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OBJECTIVES: To evaluate the various skin conditions diagnosed in intensive care unit (ICU) patients. METHODS: This is a descriptive retrospective study of all adults, pediatric, and neonatal patients who were admitted to the ICU and had a dermatological manifestation during hospital stay or patients who had dermatological condition that requires ICU admission. All skin conditions were categorized and analyzed. RESULTS: A total of 344 ICU patients with 365 different dermatological conditions were included in the study. The age of patients ranged from less than 1-96 years, with a mean age of 43.6±30.1 years. Of the patients, 189 (54.9%) were males. The top 3 general disease categories observed were skin infections, inflammatory and autoimmune diseases, and drug reactions. The most commonly reported dermatological disorders included morbilliform drug eruption (6.8%), contact dermatitis (6.3%), vasculitis (5.5%), herpes zoster (4.6%), purpura due to thrombocytopenia (3.8%), dermatitis/eczema (3.8%), candidiasis (3.8%), infantile hemangioma (2.7%), unclassified drug reaction (2.5%), intertrigo (2.5%), and herpes simplex virus (2.5%). CONCLUSION: Dermatological disorders can occur at various levels of severity in the ICU. Skin infections, inflammatory and autoimmune diseases, and drug reactions were found to be the most prevalent conditions.
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Unidades de Cuidados Intensivos , Enfermedades de la Piel , Centros de Atención Terciaria , Humanos , Arabia Saudita/epidemiología , Masculino , Femenino , Adulto , Enfermedades de la Piel/epidemiología , Niño , Persona de Mediana Edad , Adolescente , Unidades de Cuidados Intensivos/estadística & datos numéricos , Estudios Retrospectivos , Lactante , Anciano , Preescolar , Adulto Joven , Anciano de 80 o más Años , Erupciones por Medicamentos/epidemiología , Erupciones por Medicamentos/etiología , Enfermedades Cutáneas Infecciosas/epidemiología , Vasculitis/epidemiología , Hemangioma/epidemiología , Herpes Zóster/epidemiología , Dermatitis por Contacto/epidemiología , Dermatitis por Contacto/etiología , Enfermedades Autoinmunes/epidemiología , Recién Nacido , Candidiasis/epidemiología , Trombocitopenia/epidemiologíaRESUMEN
INTRODUCTION: Polymorphous light eruption (PMLE) and chronic actinic dermatitis (CAD) have been classically described in White individuals, although recent studies have reported higher prevalence in patients with dark skin types, particularly African Americans. OBJECTIVE: To evaluate for differences in demographic, and clinical features between persons with light and dark skin types who have PMLE and CAD. METHODS: Retrospective review of patients with PMLE and CAD who were diagnosed from January 1, 1998, through November 31, 2021, at a single academic dermatology center. RESULTS/DISCUSSION: A total of 844 patients (725 [85.9%] female; mean [SD] age of onset: 41.7 [16.9] years) were diagnosed with PMLE, and 60 patients (22 [36.6%] female; mean age, [SD]: 60.6 [10.6] years) of age at presentation, disease duration of 8.2 [7.3] years were diagnosed with CAD. Although just over 50% of the general clinic population was White, the prevalence of PMLE and CAD was significantly higher in dark-skinned individuals compared to light-skinned individuals (PMLE: 625 [74.0%] vs. 219 [25.9%], p value < .001; CAD: 43 [71.6%] vs. 17 [28.3%], p value = .003) respectively. The pinpoint papular variant of PMLE (PP-PMLE) was predominantly seen in dark-skinned individuals. CONCLUSION: A substantial proportion of PMLE and CAD cases are present in dark-skinned individuals. PP-PMLE can be mistaken for lichen nitidus. As such, recognition of this entity is important for adequate evaluation and management of patients with PMLE.
