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1.
Article in English | WPRIM | ID: wpr-1031008

ABSTRACT

Background@#Allergic contact dermatitis (ACD) is a common skin inflammatory reaction occurring at the site of challenge with a contact allergen in sensitized individuals and one of the most common causes for consultation in dermatology clinics. Patch testing is a method for detecting the causative component in suspected cases of ACD. Awareness about the causative allergen aids in reducing morbidity and can significantly minimize the impact of ACD in the affected people. @*Objectives@#The study aimed to measure the number of relevant positive reactions in patch tests being performed in our institution in patients with ACD to cosmetic products.@*Methods@#A total of 60 patients who were diagnosed with ACD to cosmetics and underwent patch testing were reviewed to identify the clinico‑epidemiological and patch test profiles of these patients.@*Results@#The study showed that the mean age of patients was 42 comprising mostly of females. Most of the patients were unemployed, office workers, and medical workers. The most common cosmetic products that caused ACD include soaps, shampoos, lotions, and moisturizers. Nickel is still the most tested positive among these patients, followed by fragrance mixes and 4‑phenylenediamine base. They are widely distributed in cosmetic products, especially in soaps and lotions. The pattern of dermatitis revealed facial dermatitis to be the most common reason for consult of these patients.@*Conclusion@#Patch test is valuable in the setting of establishing the etiology of ACD to cosmetic products.


Subject(s)
Dermatitis, Allergic Contact , Cosmetics , Patch Tests
2.
Article in Chinese | WPRIM | ID: wpr-985449

ABSTRACT

In China, the current standard for cosmetic adverse reactions related skin disease (GB/T 17149.1-1997) was jointly issued by the Ministry of Health and the State Bureau of Technical Supervision in 1997, cosmetic-allergic adverse reactions include allergic contact dermatitis and photo-allergic contact dermatitis according to this standard. The increasing use and changes in cosmetic ingredients or formula lead to a significant increase for the incidence of adverse reactions as the cosmetics industry is developing rapidly in the last 20 years. In the meantime, the clinical manifestations have become more diverse. In recent years, there have been many reports on the special manifestations for cosmetic allergy and allergen test, which provide a reference for the subsequent improvement of the diagnosis and prevention.


Subject(s)
Humans , Patch Tests/adverse effects , Dermatitis, Allergic Contact/therapy , Cosmetics/adverse effects , China , Incidence , Allergens/adverse effects
3.
Article in Portuguese | LILACS | ID: biblio-1532958

ABSTRACT

Objetivos: própolis é a substância resinosa que as abelhas coletam de plantas para a construção de suas colmeias. O objetivo dessa revisão foi ressaltar a importância do diagnóstico de dermatite de contato relacionada com própolis e aspectos clínicos relevantes dessa doença. Métodos: revisão narrativa da literatura realizada através da pesquisa nas bases de dados National Library of Medicine (PubMed) e Scientific Eletronic Library Online (SciELO). Resultados: foram encontrados 246 artigos e, após o processo de seleção e leitura, foram incluídas 32 publicações. Conclusões: a hipersensibilidade tardia ao própolis é de extrema importância pois a prevalência dessa alergia é crescente em diversas partes do mundo. Precisamos de estudos nacionais para avaliar nossa realidade. A comprovação de alta prevalência em nosso meio permitirá a inclusão desta substância em outras baterias de testes de contato em nosso país


Aims: propolis is the resinous substance that bees collect from plants to build their hives. The aim of this review was to highlight the importance of diagnosing propolis-related contact dermatitis and relevant clinical aspects of this disease. Methods: narrative literature review carried out by searching the National Library of Medicine (PubMed) and Scientific Electronic Library Online (SciELO) databases. Results: a total of 246 articles were found and, after the selection and reading process, 32 publications were included. Conclusions: delayed-type hypersensitivity to propolis is extremely important because the prevalence of this allergy is increasing in various parts of the world. We need national studies to assess our reality. Proof of the high prevalence in our country will allow this substance to be included in other patch tests series in our country


