Protocols for Diagnosis and Management of Arthropod Bite Allergies in Humans.

Allergic diseases have increased significantly in recent decades, with a higher incidence of severe manifestations such as anaphylaxis. This increase is attributed mainly to environmental factors associated with the Western lifestyle that alter the epithelial barrier, promoting sensitization to allergens, such as those from arthropods. Hymenoptera (bees and wasps) are the most implicated arthropods. The sting introduces a venom composed of highly sensitizing proteins that are capable of triggering reactions ranging from local and mild to potentially fatal systemic reactions. The incidence is higher in rural areas, adults, and exposed professionals such as beekeepers. On the other hand, tick bites can sensitize individuals to alpha-gal, causing allergic reactions 2-6 h later. This delay in the response leads to an underdiagnosis of this allergic disease. The diagnosis is based on the clinical history and complementary tests such as skin tests, specific IgE tests, basophil activation tests, and tryptase determination, although false negatives may occur, especially after a recent reaction or in patients with mastocytosis. Treatment includes preventive measures, adrenaline for systemic reactions, and specific immunotherapy, which are effective at reducing the risk of future severe reactions and improving quality of life. Novel oral immunotherapy food could be an effective alternative in the treatment of alpha-gal allergy.