Assuntos
Crotonatos , Hidroxibutiratos , Erupções Liquenoides , Nitrilas , Toluidinas , Humanos , Nitrilas/efeitos adversos , Toluidinas/efeitos adversos , Crotonatos/efeitos adversos , Erupções Liquenoides/induzido quimicamente , Erupções Liquenoides/patologia , Erupções Liquenoides/diagnóstico , Feminino , Toxidermias/etiologia , Toxidermias/patologia , Pessoa de Meia-Idade , Masculino , Resultado do Tratamento , Dermatoses da Mão/induzido quimicamente , Dermatoses da Mão/diagnóstico , BiópsiaRESUMO
Contact dermatitis is a common cutaneous inflammatory condition, triggered by exposure to irritant substances or allergens. Nickel is the most prevalent allergen, a metal widely used in accessories, furniture, office materials, food and in industry, with multiple exposure pathways, making it difficult to assess which exposure is causing allergic dermatitis. Here, we report a case of an administrative worker with chronic hand eczema, limited to the radial metacarpophalangeal region of the left hand, caused by occupational exposure to nickel, confirmed by nickel deposition test on the hand and a positive test with a metallic stapler used at her workplace.
Assuntos
Dermatite Alérgica de Contato , Dermatite Ocupacional , Níquel , Feminino , Humanos , Dermatite Alérgica de Contato/etiologia , Dermatite Alérgica de Contato/diagnóstico , Dermatite Ocupacional/etiologia , Dermatite Ocupacional/diagnóstico , Dermatoses da Mão/induzido quimicamente , Dermatoses da Mão/etiologia , Níquel/efeitos adversos , Exposição Ocupacional/efeitos adversosRESUMO
We describe a patient with leukemia undergoing chemotherapy who developed painful purpuric nodules of the digits. These findings were concerning for endocarditis (clinically) and angiokeratomas on gross histology. After extensive evaluation, we report the development of painful purpuric nodules as a likely side effect of the patient's therapeutic regimen (hydroxyurea, danorubicin, cytarabine, and methotrexate).
Assuntos
Angioceratoma/induzido quimicamente , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Dermatoses da Mão/induzido quimicamente , Leucemia/tratamento farmacológico , Púrpura/induzido quimicamente , Neoplasias Cutâneas/induzido quimicamente , Angioceratoma/diagnóstico , Citarabina/administração & dosagem , Daunorrubicina/administração & dosagem , Diagnóstico Diferencial , Feminino , Dermatoses da Mão/diagnóstico , Humanos , Hidroxiureia/administração & dosagem , Metotrexato/administração & dosagem , Pessoa de Meia-Idade , Púrpura/diagnóstico , Púrpura/patologia , Neoplasias Cutâneas/diagnósticoRESUMO
ABSTRACT: A case of localized argyria in a 36-year-old female jeweler is described who presented with 2 discrete and asymptomatic bluish-black pigmented macules on the pulp of her left middle finger. A skin biopsy from both lesions demonstrated deposition of brown/black pigmented granules along the basement membrane zone of eccrine glands, blood vessels, nerves, and the dermo-epidermal junction fully in keeping with silver deposition. In addition, there was yellow-brown deposition seen within the interstitial dermis mimicking an early form of ochronosis, so called "pseudo-ochronosis." This latter feature is rarely described in cases of argyria. Transmission electron microscopy and energy dispersive x-ray spectroscopy confirmed the presence of electron dense particles up to 150 nm in diameter and the presence of silver, respectively. On further questioning, the patient had a history of localized and chronic exposure to silver, which specifically involved holding and manipulating silver wires and rings over the left middle finger. This case highlights an unusual and rare presentation of localized argyria in a jeweler. In addition, our case showed preferential silver deposition on dermal elastic fibers which has not been previously described in the literature.
