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1.
Wien Klin Wochenschr ; 2024 Sep 11.
Artículo en Inglés | MEDLINE | ID: mdl-39259224

RESUMEN

BACKGROUND: Vaccination against severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) was one crucial element to overcome the coronavirus disease 2019 (COVID-19) pandemic. Even though anaphylaxis to vaccines is rare, 47 patients came to the Allergy Unit at the University Hospital Graz, Austria, reporting immediate anaphylactoid symptoms after administration of COVID-19 vaccines. In addition, 29 patients with known drug-induced anaphylaxis wanted to be tested for a possible sensitization against COVID-19 vaccines or excipients, such as polyethylene glycol (PEG) or polysorbate 80 (PS80) before the first COVID-19 vaccination. Skin prick tests and intradermal tests were performed in all 76 patients, mostly using PEG 2000, and/or PS80. Skin prick tests with COVID-19 vaccines were performed depending on availability. OBJECTIVE: Our aim was to characterize this patient cohort in terms of patients' anaphylactoid responses, their willingness to future vaccinations against SARS-Cov­2, and reasons for their decision. METHODS: We developed a questionnaire and analyzed 34 completed copies. RESULTS: Of the 47 patients with anaphylactoid reactions to COVID-19 vaccination, most were female (40 female/7 male). The skin tests, even when performed with the respective COVID-19 vaccine, were negative in all but one patient. Most patients who experienced anaphylactoid reactions after a COVID-19 vaccination, did not want another COVID-19 vaccination at the time of answering the questionnaire because of anxiety for another anaphylactoid response at the next shot. Premedication with antihistamines significantly lowered (n = 74 vaccinations) the severity of anaphylactoid responses after COVID-19 vaccinations. CONCLUSION: Anxiety about another anaphylactoid episode hinders patients to be vaccinated against SARS-CoV­2 again. Premedication with antihistamines and collaboration of allergologists with psychologists might lower the risk of an anaphylactic/anaphylactoid response as well anxiety in drug-induced anaphylactic patients.

3.
Br J Dermatol ; 190(6): 895-903, 2024 May 17.
Artículo en Inglés | MEDLINE | ID: mdl-38123140

RESUMEN

BACKGROUND: Concerns regarding contact allergies and intolerance reactions to dental materials are widespread among patients. Development of novel dental materials and less frequent amalgam use may alter sensitization profiles in patients with possible contact allergy. OBJECTIVES: To analyse current sensitization patterns to dental materials in patients with suspected contact allergy. METHODS: This retrospective, multicentre analysis from the Information Network of Departments of Dermatology (IVDK) selected participants from 169 834 people tested in 2005-2019 and registered with (i) an affected area of 'mouth' (and 'lips'/'perioral'), (ii) with the dental material in question belonging to one of three groups (dental filling materials, oral implants or dentures or equivalents) and (iii) with patch-testing done in parallel with the German baseline series, (dental) metal series and dental technician series. RESULTS: A total of 2730 of 169 834 tested patients met the inclusion criteria. The patients were predominantly women (81.2%) aged ≥ 40 years (92.8%). The sensitization rates with confirmed allergic contact stomatitis in women (n = 444) were highest for metals (nickel 28.6%, palladium 21.4%, amalgam 10.9%), (meth)acrylates [2-hydroxyethyl methacrylate (HEMA) 4.8%] and the substances propolis (6.8%) and 'balsam of Peru' (11.4%). The most relevant acrylates were HEMA, 2-hydroxypropyl methacrylate, methyl methacrylate, ethylene glycol dimethacrylate and pentaerythritol triacrylate. Few men were diagnosed with allergic contact stomatitis (n = 68); sensitization rates in men were highest for propolis (14.9%) and amalgam (13.6%). CONCLUSIONS: Allergic contact stomatitis to dental materials is rare. Patch testing should not only focus on metals such as nickel, palladium, amalgam and gold, but also (meth)acrylates and the natural substances propolis and 'balsam of Peru'.


