users and nonusers of AM in a population-based setting. Methods: In a population-based nested case control study, computer-assisted telephone interviews were performed in subjects (n = 351, age median 46 years, response 76.1%) who had reported allergies (hay fever, asthma, atopic eczema and food hypersensitivity) in a previous survey. Questions on health-related QoL and evaluated instruments measuring life satisfaction ("Questions on Life Satisfaction" (FLZ(M))) and health locus of control ("Fragebogen zur Erhebung von Kontrolluberzeugungen zu Krankheit und Gesundheit" (KKG)) were applied. Results: A total of 93 subjects (26.6%), who were younger and better educated than the remaining participants (n=257), reported experiences with AM. General and health-related life satisfaction was not statistically different between users (71.5 and 71.6) and nonusers (68.5 and 67.0) of AM. Nonusers scored significantly higher for fatalistic externality (21.6) than users (19.0) of AM (P=.005, adjusted age, gender and school education). The impact on overall health-related QoL was significantly higher for users (11.7) than nonusers (10.3) of AM. This difference was also significant for the domains "physical," "psychological," "friends and family" and "leisure activities" (adjusted P<.001). Conclusion: Users and nonusers of AM with allergies can be distinguished by psychosocial characteristics such as health locus of control and QoL. (C) 2003 Elsevier Inc. All rights reserved.

Das Thema Umwelt und deren Auswirkungen auf die menschliche Gesundheit wird derzeit mit starker politisch-emotionaler Überlagerung von den Medien behandelt.