Assuntos
Dor Abdominal/tratamento farmacológico , Bálsamos/efeitos adversos , Dermatite de Contato/diagnóstico , Ferula , Flatulência/tratamento farmacológico , Óleos Voláteis/efeitos adversos , Dor Abdominal/diagnóstico , Bálsamos/administração & dosagem , Cumarínicos/administração & dosagem , Cumarínicos/efeitos adversos , Flatulência/diagnóstico , Humanos , Lactente , Óleos Voláteis/administração & dosagem , Sesquiterpenos/administração & dosagem , Sesquiterpenos/efeitos adversosAssuntos
Corticosteroides/administração & dosagem , Corticosteroides/efeitos adversos , Dermatite de Contato/diagnóstico , Dermatite de Contato/epidemiologia , Fármacos Dermatológicos/administração & dosagem , Fármacos Dermatológicos/efeitos adversos , Administração Tópica , Adulto , Idoso , Feminino , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Testes do Emplastro/métodosRESUMO
BACKGROUND: Azathioprine in daily doses has been shown to be effective and safe in the treatment of Parthenium dermatitis. Weekly pulses of azathioprine (WAP) are also effective, but there are no reports comparing the effectiveness and safety of these two regimens in this condition. AIMS: To study the efficacy and safety of WAP and daily azathioprine in Parthenium dermatitis. METHODS: Sixty patients with Parthenium dermatitis were randomly assigned to treatment with azathioprine 300 mg weekly pulse or azathioprine 100 mg daily for 6 months. Patients were evaluated every month to assess the response to treatment and side effects. RESULTS: The study included 32 patients in the weekly azathioprine group and 28 in the daily azathioprine group, of whom 25 and 22 patients respectively completed the study. Twenty-three (92%) patients on WAP and 21 (96%) on daily azathioprine had a good or excellent response. The mean pretreatment clinical severity score decreased from 26.4±14.5 to 4.7±5.1 in the WAP group, and from 36.1±18.1 to 5.7±6.0 in the daily azathioprine group, which was statistically significant and comparable (P=0.366). Patients on WAP had a higher incidence of adverse effects (P=0.02). LIMITATIONS: The study had a small sample size and the amount of clobetasol propionate used in each patient was not determined, though it may not have affected the study outcome due to its comparable use in both groups. CONCLUSIONS: Azathioprine 300 mg weekly pulse and 100 mg daily dose are equally effective and safe in the treatment of Parthenium dermatitis.
Assuntos
Azatioprina/administração & dosagem , Dermatite de Contato/tratamento farmacológico , Imunossupressores/administração & dosagem , Extratos Vegetais/efeitos adversos , Adulto , Idoso , Dermatite de Contato/diagnóstico , Dermatite de Contato/etiologia , Esquema de Medicação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Partenogênese , Pulsoterapia/métodos , Resultado do TratamentoAssuntos
Azatioprina/uso terapêutico , Dermatite de Contato/diagnóstico , Dermatite de Contato/tratamento farmacológico , Metotrexato/uso terapêutico , Material Particulado/efeitos adversos , Extratos Vegetais/efeitos adversos , Azatioprina/economia , Dermatite de Contato/economia , Feminino , Humanos , Masculino , Metotrexato/economia , Pessoa de Meia-Idade , Partenogênese , Resultado do TratamentoAssuntos
Instituições de Assistência Ambulatorial , Dermatite de Contato/diagnóstico , Testes do Emplastro/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Dermatite de Contato/epidemiologia , Feminino , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
Allergic contact dermatitis (ACD) in children, until recently, was considered rare. ACD was considered as a disorder of the adult population and children were thought to be spared due to a lack of exposure to potential allergens and an immature immune system. Prevalence of ACD to even the most common allergens in children, like poison ivy and parthenium, is relatively rare as compared to adults. However, there is now growing evidence of contact sensitization of the pediatric population, and it begins right from early childhood, including 1-week-old neonates. Vaccinations, piercing, topical medicaments and cosmetics in younger patients are potential exposures for sensitization. Nickel is the most common sensitizer in almost all studies pertaining to pediatric contact dermatitis. Other common allergens reported are cobalt, fragrance mix, rubber, lanolin, thiomersol, neomycin, gold, mercapto mix, balsum of Peru and colophony. Different factors like age, sex, atopy, social and cultural practices, habit of parents and caregivers and geographic changes affect the patterns of ACD and their variable clinical presentation. Patch testing should be considered not only in children with lesions of a morphology suggestive of ACD, but in any child with dermatitis that is difficult to control.
