Introduction: The management of the COVID-19 vaccine in children with mastocytosis is unclear due to a lack of data. In the current study, we aimed to evaluate the adverse reactions following COVID-19 vaccination in adolescents with cutaneous mastocytosis (CM). Methods: This study included 27 paediatric patients who were diagnosed with CM and were followed up in the paediatric allergy department of a tertiary care children’s hospital. Results: The median (IQR) age of the patients at the time of COVID-19 vaccination was 180 (156–203) months. Forty-four per cent of patients were vaccinated with the COVID-19 vaccine. Among all participants, the vaccination rate was found to be higher in older children, those who had been diagnosed with MPCM, and those who had not been infected with COVID-19 (p = 0.019, p = 0.009, p = 0.002, respectively). A total of 23 doses of the COVID-19 vaccine, including two doses of Sinovac/CoronaVac and 21 doses of Pfizer/BioNTech, were administered to 12 paediatric patients with CM. One of the patients had a history of intense itch, erythematous urticarial plaques, and had an exacerbation of existing skin lesions within 24–48 h after both doses of Pfizer/BioNTech vaccination. Conclusion: The COVID-19 vaccination of patients with CM in this series seems to be safe, and the rate of adverse events was comparable to that in the general population. These results found in adolescents with CM are in line with the existing evidence that CM does not preclude vaccination in children.

Background/Objectives: Children with atopic dermatitis (AD) are at increased risk of food allergy (FA). This study aimed to develop and evaluate machine learning (ML) models for predicting FA in children aged <2 years with AD and to assess feature contribution. Methods: This retrospective study included children aged 1 month to 2 years who were diagnosed with AD and underwent evaluation for FA. Demographic characteristics, clinical features, and laboratory findings were extracted from electronic medical records. Four ML algorithms—CatBoost, XGBoost, LightGBM, and logistic regression—were evaluated for predicting FA. Results: A total of 435 children with AD were included, of whom 185 (42.5%) were female. The median age at presentation was 7.4 months (IQR, 4.8–10.8), and FA was present in 101 patients (23.2%). Among all evaluated models, CatBoost using clinical features alone demonstrated the best overall performance, achieving an AUC of 0.91 (95% CI, 0.84–0.97), with a sensitivity of 0.85 and a specificity of 0.91. Using combined clinical and laboratory features, XGBoost achieved an AUC of 0.88 (95% CI, 0.79–0.95), with a sensitivity of 0.70 and a specificity of 0.96. Using clinical features alone, LightGBM and logistic regression achieved AUCs of 0.89 (95% CI, 0.82–0.96) and 0.86 (95% CI, 0.75–0.95), respectively, with sensitivities of 0.85 and 0.65 and specificities of 0.82 and 0.88. Conclusions: CatBoost demonstrated the best overall performance in predicting FA in children aged <2 years with AD using clinical features alone. ML models may help identify children with AD who require further diagnostic evaluation for FA.

Aims: Plantago lanceolata (P. lanceolata) is a clinically relevant weed pollen allergen; however, the clinical characteristics of children with allergic rhinitis sensitized to P. lanceolata remain poorly defined. This study aimed to evaluate whether concomitant asthma is associated with distinct clinical features and aeroallergen sensitization profiles in children with allergic rhinitis and extract-based P. lanceolata sensitization.Methods: This retrospective observational study included children aged 4-18 years with allergic rhinitis and extract-based P. lanceolata sensitization who attended a tertiary pediatric allergy clinic between April 2024 and April 2025. Patients were classified according to the presence or absence of concomitant asthma.Results: Among 1,135 children with allergic rhinitis who underwent skin prick testing, 145 (12.8%) were sensitized to P. lanceolata. Concomitant asthma was present in 53 patients (36.6%). Male gender was more common among children with asthma than among those without asthma (71.7% vs. 53.3%, p=0.03). Children with asthma had significantly higher total IgE levels (p=0.01). Perennial symptoms were more frequent in the asthma group (34.0% vs 15.2%, p=0.01). The overall seasonal distribution of clinic visits did not differ according to asthma status (p=0.08). Polysensitization was highly prevalent (91.7%) and did not differ according to asthma status. Aeroallergen co-sensitization patterns were also comparable between groups.Conclusion: Asthma was common among children with allergic rhinitis and P. lanceolata sensitization and was associated with male gender, higher total IgE levels, and perennial symptoms. Given the high prevalence of polysensitization and grass pollen co-sensitization, extract-based P. lanceolata positivity may reflect broader pollen polysensitization rather than isolated plantain sensitization.

Objectives: To evaluate the allergic rhinitis (AR) symptoms, asthma control, and quality of life (QoL) outcomes following treatment in children with seasonal allergic rhinitis (SAR), with and without asthma. Methods: Children diagnosed with SAR and presenting during the pollen season were included in the study. Symptom severity of SAR was assessed using the Total Nasal Symptom Score (TNSS), Total Ocular Symptom Score (TOSS), and Visual Analog Scale (VAS). Asthma control was measured using the Childhood Asthma Control Test (C-ACT), Asthma Control Test (ACT), and CARATkids. Quality of life (QoL) was evaluated using the Pediatric Rhinoconjunctivitis Quality of Life Questionnaire. Data were collected at admission, the first month, and the second month of treatment. Results: Fifty-five children aged 5-16 years with SAR were evaluated of whom twenty three (42%) had asthma. Sensitivities to grass, tree, and weed allergens were observed in 74.5%, 50.9%, and 80% of patients, respectively. During the study period, TNSS, TOSS, and VAS scores significantly decreased (P<0.05 for all). Significant improvements were also observed in CARATkids, C-ACT and ACT scores among SAR patients with asthma (P<0.05 for all). All domains of QoL score showed significant improvement (P<0.001 for all), and positively correlated with TNSS, TOSS, and VAS scores. In SAR patients with asthma, ACT and C-ACT scores demonstrated a positive correlation with QoL scores, while CARATkids scores showed a negative correlation. Conclusions: Treatment for SAR in children significantly reduces symptom severity, improves asthma control, and enhances QoL. Effective management of SAR is crucial for alleviating the disease burden and improving patients' overall well-being.