Subject(s)
Patch Tests , Dermatitis, Contact , Propolis , Hypersensitivity
5.
An. bras. dermatol ; An. bras. dermatol;96(6): 706-711, Nov.-Dec. 2021. tab, graf
Article in English | LILACS | ID: biblio-1355619

ABSTRACT

Abstract Background: Despite being widely used in different areas of dermatology, there have been few studies evaluating the benefit of dermoscopy in the interpretation of patch tests, especially in weak and doubtful reactions. Objectives: To evaluate the role of dermoscopy in the interpretation of patch tests and describe the main findings of the reactions. Method: Prospective study, carried out in dermatology reference centers in southern Brazil, which evaluated the final results of patch tests analyzed with the aid of dermoscopy. Results: 77 patients and 160 reactions were included. The most prevalent substances were nickel sulphate (23.8%), kathon CG (9.4%), and perfume mix (8.8%). The main dermoscopic findings were reaction area greater than half of the chamber site (90%), homogeneous erythema (86.9%), vesicles (30%), crusts (21.3%), perifollicular erythema (35%), pore reaction (19.4%) and pustules (8.8%). Dermoscopy was found to facilitate the definition of erythema in reactions on black skin and when due to substances with deposition of pigment. Of the 64 weak or doubtful reactions, 36 (56.25%) showed a change in the final result after dermoscopy evaluation; of the 36 doubtful reactions, 33 (91.6%) showed a change in the final result after dermoscopy evaluation (p < 0.001). Study limitations: The probable limitation of the study is its sample size. Though certain significance levels have been reached, other possible relationships may not have been observed. Conclusion: Dermoscopy improves significantly the interpretation of patch tests, especially in weak and doubtful reactions.


Subject(s)
Humans , Dermatitis, Allergic Contact , Dermoscopy , Patch Tests , Prospective Studies , Erythema
6.
Arq. Asma, Alerg. Imunol ; 5(3): 314-317, jul.set.2021. ilus
Article in Portuguese | LILACS | ID: biblio-1399408

ABSTRACT

A erupção pigmentar fixa (EPF) é uma reação cutânea adversa a drogas relativamente comum, envolvendo cerca de 10% de todas as reações de hipersensibilidade a medicamentos (RHM). Envolve uma reação imunológica não imediata, mediada por células T CD8+ sensibilizadas, relacionada ao mecanismo do tipo IVc na classificação de Gell e Coombs. Um dos grupos mais frequentemente implicados nesse tipo de reação é o dos antiinflamatórios. Relatamos o caso de um homem que, 24 horas após iniciar tratamento com nimesulida para lombalgia, apresentou um quadro de lesões cutâneas tipo máculas eritemato-violáceas bem delimitadas e disseminadas pelo corpo. A nimesulida é um fármaco anti-inflamatório não esteroidal (AINE) pertencente à classe das sulfonanilidas, que atua como inibidor seletivo da enzima da síntese de prostaglandina, a ciclo-oxigenase, inibindo preferencialmente a COX-2. O diagnóstico foi comprovado pela realização do teste de contato, também conhecido como patch test, que traduziu positividade na segunda leitura realizada após 72 horas da sua colocação.


Fixed pigmented erythema (FPE) is a relatively common adverse drug reaction, consisting of approximately 10% of all drug hypersensitivity reactions. It involves a non-immediate immune reaction mediated by sensitized CD8+ T cells and related to the type IVc mechanism in the Gell-Coombs classification. One of the groups most frequently involved in this type of reaction is that of anti-inflammatory drugs. We report the case of a man who, 24 hours after starting treatment with nimesulide for low back pain, presented with well-defined cutaneous lesions consisting of erythematous-violaceous macules and spread throughout the body. Nimesulide is a non-steroidal anti-inflammatory drug (NSAID) belonging to the sulfonanilide class that acts as a selective inhibitor of the prostaglandin synthesis enzyme, cyclooxygenase (COX), preferentially inhibiting COX-2. The diagnosis was confirmed by a patch test, which translated positively in the second reading performed 72 hours after its placement.


