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Vol. 42. Issue 4.
Pages 384 (July - August 2014)
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Vol. 42. Issue 4.
Pages 384 (July - August 2014)
Letter to the Editor
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Heat immersion therapy—A new approach for contact dermatitis to propolis?
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Karsten Münstedt
Department of Obstetrics and Gynaecology, Justus-Liebig-University of Giessen, Giessen, Germany
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To the Editor,

Recently, I summarised the current evidence on the treatment of bee stings in a German beekeeping magazine. One major aspect was the use of direct heat and heat immersion therapy. I discussed the study by Müller et al. who showed that patients who suffered from wasp, mosquito and bee stings had fast amelioration of symptoms after locally administrated concentrated heat.1 An absence of symptoms was reported 10min after administration. It was also discussed that the concept of heat treatment was found to be effective in a number of other scenarios, like in bluebottle (Physalia sp.) stings and acute jellyfish (Carybdea alata) stings.2,3

After publication of the article I was contacted by a 62-year-old beekeeper who wrote that he has kept bees since 1958 and has suffered from propolis contact allergy since 1985. In spite of this, he continued beekeeping, but reduced the number of attended bee hives and wore cotton gloves as a protective measure. Since contact with propolis could not be avoided completely, he frequently suffered from contact allergy with itchy rashes and ablation of areas of skin. He wrote that a while ago he started to immerse his hands in water with a temperature of about 50°C, which intensified itching at the beginning but gave relief after a few minutes. He reported that he repeated this five to six times if necessary. Most importantly he wrote that the itching was gone after the procedure and that all skin affections did not occur. He was also able to stop taking corticoid containing creams which he had previously required.

It may be hypothesised that protease-activated receptor-2 plays an important role in contact allergies as it does in atopic dermatitis which can be inhibited/inactivated by heat.4–8 Consequently, there is less histamine liberation and a lesser contact allergic reaction.

I believe that the concept of heat therapy should be tested since there is currently no effective treatment for propolis contact allergy or other contact allergies.

Conflict of interest

The author has no conflict of interest to declare.

References
[1]
C. Müller, B. Großjohann, L. Fischer.
The use of concentrated heat after insect bites/stings as an alternative to reduce swelling, pain, and pruritus: an open cohort-study at German beaches and bathing-lakes.
Clin Cosmet Investig Dermatol, 4 (2011), pp. 191-196
[2]
C. Loten, B. Stokes, D. Worsley, J.E. Seymour, S. Jiang, G.K. Isbister.
A randomised controlled trial of hot water (45°C) immersion versus ice packs for pain relief in bluebottle stings.
Med J Aust, 184 (2006), pp. 329-333
[3]
J.T. Nomura, R.L. Sato, R.M. Ahern, J.L. Snow, T.T. Kuwaye, L.G. Yamamoto.
A randomised paired comparison trial of cutaneous treatments for acute jellyfish (Carybdea alata) stings.
Am J Emerg Med, 20 (2002), pp. 624-626
[4]
G. Yosipovitch, M.I. Duque, K. Fast, A.G. Dawn, R.C. Coghill.
Scratching and noxious heat stimuli inhibit itch in humans: a psychophysical study.
Br J Dermatol, 156 (2007), pp. 629-634
[5]
G. Yosipovitch, K. Fast, J.D. Bernhard.
Noxious heat and scratching decrease histamine-induced itch and skin blood flow.
J Invest Dermatol, 125 (2005), pp. 1268-1272
[6]
M. Steinhoff, U. Neisius, A. Ikoma, M. Fartasch, G. Heyer, P.S. Skov, et al.
Proteinase-activated receptor-2 mediates itch: a novel pathway for pruritus in human skin.
J Neurosci, 23 (2003), pp. 6176-6180
[7]
J. Kawagoe, T. Takizawa, J. Matsumoto, M. Tamiya, S.E. Meek, A.J. Smith, et al.
Effect of protease-activated receptor-2 deficiency on allergic dermatitis in the mouse ear.
Jpn J Pharmacol, 88 (2002), pp. 77-84
[8]
S.E. Lee, S.K. Jeong, S.H. Lee.
Protease and protease-activated receptor-2 signaling in the pathogenesis of atopic dermatitis.
Yonsei Med J, 51 (2010), pp. 808-822
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Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos

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