elmundo.es | digital meeting with Tomás Chivato

He has been with us...08 April 2003

1. Doctor, do you think it is possible to have an allergy to the sun only when it is accompanied by a marine environment, sand, salt, etc? Because this allergy does not occur to me in the city, and it is not intolerance because I have always turned tan without burning, This is an allergy like with pimples that itch a lot, thank you.

Sun allergy is a process that is increasing year by year due to the thinning of the ozone layer in the atmosphere. Indeed, it is more frequent in patients who are exposed to the sun in coastal areas, where the time and intensity of exposure is much longer. Usually using solar filters the first few days this problem can be easily controlled.

2. I have never been allergic but lately I have isolated allergic episodes (sneezing, watery eyes. What can I do or take? Thank you

First of all, carry out an allergological study since a differential diagnosis must be made with other processes that can also present with rhinitis or conjunctivitis in which the cause is not allergic. Without doing this study it is not possible to recommend any treatment.

3. I have a friend who is tremendously allergic to dust and they recommended a vacuum cleaner from the vorwerk house and she says that her improvement has been remarkable.She says that the house has the seal of the seaic. Do you know him? What opinion does he deserve? Thank you very much.

Indeed, environmental control measures play an essential role in de-allergy in patients allergic to house dust mites. There are different measures for these patients: acaricides, mattress covers, dehumidifiers and also, of course, these vacuum cleaners. We do not recommend their use in a generalized way, since it depends on the area in which you live, they would be necessary or not.

4. Is there an allergic cough? What is it? Could it be an irritating cough due to an allergy?

Cough does indeed exist as an asthmatic equivalent, being the only manifestation of allergic bronchial asthma. It is important to rule out other processes that can occur with a cough, such as sinusitis or bronchitis.

5. Is the Jacaranda tree (blue flowers in summer) one of those that produces allergies like platanus or cupressaceae? Thank you so much.

This tree, which can be found in Seville and Santa Cruz de Tenerife, for example, is exceptional in that it causes allergies since the flowers pollinate with a special entomophilous pollen, which is carried by insects. I am not aware of any case published in the medical literature of allergy to this tree. It does not belong to the family Cupressaceae nor to that of the plane tree.

6. Good afternoon, I am a former student from Seville and for several years something has happened to me at this time. At first I attributed it to the exams, or more specifically to the contact with the paper of the pages, and it is that the skin of my hands cracks and dries a lot, especially the flames, and it takes on a texture as if it had kept wet for a long time. Now I work as a professor at the university and the problem is marked by the constant use of chalk for my explanations. That is why I would like you to tell me if this fact could be due to an allergy. If so, why had it not happened to me until three years ago? Thank you very much for your time. Greetings. Jose Antonio Becerra Villanueva.

The symptoms you describe are compatible with dyshidrosis. It is a special type of eczema, associated with disorders in the sweating of the palms and fingers of the hands. Sometimes it is due to stress, work or student situations. It is not due to an allergic process and is usually studied and treated by dermatologists.

7. At what age can the first allergy symptoms appear?

Food allergies appear in the first months of life, for example, to cow's milk proteins. Another process that appears in the first months of life is atopic dermatitis; later, at three or four years, allergic rhinitis appears, and then bronchial asthma. This process is what allergists call the allergic march.

8. THEY TELL ME THAT SEBORRHEIC DERMATITIS IS THE PRODUCT OF AN ALLERGY, IS THIS TRUE?

In principle, it is not due to an allergic disease. It is rather a fungal infection, pitosporum ovale, which is associated with stressful situations (work, affective, student, family, etc.). It is treated with topical antifungals or corticosteroids, also topical.

9. Some time ago I used to get rashes when I ate chocolate, then this is over. Does this mean that an allergy can be temporary and disappear suddenly?

Indeed, food allergy is the only type of allergy that can evolve spontaneously to a cure. It happens, for example, with children who are allergic to cow's milk or eggs, and who, later, with the passage of time (months or years, depending on the case), develops a tolerance to the proteins that triggered the allergy, disappearing the hypersensitivity process.

10. Three years ago it was impossible for me to sunbathe because some very annoying red and white welts appeared on me. Now this reaction has subsided. What is it due to?

Skin undergoes changes throughout life. These changes depend on many factors, such as hydration, diet, care, hormonal changes, taking certain medications, etc. These situations mean that in certain circumstances, the skin is more sensitive than at other times of life.

11. Almost always your eyes get very red with allergies, what should and what not to do?

In the case of eye allergies, it is very important to avoid direct contact with the substance that causes the allergy, such as pollens, mites, epithelium, or fungi. For this reason, the use of sunglasses in the spring season plays a fundamental role in preventing the first symptoms of allergic conjunctivitis. It is also important to use the correct oral antihistamines or eye drops to control the allergic reaction. In this sense, self-medication must be avoided, as there are eye drops with active ingredients that could be harmful to the eye.

