Frequency of sensitization to the individual fragrances of fragrance mix I and II according to the factors included in the MOAHLFA index.

BACKGROUND: Fragrances constitute the second most frequent cause of allergic contact dermatitis in Spain. OBJECTIVES: To determine the rate of sensitization to the individual fragrances of fragrance mix (FM) I and FM II for each of the demographic and clinical factors included in the MOAHLFA (male, occupational dermatitis, atopic dermatitis, hand dermatitis, leg dermatitis, facial dermatitis, age) index. METHODS: We conducted a 5-year retrospective study in 23 Spanish centres. We identified the patients who had undergone patch testing with a specific fragrance series after reacting positively to fragrance markers in a baseline series. We obtained the MOAHLFA index items in this population, then calculated for each demographic and clinical factor the frequencies of sensitization to the individual fragrances of FM I and FM II. RESULTS: A specific fragrance series was patch tested in 1013 patients. The most frequent allergens in men, women, children, and retired people were Evernia prunastri (16%), geraniol (16.6%), isoeugenol (17.9%), and geraniol (22.4%), respectively. Citral (20.5%) and hydroxyisohexyl 3-cyclohexene carboxaldehyde (HICC) (14.5%) were the most common allergens in occupational eczemas and were also associated with a large proportion of hand and facial dermatitis. CONCLUSIONS: Frequency of sensitization to the individual fragrances of FM I and FM II varies with age, sex, affected body region, and history of occupational or atopic dermatitis.

Sensitization to fragrances in Spain: A 5-year multicentre study (2011-2015).

BACKGROUND: Fragrance chemicals constitute the second most frequent cause of contact allergy in Spain. There are no data available concerning the individual fragrances that are most frequently involved. OBJECTIVES: To describe the diagnostic contribution provided by specific fragrance series to the results obtained with baseline series fragrance markers by correlating the results of both series. MATERIALS AND METHODS: We performed a 5-year retrospective study of fragrance marker-positive patients tested with specific fragrance series in 23 Spanish centres. We collected the demographic and clinical characteristics, and compared the results of patch tests obtained from different suppliers. RESULTS: Of 19 588 patients patch tested with the Spanish baseline series, 1590 (8.1%) reacted positively to a fragrance marker. Of these, 1013 (63.7%) were patch tested with a fragrance series, and 664 patients reacted positively to at least one individual fragrance other than hydroxyisohexyl 3-cyclohexene carboxaldehyde. Geraniol was the most frequent allergen. Positive reactions to substances not included in fragrance mix (FM) I or FM II were found in 230 patients. Of the 436 FM I-positive patients and the 419 FM II-positive patients, 184 (42%) and 64 (39.1%), respectively, had no positive reactions to fragrance series. In the case of FM I, negative results were more common when individual fragrances were patch tested at low concentrations. CONCLUSIONS: We recommend patch testing all patients positive for any fragrance marker with a specific fragrance series. The correlation between the results of baseline series and fragrance series could be improved by increasing the concentrations of individual fragrances.

Contact sensitization to limonene and linalool hydroperoxides in Spain: a GEIDAC* prospective study.

BACKGROUND: Limonene and linalool are common fragrance terpenes widely used in cosmetic, household and hygiene products. Their primary oxidation products formed after air exposure, the hydroperoxides, have been recognized as important contact haptens. OBJECTIVES: To investigate the prevalence of contact allergy to hydroperoxides of limonene (Lim-OOHs) and hydroperoxides of linalool (Lin-OOHs) in Spain, and to define the optimal concentration for screening in consecutive patients. METHODS: Three different concentrations of Lim-OOHs (0.1%, 0.2% and 0.3% pet.) and Lin-OOHs (0.25%, 0.5% and 1.0% pet.) were simultaneously tested in 3639 consecutive patients at 22 departments of dermatology in Spain. RESULTS: Lim-OOHs at 0.1%, 0.2% and 0.3% yielded positive patch test reactions in 1.4%, 3.4% and 5.1% of the tested patients, respectively; and Lin-OOHs at 0.25%, 0.5% and 1.0% yielded positive reactions in 1.3%, 2.9% and 4.9% of the tested patients, respectively. Few irritant (1.5-1.9%) and doubtful reactions (0.4-0.5%) to both terpene hydroperoxides were registered at the highest concentrations tested. CONCLUSIONS: Lim-OOHs and Lin-OOHs can be considered as common causes of contact allergy, and their inclusion in an extended baseline patch test series therefore seems to be appropriate. The patch test preparations of Lim-OOHs 0.3% pet. and Lin-OOHs 1.0% pet. are useful tools for screening of contact sensitization.

Muir-Torre syndrome.

Muir-Torre syndrome (MTS) is an autosomal dominant genodermatosis that consists of unusual cutaneous sebaceous neoplasm, with or without kerathoacantomas and one or more low-grade visceral malignancies, with or without colonic polyps, in the absence of other predisposing factors. This chapter presents a review of the principal clinical and genetic findings in this syndrome and discusses its relation with Lynch syndrome.

Automatic incident detection on freeways based on Bluetooth traffic monitoring.

A novel automatic incident detection (AID) method for freeways, based on the use of data provided by Bluetooth sensors and an unsupervised anomaly detection approach, is presented. The two main advantages of the proposed AID system are: (i) the use of Bluetooth sensors offers several practical advantages over inductive loop detectors (ILD), which is one of the preferred sensing technology for traffic flow; and (ii) the unsupervised anomaly detection approach builds a model without the need of incident information. A common problem when designing an AID system is that incident information, i.e., ground-truth data, with enough accuracy is seldom available. Isolation forest is the unsupervised anomaly detection approach adopted in this work. This method is based on characterizing anomalous traffic conditions by exploiting the fact that anomalies tend to be isolated. The most remarkable feature of this anomaly detection method is its high detection performance while having a very simple tuning procedure and an extremely low computational demand. Finally, the effectiveness of the presented AID method is demonstrated using real traffic data collected by a network of Bluetooth sensors installed in Ayalon Highway, Tel Aviv.