Assuntos
Argiria/patologia , Dermatite Ocupacional/patologia , Joias , Adulto , Argiria/diagnóstico , Argiria/etiologia , Feminino , Dedos , Dermatoses da Mão/induzido quimicamente , Dermatoses da Mão/patologia , Humanos , Ocronose/patologiaRESUMO
A 61-year-old man with metastatic renal cell carcinoma on cabozantinib developed hand-foot skin reaction with predominantly dorsal involvement including painful violaceous plaques over the joints and keratotic yellow plaques on the palmar fingers. The medication was discontinued with resolution of the plaques and later reinitiated at a lower dose uneventfully.
Assuntos
Anilidas/efeitos adversos , Carcinoma de Células Renais/tratamento farmacológico , Dermatoses da Mão/induzido quimicamente , Neoplasias Renais/tratamento farmacológico , Inibidores de Proteínas Quinases/efeitos adversos , Piridinas/efeitos adversos , Anilidas/uso terapêutico , Biópsia , Dermatoses do Pé/induzido quimicamente , Dermatoses da Mão/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Inibidores de Proteínas Quinases/uso terapêutico , Piridinas/uso terapêutico , Receptores Proteína Tirosina Quinases/antagonistas & inibidores , Pele/patologiaAssuntos
Cobalto/efeitos adversos , Dermatite Alérgica de Contato/etiologia , Dermatoses do Pé/induzido quimicamente , Dermatoses da Mão/induzido quimicamente , Vitamina B 12/análogos & derivados , Alérgenos/efeitos adversos , Dermatite Alérgica de Contato/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Vitamina B 12/efeitos adversosRESUMO
BACKGROUND: Metal work apprentices (MWAs) frequently develop work-related hand eczema (HE). OBJECTIVES: To evaluate the effect of health education on incidence of work-related HE in MWAs and to assess confounding factors. MATERIALS/METHODS: In a prospective controlled intervention study, 131 MWAs received educational training on prevention of HE, whereas 172 MWAs and 118 office work apprentices served as controls. At baseline and during three yearly follow-ups, questionnaires were completed and hands were examined. Saliva samples were collected for assessment of filaggrin (FLG) null mutations and an explorative genome-wide association study (GWAS), and levels of various cytokines were assessed from stratum corneum samples. RESULTS: The 2-year and 3-year incidence of HE in the metalwork control group was 20.9% and 32.6%, respectively, which was significantly higher than in the intervention group (odds ratio [OR] 2.63, 95% confidence interval [CI] 1.31 to 5.28, P < .01 and OR 3.47, 95% CI 1.88 to 6.40, P < .0001). The knowledge score was higher in unaffected MWAs (P < .05). Other factors significantly associated with developing HE in MWAs were smoking cigarettes (P < .01) and FLG mutations (P < .001). No significant associations were found regarding epidermal cytokine levels and GWAS. CONCLUSIONS: Health education is effective in primary prevention of HE in MWAs. Individual factors should be considered in targeted counseling.
Assuntos
Dermatite Ocupacional/prevenção & controle , Eczema/prevenção & controle , Dermatoses da Mão/prevenção & controle , Educação em Saúde , Metalurgia , Exposição Ocupacional/prevenção & controle , Adolescente , Citocinas/metabolismo , Dermatite Alérgica de Contato , Dermatite Ocupacional/epidemiologia , Eczema/induzido quimicamente , Eczema/epidemiologia , Epiderme/metabolismo , Feminino , Proteínas Filagrinas , Seguimentos , Dermatoses da Mão/induzido quimicamente , Dermatoses da Mão/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Incidência , Capacitação em Serviço , Masculino , Mutação , Exposição Ocupacional/efeitos adversos , Estudos Prospectivos , Fatores de Risco , Proteínas S100/genética , Inquéritos e Questionários , Adulto JovemAssuntos
