Contact dermatitis from a presumed allergy to paraphenylenediamine

Paraphenylenediamine (PPD) is a potent skin allergen found in permanent hair dye and temporary henna tattoo ink. Several cases of adverse skin reactions to PPD have been reported in the literature. Here we present a case involving a patient who acquired a temporary tattoo while vacationing in Mexico and subsequently developed contact dermatitis at the tattoo site. He provided a history of permanent hair dye use in the past with associated cutaneous reaction. Temporary tattoos have become increasingly popular with travelers and as a result so have reports of associated allergic contact dermatitis. Of concern is cross‐reaction of PPD to related compounds, severe reactions in younger populations and sequelae including increased sensitization, permanent scarring, and persistent postinflammatory hyperpigmentation.     

Contact dermatitis to topical acne drugs: a review of the literature

Acne vulgaris is a chronic dermatological disorder that affects the majority of teenagers in the Western world. Topical therapy is widely used to treat mild‐moderate acne and is known as well‐tolerated thanks to its low systemic toxicity, although associated to skin adverse effects. Acne seems to be associated also to an intrinsic alteration of the epidermal barrier, regarding both the upper and the follicular stratum corneum that promotes the onset of such local side effects. The commonest one is irritant contact dermatitis, an event of frequent observation occurring with erythema, burning, dryness, scaling, and itching, usually characterized by low severity and limited duration. Among topical acne drugs, retinoids are the most irritating ones. Another side effect is allergic contact dermatitis: it is rare and mainly associated to benzoyl peroxide.     

Allergic contact dermatitis in children

INTRODUCTION: Allergic contact dermatitis (ACD) is equally as likely in infancy as in adulthood, and represents 20% of all cases of dermatitis in children. Its true prevalence and incidence are, however, unknown. MATERIALS AND METHODS: We have conducted a retrospective study over 10 years of a group of patients aged 15 years or less, with clinical suspicion of ACD. Patch tests were performed in accordance with the standards of the GEIDC. RESULTS: The study covered 96 patients with a mean age of 10.57+/-0.67 years. The zones most frequently affected by eczemas were those of diffuse distribution (28% of patients) and of the hands (27%). We found at least one positive response in 52% of the cases. The most frequent allergens were thiomersal (21%), mercury (19%) and nickel (18%). We have found a statistically significant association between age of less than 15 years and positive response to thiomersal [P<0.01; OR: 8.5 with confidence interval (CI) 95%: 5.08相似文献   

Nickel-elicited systemic contact dermatitis

20 patients with systemic contact dermatitis due to nickel are described. Of these patients, 15 were female and 5 were male. Their mean age was 24.8 years (16-51 years). All had experienced contact dermatitis in the umbilical area due to continual contact with metal belt-buckles or buttons. Then, with long- or short-term aggravation of such periumbilical dermatitis, commonly in summer, lesions spread to other sites such as the side of the neck, the flexures of the extremities, etc. All patients showed a positive patch test to nickel sulphate (2.5% in petrolatum) and the dimethylglyoxime test demonstrated the presence of free nickel on metal buttons or belt-buckles. Punch biopsies performed in 7 patients showed subacute dermatitis. After avoidance of continual exposure to objects containing nickel and foods rich in nickel, as well as treatment with oral antihistamines and topical corticosteroids, all patients improved or cleared. It has been reported that nickel can cause systemic contact dermatitis by some internal systemic route, such as oral intake, transfusion, inhalation, implantation of metal medical devices, etc. In our patients, we found that continual local skin contact could also elicit systemic contact dermatitis.     

初次变应性接触性皮炎小鼠模型的建立与评价

目的 建立并评价初次变应性接触性皮炎（ACD）小鼠模型。方法 用1-氟-2,4二硝基苯（DNFB）分别制作经典ACD小鼠模型及初次ACD模型,在以下3方面对二者进行比较：以激发前后耳肿度为临床观察指标;以ELISA与实时RT-PCR方法检测耳组织中IL-2、INF-γ与IL-4的表达水平;进行局部淋巴结分析（LLNA）,以流式细胞术检测耳引流淋巴结中淋巴细胞增殖与活化的情况。结果 初次ACD小鼠模型耳背部单次用药6天后出现较明显的耳肿度变化,这与经典ACD模型自诱导至炎症出现的时间相同;与经典ACD小鼠模型相似,初次ACD小鼠模型的耳肿度亦呈现出随时间变化的趋势;二者组织浸润细胞均以单一核细胞为主;与正常小鼠相比,二者组织中Th1型细胞因子IL-2与IFN-γ表达均增加,Th2型因子IL-4均未增加,耳引流淋巴结中T淋巴细胞均出现明显增殖与活化。结论 初次ACD模型与经典模型机制相似,均为Th1型变态反应,二者可以互用。     