12. Could a person who in his youth has not been allergic to anything, become so with the passage of time?

Without a doubt, we are witnessing a process of relentless growth of allergies in general. The numbers of those affected increase year by year, therefore, it is very common to observe people who were not allergic and now are. It occurs more frequently in cities, and this is due to environmental pollution, produced by the combustion engines of diesel vehicles.

13. Can liquid from contact lenses cause allergies? Would these allergies be very dangerous for the eye?

Liquid lens cleaners can cause allergic conjunctivitis. In addition, sometimes these liquids are enhanced by exposure to pollen and this is why patients allergic to pollen are recommended to wear glasses instead of contact lenses in periods of maximum pollination.

14. The antihistamines that repercussions have for health

Antihistamines are the most widely used drugs in the treatment of different allergic diseases. There are two large groups with clearly defined indications. They are usually safe drugs and we even have antihistamines that can be used during pregnancy and lactation. It is very important to adjust the dose based on age and weight. It is essential to note that some of them can cross the blood-brain barrier, causing drowsiness, fatigue and, above all, loss of reflexes. Obviously, this could even lead to traffic accidents; Allergy patients should be aware of these possible side effects and only use them when prescribed by their doctor. Up to 10 percent of allergic patients self-medicate, and this must be avoided.

15. Hello: I am working as a pastry chef and I touch flour, to which I am allergic. Before work I have to take a pill almost every day (only when I touch flour) 2-3 a week. Question: By always taking medication like this, is so many pills bad in the long run? The brand of the pills is: CLARITINE. THANK YOU

In principle, the antihistamine you use is safe and effective, but it is interesting to note that allergies to flour can be treated with vaccines. I recommend that it be studied at your reference allergy service to assess this possibility.

16. Very good, I have had allergy tests done and they have been negative, but especially when spring arrives, when I wake up my nose is completely congested. Is it normal? Thank you so much.

Not all sneezing is due to allergies. There are different types of rhinitis: allergic, intrinsic, cholinergic, vasomotor, irritative, infectious... Allergic tests are the first diagnostic step, but if the suspicion of allergic rhinitis is very evident, it would be interesting to perform other types of tests, such as analysis or even challenge tests. In any case, it is not normal to be congested and should be reassessed.

17. Is there any way to prevent a child from being allergic or at least reduce the chances? I am 5 months pregnant and I would like to know if there is anything that can be done. Thank you

The fundamental measure is to avoid smoking during pregnancy. Secondly, whenever possible, we advise to prolong breastfeeding as long as possible; There are very recent studies that have shown that the introduction of cereals in the diet of babies could be related to subsequent sensitization to grass pollens. This scientific finding is under study, but, in any case, we insist on the importance of prolonging breastfeeding in newborns. On the other hand, living in a city, we advise avoiding the presence of domestic pets in the bedroom.

18. In the winter, as soon as I showered or washed my hands, white and reddish bumps appeared with a lot of itching on my hands and feet. Is it an allergic reaction to water?

In the winter season, the skin is more sensitive and the manifestations you mention could be related to vascular (circulation) disorders of the hands and feet. It does not give the impression of being an allergic picture since the allergy to water would be throughout the year. A different picture is that of allergy to cold, which can manifest with rashes like the ones you describe, but which, in the summer, appear problems with cold drinks and ice cream. Since you do not tell us symptoms of this type, it does not seem that it is an allergic condition.

19. I have an allergy to dust mites and from this it follows that in humid environments where mites live I have respiratory difficulties. I have two treatments: one with Ventolin for mild episodes and the other with corticosteroids (Seretide) for severe episodes. I know that there are also vaccines but I have been told that they are not 100% effective and that they take a long time to take effect. Could you explain a little more about vaccines and whether there is any new medicine under investigation that can make life a bit easier?

The treatment of allergy to mites includes four sections: 1.- environmental control measures (such as those I have already described), 2.- pharmacological treatment, 3.- vaccines and 4.- education of the allergic patient The WHO recommends the use of vaccines as long as the patient has been correctly diagnosed and there are vaccines available on the market that can be used against that specific type of allergy. In the specific case of allergy to dust mites, the efficacy of vaccines reaches 90 percent. There are new drugs that are in the research phase, but currently we have a sufficient therapeutic arsenal for you to be free of symptoms and with a good quality of life.

20. Doctor, could low-dose betamethasone alter blood pressure?

Any drug can produce side effects, these are a function of the dose and the time they are used. In the specific case that you mention, it is not a common side effect, without knowing the time of administration or the dose, we cannot specify the answer.

