RESUMEN
BACKGROUND: There is controversy over late and long-lasting reactions to gold sodium thiosulfate (GST). OBJECTIVES: To study the GST patch-test reaction by observing the application site after 1 month, and to clarify the relevance of GST sensitization by piercings and dental metals. PATIENTS: A retrospective analysis was performed on 746 patients (143 male; 603 female) who were patch tested using GST of the TRUE Test. We conducted a questionnaire on the presence of piercings or dental metals in these patients. RESULTS: The GST positive rate was 27.9% at day (D)3 and/or D7 and 40.3% up to the 1-month reading. The positive rate was significantly higher in female patients and increased with age. Sixty-two percent of cases with a positive reaction at D7 continued to show a positive reaction after 1 month. Eleven percent of cases with a negative reaction at D3 and D7 showed a late reaction. Both piercings and dental metals were related to gold sensitization. CONCLUSIONS: The GST of the TRUE Test had a high positive and low false-negative rate. The 1-month reading after the patch test was important for identifying late reactions. Piercing history and dental metal were associated with gold sensitization.
RESUMEN
In 2013, a guideline for occupational allergic diseases was published for the first time in Japan. Occupational allergic diseases are likely to worsen or become intractable as a result of continuous exposure to high concentrations of causative antigens, and are socioeconomically important diseases with which the patients might sometimes lose jobs due to work interruptions. Guidelines for occupational allergic diseases have been published in many countries. This guideline consists of six chapters about occupational asthma, occupational allergic rhinitis, occupational skin diseases, hypersensitivity pneumonitis and occupational anaphylaxis shock, and legal aspects of these diseases. The guideline is characterized with the following basic structure: Clinical Questions (CQs) are set with reference to Minds (Medical Information Network Distribution Service), statements by the committee are correspondingly listed, recommended grades and evidence levels are defined, and then descriptions and references are indicated.
Asunto(s)
Hipersensibilidad/diagnóstico , Hipersensibilidad/terapia , Enfermedades Profesionales , Guías de Práctica Clínica como Asunto , Alérgenos/inmunología , Anafilaxia/diagnóstico , Anafilaxia/epidemiología , Anafilaxia/etiología , Anafilaxia/terapia , Diagnóstico Diferencial , Manejo de la Enfermedad , Humanos , Hipersensibilidad/epidemiología , Hipersensibilidad/etiología , Japón , Exposición Profesional , FenotipoAsunto(s)
Alérgenos/inmunología , Desensibilización Inmunológica/métodos , Proteínas de Peces en la Dieta/efectos adversos , Hipersensibilidad a los Alimentos/inmunología , Hipersensibilidad a los Alimentos/terapia , Parvalbúminas/efectos adversos , Administración Oral , Alérgenos/administración & dosificación , Animales , Biomarcadores , Manejo de la Enfermedad , Susceptibilidad a Enfermedades , Femenino , Humanos , Inmunoglobulina E/sangre , Inmunoglobulina E/inmunología , Evaluación de Síntomas , Resultado del Tratamiento , Adulto JovenRESUMEN
Identifying the causative substances of occupational contact dermatitis is challenging because of several chemicals and materials in the workplace that can cause contact dermatitis. We experienced three cases of intractable eczema identified as work-related contact dermatitis by Patch Test Panel S, which helped identify the possible substances. We experienced three cases of occupational allergic contact dermatitis, and their causative agents were identified by Patch Test Panel S. Although there are some limitations, Patch Test Panel S might be useful to determine the substrates to cause allergic contact dermatitis in occupational scenarios.
RESUMEN
An 8-year-old boy presented with hydroa vacciniforme with recurrent oral mucosal ulcers and treatment-resistant gingivitis/periodontitis. Symptoms of oral mucosal involvement and gingivitis/periodontitis mirrored the severity of the skin lesions in sun-exposed areas. Although Epstein-Barr virus was negative in the skin lesions, Epstein-Barr virus DNA was detected in the gingival lesions when skin disease activity increased. Human herpes viruses-6 and -7 were also positive in the gingival lesions. Notably, human parvovirus B19 DNA was detected in both skin and gingival lesions. Impairment of systemic immunity was not detected. This report describes a rare case of hydroa vacciniforme with mucosal involvement and periodontal disease accompanied by multiple local virus re-activation.
