Correction: Latex hypersensitivity to injection devices for biologic therapies in psoriasis patients.

The Table in the article "Latex Hypersensitivity to Injection Devices for Biologic Therapies in Psoriasis Patients" (Cutis. 2018;102:116-118.) incorrectly stated that guselkumab contains latex. The article has been corrected online at www.mdedge.com/dermatology, and the revised Table appears reflecting that guselkumab does not contain latex.

Latex hypersensitivity to injection devices for biologic therapies in psoriasis patients.

An allergic reaction provoked by reexposure to an allergen or antigen is known as a type I or immediate hypersensitivity reaction. Latex allergy is a common cause of type I hypersensitivity reactions. Allergic responses to latex in psoriasis patients receiving frequent injections with biologic agents are not commonly reported in the literature. We report the case of a patient with a long history of psoriasis who developed an allergic response after exposure to injection devices that contained latex components while undergoing treatment with biologic agents.

Using Dermoscopy to Identify Melanoma and Improve Diagnostic Discrimination.

Use of dermoscopy and detection algorithms by primary care physicians can enhance assessment of clinically suspicious lesions compared with that of naked eye examinations.

Reversed needle pass clear-corneal or limbal incision suturing technique using the 3-throw (1-1-1) adjustable square knot.

A single radial suture is required for a corneal or limbal incision that does not seal despite stromal hydration. In the traditional technique for placing this suture, the needle enters from the corneal side of the limbal incision and exits toward the scleral side and the suture is usually tied with a 3-1-1 surgical knot. We present an improved suturing technique in which the needle path is reversed. The needle enters on the scleral side of the limbal incision, exits on the corneal side toward the apex, and is tied with an adjustable 1-1-1 knot.

Determination of benzodiazepines in oral fluid using LC-MS-MS.

A rapid, simple, highly sensitive procedure for the simultaneous analysis of bromazepam, alprazolam, clonazepam, lorazepam, oxazepam, diazepam, midazolam, flurazepam, flunitrazepam, nordiazepam, triazolam, temazepam, nitrazepam, and chlordiazepoxide in oral fluid is described, using liquid chromatography coupled to a triple quadrupole mass spectrometer in positive electrospray mode. Benzodiazepines in oral fluid samples (1 mL) were analyzed using the Quantisal collection device, quantified using solid-phase extraction, and detected using liquid chromatography with tandem mass spectrometric detection. For confirmation, two transitions were monitored and one ion ratio determined, which was within 20% of the ratio for known calibration standards. The limits of quantitation ranged from 0.5-5 ng/mL of neat oral fluid; the intraday precision of the assays (n=5) ranged from 2.8-7.29%; and the interday precision ranged from 1.42-6.8% (n=5). The percentage recovery of the drugs from the collection pads ranged from a low of 81.4% for midazolam to the highest of 90.17% for nitrazepam. The procedure can be applied to authentic oral fluid specimens.

Determination of ion and neutral loss compositions and deconvolution of product ion mass spectra using an orthogonal acceleration time-of-flight mass spectrometer and an ion correlation program.

Exact masses of monoisotopic ions, and the relative isotopic abundances (RIAs) of ions greater in mass by 1 and 2 Da than the monoisotopic ion, are independent and complementary physical properties useful for distinguishing among elemental compositions of ions possible for a given nominal mass. Using these properties to determine elemental compositions of product ions and neutral losses increases the masses of precursor ions for which unique compositions can be determined. Compositions of the precursor ion, product ion, and neutral loss aid mass spectral interpretation and guide modest chemical literature searches for candidate standards to be obtained for confirmation of tentative compound identifications. This approach is essential for compound characterization or identification due to the absence of commercial libraries of electrospray ionization (ESI) and atmospheric pressure chemical ionization (APCI) product ion spectra. For a series of 34 exact mass measurements, an orthogonal acceleration time-of-flight mass spectrometer provided 34 and 29 values accurate to within 2 and 1 mDa, respectively, for ions from eight simulated unknowns with [M+H](+) ion masses between 166 and 319 Da. Of 36 RIA measurements for +1 Da or +2 Da ions, 35 were accurate to within 20% of their predicted values (or to within 0.4 RIA % when the RIA value was less than 1%) in the absence of obvious interferences, in cases where the monoisotopic ion peak areas were at least 1.7 x 10(5) counts and the ion masses exceeded 141 Da. An ion correlation program (ICP) provided the unique and correct compositions for all but three of the 34 ions studied. Manual inspection of the data eliminated the incorrect compositions. To test the utility of the ICP for deconvoluting composite product ion spectra, all 34 ions were tested for correlation. Six of eight precursor ions were identified as such, while two were compositional subsets of others and were not properly identified. The six precursor ion compositions were still found by the ICP even though ions with masses less than 158 Da were not considered since they could no longer be correlated with a single precursor ion. Finally, two unidentified analytes were characterized, based on data published by others and using the ICP together with mass spectral interpretation.