Shoe contact dermatitis from dimethyl fumarate: clinical manifestations, patch test results, chemical analysis, and source of exposure.

BACKGROUND: The methyl ester form of fumaric acid named dimethyl fumarate (DMF) is an effective mould-growth inhibitor. Its irritating and sensitizing properties were demonstrated in animal models. Recently, DMF has been identified as responsible for furniture contact dermatitis in Europe. OBJECTIVE: To describe the clinical manifestations, patch test results, shoe chemical analysis, and source of exposure to DMF-induced shoe contact dermatitis. PATIENTS, MATERIALS, AND METHODS: Patients with suspected shoe contact dermatitis were studied in compliance with the Declaration of Helsinki. Patch test results obtained with their own shoe and the European baseline series, acrylates and fumaric acid esters (FAE), were recorded according to international guidelines. The content of DMF in shoes was analysed with gas chromatography and mass spectrometry. RESULTS: Acute, immediate irritant contact dermatitis and non-immunological contact urticaria were observed in eight adults and two children, respectively. All the adult patients studied developed a delayed sensitization demonstrated by a positive patch testing to DMF < or = 0.1% in pet. Cross-reactivity with other FAEs and acrylates was observed. At least 12 different shoe brands were investigated. The chemical analysis from the available shoes showed the presence of DMF. CONCLUSION: DMF in shoes was responsible for severe contact dermatitis. Global preventive measures for avoiding contact with DMF are necessary.

A PI tuning rule for integrating plus dead time processes with parametric uncertainty.

A novel method to tune a Proportional-Integral (PI) compensator for an integrating plus dead time (IPDT) process, in presence of interval parametric uncertainty, is presented. The design is based on optimization of load disturbance rejection with constraints on the magnitude of the sensitivity and complementary sensitivity functions, that must be satisfied for any element belonging to a set of plants. Instead of solving this problem with a brute force approach (grid the uncertainty set), we prove that this problem can be solved by considering only two plants. That lets us to obtain a tuning rule, after using some approximations. To conclude, some examples will be given in order to elucidate the usefulness of the proposed tuning rule.

Reticular telangiectatic erythema associated with an implantable cardioverter defibrillator.

Reticular telangiectatic erythema (RTE) is a skin reaction associated with implantable cardiac devices (ie, pacemakers and cardioverter defibrillators). We present a patient who developed an erythematous patch over the implantable cardioverter defibrillator site. We discuss the clinical features, histologic findings, and patch testing of this entity.

Localized bullous pemphigoid overlying a fistula for hemodialysis.

Two cases of bullous pemphigoid exclusively limited to the skin overlying a hemodialysis fistula in patients with chronic renal failure are reported. This is an unusual association, but should be taken into account in the differential diagnosis of bullous disorders among patients on hemodialysis. We hypothesize about the pathogenesis of this process.

Influence of loss of function MC1R variants in genetic susceptibility of familial melanoma in Spain.

We explored the presence of germline alterations in CDK4 exon 2, CDKN2A and MC1R in a hospital-based study of 89 melanoma cases from 89 families with at least two members affected by cutaneous melanoma. A total of 30% of the melanoma kindreds studied were carriers of CDKN2A variants, and three of these variants were known predominant alleles that have been identified earlier in Mediterranean populations (p.G101W, p.V59G and c.358delG). We observed a higher frequency of nonsynonymous MC1R variants in these Spanish melanoma kindreds (72%) with respect to the general population (60%). We observed a higher frequency of nonsynonymous MC1R variants in this Spanish melanoma kindred (72%) respect to general population (60%). A new classification of MC1R variants based on their functional effects over melanocortin-1 receptor, including the dominant-negative effect of some of them in heterozygotes, suggested an association of loss of function MC1R variants and multiple primary melanoma cases from melanoma kindred (odds ratio: 6.07, 95% confidence interval: 1.35-27.20). This study proposes the relevance of loss of function MC1R variants in the risk of melanoma in multiple primary melanoma cases with family history from areas with low melanoma incidence rate.

[Pseudovascular squamous cell carcinoma]. / Carcinoma epidermoide pseudovascular.

The adenoid form of squamous cell carcinoma is a neoplasm that is characterized by the fact that it presents a pseudoglandular pattern in the histological study. The biological phenomenon that explains this histological pattern is acantholysis; when the latter is massive, the tumor may even mimic a vascular proliferation, and is known as pseudovascular squamous cell carcinoma. This tumor has the clinical characteristics of a squamous cell carcinoma, but histologically, it may mimic an angiosarcoma. Most cases of pseudovascular squamous cell carcinoma of the skin have a poor prognosis.

[Nail disorders from epothilone]. / Alteraciones ungueales por epotilona.

We present the cases of two patients diagnosed with non-microcytic lung carcinoma who were treated with epothilone, a new chemotherapeutic agent which disrupts microtubule dynamics. The first one developed nail symptoms consisting of painful nails with a hemorrhagic appearance, which developed into significant structural disorders and onycholysis of all of the fingernails. The patient required antibiotic treatment for the associated paronychia and surgical removal of some of the nails. In the second case, asymptomatic dyschromia of the toenails appeared, with no inflammatory component. These findings show the similarity of the adverse effects of epothilone with those of the taxanes.