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August 5, 1974

Hymenoptera Stings

Author Affiliations

San Mateo, Calif

JAMA. 1974;229(6):637. doi:10.1001/jama.1974.03230440013004

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To the Editor.—  Dr. Solomon Barr, in his article, "Allergy to Hymenoptera Stings" (228:718, 1974), while attempting to shed light on the desensitization treatment of patients suffering from Hymenoptera stings, unfortunately adds to the confusion.Dr. Barr says that 23% of his series of 249 patients had localized insectsting reactions. As I have pointed out in a previous letter (222:1309, 1972), such localized reactions are not lifethreatening, begin 12 to 24 hours after the sting, and respond dramatically to a four- to seven-day course of systemic corticosteroids. They are quite distinct from the immediate life-threatening types of reaction affecting the circulatory and respiratory systems. Patients having localized reactions should be reassured that these are immunologically distinct from the life-threatening ones, and the patients need not be subjected to either skin testing or desensitization. Such localized reactions are not uncommon in spite of the fact that little mention of them is