Subject(s)
Humans , Male , Middle Aged , Anti-Inflammatory Agents, Non-Steroidal , Drug Hypersensitivity , Erythema , Therapeutics , Patch Tests , Prostaglandin-Endoperoxide Synthases , Low Back Pain , Diagnosis , Drug-Related Side Effects and Adverse Reactions
7.
Rev. méd. Minas Gerais ; 31: 31405, 2021.
Article in Portuguese | LILACS | ID: biblio-1291368

ABSTRACT

A metilisotiazolinona (MI) é um conservante presente em produtos químicos de limpeza e cosméticos na forma isolada ou associada à metilclorotiazolinona (MCI/MI). Seu uso tem sido associado ao aumento progressivo de casos de dermatite alérgica de contato (DAC) no mundo, constituindo uma das principais causas dessa entidade. O diagnóstico padrão-ouro de DAC a essa substância é realizado pelo teste de contato. No Brasil, a bateria padrão contempla apenas o composto MCI/MI, não avaliando isoladamente a MI. Relatamos caso clínico de uma paciente com eczema crônico predominante em mãos, que possuía nexo ocupacional com utilização de produtos de limpeza, tendo apresentado teste de contato, através da bateria Latino-Americana, fortemente positivo (+++) à MI 0,2% e negativo para MCI/MI. Objetivamos demonstrar a importância da inclusão da metilisotiazolinona, de forma isolada, na bateria padrão brasileira para maior sensibilidade diagnóstica, além da necessidade de especificação da presença desse conservante em produtos de limpeza.


Methylisothiazolinone (MI) is a preservative present in cleaning and cosmetic products, in the isolated form or associated to methylchloroisothiazolinone (MCI/MI). Its use has been associated with the progressive increase in cases of allergic contact dermatitis (ACD) in the world, constituting one of the main causes of this entity. The gold standard diagnosis of ACD for this substance is performed by the patch test. In Brazil, the baseline series only includes the MCI / MI compound, not evaluating the MI alone. We case report of a patient with predominant chronic eczema on the hands, who had an occupational nexus with the use of cleaning products, having presented a patch test, through the Latin American series, extremely positive for 0.2% MI (+++) and negative for the MCI/MI. We aim to demonstrate the importance of including methylisothialzoninone, in isolation, in the Brazilian baseline series for greater diagnostic sensitivity, in addition to the need to specify the presence of this preservative in products.


Subject(s)
Female , Adult , Dermatitis, Allergic Contact , Wounds and Injuries , Patch Tests , Chemical Compounds/adverse effects , Eczema , Additives in Cosmetics , Hypersensitivity
8.
Article in Portuguese | LILACS | ID: biblio-1292407

ABSTRACT

OBJETIVO: Dermatite de contato é doença inflamatória cutânea, não infecciosa, prevenível, que afeta a qualidade de vida do indivíduo, ocorrendo após exposição de substâncias prejudiciais à pele. Pode ser alérgica ou irritativa. É a principal causa de doença cutânea ocupacional. A pandemia de Covid-19 afeta as pessoas de diferentes maneiras mexendo com paradigmas laborais e recreacionais. Objetivamos alertar que importantes alergias inaparentes podem se manifestar pela alteração da rotina individual transformando hobby em atividade ocupacional decorrente da epidemia global causada pelo SARS-CoV-2. DESCRIÇÃO DO CASO: Relatamos um caso do sexo masculino que desenvolveu há 8 meses, intenso eczema de mãos após mudança de hábito relacionado ao isolamento social. Negava atopia. Clinicamente apresentava marcada dermatite com hiperemia, fissuras, erosões, num padrão conhecido como de pinçamento. Ele que exercia atividade laboral extradomiciliar, passou a ficar recluso trocando sua atividade anteriormente de lazer para atividade ocupacional. Feito teste de contato, utilizando-se da bateria padrão Latino-Americana, constatou-se forte reação em 48 e 96 horas para a resina epóxi de bisfenol A. CONCLUSÃO: Mostramos que a pandemia do Covid-19, mesmo indiretamente, é capaz de revelar alergias ocultas pela alteração das atividades ocupacionais desempenhadas pelos indivíduos.