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Dermatitis por Contacto , Trastornos por Fotosensibilidad , Femenino , Humanos , Masculino , Negro o Afroamericano , Dermatitis por Contacto/epidemiología , Trastornos por Fotosensibilidad/epidemiología , Prevalencia , Adulto , Persona de Mediana Edad , Anciano , Pigmentación de la PielRESUMEN
OBJECTIVE: This study was aimed to explore the prevalence and risk factors of work-related contact dermatitis (WRCD) symptoms among cleaners working in healthcare institutions in Gondar city, Northwest Ethiopia, during the COVID-19 pandemic. DESIGN: A multicentre cross-sectional study was conducted from September to October 2021. An interviewer-administered standardised Nordic Occupational Skin Questionnaire, V.2002 (NOSQ-2002) was used to assess WRCD. The collected data were entered into EpiData V.4.6 and analysed using Stata V.14 software. The association between dependent and independent variables was computed with a binary logistic regression. The association was determined using an adjusted OR (AOR) with a 95% CI at a p value of <0.05. SETTING: The study was conducted in Gondar city healthcare institutions, Northwestern Ethiopia. PARTICIPANTS: A total of 409 cleaners participated in this study. OUTCOME MEASURES: The primary outcome is the prevalence of WRCD symptoms, which was measured using the NOSQ-2002. RESULTS: The response rate was 95.6%. The majority, 302 (73.8%), of the study participants were female. The mean age (±SD) was 31 (±7.87) years old. The overall prevalence of self-reported WRCD during the last 12 months was 213 (52.1%) (95% CI (47.1% to 57.0%)). The highest symptoms reported were skin redness, 51.6% (n=110), and the most affected skin body sites were hands (hand dermatitis), 74.2% (n=158). Hand washing frequency more than 20 times per day (AOR=1.73, 95% CI (1.03 to 2.92)), personal history of eczema (AOR=1.46, 95% CI (1.01 to 2.42)) and lack of training on skin hazards (AOR=2.06, 95% CI (1.16 to 3.63)) were factors influencing the occurrence of WRCD. CONCLUSIONS: This study revealed the prevalence of WRCD is common during the COVID-19 pandemic. Adjusting hand washing frequency per day, educating people with atopy about the avoidance of exposure to skin irritants and providing training on skin hazards were recommended to minimise the condition.
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COVID-19 , Dermatitis por Contacto , Eccema , Femenino , Humanos , Masculino , Adulto Joven , Adulto , Estudios Transversales , COVID-19/epidemiología , Prevalencia , Etiopía/epidemiología , Pandemias , Factores de Riesgo , Dermatitis por Contacto/epidemiología , Dermatitis por Contacto/etiología , Atención a la SaludRESUMEN
BACKGROUND: Chlormethine gel was approved for treatment of mycosis fungoides, the most common cutaneous T-cell lymphoma, on the basis of results from study 201 and study 202. A post-hoc analysis of study 201 found interesting trends regarding improved efficacy of chlormethine gel vs ointment and noted a potential association between dermatitis and clinical response. OBJECTIVE: To expand these results by performing a post-hoc analysis of study 202. PATIENTS AND METHODS: Patients received chlormethine gel or ointment during study 201 (12 months) and higher-concentration chlormethine gel during study 202 (7-month extension). Response was assessed using Composite Assessment of Index Lesion Severity (CAILS). Associations between treatment frequency, response, and skin-related adverse events (AEs) were assessed using multivariate time-to-event analyses. Time-to-response and repeated measures analyses were compared between patients who only used chlormethine gel and those who switched from ointment to gel. RESULTS: No associations were seen between treatment frequency and improved skin response (CAILS) or AE occurrence within the 201/202 study populations. However, an association was observed specifically between contact dermatitis and improved CAILS response at the next visit (p < 0.0001). Patients who used chlormethine gel during both studies had a significantly (p < 0.05) shorter time to response and higher overall response rates than patients who initiated treatment with ointment. CONCLUSIONS: This post-hoc analysis shows that patients who initiated treatment using chlormethine gel had faster and higher responses compared with patients who initially used chlormethine ointment for 12 months. The development of contact dermatitis may be a potential prognostic factor for response. TRIAL REGISTRATION NUMBERS AND DATES OF REGISTRATION: Study 201: NCT00168064, September 14, 2002; Study 202: NCT00535470, September 26, 2007.
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Mecloretamina , Micosis Fungoide , Neoplasias Cutáneas , Ensayos Clínicos como Asunto , Dermatitis por Contacto/epidemiología , Geles , Humanos , Mecloretamina/efectos adversos , Micosis Fungoide/tratamiento farmacológico , Pomadas , Neoplasias Cutáneas/tratamiento farmacológico , Resultado del TratamientoRESUMEN
Since the Coronavirus Disease 2019 (COVID-19) pandemic began, people have been wearing face masks for many hours every day. As these face masks are in contact with the skin, it is important to pay more attention to their quality and safety. This study examined the concentration of free formaldehyde in 90 non-medical face masks and related products (33 nonwoven, 30 woven cloth, 12 polyurethane, and 15 related products) because formaldehyde is a common contact allergen in textile products. For products consisting of mixed materials, each material was sampled, resulting in 103 samples for analysis. Free formaldehyde (34-239 µg/g) was found in three cloth masks, which consisted of cotton and polyester, with antibacterial and antiviral labeling. It was confirmed that the detected formaldehyde originated from the mask-finishing treatment by a hydrochloric acid extraction discrimination test. These masks may elicit contact dermatitis if the consumers have already been sensitized to formaldehyde. However, the risk of contact dermatitis caused by formaldehyde in masks may be considered low since the frequency of formaldehyde detection in masks in Japan is low.