Assuntos
Alérgenos/imunologia , Dermatite de Contato/diagnóstico , Dermatite de Contato/imunologia , Níquel/imunologia , Testes do Emplastro , Criança , Humanos , ÍndiaAssuntos
Dermatite de Contato/diagnóstico , Líquen Nítido/induzido quimicamente , Líquen Nítido/diagnóstico , Extratos Vegetais/toxicidade , Dermatite de Contato/patologia , Diagnóstico Diferencial , Humanos , Líquen Nítido/patologia , Masculino , Partenogênese , Testes do Emplastro/métodos , Tanacetum parthenium/toxicidade , Adulto JovemRESUMO
BACKGROUND AND AIMS: Elimination of allergens/topical medications causing contact dermatitis in venous eczema, which poses a significant problem in its chronicity and treatment, provides the basis for better therapeutic outcome. Our objective was to determine the pattern of contact sensitization in venous eczema patients in Himachal Pradesh (India). METHODS: Thirty-four patients (M:F, 31:3) and 10 controls (M:F, 6:4) were patch tested with Indian standard series and 10 commonly used topical medicaments. RESULTS: Positive patch test results were seen in 50% (M:F, 16:1) of the patients. Common allergens were Fragrance mix (15%), p-phenylendiamine (15%), nickel (9%), wool alcohol (9%), chinoform (9%), balsum of Peru (5%), cobalt chloride (5%), potassium dichromate (3%), epoxy resin (3%), thiuram mix (3%) and formaldehyde (3%). Only sisomycin and miconazole among the topical medications elicited a positive patch test reaction in 3 and 5% patients, respectively. Neomycin contact sensitivity was not seen in any of the patients. One patient who had exacerbation of venous eczema following accidental application of topical diclofenac showed a positive patch test reaction to it. CONCLUSIONS: Patch test should be used to identify the topical agents that may be responsible for perpetuation or aggravation of eczema, especially in patients who do not improve despite adequate treatment of other underlying cause(s).
Assuntos
Eczema/diagnóstico , Testes do Emplastro/normas , Úlcera Varicosa/diagnóstico , Administração Tópica , Adulto , Idoso , Dermatite de Contato/diagnóstico , Dermatite de Contato/etiologia , Toxidermias/diagnóstico , Toxidermias/etiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Eczema/induzido quimicamente , Eczema/etiologia , Feminino , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Testes do Emplastro/métodos , Preparações Farmacêuticas/administração & dosagem , Úlcera Varicosa/induzido quimicamente , Úlcera Varicosa/etiologiaAssuntos
Piercing Corporal/efeitos adversos , Dermatite de Contato/diagnóstico , Orelha Externa/patologia , Granuloma/diagnóstico , Adulto , Piercing Corporal/instrumentação , Dermatite de Contato/tratamento farmacológico , Dermatite de Contato/etiologia , Orelha Externa/efeitos dos fármacos , Granuloma/tratamento farmacológico , Granuloma/etiologia , Humanos , Masculino , Paládio/efeitos adversos , Esteroides/farmacologia , Esteroides/uso terapêuticoAssuntos
Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/epidemiologia , Adolescente , Adulto , Idoso , Criança , Dermatite de Contato/diagnóstico , Dermatite de Contato/epidemiologia , Dermatite Ocupacional/diagnóstico , Dermatite Ocupacional/epidemiologia , Feminino , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Testes do EmplastroAssuntos
Humanos , Dermatite de Contato/diagnóstico , Dermatite de Contato/fisiopatologia , Dermatite de Contato/reabilitação , Pele/anatomia & histologia , Pele/citologia , Pele/ultraestrutura , Neuropatia Hereditária Motora e Sensorial/fisiopatologia , Neuropatias Hereditárias Sensoriais e Autônomas/fisiopatologiaRESUMO
In order to help primary health care (PHC) workers in developing countries in the care of common skin diseases, an algorithm for the management of pyoderma, scabies, superficial mycoses, contact dermatitis and referral of early leprosy cases (based on the identification of diseases through the presence of objective key signs, and on treatments by generic drugs) was elaborated. One thousand patients were seen by trained dermatologists, who established diagnoses and treatments; in addition, there was systematic recording of each key sign, according to the successive algorithm steps. We compared the diagnostics and treatments obtained for several combinations of diagnostic signs, with those of the dermatologists. Sensitivity, specificity, positive predictive value and negative predictive value of defined combinations were high for pyoderma, scabies and superficial mycoses. Values were less exact for dermatitis and leprosy, but were considered sufficient for the level of health care targeted. The apportionment of treatments between the algorithm and the dermatological approaches was considered appropriate in more than 80% of cases; mismanagement was possible in 7% of cases, with few predictable harmful consequences. The algorithm was found satisfactory for the management of the dermatological priorities according to the standards required at the PHC level.