T lymphocytes expressing the CLA antigen constitute a subset of effector memory lymphocytes that are functionally involved in T-cell-mediated cutaneous diseases. Skin-seeking lymphocytes recirculate between inflamed skin and blood during cutaneous inflammation. Many studies in different T-cellmediated inflammatory cutaneous diseases have clearly related their pathologic mechanisms to CLA+ T cells. Based on common features of these cells in different cutaneous disorders mediated by T cells, we propose that circulating CLA+T cells could constitute very useful peripheral cellular biomarkers for T-cell-mediated skin diseases.

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Background In recent years, skin reactions secondary to the use of medical devices (MD), such as allergic contact dermatitis have increasingly been observed (e.g. to continuous blood sugar monitoring systems, insulin pumps, wound dressings, medical gloves, etc.): this is regarded as a developing epidemic. Lack of labelling of the composition of MD, as well as frequent lack of cooperation of manufacturers to disclose this relevant information, even when contacted by the clinician for the individual case of an established adverse reaction, significantly impede patient care. Objectives To advocate for full ingredient labelling in the implementation of EU regulation for MD. Methods This position paper reviews the scientific literature, the current regulatory framework adopted for MD to date, and the likely impact, including some costs data in case of the absence of such labelling. Results Efforts made by several scientific teams, who are trying to identify the culprit of such adverse effects, either via asking for cooperation from companies, or using costly chemical analyses of MD, can only partly, and with considerable delay, compensate for the absence of meaningful information on the composition of MD; hence, patient management is compromised. Indeed, without knowing the chemical substances present, physicians are unable to inform patients about which substances they should avoid, and which alternative MD may be suitable/tolerated. Conclusion There is an urgent need for full and accurate labelling of the chemical composition of MD in contact with the human body.

Chronic spontaneous urticaria (CSU) is a heterogeneous condition that can severely impact quality of life, which is why rapid disease control is essential. Symptomatic first-line treatment of CSU is the licensed dose of second-generation H1 antihistamines. For second-line treatment, this dose may be increased by up to four times. In patients who fail to respond to these higher doses of H1 antihistamines, treatment with omalizumab (up to 24 weeks) is recommended to achieve disease control. After this 24-week period, the patient response profile to omalizumab should be defined in order to identify refractory patients. The optimal management approach for refractory patients has not been established. In this context, the aim of the present expert consensus study involving a group of specialists (allergists and dermatologists) with specific expertise in treating urticaria was to define specific patient profiles based on their differing responses to omalizumab. Another objective was to develop a treatment algorithm based on the specific response profile. First, a comprehensive literature review was conducted. Then, a group meeting was held to discuss all issues related to the therapeutic management of these patients that had not been addressed in any previous studies. In all cases, the experts considered both the available evidence and their own clinical experience with omalizumab. We believe that implementation of this proposed algorithm will help to optimise the management of CSU patients who are refractory to antihistamine treatment, reduce disease-related costs, and improve QoL.

The prevalence of sensitization to formaldehyde releasers (FRs) differs according to geographic area and has changed over time. Several factors may influence prevalence, including different patch test systems or concentrations or the allergen selection in different baseline patch test series, habits of the populations, and regulations and legal concentration limits in cosmetics. 1,2 Quaterium-15 had been SANZ-SÁNCHEZ ET AL. 173