Asunto(s)
Gingivitis/virología , Herpesvirus Humano 4/aislamiento & purificación , Papillomavirus Humano 6/aislamiento & purificación , Hidroa Vacciniforme/virología , Mucosa Bucal/virología , Úlceras Bucales/virología , Parvovirus B19 Humano/aislamiento & purificación , Periodontitis/virología , Luz Solar/efectos adversos , Activación Viral , Niño , ADN Viral/aislamiento & purificación , Gingivitis/patología , Herpesvirus Humano 4/genética , Humanos , Hidroa Vacciniforme/patología , Masculino , Mucosa Bucal/patología , Úlceras Bucales/patología , Periodontitis/patología , Índice de Severidad de la Enfermedad , Piel/patología , Piel/virologíaRESUMEN
We describe the development of a cutaneous lymphoproliferative disorder in a patient with rheumatoid arthritis who was treated with methotrexate. Skin manifestations were characterized by thrombophlebitis-like lesions and ulcerated nodules. Histologic examination revealed large polymorphic atypical cells including Reed-Sternberg-like cells expressing CD20 and CD30 in the dermis and subcutaneous tissues. Tumor cells infiltrated the walls of dermal arterioles, subcutaneous arteries, and veins, leading to the destruction of vascular structures. Activation of Epstein-Barr virus was detected. Skin lesions improved remarkably after the discontinuation of methotrexate. This case illustrates the rare occurrence of cutaneous vascular involvement in methotrexate-related lymphoproliferative disorder that did not require any specific chemotherapy.
Asunto(s)
Artritis Reumatoide/tratamiento farmacológico , Trastornos Linfoproliferativos/inducido químicamente , Metotrexato/efectos adversos , Anciano de 80 o más Años , Infecciones por Virus de Epstein-Barr/inmunología , Femenino , Herpesvirus Humano 4/inmunología , Humanos , Metotrexato/uso terapéutico , Enfermedades de la Piel/inducido químicamente , Enfermedades de la Piel/patologíaAsunto(s)
Carcinoma de Células Transicionales/complicaciones , Síndromes Paraneoplásicos/diagnóstico , Sarcoidosis/complicaciones , Enfermedades Cutáneas Papuloescamosas/complicaciones , Neoplasias de la Vejiga Urinaria/complicaciones , Carcinoma de Células Transicionales/terapia , Femenino , Humanos , Persona de Mediana Edad , Remisión Espontánea , Sarcoidosis/patología , Enfermedades Cutáneas Papuloescamosas/patología , Neoplasias de la Vejiga Urinaria/terapiaRESUMEN
Impairments in taste perception may be caused by a number of factors, including the presence of Candida albicans in the oral cavity. We attempted to establish whether the presence of Candida albicans on the tongue is a cause of taste disorders by studying taste disorders in patients with candidosis of the tongue and in healthy "carriers" and "non-carriers" of C. albicans. Taste disorders and their severity were objectively assessed by the filter-paper disk method in 18 patients with candidosis of the tongue and in 33 healthy "carriers" and 167 healthy "non-carriers" of C. albicans. The gustatory function was re-tested in 7 patients and 8 "carriers" after treatment with topical anti-mycotic medication to detect any improvement. Patients with candidosis of the tongue and "carriers" of C. albicans demonstrated significantly higher incidences (p<0.001) of taste disorders than did "non-carriers". The mean taste threshold of each of the four individual taste qualities was significantly higher in patients with candidosis than in "non-carriers". The average taste threshold was significantly higher in "carriers" than in "non-carriers". Post-treatment improvement or recovery from taste disorders was obtained in 5 out of 7 patients (71.4%) with candidosis and in 7 out of 8 "carriers" (87.5%) of C. albicans. This study clearly demonstrates that not only overt candidosis of the tongue but also commensal harboring of C. albicans is a cause of taste disorders.
Asunto(s)
Candidiasis Bucal/complicaciones , Portador Sano/microbiología , Trastornos del Gusto/microbiología , Enfermedades de la Lengua/microbiología , Administración Tópica , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Antifúngicos/administración & dosificación , Antifúngicos/uso terapéutico , Candida albicans/aislamiento & purificación , Candidiasis Bucal/tratamiento farmacológico , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores Sexuales , Gusto/efectos de los fármacos , Gusto/fisiología , Umbral Gustativo/efectos de los fármacos , Umbral Gustativo/fisiología , Lengua/microbiología , Enfermedades de la Lengua/tratamiento farmacológicoAsunto(s)
Vasculitis por IgA/terapia , Infecciones Neumocócicas/complicaciones , Choque Séptico/complicaciones , Esplenectomía , Lesión Renal Aguda/etiología , Lesión Renal Aguda/terapia , Anciano , Coagulación Intravascular Diseminada/complicaciones , Coagulación Intravascular Diseminada/terapia , Humanos , Vasculitis por IgA/etiología , Masculino , Infecciones Neumocócicas/terapia , Choque Séptico/terapia , SíndromeAsunto(s)
Vesícula/diagnóstico , Eosinofilia/diagnóstico , Eritema/diagnóstico , Enfermedades Cutáneas Genéticas/diagnóstico , Anciano , Vesícula/tratamiento farmacológico , Diagnóstico Diferencial , Eosinofilia/tratamiento farmacológico , Eritema/tratamiento farmacológico , Femenino , Técnica del Anticuerpo Fluorescente Indirecta , Glucocorticoides/uso terapéutico , Humanos , Inmunohistoquímica , Prednisolona/uso terapéutico , Enfermedades Cutáneas Genéticas/tratamiento farmacológicoRESUMEN