AIMS: Contact dermatitis is a non-infectious, preventable skin inflammatory disease that affects the quality of life of the individual, occurring after exposure to substances harmful to the skin. It can be allergic or irritating. It is the main cause of occupational skin disease. The Covid-19 pandemic affects people in different ways by messing with occupational and recreational paradigms. We aim to warn that important unapparent allergies can manifest themselves by the alteration of the individual routine transforming hobby into occupational activity due to the global epidemic caused by SARS-CoV-2. CASE DESCRIPTION: We report a male case that developed eigth months ago, severe hand eczema after a habit change related to social isolation. He denied atopy. Clinically he presented marked dermatitis with hyperemia, cracks, erosions, in a pattern known as clamping. He, who exercised extradomic labor activity, became a recluse changing his previous activity from leisure to occupational activity. A patch test, using the Latin American baseline series, showed a strong reaction in 48 and 96 hours for the bisphenol A epoxy resin. CONCLUSION: We have shown that the Covid-19 pandemic, even indirectly, can reveal hidden allergies due to altered occupational activities performed by individuals.


Subject(s)
Humans , Male , Dermatitis, Allergic Contact , Patch Tests , Pandemics
9.
Article in Portuguese | LILACS | ID: biblio-1359467

ABSTRACT

RESUMO: Dermatite alérgica de contato é uma doença cutânea inflamatória, não infecciosa, cuja base do tratamento é a identificação e eliminação do agente causal. Cocoamidopropil betaína é um surfactante muito utilizado nos produtos de uso pessoal, notadamente de uso capilar. Essa substância não está presente na bateria padrão brasileira. Neomicina é um antibiótico usado em preparações tópicas. Objetivamos mostrar paciente que desenvolveu alergia no couro cabeludo e que fez erroneamente automedicação com produto que continha substância a qual era ainda mais sensível. O caso é de uma mulher, 36 anos, evoluindo há dois meses com eczema pruriginoso, em áreas de implantação capilar e nuca. Relatava progressiva piora. Diante da suspeita de dermatite de contato, foi realizado teste de contato, utilizando-se da bateria padrão Latino-Americana. Com 96 horas (D4) evidenciou-se positividade leve (+) para cocoamidopropil betaína e forte (++) para neomicina. O resultado positivo para a neomicina foi intrigante, uma vez que a observação do rótulo dos produtos de uso pessoal não a continha. Diante do resultado do teste, após ser questionada novamente, ela confirmou a omissão da automedicação diária com pomada de neomicina. Em conclusão, mostramos a alergia a produtos de uso capilar. Reforçamos a necessidade de se fazer um teste de contato com bateria padrão atualizada. Por fim, alertamos sobre o risco da automedicação. (AU)


ABSTRACT: Allergic contact dermatitis is an inflammatory, non-infectious skin disease. The treatment is based on the identification and elimination of the causal agent. Cocamidopropyl betaine is a surfactant widely used in products for personal use, especially capillary use. This substance is not present in the Brazilian baseline series. Neomycin is an antibiotic used in topical preparations. We aimed to show a patient who developed na allergy in the scalp and mistakenly self-medicated with a product that contained a substance to which it was even more sensitive. The case is of a woman, 36 years old, evolving for 2 months with pruritic eczema, in areas of capillary and nape implantation. She reported progressive worsening. When contact dermatitis was suspected, a contact test was performed using the Latin American baseline series. At 96 hours (D4) there was mild positivity (+) for cocamidopropyl betaine and strong (++) for neomycin. The positive result for neomycin was intriguing, since the observation of the label of products for personal use did not contain it. In view of the test result, after being questioned again, she confirmed the omission of daily self-medication with neomycin ointment. In conclusion, we showed the allergy to hair products. We reinforced the need for an updated baseline series patch test. Finally, we warned about the risk of self-medication. (AU)


Subject(s)
Humans , Female , Adult , Scalp , Self Medication , Skin Diseases, Infectious , Patch Tests , Neomycin/therapeutic use , Dermatitis, Allergic Contact/diagnosis , Dermatitis, Allergic Contact/therapy
10.
An. bras. dermatol ; An. bras. dermatol;95(6): 766-767, Nov.-Dec. 2020. tab, graf
Article in English | LILACS, ColecionaSUS | ID: biblio-1142112
11.
An. bras. dermatol ; An. bras. dermatol;95(6): 696-701, Nov.-Dec. 2020. tab
Article in English | LILACS, ColecionaSUS | ID: biblio-1142127