Dermatite Alérgica de Contato/etiologia , Dermatite Ocupacional/etiologia , Dermatoses da Mão/induzido quimicamente , Tiazóis/efeitos adversos , Adulto , Dermatite Alérgica de Contato/diagnóstico , Dermatite Ocupacional/diagnóstico , Dermatoses Faciais/induzido quimicamente , Humanos , MasculinoRESUMO
BACKGROUND: The epidemiology of nickel allergy in occupational settings is not well understood. OBJECTIVE: The aim of the study was to characterize occupationally related nickel allergy (ORNA). METHODS: This is a retrospective cross-sectional analysis of 44,378 patients patch tested by the North American Contact Dermatitis Group from 1998 to 2016. Characteristics of individuals with ORNA were compared with those with non-ORNA (NORNA). RESULTS: A total of 7928 (18.2%) individuals were positive to nickel sulfate 2.5%. Two hundred sixty-eight (3.4%) had ORNA. As compared with NORNA, ORNA was statistically associated with the male sex (41.0% vs 12.9%, P < 0.001), a diagnosis of irritant contact dermatitis (22.4% vs 12.0%, P < 0.001), and no history of eczema (81.7% vs 75.7%, P = 0.0217). The most common sites of ORNA dermatitis were hand (39.9%) and arm (18.1%), which were significantly more common than in NORNA (P < 0.0001). Sixteen industry categories and 22 occupation categories were identified for ORNA; the most common industries were durable goods manufacturing (24.6%) and personal services (15.7%), and the most frequent occupations were hairdressers/cosmetologists/barbers (14.3%), machine operators (9.3%), and health care workers (7.1%). Overall 30% of ORNA occupations were in metalworking. Of 215 ORNA sources identified, instruments/phones/other equipment (16.3%), vehicles/machinery (15.8%), and tools (15.3%) were the most common. CONCLUSIONS: Occupational nickel allergy is distinct from nonoccupational nickel allergy.
Assuntos
Dermatite Alérgica de Contato/epidemiologia , Dermatite Alérgica de Contato/etiologia , Dermatite Ocupacional/epidemiologia , Dermatite Ocupacional/etiologia , Níquel/toxicidade , Exposição Ocupacional/efeitos adversos , Adolescente , Adulto , Fatores Etários , Braço , Estudos Transversais , Dermatite Alérgica de Contato/diagnóstico , Dermatite Ocupacional/diagnóstico , Feminino , Dermatoses da Mão/induzido quimicamente , Dermatoses da Mão/epidemiologia , Humanos , Indústrias/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , América do Norte/epidemiologia , Ocupações/estatística & dados numéricos , Testes do Emplastro , Estudos Retrospectivos , Fatores Sexuais , Adulto JovemRESUMO
Capecitabine is a prodrug used primarily as a chemotherapeutic agent. Despite its good tolerance, it has several adverse effects, including the appearance of eruptive nevi. We present the case of a patient, with a history of EC IV breast adenocarcinoma and superficial extension melanoma, which developed 2 weeks after the start of therapy with capecitabine multiple eruptive palmoplantar pigmented lesions, with diverse benign dermatoscopic patterns. With the increasing incidence of solid tumors, these agents are being more used. It is important that the treating physician knows its adverse effects and apply non-invasive diagnostic tools like dermoscopy to avoid unnecessary biopsies.
La capecitabina es un profármaco utilizado sobre todo como medicamento quimioterapéutico. A pesar de su buena tolerancia, produce diversos efectos adversos como la aparición de nevos eruptivos. Se presenta el caso de una paciente, con antecedentes de adenocarcinoma de mama (EC IV) y melanoma de extensión superficial, que desarrolló dos semanas posteriores al inicio del tratamiento con capecitabina múltiples lesiones eruptivas pigmentadas palmoplantares, con patrones variados benignos a la dermatoscopia. Con el incremento de las neoplasias sólidas, estos agentes se utilizan cada vez más. Es importante que el médico tratante conozca sus efectos adversos y aplique herramientas diagnósticas no invasivas como la dermatoscopia para evitar biopsias innecesarias.
