Dermatitis alérgica de contacto a cosméticos

Contact dermatitis due to cosmetic products is a common dermatologic complaint that considerably affects the patient's quality of life. Diagnosis, treatment, and preventive strategies represent a substantial cost. This condition accounts for 2% to 4% of all visits to the dermatologist, and approximately 60% of cases are allergic in origin. Most cases are caused by skin hygiene and moisturizing products, followed by cosmetic hair and nail products. Fragrances are the most common cause of allergy to cosmetics, followed by preservatives and hair dyes; however, all components, including natural ingredients, should be considered potential sensitizers. We provide relevant information on the most frequent allergens in cosmetic products, namely, fragrances, preservatives, antioxidants, excipients, surfactants, humectants, emulsifiers, natural ingredients, hair dyes, sunscreens, and nail cosmetics.     

Dermatitis alérgica de contacto por acrilatos en esmaltes permanentes

The first reported cases of allergic contact dermatitis from acrylates in manicure procedures in relation to the application of porcelain nails were published decades ago. The frequency of sensitization has increased due to the introduction of the so-called permanent nail polish containing photo-bonded acrylates, mainly involving the beauticians who apply them, and to a lesser extent, the consumers. The recent commercialized permanent polish kits for domestic use could trigger even higher degrees of sensitization. In this article, the clinical features, diagnostic procedures, treatment and preventive measures are described. Acrylates are present in a wide range of sources including multiple medical materials. Sensitization caused by a merely aesthetic procedure might end up having an eventual important impact in the future consumer's health which is why restrictive policies should be implemented limiting its use to qualified professionals and banning the indiscriminate sale of domestic kits.     

Dermatitis alérgica de contacto a dietiltiourea por un traje de pesca de neopreno

Diethylthiourea, like other thioureas, is often used by the rubber industry and in the manufacture of neoprene. We present a patient who suffered allergic contact dermatitis to diethylthiourea in a neoprene wader and who required admission to hospital and systemic treatment. We review the literature on allergy to diethylthiourea. Thioureas are not included in the standard GEIDAC (Spanish Contact Dermatitis Research Group) battery of patch tests. In these cases, it is necessary to use a special battery of rubber allergens, which includes thiourea compounds, for diagnosis of the disease and to ensure that cases of contact allergic dermatitis to thioureas do not go undiagnosed.     

Eccema alérgico de contacto por calzado

.—We have reviewed cases of allergic contact dermatitis from shoes seen at the Hospital 12 de Octubre over the last 2 years; we have analysed personal history, clinics and positive results to different allergens; we also compared our result with other series.Materials and method: We review patients with possible footwear dermatitis seen at our hospital between January 1999 and March 2001.Results: allergic contact dermatitis from shoes have been suspected in 41 patients, 11 men and 7 women, between 16 and 64 years old. A 78% of patients have atopy. The most frequent clinic presentation was eccematous pattern with 89%. The responsible allergen was chromo in 83% cases. We want to mention the little contribution of the specific battery for shoes, only in one patient would have not known one responsible allergen if we had used only standard battery.     

Dermatitis de contacto alérgica profesional a la resina epoxi y urticaria alérgica de contacto al látex en trabajador de una fábrica de raquetas de paddle

—Epoxy resin (ER) is a widely used industrial material and a strong sensitizer. For some years, latex has been a well-known allergen among health workers, and recently it is being related to other occupations. This work sets forth the clinical case of a 20-year-old patient who worked at a paddleball paddle factory, and at the end of a year and a half presented with simultaneous sensitization to ER and latex, with clinical signs of contact eczema on the hands and airborne dermatitis. The patient was studied, and exhibited skin test positivity (++) to epoxy resin, and prick text positivity to latex.     

Actualización en la dermatitis de contacto alérgica por metilcloroisotiazolinona/metilisotiazolinona y metilisotiazolinona

The combination of methylchloroisothiazolinone (MCI) and methylisothiazolinone (MI) is widely used as a preservative in cosmetics, household, and industrial products. Furthermore, MI at a concentration of 100 ppm has been permitted in cosmetic products since 2005. Recently, a considerable increase in cases of contact dermatitis to both MCI and MI have been noted, and this warrants closer monitoring by relevant authorities and, probably, stricter legislation. In fact, MI at a test concentration of 2000 ppm was recently included in the European baseline patch test series. The clinical manifestations of allergy to MCI/MI and MI are highly variable and diagnosis is often missed. In the standard patch test series of the Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC), MCI/MI is tested at 100 ppm, but at this concentration, up to 50% of cases might go undetected. Furthermore, our data indicate that MCI/MI at 200 ppm would make it possible to diagnose more cases of contact allergy to MI. To improve the diagnosis of contact allergy to MCI/MI and MI, we believe that the test concentration of MCI/MI should be increased to 200 ppm in the GEIDAC standard series and that MI should be added in the GEIDAC standard series.     

Eczema de contacto alérgico por tilosina en un criador de canarios

—Animal breeders come into contact with many substances added to animal feed. Some of them may give rise to contact dermatitis.We present the case of a male amateur canary breeder, who developed allergic contact dermatitis secondary to tylosin, a broad-spectrum macrolide antibiotic widely used in veterinary medicine.     