ABSTRACT

Abstract Background: Cosmetics are part of the daily life of the population, and their use can lead to allergic contact dermatitis. Objectives: To assess the profile of patients diagnosed with allergic contact dermatitis to cosmetics treated at a referral center for 13 years, as well as the characteristics of the clinical picture and allergens involved. Methods: This was a retrospective study, with analysis of medical records of patients attended at this service. The individuals included had a diagnostic hypothesis of allergic contact dermatitis to cosmetics and had previously been submitted to epicutaneous tests. Results: A total of 1405 medical records were analyzed, 403 (28.7%) with suspected allergic contact dermatitis to cosmetics and 232 (16.5%) with confirmed diagnosis. Of these, 208 (89.7%) were women, and the age group most affected was 31 − 60 years. The most common locations were face in 195 cases (25.8%), cervical region in 116 (15.3%), and trunk in 96 (12.6%). The main allergens in the contact tests were toluene-sulfonamide-formaldehyde resin in 69 cases (29.7%), paraphenylenediamine in 54 (26.3%), Kathon CG® in 41 (20.7%), and fragrance-mix 1 in 29 (16.4%). In 154 (66.4%) of the 232 patients with a confirmed diagnosis of allergic contact dermatitis to cosmetics it was possible to specify the cosmetic product responsible for the lesions. Study limitations: The absence of some allergens considered important in the world as causes of allergic contact dermatitis, which are not readily accessible among us. Conclusions: The data of the analyzed population (predominance of young women), as well as the location of the lesions (face and cervical area) and the main allergens involved were consistent with those from the world literature.


Subject(s)
Humans , Female , Dermatitis, Allergic Contact/diagnosis , Dermatitis, Allergic Contact/etiology , Dermatitis, Allergic Contact/epidemiology , Cosmetics/adverse effects , Patch Tests , Allergens/adverse effects , Retrospective Studies
13.
Arq. Asma, Alerg. Imunol ; 4(2): 213-215, abr.jun.2020. ilus
Article in English | LILACS | ID: biblio-1381929

ABSTRACT

Erythema multiforme is generally associated with infections and drugs. Although less common, there are also reported cases of this disorder after patch testing. We described a 22 year-old female patient who, 24 hours after patch testing, progressed to erythematous iris-shaped plaques and papules with central crust, symmetrically distributed over her hands, arms, and back, with severe itch. The erythema multiforme-like lesions presented in the case were interpreted as a manifestation of systemic allergic contact dermatitis secondary to the exam. Allergic contact dermatitis may be manifested as an erythema multiforme in a hypersensitive person. Few cases of systemic allergic contact dermatitis after patch testing have been reported, for example, due to diethyl thiourea, some textile disperse dyes, and povidoneiodine. The development of erythema multiforme is not noted in most literature references as a complication after patch testing. Although unusual, this disorder needs to be considered as a potential adverse effect of this exam.


O eritema multiforme está associado comumente a infecções e medicamentos. Embora menos comum, também há casos relatados dessa doença após aplicação do teste de contato. Descrevemos uma paciente de 22 anos que evoluiu, em 24 horas após o teste, com placas e pápulas eritematosas, em formato de íris e crosta central, distribuídas simetricamente nas mãos, braços e costas, além de prurido intenso. As lesões eritema multiformesímile presentes no caso foram interpretadas como uma manifestação alérgica secundária ao exame. Dermatite de contato alérgica pode se manifestar como um eritema multiforme em pessoas hipersensíveis. Poucos casos de dermatite alérgica de contato sistêmica foram relatados após este exame, por exemplo, devido às seguintes substâncias: dietil tioureia, corantes dispersos têxteis e iodopovidona. O desenvolvimento do eritema multiforme não é usualmente apontado como uma complicação do teste de contato alérgico, na maioria das referências literárias. Embora incomum, o surgimento dessa desordem após este exame necessita ser considerado como um efeito adverso.