Asunto(s)
Amalgama Dental , Materiales Dentales , Dermatitis Alérgica por Contacto , Pruebas del Parche , Humanos , Femenino , Masculino , Estudios Retrospectivos , Dermatitis Alérgica por Contacto/diagnóstico , Dermatitis Alérgica por Contacto/etiología , Dermatitis Alérgica por Contacto/epidemiología , Dermatitis Alérgica por Contacto/inmunología , Adulto , Persona de Mediana Edad , Materiales Dentales/efectos adversos , Amalgama Dental/efectos adversos , Anciano , Adolescente , Adulto Joven , Niño , Metacrilatos/efectos adversos , Bálsamos/efectos adversos , Implantes Dentales/efectos adversos , Estomatitis/epidemiología , Estomatitis/inducido químicamente , Estomatitis/inmunología , Estomatitis/diagnóstico , Estomatitis/etiología , Própolis/efectos adversos , Dentaduras/efectos adversos , Alemania/epidemiología , Alérgenos/efectos adversos , Alérgenos/inmunología , Preescolar
4.
Contact Dermatitis ; 90(5): 470-478, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38146081

RESUMEN

BACKGROUND: EU Commission Regulation 2017/1410 prohibits using atranol and chloroatranol, the main allergens in Evernia prunastri (oakmoss), and hydroxyisohexyl 3-cyclohexene carboxaldehyde (HICC) in cosmetic products. Oakmoss absolute is contained in fragrance mix (FM) I and HICC in FM II which are patch tested as screening mixtures in the baseline series. OBJECTIVE: To describe the time trends of reaction frequencies to both FMs as well as to their components in FM-positive patients. METHODS: Retrospective analysis of data from the Information Network of Departments of Dermatology (IVDK), 2012-2021. RESULTS: Positive reactions to FM I (FM II) declined from 9.1% (4.7%) in 2012 to 4.6% (3.0%) in 2021. Full breakdown tests were performed in 24% (FM I) and 31% (FM II), respectively, of the mix-positive patients. From this data, frequencies of sensitization to the 14 single fragrances of FM I and FM II were calculated. For the majority, a decline was noted from 2012/2013 to 2020/2021, for oakmoss absolute 1.9%-0.8% and for HICC 1.8%-0.9%. CONCLUSION: EU Commission Regulation 2017/1410 was an effective measure. However, our data have some limitations, possibly causing underestimation of sensitization frequencies to fragrances.


Asunto(s)
Aldehídos , Ciclohexenos , Dermatitis Alérgica por Contacto , Perfumes , Resinas de Plantas , Terpenos , Humanos , Dermatitis Alérgica por Contacto/epidemiología , Dermatitis Alérgica por Contacto/etiología , Dermatitis Alérgica por Contacto/diagnóstico , Odorantes , Estudios Retrospectivos , Pruebas del Parche/efectos adversos , Alérgenos/efectos adversos , Perfumes/efectos adversos
5.
Contact Dermatitis ; 89(3): 161-170, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-37315639

RESUMEN

BACKGROUND: Hair cosmetic products contain several, partly potent contact allergens, including excipients like preservatives. Hand dermatitis in hairdressers is common, scalp and face dermatitis in clients or self-users (summarised here as 'consumers') may be severe. OBJECTIVE: To compare frequencies of sensitization to hair cosmetic ingredients and other selected allergens between female patch tested patients working as hairdressers and consumers without professional background, respectively, who were tested for suspected allergic contact dermatitis to such products. METHODS: Patch test and clinical data collected by the IVDK (https://www.ivdk.org) between 01/2013 and 12/2020 were descriptively analysed, focusing on age-adjusted sensitization prevalences in the two subgroups. RESULTS: Amongst the 920 hairdressers (median age: 28 years, 84% hand dermatitis) and 2321 consumers (median age: 49 years, 71.8% head/face dermatitis), sensitization to p-phenylenediamine (age-standardised prevalence: 19.7% and 31.6%, respectively) and toluene-2,5-diamine (20 and 30.8%) were most common. Contact allergy to other oxidative hair dye ingredients was also more commonly diagnosed in consumers, whereas ammonium persulphate (14.4% vs. 2.3%) and glyceryl thioglycolate (3.9 vs. 1.2%) as well as most notably methylisothiazolinone (10.5% vs. 3.1%) were more frequent allergens in hairdressers. CONCLUSIONS: Hair dyes were the most frequent sensitizers both in hairdressers and in consumers; however, as indication for patch testing may differ, prevalences cannot directly be compared. The importance of hair dye allergy is evident, often with marked coupled reactivity. Workplace and product safety need to be further improved.