Sensibilización alérgica de contacto en pacientes con rosácea

Background and objectiveRosacea is a chronic acneiform skin disorder in which impaired skin barrier function can lead to sensitization to allergens. We aimed to analyze contact allergies in our patients with rosacea.Material and methodsRetrospective cohort study of all patients who underwent patch testing in our skin allergy clinic between May 1991 and May 2019.ResultsA total of 200 patients with rosacea were referred to our clinic for patch testing during the study period; they represented 2.1% of all patch tested patients in the period. Eighty-one percent were women (mean age, 44.7 years). At least 1 positive patch test was recorded for 46.5%; 15% were of current relevance. The most frequent positive reaction was to nickel (26%), followed by cobalt chloride (6.5%), isothiazolinones (6%), p-phenylenediamine (5.5%), fragrance mix II (5%), and thimerosal (3.5%). The most common currently relevant patch test reactions were to isothiazolinones in 10 of the 200 patients (5%); to phenylenediamine, fragrance mix II, and toluensulfonamide formaldehyde resin in 4 patients (2%) each; and to tixocortol and fragrance mix I in 2 patients (1%) each. The allergen groups most often implicated were metals (of current relevance in 12.6%) and drugs (of current relevance in 25.8%). Preservatives and fragrances were the next most common allergen groups, and 70.8% and 43.7% of the positive reactions in these groups, respectively, were of current relevance. Cosmetics were the most frequent source of sensitization, followed by topical medications — notably corticosteroids and antifungal agents.ConclusionsWe emphasize the high prevalence of allergic contact dermatitis in patients with rosacea, a finding which supports patch testing, especially if eruptions worsen when these patients use cosmetics and topical medications.     

Dermatitis alérgica aerotransportada en la industria químico-farmacéutica

—Introduction. Airborne contact dermatitis (ABCD) refers to all skin reactions that appear after contact with a series of substances found in the ambient air, which cause lesions after being deposited on exposed areas of the skin, mainly the face and neck. Its clinical symptoms are polymorphic, with eczematous lesions predominating in most cases. There are numerous chemical, industrial and pharmaceutical products that have been described as professional airborne allergens, and their frequency seems to be increasing; therefore, it is important to be aware of them in order to make the correct diagnoses.Material and methodsWe present 18 cases of airborne contact dermatitis (ABCD) in workers in the chemical-pharmaceutical industry, who were diagnosed at the Occupational Dermatology Department from 1980 to 2002. We compare the type of lesions, their location, the evolution period from exposure to development of the clinical symptoms, the skin tests performed, and the age and sex of the patients and the company where they worked.ResultsIn all of the cases, the ABCD appeared during the process of manufacturing a drug, with the sensitizing agent in most cases being the final product or one of the intermediate metabolites. Sensitization was proven by positivity in the specific skin tests that were performed.ConclusionsThe study of these patients is complicated, as the collaboration of their companies (physicians, chemists, hygienists) is needed to provide us with information about the products and their composition and the work methods, as well as trained staff to prepare the dilutions used for applying patches to the patient.     

Eccema alérgico de contacto a tetracaína ¿profesional?

.—We report a case of allergic contact dermatitis from tetracaine in a 33 year old woman had care of her child with cerebral paralysis; she made vesical soundings of the child using Organon® as lubricant. We discuss it mother's sensitizacion maybe considered occupational or not.     

Sensibilización de contacto al Euxyl K-400

IntroductionEuxyl K400 is a widely used preservative in cosmetics, topical drugs, cutting fluids, etc. This antimicrobial product has two active components—methyldibromo glutaronitrile (MDGN), also known as 1,2-dibromo-2,4-dicyanobutane, and 2-phenoxyethanol, in a proportion of 1 to 4. The aim of this study was to assess the prevalence of sensitization to this preservative in cases in our dermatology department over a 5-year period. We also assessed the prevalence of sensitization to the two active components of Euxyl K400 and calculated the agreement with sensitization to Euxyl K400.Material and methodsIn this retrospective study, we analyzed the medical records of 1,092 patients attended in our skin allergy unit between January 2000 and December 2005. We undertook testing with a standard battery that included, in addition to the allergens recommended by the Spanish Group for Research Into Dermatitis and Skin Allergies (GEIDAC), 0.3 % MDGN and 1 % 2-phenoxyethanol in Vaseline (Trolab^®).ResultsOnly 15 patients developed a positive reaction to Euxyl K400. Of these, 11 were positive to MDGN and 2 to phenoxyethanol. Sensitization to Euxyl K400 was significantly more common in men. The agreement between sensitization to Euxyl K400 and MDGN was good (Kp = 0.68), whereas agreement between Euxyl K400 and phenoxyethanol was poor (Kp = 0.23).ConclusionsThe prevalence of Euxyl K400 sensitization in this study was 1.4 %. Most cases of Euxyl K400 sensitization were associated with the MDGN component, as indicated by the good agreement between the two substances.