Subject(s)
Humans , Female , Young Adult , Patch Tests , Patch Tests/adverse effects , Erythema Multiforme , Dermatitis, Allergic Contact , Arm , Pruritus , Back , Prednisolone , Coloring Agents , Hand
15.
An. bras. dermatol ; An. bras. dermatol;95(2): 194-199, Mar.-Apr. 2020. tab, graf
Article in English | LILACS, ColecionaSUS | ID: biblio-1130847

ABSTRACT

Abstract Background: Kathon CG, a combination of methylchloroisothiazolinone and methylisothiazolinone, is widely used as preservative in cosmetics, as well in household cleaning products, industrial products such as paints and glues. It has emerged as an important sensitizing agent in allergic contact dermatitis. Objectives: This study evaluated the reactivity to this substance in patients subjected to patch tests at the Dermatology Institute in Bauru, São Paulo from 2015 to 2017 and its correlation with other preservatives, the professional activity and location of the lesions. Methods: The patients were submitted to standard series of epicutaneous tests, standardized by the Brazilian Group Studies on Contact Dermatitis. Results: Out the 267 patients tested, 192 presented positivity to at least one substance and 29 of the patients (15.10%) presented reaction to Kathon CG, with predominance of the female gender (n = 27); main professional activity associated with Kathon CG sensibilization was cleaning (17.24%), followed by aesthetic areas (13.79%) and health care (10.34%). The most prevalent sensitizations among the substances tested were nickel sulphate (56.3%), followed by cobalt chloride (23.4%), neomycin (18.2%), potassium dichromate (17.7%), thimerosal (14.5%), formaldehyde (13.2%), paraphenylenediamine (9.3%), and fragrance mix (8.3%). Study limitations: We do not have data from patients that were submitted to patch test a decade ago in order to confront to current data and establish whether or no sensitization to Kathon CG has increased. Conclusion: High positivity to Kathon CG corroborates the recent findings in the literature, suggesting more attention to concentration of this substance, used in cosmetics and products for domestic use.


Subject(s)
Thiazoles/analysis , Patch Tests/methods , Dermatitis, Allergic Contact/diagnosis , Preservatives, Pharmaceutical/adverse effects , Preservatives, Pharmaceutical/chemistry , Thiazoles/adverse effects , Brazil , Patch Tests/statistics & numerical data , Logistic Models , Retrospective Studies , Dermatitis, Allergic Contact/etiology , Statistics, Nonparametric , Cosmetics/adverse effects , Cosmetics/chemistry , Middle Aged
16.
An. bras. dermatol ; An. bras. dermatol;95(1): 15-19, Jan.-Feb. 2020. graf
Article in English | LILACS | ID: biblio-1088732

ABSTRACT

Abstract Background: Palmoplantar pustulosis is a chronic and relapsing disease of the palms and soles, which is characterized by scattered clusters of pinhead-sized, sterile pustules. Objective: The aim of the present study was to determine demographic features, co-morbidities, and relation of palmoplantar pustulosis with psoriasis. Methods: A total of 48 patients (M/F: 15/33) were enrolled in the present study. A detailed history regarding age of onset, palmoplantar pustulosis duration, number of recurrences, personal and family history of psoriasis, accompanying arthritis, sternoclavicular tenderness, dental fillings, smoking status, and autoimmune disease was obtained; thorough dermatological examination was carried out. Patch testing results and laboratory investigations for thyroid autoimmunity were recorded. Results: Thirty-five of 48 patients (72.9%) were current smokers. Twenty of the 48 patients (41.7%) had dental fillings. There was not any significant correlation between palmoplantar pustulosis duration and dental filling duration (p = 0.170). Psoriasis was not detected in any patients either in history or in dermatological examination. Nail involvement and joint complaints were observed in seven of 48 patients (14%) and in nine of 48 patients (18%), respectively. Autoimmune thyroiditis was observed in four of 48 patients (12%). Patients with patch testing positivity (12.5% of patients, M/F: 1/5) had no considerable association for history of external contact with these materials. Study limitations: Retrospective analysis. Conclusion: Palmoplantar pustulosis appears to be a distinct entity from psoriasis. Routine thyroid functions test could be analyzed, but patch testing is not required in patients with palmoplantar pustulosis. Also, patients with palmoplantar pustulosis must be evaluated for musculoskeletal symptoms and signs.


