Allergic contact dermatitis to white petrolatum

White petrolatum is known for its nonsensitizing and nonirritating properties. Only a few cases of allergic contact dermatitis to white petrolatum have been reported. Although it is a rare event, the finding of contact sensitization to white petrolatum raises the potential problem of its usage of common topical agents or vehicles for patch testing. We herein report a case of allergic contact dermatitis to white petrolatum.     

Concomitant development of photoallergic contact dermatitis from ketoprofen and allergic contact dermatitis from menthol and rosin (colophony) in a compress

We describe a case of a 40-year-old non-atopic woman with recurrent leg ulcers because of the factor V Leiden mutation who developed a severe eczematous lesions of the skin surrounding an ulcer of the right leg after the use of a protease-modulating matrix (Promogran, Johnson and Johnson, Gargrave, Skipton, UK). The patient was patch tested with the SIDAPA (Italian Society of Allergological, Occupational and Environmental Dermatology) standard series, a piece of the device as is, of the bovine collagen (Zyderm, Collagen Corporation, Palo Alto, CA, USA) as is, a piece of the gauze containing only regenerated oxidized cellulose (Tabotamp, Johnson and Johnson, Gargrave, North Yorkshire, UK) and of a fold towels in pure cellulose (Foscart, Bassano del Grappa, Italy). Patch tests gave a positive reactions to nickel sulphate and Promogran as is. We showed that the sensitizing agent was regenerated oxidized cellulose, a substance the treatment of ulcers and as is in and in combination with collagen in surgery for intraoperative hemostasis. The case reported suggests that regenerated oxidized cellulose can cause allergic contact dermatitis.     

Allergic contact dermatitis to pimecrolimus

Pimecrolimus suppresses the proinflammatory cytokine production of cutaneous T and mast cells (1). It is used to treat atopic dermatitis and is the active ingredient in the topical formulation pimecrolimus 1.0% cream (Elidel, Novartis Pharma AG, Basel, Switzerland).     

Causal agents of photoallergic contact dermatitis diagnosed in the national institute of dermatology of Colombia

OBJECTIVE: To describe and identify the photoallergens causing photoallergic contact dermatitis in the population attending the outpatient clinic of the Centro Dermatologico Federico Lleras Acosta (CDFLLA), the National Institute of Dermatology of Colombia. MATERIALS AND METHODS: Eighty-two patients with clinical diagnosis of photoallergic contact dermatitis enter the study. These patients attended the CDFLLA between August 2001 and May 2003. Photopatch tests were performed using the standard series of sunscreens (Chemotechnique Diagnostics) and 6-methylcoumarin. Cetyl alcohol, phenoxyethanol, methylparabene, propylene glycol, triethanolamine, propylparabene, trichlorocarbanilide and dichromate were also included. The allergens were applied in duplicate on the healthy skin of the back and covered with opaque tape withdrawn 24 h later, the panel on the right was irradiated with an ultraviolet A dose of 5 J/cm(2). The tests were read 24 h after the application of the allergens, 24 and 72 h post-irradiation. The readings were assessed according to the visual scoring system recommended by the International Contact Dermatitis Research Group. RESULTS: Twenty-six patients (31.7%) showed positive photopatch test responses to one or several allergens. Four of them showed positive results to three components of the series and four patients to two components. Thirty-eight photoallergic and 18 allergic reactions were observed. Ultraviolet filters were the substances which more frequently produced positive photopatch test responses (30.5%). The most common ultraviolet filter photoallergen was benzophenone-3 with 22/82 positive results (26.8%), followed by octyl methoxycinnamate (8/82), benzophenone-4 and mexenone (2/82), phenylbenzimidazole sulphonic acid, methylbenziliden camphor and octyl dimethyl PABA (1/82). One patient showed a photoallergic response to 6-methylcoumarin. There was a concordance between the allergen which elicited the positive response and the use of different substances which contained that molecule among its compounds in 17 patients (65.3%). 19.5% of the patients (16/82) showed positive results to one or several allergens in the irradiated panel as well as in the unirradiated control site. These cases were diagnosed as contact allergy, probably caused by aeroallergens, presenting a natural history and a clinical picture similar to photocontact allergy. The most common allergen was dichromate with 10 positive results. CONCLUSIONS: The results of this study confirm that sunscreens are the more frequently involved substances in photoallergic contact dermatitis in our population. Identification of the photoallergen is the key element for adequate disease control and patient education.     

Occupational carprofen photoallergic contact dermatitis

Background The nonsteroidal anti‐inflammatory drug carprofen was used in humans in the 1980s, before its withdrawal due to adverse effects. It re‐emerged for veterinary uses, for which it is still widely prescribed, in the 1990s. There has been one previous report published of photoallergic contact dermatitis (PACD) in a pharmaceutical factory worker exposed to carprofen. Objectives Investigation of carprofen as a cause of PACD in pharmaceutical factory workers presenting with facial dermatitis. Methods Photopatch testing to carprofen dilutions in two pharmaceutical factory workers and three healthy volunteer controls using the European consensus methodology. This was followed by testing of eight further employees, referred by occupational health services, in the same factory. Results The index patient suspected a problem with carprofen and was found to have PACD to carprofen. The second patient presented with a widespread, although especially photoexposed site, dermatitis and was initially labelled as having an ‘unclassified dermatitis’. Only subsequently was her exposure (indirect; she did not work in the packaging section of the factory like the first patient) to carprofen recognized and testing confirmed both contact allergy and PACD to carprofen. One of three healthy volunteer controls had an active photoallergy sensitization event to carprofen starting 10 days after photopatch testing. Three of eight factory employees subsequently referred because of skin problems had carprofen PACD. Conclusions Carprofen is a potent photoallergen. These cases emphasize the importance of photopatch testing, and considering agents not included in standard series, when investigating patients presenting with a photoexposed site dermatitis.     

白介素-10对小鼠光变态反应性接触性皮炎的影响

目的：探讨白介素(IL)-10在光变态反应性接触性皮炎(photoallergic contact dermatitis，PACD)发病中的作用。方法：选用BALB／C纯系雌性小鼠建立氯丙嗪(chlorpromazine，CPZ)所致的PACD模型，采用腹腔或皮内注射重组小鼠IL-10的方法，于激发48h后检测小鼠耳肿度，局部皮损活检行苏木精-伊红染色，计数单一核细胞浸润数。结果：小鼠皮内和腹腔注射重组小鼠IL-10后，耳肿度值、单一核细胞浸润数均较阳性对照组(单纯的PACD模型)低。结论：小鼠体内IL-10对CPZ诱导的PACD的光诱导和光激发阶段均起抑制作用。     

Allergic contact dermatitis to a colophony derivative

5 patients developed acute allergic contact: dermatitis to a wood rosin present in the adhesive of tapes used to approximate the edges of incisions. The exposure history consistently included application after an orthopedic procedure with subsequent occlusion under a cast for 3 weeks.