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COVID-19 , Dermatitis por Contacto , COVID-19/epidemiología , COVID-19/prevención & control , Dermatitis por Contacto/epidemiología , Formaldehído/toxicidad , Humanos , Japón , Máscaras , Pandemias , SARS-CoV-2RESUMEN
In this study, the mobility, incidence, and severity of contact dermatitis and litter moisture content were assessed in 14 strains of broiler chickens differing in growth rate. The strains encompassed 2 conventional (CONV; ADG0-48 > 60 g/d) and 12 slower growing (SG) strains categorized as FAST (ADG0-62 = 53-55 g/d), MOD (ADG0-62 = 50-51 g/d), and SLOW (ADG0-62 < 50 g/d), with 4 strains in each category. A total of 7,216 mixed-sex birds were equally allocated into 164 pens (44 birds/pen; 30 kg/m2) in a randomized incomplete block design, with each strain represented in 8 to 12 pens over 2-3 trials. From each pen, 4 to 6 birds were tested in the latency-to-lie (LTL) and group obstacle tests 1 wk prior to the birds reaching 2 target weights (TWs) of approximately 2.1 kg (TW1: 34 d for CONV and 48 d for SG strains) and 3.2 kg (TW2: 48 d for CONV and 62 d for SG strains). The incidence of footpad dermatitis (FPD) and hock burns (HB) were evaluated a day prior to each TW. Litter moisture content was determined biweekly from d 14 to d 56. At TW1, CONV and SLOW had longer LTL than FAST birds. At TW2, CONV, MOD, and FAST birds had similar LTL. At both TWs, CONV birds were lighter than FAST birds in the group obstacle test, yet their number of obstacle crossings was similar. At TW1, CONV birds had greater incidence of FPD than FAST and MOD, while at TW2, CONV birds had greater incidence than the other categories. The incidence of HB in CONV and MOD was greater than SLOW birds at TW1, while at TW2, the incidence of HB was greater in CONV and FAST birds vs. MOD and SLOW birds. Litter moisture content was high in all categories from d 28 onward. Our results indicate that both BW and growth rate influence leg strength and walking ability, whereas the overall high litter moisture content and to a lesser extent growth rate influenced the incidence of contact dermatitis.
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Dermatitis por Contacto , Enfermedades de las Aves de Corral , Animales , Pollos , Dermatitis por Contacto/epidemiología , Dermatitis por Contacto/etiología , Dermatitis por Contacto/veterinaria , Dieta/veterinaria , Incidencia , Enfermedades de las Aves de Corral/epidemiología , Enfermedades de las Aves de Corral/etiología , CaminataRESUMEN
OBJECTIVE: Exposure to mineral oil and petroleum derivatives is common among motor vehicle repair workers, leading to occupation-related dermatological conditions. OBJECTIVE: We aimed to determine the prevalence of contact dermatitis among workers of car garages in the unorganized sector and to explore their personal safety measures. SUBJECTS AND METHODS: This prospective community-based study was conducted among 200 workers aged 18 years and above employed at 70 car garages in Majmaah City, Saudi Arabia. Data were collected by a trained medical student using a standardized questionnaire on age, nationality, type of work, working hours, past history of dermatitis, clinical examination, personal safety equipment, and treatment-seeking behavior of workers. Descriptive analysis and chi-square test of significance were done using SPSSv25.0. RESULTS: The self-reported prevalence of eczema/contact dermatitis within the past year was 14.5% (n=29), with hand lesions being the commonest (63%). Participants aged 18-30 years, working as car mechanics, and working for more than 10 hours had a statistically significant higher prevalence of contact dermatitis as compared to their counterparts. Most of them wore some or the other safety wares like safety shoes (20.9%), gloves (20.3%), Face masks (20%), earmuffs (10%), and helmets (2.8%). However, only 30% of cases sought treatment for the condition, reflecting poor healthcare-seeking behavior. CONCLUSIONS: The prevalence of contact dermatitis among workers of car garages was found to be lower than in other countries in KSA, probably due to stringent implementation of Occupation and Health Safety laws. However, workers had poor treatment-seeking behavior for this condition, which needs to be improved by taking appropriate public health measures.