Subject(s)
Humans , Male , Female , Adult , Aged , Young Adult , Psoriasis/pathology , Psoriasis/epidemiology , Psoriasis/etiology , Autoimmune Diseases/epidemiology , Turkey/epidemiology , Patch Tests , Smoking/epidemiology , Comorbidity , Cross-Sectional Studies , Retrospective Studies , Occupational Exposure , Statistics, Nonparametric , Middle Aged
17.
Article in English | WPRIM | ID: wpr-881512

ABSTRACT

@#INTRODUCTION: Pigmented contact dermatitis (PCD) is characterized by non-eczematous pigmentation associated with contact sensitizers, usually without any active or preceding pruritus and erythema. PCD was first described by Riehl, who identified patients with brown to gray facial pigmentation concentrated on the face most commonly associated with sensitizing chemical such as cosmetics, fragrances, and textiles. CASE REPORT: This is a case of a 48-year-old female Filipino who presents with blue-grey to brown patches on the forehead of 1-year duration with no significant pathologic history. Clinical examination, dermoscopy and histology were consistent with a variant of pigmented contact dermatitis known as Riehl melanosis. Since anamnesis was unremarkable, patch testing was done to identify the contact allergen triggering the symptom. Results obtained a positive reaction to nickel, potassium dichromate, and textile dye. CONCLUSION:Treatment includes the elimination of trigger factors, hence the importance of patch testing in the investigation of its cause. Alongside adequate photoprotection, a combination treatment of 1,064 nm Q-switched neodymium-doped yttrium aluminum garnet (Nd:YAG) laser, 20% tricholoacetic acid (TCA) peel and oral retinoids, were found safe and effective in the management of facial melanosis. Three-dimensional imaging and dermoscopy were utilized to obtain a more standard and objective pre- and post-treatment comparison.


Subject(s)
Lasers, Solid-State , Patch Tests , Melanosis , Skin Abnormalities , Dermatitis, Contact
18.
Rev. chil. dermatol ; 36(4): 186-193, 2020. tab, ilus
Article in Spanish | LILACS | ID: biblio-1400567

ABSTRACT

Las fotodermatosis son un conjunto de patologías cutáneas originadas o agravadas por exposición a radiación ya sea solar o artificial. Se clasifican en cuatro categorías: 1. Idiopáticas o mediadas inmunológicamente 2. Dermatosis fotoagravadas, 3. Fotosensibilidad inducida por agentes y 4. Trastornos por reparación defectuosa del ADN. La fotosensibilidad inducida por agentes consiste en reacciones secundarias a la exposición de ciertos químicos, llamados fotosensibilizadores y a distintos tipos de radiación lumínica. Los fotosensibilizadores pueden ser de origen endógeno o exógeno, aquellos exógenos provienen desde el ambiente, fármacos u otros productos (tanto sistémicos como tópicos), los cuales sufren modificaciones estructurales al entrar en contacto con radiación, provocando como consecuencia, distintas manifestaciones cutáneas. En este artículo se revisarán principalmente las reacciones fototóxicas y fotoalérgicas (ambas, reacciones de fotosensibilidad inducidas por agentes exógenos) indagando en sus diferencias y el enfrentamiento clínico de cada una. También, se revisarán los exámenes que permiten estudiar los distintos diagnósticos diferenciales, especialmente el test de fotoparches, el cual está cobrando cada vez más importancia en la práctica clínica.


Photodermatoses are a group of skin diseases induced or aggravated by exposure to radiation, whether solar or artificial. They are classified into four general categories: 1. Idiopathic or immunologically mediated photodermatoses 2. Photoexacerbated dermatoses 3. Agent induced photosensitivity 4. DNA repair defects Photosensitivity induced by agents are secondary reactions to the exposure to some chemicals, called photosensitizers, and to different types of light radiation. Photosensitizers can be classified as exogenous or endogenous. Exogenous agents come from the environment, drugs or other products (both systemic and topical), which undergo structural changes when they come into contact with radiation, causing different skin manifestations as consequence. Differences between phototoxic and photoallergic reactions (both photosensitivity reactions induced by exogenous agents), the clinical approach of each one of them, and available tests that are used to make a diagnosis, especially, photo patch test will be reviewed in this article


