RESUMEN
OBJECTIVE: To analyse the clinical characteristics and sensitivity of an essential oil patch test series (EOS) in patients sensitized to their own essential oils (EOs). METHOD: We analysed the clinical data and patch test results obtained with the European baseline series (BSE) and an EOS, as well as the mode of use of EOs, through a questionnaire included in the patient file. RESULTS: The study included 42 patients (79% women, average age 50 years) with allergic contact dermatitis (ACD), 8 patients required hospitalization. All patients were sensitized to the EO they used, primarily lavender (Lavandula augustifolia, 8000-28-0), tea tree (Melaleuca alternifolia leaf oil, 68647-73-4), ravintsara (Cinnamomum camphora oil, 92201-50-8), and 2 cases were attributed to helichrysum (helichrysum italicum flower absolute, 90045-56-0). 71% had positive patch tests to fragrance mix I or II, 9 only to the EOS and 4 only with their personal EO. Interestingly, 40% of patients did not spontaneously mention the use of EOs, and only 33% received advice on their use at the time of purchase. CONCLUSION: Patch tests with the BSE, limonene and linalool HP, and oxidized tea tree oil is sufficient to detect most EO-sensitized patients. The most important is to test the patient's own used EOs.
Asunto(s)
Dermatitis Alérgica por Contacto , Dermatología , Lavandula , Aceites Volátiles , Aceite de Árbol de Té , Humanos , Femenino , Persona de Mediana Edad , Masculino , Aceites Volátiles/efectos adversos , Dermatitis Alérgica por Contacto/diagnóstico , Dermatitis Alérgica por Contacto/etiología , Pruebas del Parche , Aceite de Árbol de Té/efectos adversosAsunto(s)
Dermatitis Alérgica por Contacto/etiología , Hedera/efectos adversos , Adulto , Dermatitis Alérgica por Contacto/tratamiento farmacológico , Diagnóstico Diferencial , Femenino , Jardinería , Glucocorticoides/uso terapéutico , Humanos , Masculino , Persona de Mediana Edad , Pruebas del ParcheRESUMEN
BACKGROUND: Dupilumab is the first biologic available to treat atopic dermatitis (AD). Its effectiveness and safety were demonstrated in clinical trials. OBJECTIVE: We sought to assess the effectiveness and safety of dupilumab in adults with AD in a real-life French multicenter retrospective cohort. METHODS: We included patients treated during March 2017-April 2018. Efficacy outcomes, including Scoring Atopic Dermatitis (SCORAD) and Eczema Area and Severity Index (EASI) scores, were collected at baseline and 3 months when available. Adverse events (AEs) were recorded at follow-up. RESULTS: We included 241 patients. The median ± interquartile range (IQR) follow-up time was 3.8 ± 3.7 months. A ≥75% improvement in SCORAD was achieved in 27 of 163 (16.6%) patients, and a ≥75% improvement in EASI was achieved in 40 of 82 (48.8%) patients. The median SCORAD and EASI scores at 3 months were significantly lower than those at baseline (SCORAD ± IQR, 25 ± 21 vs 56 ± 27.4, P < 10-9 and EASI ± IQR, 4.1 ± 6.8 vs 17.9 ± 15.4, P < 10-9, respectively). Conjunctivitis was reported in 84 of 241 (38.2%) patients. The proportion with eosinophilia (>500 cells/mm3) during follow-up (57%) was higher than that at baseline (33.7%) (n = 172, P < 10-6). Dupilumab was stopped in 42 cases; 27 patients stopped because of AEs. LIMITATIONS: No control group, missing data. CONCLUSION: This real-life study demonstrated a similar dupilumab effectiveness as that seen in clinical trials, but it also revealed a higher frequency of conjunctivitis and eosinophilia.
Asunto(s)
Anticuerpos Monoclonales/uso terapéutico , Conjuntivitis/inducido químicamente , Dermatitis Atópica/tratamiento farmacológico , Eosinofilia/inducido químicamente , Seguridad del Paciente/estadística & datos numéricos , Adulto , Anticuerpos Monoclonales/efectos adversos , Anticuerpos Monoclonales Humanizados , Estudios de Cohortes , Conjuntivitis/epidemiología , Dermatitis Atópica/diagnóstico , Relación Dosis-Respuesta a Droga , Esquema de Medicación , Eosinofilia/epidemiología , Femenino , Francia , Humanos , Inyecciones Subcutáneas , Estimación de Kaplan-Meier , Masculino , Modelos de Riesgos Proporcionales , Estudios Retrospectivos , Medición de Riesgo , Índice de Severidad de la EnfermedadRESUMEN
Cutaneous adverse drug reactions present as many different clinical symptoms which may be induced by triggers other than drugs. This review focuses on the non-drug causes of fixed "drug" eruptions, acute generalized erythematous pustulosis (AGEP), "drug" reactions with eosinophilia and systemic symptoms (DRESS) and Stevens-Johnson syndrome/toxic epidermal necrolysis (TEN), which may be induced by foods, xenobiotics, venoms etc...