Asunto(s)
Dermatitis Alérgica por Contacto , Dermatitis Profesional , Eccema , Tinturas para el Cabello , Preparaciones para el Cabello , Humanos , Femenino , Adulto , Persona de Mediana Edad , Dermatitis Alérgica por Contacto/diagnóstico , Dermatitis Alérgica por Contacto/epidemiología , Dermatitis Alérgica por Contacto/etiología , Preparaciones para el Cabello/efectos adversos , Tinturas para el Cabello/efectos adversos , Alérgenos/efectos adversos , Pruebas del Parche , Vehículos Farmacéuticos , Dermatitis Profesional/diagnóstico , Dermatitis Profesional/epidemiología , Dermatitis Profesional/etiología
6.
Dermatologie (Heidelb) ; 74(8): 614-617, 2023 Aug.
Artículo en Alemán | MEDLINE | ID: mdl-37237145

RESUMEN

Starting in 2020, the global health system faced unprecedent challenges due to the coronavirus disease 2019 (COVID-19) pandemic and the consequences are still felt. All the more fascinating and of particular importance for health policy was the development of potent vaccines within about one year by several research groups after the first reports of COVID-19 infections. To date, three types of COVID-19 vaccines are available, i.e., messenger RNA-based vaccines, adenoviral vector vaccines, and inactivated whole-virus vaccines. We report a woman who developed reddish, partially urticarial skin lesions on her right arm and flank shortly after the first dose with the corona vaccination from AstraZeneca/Oxford (ChAdOx1). The lesions were transient, however reoccurred in loco and at other locations over several days. The clinical presentation was unusual and was correctly assigned due to the clinical course.


Asunto(s)
Vacunas contra la COVID-19 , COVID-19 , Enfermedades de la Piel , Urticaria , Femenino , Humanos , COVID-19/prevención & control , Vacunas contra la COVID-19/efectos adversos , Emociones , Vacunas de ARNm , Palidez
7.
Contact Dermatitis ; 89(2): 85-94, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-37177844

RESUMEN

BACKGROUND: Hydroperoxides of limonene (Lim-OOHs) and linalool (Lin-OOHs) are potent contact sensitizers. OBJECTIVES: To investigate the prevalence of positive patch test (PT) reactions to Lim-OOHs and Lin-OOHs in consecutive patients, their demographic factors and concomitant reactions. METHODS: Between 7/2018 and 12/2020, Lim-OOHs 0.3% pet. and Lin-OOHs 1% pet. were patch tested in 5511 consecutive patients. We assessed PT reactivity and analysed data from patients with either positive or negative PTs to Lim-OOHs and Lin-OOHs. RESULTS: Positive PT results to Lim-OOHs (n = 170, 3.1%) and Lin-OOHs (n = 483, 8.8%) were frequent. Most of the positive reactions were weak (LimOOHs n = 134/LinOOHs n = 429), and even more frequently, doubtful (n = 252/n = 578) or irritant reactions (n = 81/n = 178) were documented. PT reactivity to Lim-OOHs and Lin-OOHs was increased in patients with irritant reactions to sodium lauryl sulphate (SLS). The proportion of leg dermatitis and concomitant positive reactions to fragrances and essential oils was increased in patients with reactivity to these hydroperoxides. CONCLUSION: The observed reaction pattern suggests that both test preparations display an irritant potential with an increased risk of false positive reactions. Preparations should be chemically monitored in order to reduce irritancy. Mindful interpretation of PT results and aimed patch testing of lower concentrations is recommended.


Asunto(s)
Dermatitis Alérgica por Contacto , Perfumes , Humanos , Limoneno/efectos adversos , Monoterpenos/efectos adversos , Peróxido de Hidrógeno/efectos adversos , Pruebas del Parche/efectos adversos , Irritantes , Dermatitis Alérgica por Contacto/diagnóstico , Dermatitis Alérgica por Contacto/epidemiología , Dermatitis Alérgica por Contacto/etiología , Perfumes/efectos adversos , Alérgenos/efectos adversos
8.
Dermatol Pract Concept ; 12(4): e2022225, 2022 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-36534558
9.
Front Med (Lausanne) ; 9: 931765, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36091700

RESUMEN

The purpose of this mini-review was to provide the latest information and concepts on diagnosis and treatment of the most common sexually transmitted pathogens causing urethritis. The incidence of several sexually transmitted infections that cause urethritis is increasing, and this genitourinary syndrome is among the most common reason young men see clinical care. The authors performed a literature search including the currently valid guidelines, and an overview of the most relevant pathogens is given. Moreover, the authors developed a clinically applicable diagnostic and therapeutic algorithm, because early diagnosis and correct treatment can sometimes prevent infected individuals from significant morbidity. Future research will focus on new methods to combat pathogens that cause urethritis, including vaccination.