Subject(s)
Humans , Male , Female , Patch Tests/methods , Dermatitis, Photoallergic/diagnosis , Dermatitis, Photoallergic/etiology , Photosensitizing Agents/adverse effects , Diagnosis, Differential
19.
Arq. Asma, Alerg. Imunol ; 3(2): 151-156, abr.jun.2019. ilus
Article in Portuguese | LILACS | ID: biblio-1381188

ABSTRACT

Objetivos: Investigar o papel do patch test na avaliação da sensibilização por alimentos e no diagnóstico de alergia alimentar em pacientes com dermatite atópica (DA) e comparar duas distintas apresentações do teste. Métodos: Esse estudo prospectivo envolveu 20 crianças (mediana de idade de 8,4 anos) com dermatite atópica moderada ou grave que foram submetidas ao teste cutâneo de hipersensibilidade tardia (patch test ) com alimentos frescos e extratos comerciais, seguidos de teste de provocação oral (TPO) nos casos de resultado positivo, no intuito de avaliar a correlação clínica. Resultados: Entre os 20 pacientes avaliados, somente 4 (20%) apresentaram resultados positivos para o patch test, com maior positividade para os extratos comerciais (3/4), em comparação aos alimentos in natura. Não se observou concordância dos resultados obtidos entre as duas apresentações comparadas. Do total de 7 TPO realizados, 4 foram positivos (soja e milho para um paciente e amendoim para outros dois), com piora das lesões da DA (valor preditivo positivo de 57%). Apenas uma criança apresentou efeito adverso mais significativo. Conclusões: Embora tenha sido encontrada baixa sensibilização aos alérgenos alimentares na população estudada e discordância entre os resultados dos patch tests com alimentos frescos e extratos comerciais, o teste mostrou-se seguro. Para uma melhor análise estatística, recomenda-se estudo em população maior.


Objective: To evaluate the use of patch testing in determining food sensitization and allergy in patients with atopic dermatitis (AD) and compare two distinct assays. Method: Twenty children (median age, 8.4 years) with moderate-to-severe AD were prospectively evaluated by atopy patch test with commercial extracts and fresh food allergens. Positive results were further investigated by oral food challenge (OFC). Results: Only 4/20 patients (20%) had positive patch results, mostly to commercial extracts (3/4) compared to fresh food. There was no agreement between the results of the two presentations tested. Four of seven OFCs were positive (one patient to soy and corn, two others to peanut), with worsening AD eczema (positive predictive value of 57%). One child had a more significant side effect. Conclusion: In spite of poor sensitization rates in the study population and no observed correlation between the two presentations tested, atopy patch testing was safe. Studies with a broader population are needed for better conclusions.


Subject(s)
Humans , Child, Preschool , Child , Adolescent , Dermatitis, Atopic , Food Hypersensitivity , Paper , Patch Tests , Allergens , Predictive Value of Tests , Prospective Studies , Diagnosis , Eczema , Food , in natura Foods , Methods
20.
An. bras. dermatol ; An. bras. dermatol;94(2): 147-156, Mar.-Apr. 2019. tab, graf
Article in English | LILACS | ID: biblio-1001140

ABSTRACT

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.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Young Adult , Occupational Exposure/statistics & numerical data , Dermatitis, Allergic Contact/epidemiology , Dermatitis, Occupational/epidemiology , Potassium Dichromate/adverse effects , Socioeconomic Factors , Brazil/epidemiology , Patch Tests/statistics & numerical data , Caustics/adverse effects , Construction Industry , Sex Factors , Cross-Sectional Studies , Retrospective Studies , Occupational Exposure/adverse effects , Age Factors , Dermatitis, Irritant/etiology , Dermatitis, Irritant/epidemiology , Dermatitis, Allergic Contact/etiology , Dermatitis, Occupational/etiology , Educational Status , Hand Dermatoses/chemically induced , Hand Dermatoses/epidemiology , Irritants/adverse effects , Nickel/adverse effects
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