Multiple cases of sensitization to an antiseptic containing chlorhexidine digluconate/benzalkonium chloride/benzyl alcohol with different profiles of sensitization in adults and children.

BACKGROUND: An aqueous antiseptic containing "chlorhexidine digluconate/benzalkonium chloride/benzyl alcohol" (CBB) is widely used in France. The only previous documented study dealing with allergic contact dermatitis (ACD) to this antiseptic is one small case series in children. The French Vigilance Network for Dermatology and Allergy (REVIDAL-GERDA) has collected many cases in the last few years. OBJECTIVES: To evaluate the clinical and sensitization profiles of patients diagnosed with ACD to CBB. METHODS: We performed a retrospective study of patients with contact dermatitis to CBB and positive tests to CBB and/or at least one of its components. All patients had to be tested with all components of CBB. RESULTS: A total of 102 patients (71 adults and 31 children) were included. The lesions were extensive in 63% of patients and 55% had delayed time to diagnosis. CBB patch tests were positive in 93.8% of cases. The allergen was identified in 97% of patients, mainly benzyl alcohol in adults (81.7%) and chlorhexidine digluconate in children (54.8%). About 32.4% of the patients were sensitized to several components. CONCLUSION: CBB is a cause of ACD at all ages. The components of the antiseptic should be tested. The sensitization profile seems to be different between adults and children.

[The 5-word test in 85 patients with generalized anxiety disorder]. / Le test des 5 mots chez 85 patients ayant un trouble anxieux généralisé

OBJECTIVES: Patients with generalized anxiety disorder (GAD) expressed frequent memory complaints leading to consultations in memory clinics. The 5-word test (5WT) is a serial verbal memory test with semantic cuing. It is proposed to rapidly evaluate memory of people with memory complaints. It has previously shown its sensitivity and its specificity in identifying patients with Alzheimer's disease (AD). The objective was to evaluate memory performances of patients with GAD. METHODS: Characteristics of the 5WT were investigated in a sample of 85 patients with GAD compared with 183 normal controls aged from 40 to 70 years. RESULTS: For each score of the 5WT, GAD patients significantly differed from controls. Forgetting rate was twice more important in GAD patients than in controls. However, for any score of the 5WT, Receiver Operating Characteristic (ROC) curves found no significant cut-off scores combining reliable sensitivity, specificity and correct classification of the subjects. DISCUSSION: In spite of ancient and severe mnestic complaints, GAD patients have significant difficulties with the 5WT as compared to controls without being of the magnitude of those observed in AD patients. CONCLUSION: The 5WT is an easy and rapid test allowing a reliable evaluation of memory in GAD patients. Results could usually confort patients. The presence of true memory deficits with the 5WT could not be ascribed to anxiety but to other pathological conditions. Consequently, further memory testing should be done.