14.
Contact Dermatitis ; 2021 Mar 17.
Artículo en Inglés | MEDLINE | ID: mdl-33729576

RESUMEN

BACKGROUND: Irritant contact dermatitis (ICD) is caused by the acute locally toxic effect of a strong irritant, or the cumulative exposure to various weaker physical and/or chemical irritants. OBJECTIVES: To describe the characteristics of patients with ICD in the population patch tested in the European Surveillance System on Contact Allergies (ESSCA; www.essca-dc.org) database. METHODS: Data collected by the ESSCA in consecutively patch-tested patients from January 2009 to December 2018 were analyzed. RESULTS: Of the 68 072 patients, 8702 were diagnosed with ICD (without concomitant allergic contact dermatitis [ACD]). Hand and face were the most reported anatomical sites, and 45.7% of the ICD was occupational ICD (OICD). The highest proportions of OICD were found in metal turners, bakers, pastry cooks, and confectionery makers. Among patients diagnosed with ICD, 45% were found sensitized with no relevance for the current disease. CONCLUSIONS: The hands were mainly involved in OICD also in the subgroup of patients with contact dermatitis, in whom relevant contact sensitization had been ruled out, emphasizing the need for limiting irritant exposures. However, in difficult-to-treat contact dermatitis, unrecognized contact allergy, or unrecognized clinical relevance of identified allergies owing to incomplete or wrong product ingredient information must always be considered.

15.
Contact Dermatitis ; 84(6): 407-418, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33533485

RESUMEN

BACKGROUND: In about half of the patients reacting positive to fragrance mix I (FM I), breakdown testing remains negative. This raises the question of whether the reaction to FM I is false-positive, or the breakdown test is false-negative. OBJECTIVES: To identify characteristics and sensitization patterns of patients positive to FM I, but not to its fragrance constituents. PATIENTS AND METHODS: Retrospective analysis of data from the Information Network of Departments of Dermatology (IVDK) between 2005 and 2019. Three patient groups were defined according to their reaction pattern: Group I, FM I positive and ≥1 single fragrance positive in the breakdown test (n = 1912); Group II, FM I positive and breakdown test negative (n = 1318); Group III, FM I negative (n = 19 790). RESULTS: Regarding the pattern of concomitant reactions to other fragrances, Group II had an intermediate position between Group I and Group III. In other respects (age and sex distribution, frequency of sensitization to non-fragrance baseline series allergens), Group II rather resembled Group I. CONCLUSIONS: Not every positive reaction to FM I in patients with negative breakdown tests is false-positive. There may be false-negative reactions to the single fragrance components when patch tested at 1% pet. Raising patch concentrations of some single fragrances is recommended.


Asunto(s)
Dermatitis Alérgica por Contacto/diagnóstico , Odorantes , Pruebas del Parche/métodos , Adulto , Dermatitis Atópica/diagnóstico , Dermatitis Profesional/diagnóstico , Reacciones Falso Negativas , Reacciones Falso Positivas , Dermatosis de la Mano/diagnóstico , Humanos , Dermatosis de la Pierna/diagnóstico , Masculino , Estudios Retrospectivos
17.
J Cosmet Dermatol ; 20(8): 2574-2578, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-33253493

RESUMEN

BACKGROUND: Baboon syndrome is a rare, type IV hypersensitivity reaction causing a maculopapular rash. Tamoxifen is an antineoplastic agent, working as an estrogen receptor antagonist, also called a selective estrogen receptor modulator. A variety of rashes were reported with Tamoxifen use to-date except baboon syndrome. The Tamoxifen-induced baboon syndrome seems to be reversible, as discontinuation of the drug improves clinical outcomes. AIM: Herein, we present the first case of Tamoxifen-induced baboon syndrome which occurred 8 years after initiation of Tamoxifen use. PATIENTS: A 44-year-old woman presented with papulovesicular eruption on her body and erythema on her face for a duration of 6 months. There was no evidence of ocular or mucosal involvement. She was diagnosed with breast cancer and treated with tamoxifen 10 mg twice daily over the past 8 years. She was not taking other medications or over-the-counter supplements at the time of presentation. The patient underwent urgent skin biopsies of two lesions on her buttock and thigh. No organisms were seen on Gram stain. The patient's skin biopsy revealed extensive hyperorthokeratosis, minimal parakeratosis, hypergranulosis, and lichenoid interface dermatitis in the irregularly acanthotic epidermis supporting diagnosis of fixed drug eruption. Following a multidisciplinary discussion, the patient was diagnosed with baboon syndrome or symmetrical drug-related intertriginous and flexural exanthema (SDRIFE) associated with Tamoxifen. RESULTS: Hence, Tamoxifen was immediately discontinued and treated with oral steroid along with topical agents. She showed improvement of clinical abnormalities within days after discontinuation of Tamoxifen. CONCLUSIONS: Given the widespread use of Tamoxifen in the management of patients with breast cancer, it is important that healthcare professionals monitor for rare, however clinically significant, and potentially life-threatening dermatological manifestations of Tamoxifen use, such as baboon syndrome.