Sites of dermatitis in a patch test population: hand dermatitis is associated with polysensitization

Background  Sites of dermatitis in larger series of contact allergic patients are rarely reported. Increased risk of polysensitization has been linked only to stasis dermatitis and leg ulcers. However, a large proportion of polysensitized individuals may have dermatitis in other skin areas.
Objectives  To examine the site of dermatitis at time of first appearance in contact allergic individuals with special focus on the distribution of dermatitis in polysensitized individuals and to examine if widespread dermatitis is more frequent in polysensitized than in single/double-sensitized patients.
Methods  A matched case–control study was carried out including 394 polysensitized and 726 single/double-sensitized patients who responded to a postal questionnaire. All subjects were recruited from a hospital patch test population.
Results  The hands were the most frequent and the anogenital region was the least frequent skin area affected with dermatitis. Dermatitis on the hands/wrists [odds ratio (OR) 1·58], in the armpits (OR 1·56) and on the back (OR 1·91) was positively associated with polysensitization. The hands were the only skin area with dermatitis which maintained the association to polysensitization in two subpopulations consisting of, respectively, individuals with and without atopic eczema. Dermatitis on the scalp was negatively associated with polysensitization (OR 0·66) primarily for individuals without atopic eczema. The dermatitis did not seem to be more widespread in polysensitized compared with single/double-sensitized patients.
Conclusions  Special awareness in patients with hand dermatitis seems justified either to prevent development of multiple contact allergies or to document polysensitization as an aetiological factor.     

Systemic Contact Dermatitis from Propolis Ingestion

Propolis, also known as bee glue, is a substance collected by worker bees and it is used as a material for constructing and maintaining their beehives. It has been used topically and orally by humans for its anti-inflammatory properties. However, the growing use of propolis has been paralleled by reports of allergic contact dermatitis as a reaction to the substance. Contact dermatitis with generalized cutaneous manifestations elicited by propolis ingestion has not been previously reported. Here we report on the first case of systemic contact dermatitis from propolis ingestion in a 36-year-old woman.     

Occupational contact dermatitis

The dermatologist should be aware of the many facets of occupational skin diseases, which can be caused by physical, chemical, and biological insults. The most common manifestation of occupational skin diseases is contact dermatitis (both irritant and allergic). Three factors point out the importance of occupational skin diseases as diseases that have a public health impact: 1) occupational skin diseases are common; 2) they often have a poor prognosis; and 3) they result in a noteworthy economic impact for society and for an individual. They are also diseases amenable to public health interventions. Specific industries and exposures may put a worker at risk of occupational contact dermatitis. The accuracy of the diagnosis of occupational contact dermatitis is related to the skill level, experience, and knowledge of the medical professional who makes the diagnosis and confirms the relationship with a workplace exposure. Prevention of occupational contact dermatitis is important, and a variety of prevention strategies are available.     

Persistent post-occupational dermatitis

Wall and Gebauer (Contact Dermatitis 1991: 24: 241-243) first described persistent post-occupational dermatitis (PPOD) as ongoing dermatitis for which there is no obvious present cause, precipitated by prior occupational contact dermatitis (OCD). We propose that individuals exhibiting PPOD lose the capacity for resolution of their condition upon removal from exposure to causative agents and subsequently develop persistent dermatitis, which can be continual or intermittent. Accordingly, we suggest modification of criterion 6 of the OCD criteria developed by Mathias (J Am Acad Dermatol 1989: 20: 842-848): 'Removal from exposure initially leads to improvement of dermatitis, however, over time there may be incomplete or no improvement, despite removal from exposures at work'. To satisfy the definition of PPOD, individuals must meet at least 4 of the 7 criteria, including the altered criterion 6. We present 6 cases of PPOD exemplifying these scenarios, which met the altered Mathias criteria. In some cases, subsequent failure to recognize the initial work relatedness of their skin conditions resulted in the termination of workers' compensation benefits. This situation is particularly relevant in the Australian context. The diagnosis of PPOD needs to be considered in all individuals with work-initiated dermatitis who present with ongoing endogenous-like eczema.     

