title: Hymenoptera stings in the head region induce impressive, but not severe sting reactions.
abstract: Stings in the head region are considered to be a risk factor for severe systemic reactions to hymenoptera stings. We supposed that stings in skin areas, which are well supplied with blood, lead to more severe reactions and tested our hypothesis in 847 patients with confirmed hymenoptera venom allergy. However, symptom severity was independent from sting site: only 16.3% of patients with severe reactions were stung on the head (P = 0.017). But we confirmed age > 40 years (P < 0.001) as well as elevated basal tryptase levels (P = 0.001) as risk factors. Taking antihypertensive drugs seemed to have an influence: 41.7% of patients taking antihypertensive drugs experienced a severe reaction compared to 29.5% of patients, not taking such drugs (P = 0.019). However, considering patients' age in regression analysis, taking antihypertensive drugs had no effect on symptom severity (P = 0.342). Importantly, in most patients with severe reactions, cutaneous signs were absent (P < 0.001).
authors.affiliation: Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria.
authors.forename: L
authors.initials: L
authors.lastname: Arzt
authors.affiliation: Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria.
authors.forename: D
authors.initials: D
authors.lastname: Bokanovic
authors.affiliation: Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria.
authors.forename: I
authors.initials: I
authors.lastname: Schwarz
authors.affiliation: Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria.
authors.forename: C
authors.initials: C
authors.lastname: Schrautzer
authors.affiliation: Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria.
authors.forename: C
authors.initials: C
authors.lastname: Massone
authors.affiliation: Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria.
authors.forename: M
authors.initials: M
authors.lastname: Horn
authors.affiliation: Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria.
authors.forename: W
authors.initials: W
authors.lastname: Aberer
authors.affiliation: Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria. gunter.sturm@allamb.at.
authors.forename: G
authors.initials: G
authors.lastname: Sturm
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000485:Allergens / Q000276:immunology*; D000818:Animals; D001180:Arthropod Venoms / Q000276:immunology*; D015415:Biomarkers; D002648:Child; D005260:Female; D006801:Humans; D006927:Hymenoptera / Q000276:immunology*; D007299:Insect Bites and Stings / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D012867:Skin / Q000276:immunology / Q000473:pathology; D063189:Symptom Assessment; D055815:Young Adult
chemical_list: D000485:Allergens; D001180:Arthropod Venoms; D015415:Biomarkers
keywords: age; antihypertensive drugs; head; severe systemic sting reaction; sting localization