Asunto(s)
Erupciones por Medicamentos , Exantema , Adulto , Animales , Erupciones por Medicamentos/etiología , Exantema/inducido químicamente , Femenino , Humanos , Papio , Síndrome , Tamoxifeno/efectos adversos
19.
J Dtsch Dermatol Ges ; 14(11): 1125-1133, 2016 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-27879082

RESUMEN

ZIELE: Informationen zur Häufigkeit von Arzneimittelwechselwirkungen und unerwünschten Arzneimittelwirkungen zu präsentieren und Hilfestellung zu leisten, wie diese wichtigen Probleme in der pharmakologischen Behandlung stationärer dermatologischer Patienten minimiert werden können. PATIENTEN UND METHODEN: Die Medikation von 1 099 stationären dermatologischen Patienten wurde retrospektiv mittels einer Internet-basierten Software für Medikamenteninteraktionen (Diagnosia® Check) auf Arzneimittelwechselwirkungen und unerwünschte Arzneimittelwirkungen analysiert. ERGEBNISSE: Wir beschreiben eine Gesamthäufigkeit relevanter Arzneimittelwechselwirkungen von 51,7 % mit durchschnittlich 3,2 Interaktionen pro betroffenem stationären Patienten. Arzneimittelkombinationen, die gemieden werden sollten, wurden bei 5,7 % der Studienpopulation festgestellt. Der wichtigste Risikofaktor war die Gesamtzahl der verabreichten Medikamente. Die Arzneimittelgruppen, die bei der Mehrzahl der Wechselwirkungen beteiligt waren, waren Analgetika, Herz-Kreislauf-Medikamente und gerinnungshemmende Medikamente sowie Antidepressiva. Das Risiko unerwünschte Arzneimittelwirkungen auszubilden wurde bei 53,1 % der stationären Patienten als "hoch" eingestuft. Die fünf wichtigsten unerwünschten Nebenwirkungen in dieser Patientengruppe waren Blutungen, Obstipation, anticholinerge Effekte, Sedierung und orthostatische Effekte. SCHLUSSFOLGERUNGEN: Potenzielle Arzneimittelwechselwirkungen sowie unerwünschte Arzneimittelwirkungen sind bei stationären dermatologischen Patienten alarmierend häufig. Bei jedem zweiten Patienten besteht die Gefahr, derartige Wechselwirkungen oder unerwünschte Nebenwirkungen zu erleiden und jeder zwanzigste Patient erhält eine Arzneimittelkombination, die nicht verabreicht werden sollte. Erhöhte Wachsamkeit ist erforderlich, um die gefährdeten Patienten zu erkennen.

20.
J Dtsch Dermatol Ges ; 14(11): 1122-1129, 2016 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-27879085

RESUMEN

OBJECTIVES: To present information on the frequency of drug-drug interactions and adverse drug reactions, and to provide assistance on how to minimize these major problems in the pharmacological treatment of dermatological inpatients. PATIENTS AND METHODS: The medications given to 1,099 dermatological inpatients were retrospectively analyzed for drug-drug interactions and adverse drug reactions using web-based drug interaction software (Diagnosia® Check). RESULTS: We report an overall frequency of relevant drug-drug interactions of 51.7 %, with an average of 3.2 interactions per affected inpatient. Drug combinations that should have been avoided were found in 5.7 % of the study population. Total drug count was the most important risk factor. Drug groups involved in the majority of interactions were analgesics, cardiovascular and antithrombotic agents, as well as antidepressants. The risk of developing adverse drug reactions was rated as "high" in 53.1 % of inpatients. The top five adverse reactions in this patient group were bleeding, constipation, anticholinergic effects, sedation, and orthostatic effects. CONCLUSIONS: Potential drug-drug interactions as well as adverse drug reactions are alarmingly common in dermatological inpatients. Every other patient is at risk of experiencing such interactions or adverse reactions, and every twentieth patient receives a drug combination that should not be administered. Increased alertness is a must in order to identify patients at risk.


Asunto(s)
Fármacos Dermatológicos/uso terapéutico , Incompatibilidad de Medicamentos , Quimioterapia Combinada/estadística & datos numéricos , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/epidemiología , Pacientes Internos/estadística & datos numéricos , Enfermedades de la Piel/tratamiento farmacológico , Enfermedades de la Piel/epidemiología , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Austria/epidemiología , Niño , Preescolar , Fármacos Dermatológicos/efectos adversos , Revisión de la Utilización de Medicamentos , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/etiología , Femenino , Humanos , Incidencia , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Distribución por Sexo , Adulto Joven
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