21. About three years ago I went swimming around this time and the sea was calm and covered in pollen. When I left, I began to feel itchy and I got some kind of pimples, like mosquito bites all over my body. When I went to the doctor, he told me that I had a fairly strong allergy to pollen. Since then I continue to lead my normal life except that I cannot swim in the sea without taking antihistamines (EBASTEL). Are there many cases of allergy to the sea? Is it treatable? Is it reversible?

Allergy to pollens can usually manifest itself at the respiratory level (rhinitis, conjunctivitis, asthma...), but skin manifestations can also appear (for example, like the ones you mention or when lying on the grass in the pool), digestive (in some patients when ingesting herbal products that contain raw pollen from different plants). In your case, there are few cases of allergy to seawater, it probably coincided with sun exposure and, therefore, we could use the treatment that we have mentioned before (sunscreens, vitamin D complex...).

22. I had hepatitis a long time ago, then I had thyroid surgery and I am under constant medication. I have more and more spots on my skin. Is this due to the diseases themselves or the medicines I take?

It is difficult to assess your skin manifestations. All three processes (hepatitis, thyroid, and drugs) may be individually responsible for your symptoms. It is important that each of your doctors (digestive, endocrinologist, family doctor) assess these symptoms. And, when in doubt, they can refer you to the local allergist.

23. 3 or 4 years ago I had rashes and it turned out to be an allergy to aspirin, now I have more of them (psoriasis-like redness) and all I'm taking is Permixon 160. Could it be an allergy again? Thank you

Any drug can cause a rash. But not all skin rashes are due to drugs. It is important to rule out the presence, for example, of parasitic infections, or dermatological processes that have nothing to do with taking drugs. If your family doctor and the area dermatologist deem it appropriate, they could refer you to the corresponding allergist and assess you.

24. I have a 14 month old daughter. Since he was 2 months old, he has suffered from atopic dermatitis. You have recently been diagnosed with an egg and fish allergy. Is it possible that these allergies are temporary? Is there any treatment that can help? Thank you.

Yes, these allergies tend to evolve favorably spontaneously. The best treatment currently available for food allergy is to follow strictly the elimination diets recommended by your allergist. There is an association of parents and children with food allergies (AEPNAA), you will be surprised by the amount of delicious foods for children that you can make with their recipes without using eggs or fish.

25. Good morning, I'm Silvia Fernández Hernáez, I don't know if you can answer the following question, not as an allergist but as an immunologist. I was diagnosed with Acute T Leukemia in the year 10 years ago. Now they have to perform a cornea transplant, but I have to take cyclosporine. Can I take this immunosuppressant after an episode of leukemia that subsided 10 years ago? Thank you very much and greetings.

It would be important to know your age, your general condition, your immune status and, above all, to congratulate you because you are in complete remission ten years after the disease. In principle, the administration of cyclosporine for a short period of time and at low doses should not constitute a risk to your health.

26. What therapeutic procedure is recommended in cases of rhinitis?

In allergic rhinitis, we have four fundamental pillars: 1.-environmental control, 2.-pharmacological treatment, 3.-vaccines, 4.-patient education. The most commonly used drugs are antihistamines, orally or nasally. Depending on age and weight, the most appropriate antihistamine must be selected.

27. Doctor: Can a patient with COPD be allergic "suddenly", let me explain: 80 years old and with no history. In your case, would antihistamines be beneficial? Thank you very much.

Yes, as we have mentioned previously, respiratory allergies are constantly increasing, there are allergic people with no age limit and no previous history. The use of antihistamines could be beneficial, but it is important to know if you take other drugs because of the risk of drug interactions and also the condition of your liver and kidneys.

28. Can ointments be applied to skin eruptions without the authorization of a specialist? There are a large number of them without a prescription

Indeed, self-medication is a big problem in the case of allergic diseases. We don't know why, nobody thinks of controlling their diabetes or hypertension on their own, but in the case of allergies, patients trust their friends or acquaintances and self-medicate. This phenomenon occurs with ointments and creams. Not all of them are indicated and their use may even be contraindicated, constituting a risk of aggravation of the pre-existing lesion. Don't self medicate.

29. When I enter closed places I feel like I have a scratchy throat and runny nose, however if I am on the beach these symptoms go away, what could this be?

The clinical manifestations are compatible with a picture of cholinergic or vasomotor rhinitis. This type of frame improves outdoors, in the mountains and on the beach. It is a mild picture, but obviously annoying when you are working or with family and friends. It is self-limiting and rarely requires treatment.

Farewell

I thank all the Internet users for your active participation, I hope I was able to help you in this hour. I advise you to visit the website of the Spanish Allergy and Clinical Immunology to answer more questions. The last message, I insist, avoid self-medication.