Eruptive pseudoangiomatosis is a skin eruption characterized by millet-sized erythema with an anemic halo appearing on exposed body areas. Insect bites, particularly mosquito bites, have been reported as one of the causes of eruptive pseudoangiomatosis. We experienced two cases of eruptive pseudoangiomatosis and the eruption was seen on the face and upper extremities of two women aged 48 and 77 years old. The two cases consented to be experimentally bitten by Culex pipiens mosquitoes and Aedes albopictus to determine if eruptive pseudoangiomatosis could be experimentally elicited by these mosquitoes. Our results showed that several minutes after a C. pipiens mosquito bite, an erythematous spot appeared on the bite site, followed by the formation of an anemic halo surrounding the erythema in 30 min; a successful reproduction of eruptive pseudoangiomatosis. The erythema lasted for more than a week and was not accompanied by any pruritus. With A. albopictus, we were able to reproduce a milder eruptive pseudoangiomatosis eruption: in case 1, a smaller erythematous spot with an ill-defined halo which disappeared within 1 week; and in case 2, an immediate response consisting of a wheal and erythema but not eruptive pseudoangiomatosis. We demonstrated that eruptive pseudoangiomatosis was the response manifested in individuals who normally did not demonstrate any immediate or delayed reaction to insect bites; and the typical eruptive pseudoangiomatosis eruption was elicited by C. pipiens mosquito bites. However, the mechanism resulting in the manifestation of eruptive pseudoangiomatosis is still unknown.
Asunto(s)
Aedes , Culex , Mordeduras y Picaduras de Insectos/complicaciones , Enfermedades Cutáneas Vasculares/etiología , Enfermedades Cutáneas Vasculares/patología , Anciano , Animales , Femenino , Humanos , Persona de Mediana EdadRESUMEN
BACKGROUND: Painful feet and lower limb dysfunction are risk factors for falling. Toenail deformities are common disorders in elderly people, but the relationship between nail deformities and lower limb function remains unclear. The aims of the present study were to assess the impairment of lower limb function in patients with deformities of the great toe and to determine whether foot care treatment is beneficial in reducing the risk of falling. METHODS: Functional tests of the lower extremities were performed in 263 adults, including patients with any of hallux valgus, ingrown nail, or pachyonychia, and volunteers. Fifty-five subjects with nail disorders of the great toe received medical foot care treatment. RESULTS: The presence of ingrown nail, pachyonychia, or tenderness of the great toe was significantly correlated with impaired postural performance and reduced muscular strength as assessed by functional tests. Medical foot care markedly reduced pain levels in the great toe and improved scores on functional tests of the lower extremities. CONCLUSIONS: Toenail disorders of the great toe cause dysfunction of the lower extremities and are likely to increase the risk of falling in daily life. Foot care management of toenail disorders has the potential to improve functional abilities in daily life, particularly in elderly individuals.
Asunto(s)
Hallux Valgus/terapia , Uñas Encarnadas/terapia , Uñas Malformadas/terapia , Dedos del Pie/anomalías , Actividades Cotidianas , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Hallux Valgus/complicaciones , Hallux Valgus/patología , Humanos , Japón , Extremidad Inferior/fisiopatología , Masculino , Persona de Mediana Edad , Debilidad Muscular/etiología , Uñas Encarnadas/complicaciones , Uñas Encarnadas/patología , Uñas Malformadas/complicaciones , Uñas Malformadas/patología , Dedos del Pie/patología , Adulto JovenRESUMEN
Atopy patch testing with Japanese cedar pollen extract has been used to investigate patients with atopic dermatitis whose condition is exacerbated by contact with Japanese cedar pollen. Comparative atopy patch testing, scratch tests, and assays for total IgE and specific IgE were performed in 74 patients with atopic dermatitis, 5 patients with Japanese cedar pollinosis and 15 control subjects. A skin biopsy was performed on any sites that were positive to Japanese cedar pollen patch test. The results after 48 h of atopy patch testing were compared with the patient's history, skin scratch test and specific IgE. Twenty-two of the 74 patients (30%) had a history of exacerbation every spring after contact with Japanese cedar. Of these patients 68% showed a positive reaction to Japanese cedar pollen extract, as did 21% of patients with atopic dermatitis without a history of exacerbation by Japanese cedar pollen, 20% of patients with Japanese cedar pollinosis without eruption and 7% of control subjects. A histological examination revealed eczematous changes and infiltration of lymphocytes and eosinophils in atopy patch testing positive sites. In conclusion, atopy patch testing with Japanese cedar pollen extract is a useful method for investigating trigger factors for eczematous skin lesions in a subgroup of patients with atopic dermatitis.