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Honey bees are the second leading cause of SSR. Depending on the global region, other Hymenoptera such as different ant genera are responsible for SSR. Widely distributed hornets and bumblebees or local vespid or bee genera rarely induce SSR. Hematophagous insects such as mosquitoes and horse flies usually cause (large) local reactions while SSR occasionally occur. This position paper aimed to identify either rare or locally important insects causing SSR as well as rarely occurring SSR after stings or bites of widely distributed insects. We summarized relevant venom or saliva allergens and intended to identify possible cross\u2010reactivities between the insect allergens. Moreover, we aimed to locate diagnostic tests for research and routine diagnosis, which are sometimes only regionally available. Finally, we gathered information on available immunotherapies. Major allergens of most insects were identified, and cross\u2010reactivity between insects was frequently observed. While some diagnostics and immunotherapies are locally available, standardized skin tests and immunotherapies are generally lacking in rare insect allergy.<\/jats:p>","DOI":"10.1111\/all.15769","type":"journal-article","created":{"date-parts":[[2023,5,16]],"date-time":"2023-05-16T10:55:20Z","timestamp":1684234520000},"page":"2089-2108","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Allergy to stings and bites from rare or locally important arthropods: Worldwide distribution, available diagnostics and treatment"],"prefix":"10.1111","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7245-121X","authenticated-orcid":false,"given":"Gunter Johannes","family":"Sturm","sequence":"first","affiliation":[{"name":"Department of Dermatology and Venereology Medical University of Graz  Graz Austria"},{"name":"Allergy Outpatient Clinic Reumannplatz  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2644-1114","authenticated-orcid":false,"given":"Elisa","family":"Boni","sequence":"additional","affiliation":[{"name":"Allergy and Immunology Department Metropolitan Laboratory AUSL Bologna, Maggiore Hospital  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dar\u00edo","family":"Antol\u00edn\u2010Am\u00e9rigo","sequence":"additional","affiliation":[{"name":"Allergy Department, Hospital Universitario Ram\u00f3n y Cajal Instituto Ram\u00f3n y Cajal de Investigaci\u00f3n Sanitaria (IRYCIS)  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria\u00a0Beatrice","family":"Bil\u00f2","sequence":"additional","affiliation":[{"name":"Department of Clinical and Molecular Sciences Marche Polytechnic University  Ancona Italy"},{"name":"Allergy Unit, Department of Internal Medicine Ospedali Riuniti Ancona University Hospital  Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Breynaert","sequence":"additional","affiliation":[{"name":"Department of General Internal Medicine \u2013 Allergy and Clinical Immunology University Hospitals Leuven  Leuven Belgium"},{"name":"KU Leuven Department of Microbiology, Immunology and Transplantation Allergy and Clinical Immunology Research Group  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0732-9090","authenticated-orcid":false,"given":"Filippo","family":"Fassio","sequence":"additional","affiliation":[{"name":"Allergy and Clinical Immunology Unit Ospedale San Giovanni di Dio, Azienda USL Toscana Centro  Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kymble","family":"Spriggs","sequence":"additional","affiliation":[{"name":"Department of Allergy &amp; Immunology Monash Medical Centre  Clayton Victoria Australia"},{"name":"Department of Allergy &amp; Immunology The Royal Melbourne Hospital  Parkville Victoria Australia"},{"name":"Department of Medicine, Melbourne Medical School The University of Melbourne  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arantza","family":"Vega","sequence":"additional","affiliation":[{"name":"Allergy Department University Hospital of Guadalajara  Guadalajara Spain"},{"name":"ARADyAL Spanish Thematic Network and Co\u2010operative Research Centre RD16\/0006\/0023  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luisa","family":"Ricciardi","sequence":"additional","affiliation":[{"name":"Allergy and Clinical Immunology Unit, AOU Policlinico G. 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