An update on airborne contact dermatitis: 2001-2006

Reports on airborne dermatoses are mainly published in the context of occupational settings. Hence, in recent years, dermatologists and also occupational physicians have become increasingly aware of the airborne source of contact dermatitis, resulting mainly from exposure to irritants or allergens. However, their occurrence is still underestimated, because reports often omit the term 'airborne' in relation to dust or volatile allergens. For the present update, we screened the journals 'Contact Dermatitis' (July 2000 to December 2006); 'Dermatitis', formerly named 'American Journal of Contact Dermatitis'; 'La Lettre du Gerda' (January 2000 to December 2006); and also included relevant articles from other journals published during the same period. This resulted in an updated list of airborne dermatitis causes.     

Hidden risks in toys: A systematic review of pediatric toy contact dermatitis

Toys are a reflection of the compounds used frequently in manufacturing. Allergic contact dermatitis to potties, metal toys, and children's jewelry is well known, however, there is a broad range of skin risks in toys. With the objective to identify and publicize the associated risk of contact dermatitis in children's toys, we have searched the PubMed database from creation to September 9, 2019. Studies were eligible if they reported a new case of contact dermatitis secondary to interaction with a toy in patients from birth to 18 years of age. A toy was defined as something children interact with for entertainment during leisure time. In this review of the PubMed database we filtered by age and language which may have prevented us from detecting cases in adults that could be extrapolated to children. In addition, several articles were excluded based on title alone. A total of 1312 articles were identified and reviewed manually for inclusion criteria. Review of the articles found 25 original articles for consideration. Several toys were found to be associated with contact dermatitis. These included electronics, toy cars, costume jewelry, bicycles, sqwish balls, slime, Play-Doh, and plasticine. Electronics such as video game controllers, cellphones, iPads, and computers were implicated. In conclusion, there is still an unmet need for observation of this segment of industry for labeling of contents and ongoing surveillance.     

Allergic and photoallergic contact dermatitis to chlorpromazine

Chlorpromazine is known to produce both systemic phototoxic and photoallergic reactions. However, it may also cause photoallergic contact dermatitis and, albeit exceptionally, allergic contact dermatitis (ACD). We present a series of photoallergic contact dermatitis and ACD to chlorpromazine diagnosed at a tertiary centre cutaneous allergy unit between 1980 and 2019.     

Allergic contact dermatitis to slime: The epidemic of isothiazolinone allergy encompasses school glue

The slime craze is all the rage among tweens. Slime is a homemade stretchy play material created by mixing together household items such as school glue, borax, shaving cream, and contact lens solution. We present a case of allergic contact dermatitis secondary to methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) in school glue used to make slime; mass spectroscopy confirmed MCI/MI in the patient's glue. Clinicians should be aware of slime as an emerging source of MCI/MI contact allergy.     

Analysis of patch testing results in patients with contact dermatitis in Istanbul,Turkey, from 2012 to 2022

Background

Allergens responsible for allergic contact dermatitis (ACD) differ between populations. They can even change over the years with the effect of environmental factors.

Aims

To evaluate the results of patch testing performed in our center.

Methods

In this study, the thin-layer rapid-use epicutaneous (T.R.U.E.) test results of patients with a diagnosis of ACD between 2012 and 2022 were retrospectively evaluated.

Results

In 431 (42.5%) of the total 1012 patients, a positive reaction to at least one allergen was detected in the patch test. Allergen positivity was most detected for nickel sulphate (16.8%), gold sodium thiosulfate (GST) (6.9%), thimerosal (4.2%), fragrance mix (3.4%), carba mix (3.2%), and cobalt dichloride (2.9%). Nickel sulfate and GST sensitivity was found to be significantly higher in women, fragrance mix sensitivity in men, thimerosal sensitivity in individuals aged under 40 years, colophony and balsam of Peru sensitivity in head and neck dermatitis, and carba mix and thiuram mix sensitivity in atopic individuals.

Conclusions

This study presents comprehensive data from Turkey concerning the sensitivity frequencies for allergens included in the T.R.U.E. test.