Assuntos
Antimetabólitos Antineoplásicos/efeitos adversos , Capecitabina/efeitos adversos , Dermoscopia , Toxidermias/diagnóstico por imagem , Dermatoses do Pé/induzido quimicamente , Dermatoses da Mão/induzido quimicamente , Adenocarcinoma , Antimetabólitos Antineoplásicos/uso terapêutico , Neoplasias da Mama , Capecitabina/uso terapêutico , Diagnóstico Diferencial , Toxidermias/etiologia , Feminino , Dermatoses do Pé/diagnóstico por imagem , Dermatoses da Mão/diagnóstico por imagem , Humanos , Melanoma/diagnóstico , Melanoma/tratamento farmacológico , Pessoa de Meia-Idade , Segunda Neoplasia Primária/tratamento farmacológico , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/tratamento farmacológicoAssuntos
Aromaterapia/efeitos adversos , Dermatite Alérgica de Contato/etiologia , Dermatite Ocupacional/etiologia , Dermatoses da Mão/induzido quimicamente , Óleos Voláteis/efeitos adversos , Adulto , Aromaterapia/métodos , Humanos , Lavandula , Masculino , Testes do Emplastro , Óleos de Plantas/efeitos adversosAssuntos
Dermatite Alérgica de Contato/etiologia , Dermatite Ocupacional/etiologia , Dermatoses da Mão/induzido quimicamente , Níquel/efeitos adversos , Exposição Ocupacional/efeitos adversos , Adulto , Dermatite Alérgica de Contato/diagnóstico , Dermatite Ocupacional/diagnóstico , Feminino , Dermatoses da Mão/diagnóstico , Humanos , Enfermeiras e Enfermeiros , Testes do EmplastroAssuntos
Dermatoses do Pé/induzido quimicamente , Dermatoses da Mão/induzido quimicamente , Leucemia Linfocítica Crônica de Células B/tratamento farmacológico , Pirazóis/efeitos adversos , Pirimidinas/efeitos adversos , Adenina/análogos & derivados , Feminino , Humanos , Pessoa de Meia-Idade , PiperidinasAssuntos
Antineoplásicos/efeitos adversos , Neoplasias Colorretais/tratamento farmacológico , Compostos de Fenilureia/efeitos adversos , Piridinas/efeitos adversos , Antineoplásicos/uso terapêutico , Neoplasias Colorretais/patologia , Diarreia/induzido quimicamente , Diarreia/terapia , Relação Dose-Resposta a Droga , Monitoramento de Medicamentos , Dermatoses do Pé/induzido quimicamente , Dermatoses do Pé/terapia , Dermatoses da Mão/induzido quimicamente , Dermatoses da Mão/terapia , Humanos , Hipertensão/induzido quimicamente , Hipertensão/terapia , Metástase Neoplásica , Educação de Pacientes como Assunto , Compostos de Fenilureia/uso terapêutico , Piridinas/uso terapêuticoRESUMO
Abstract: BACKGROUND: Occupational dermatoses are common, especially contact dermatitis. Epidemiological studies on these dermatoses are scarce in Brazil and they are necessary as part of the public policy to protect workers' health. OBJECTIVES: To identify sociodemographic and clinical profile of patients with occupational contact dermatitis seen between 2000 and 2014 at an occupational dermatology service. METHODS: It is a cross-sectional and retrospective study, based on information obtained from the service's database. RESULTS: Of 560 patients with conclusive patch test, 289 (46.9%) presented occupational dermatoses and 213 occupational contact dermatitis with predominance of the allergic type in relation to the irritative type (149:64 respectively). The odds of occupational dermatoses were higher among men and lower among patients aged 50 years or older and with higher level of education. Regarding the possibility of presenting occupational allergic contact dermatitis, only the gender variable was statistically significant. The professions most seen were cleaners, construction workers, painters, mechanics/metallurgists and cooks. The commonest allergens were nickel sulfate, potassium dichromate, cobalt chloride, carba-mix and formaldehyde. STUDY LIMITATIONS: The main limitations of this study are the fact that it was carried out in a tertiary service of occupational dermatoses and the lack of access to some allergens outside the patch test baseline series. CONCLUSIONS: It was possible to identify the sociodemographic and clinical profile of patients with suspected occupational contact dermatitis seen at the Service, beyond the professional groups and allergens related to a high risk of occupational contact dermatitis in this population.