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Dermatitis por Contacto/epidemiología , Eccema/epidemiología , Enfermedades Profesionales/epidemiología , Adolescente , Adulto , Automóviles , Dermatitis por Contacto/prevención & control , Eccema/prevención & control , Pie , Mano , Humanos , Persona de Mediana Edad , Enfermedades Profesionales/prevención & control , Equipo de Protección Personal , Arabia Saudita/epidemiología , Autoinforme , Adulto JovenRESUMEN
ABSTRACT: Skin adhesives are used to close clean surgical wounds. We aimed to investigate the incidence of skin adhesive-related contact dermatitis and the characteristics that differentiate it from a surgical site infection.We retrospectively analyzed patients whose surgical wound was closed using a liquid skin adhesive (Dermabond Prineo skin closure system, Ethicon, NJ) by a single surgeon between March 2018 and June 2020. Medical records were reviewed to evaluate complications indicating contact dermatitis, including wound infections and hematomas.We included 143 patients (men, 59; women, 84; mean age, 60.8âyears). No patient had an early surgical site infection or wound dehiscence, but 4 (2.8%) developed postoperative contact dermatitis (week 7, 1; week 4, 2; day 9, 1). Manifestations included eczema and pruritus, without local heat or wound discharge. All cases resolved without complications, including infection.Contact dermatitis occurred in 2.8% of patients who received liquid skin adhesive, and the symptoms differed from those of surgical site infection. Patients should be informed about the risk of contact dermatitis before applying a liquid skin adhesive.
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Cianoacrilatos/efectos adversos , Dermatitis por Contacto/diagnóstico , Dermatitis por Contacto/epidemiología , Procedimientos Ortopédicos/efectos adversos , Infección de la Herida Quirúrgica/diagnóstico , Adhesivos Tisulares/efectos adversos , Adulto , Anciano , Anciano de 80 o más Años , Diagnóstico Diferencial , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Técnicas de Cierre de Heridas/efectos adversos , Técnicas de Cierre de Heridas/instrumentación , Adulto JovenRESUMEN
The most important function of the stratum corneum (SC), the uppermost layer of the human epidermis, is the formation of the epidermal permeability barrier. Lipids, particularly ceramides, cholesterol, and free fatty acids, together form lamellar membranes in the extracellular spaces of the SC that limit the loss of water and electrolytes. In addition to preventing water and electrolyte loss, the SC as a permeability barrier prevents the entry of harmful irritants, allergens, and microorganisms into the skin. Disruption of the epidermal barrier leads to skin that is irritated, more reactive, and more sensitive than normal skin. SC thickness, lipid profile, and barrier function vary with different ethnic groups, which is also reflected the differences in prevalence and manifestation of diverse skin conditions related to the skin barrier function such as atopic dermatitis and sensitive skin. In addition to these compromised skin barrier related conditions, we are just now starting to understand the direct and indirect impact of COVID-19 on the skin and how current preventative measures are contributing to skin barrier disorders. Our understanding of various approaches for restoration of skin barrier, especially the role of topically applied mixtures of cholesterol, ceramides, and essential/nonessential free fatty acids (FFAs) allows for the strengthening of the compromised skin barrier and alleviation of symptoms and discomfort associated with skin barrier disorders. Ceramide containing products on the market are commonly available and offer protection and reparative benefits to the skin barrier. J Drugs Dermatol. 20(4 Suppl):17-22. doi:10.36849/JDD.S589C.
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COVID-19/patología , Dermatitis por Contacto/patología , Piel/patología , COVID-19/complicaciones , Dermatitis por Contacto/epidemiología , Dermatitis por Contacto/terapia , Etnicidad , Humanos , Permeabilidad , Enfermedades de la Piel/epidemiología , Enfermedades de la Piel/patología , Enfermedades de la Piel/terapiaRESUMEN
BACKGROUND: During the COVID-19 pandemic, wearing face masks is mandatory not only for health care workers (HCWs) but also for the general population in many countries around the globe. OBJECTIVES: The aim of the study was to investigate the onset of adverse facial skin reactions due to compulsory face masks during the COVID-19 pandemic in HCWs and non-HCWs, and draw awareness of this new dermatological condition and its preventive measures. MATERIALS & METHODS: A questionnaire was distributed to 550 patients and HCWs from the Department of Dermatology and Allergy of the University Hospital Munich (LMU), Germany. Participants were surveyed regarding mask type, duration of usage and adverse facial skin reactions. Information on symptoms and the use of skin care products and topical drugs were retrieved. RESULTS: The duration of wearing masks showed a significant impact on the prevalence of symptoms (p < 0.001). Type IV hypersensitivity was significantly more likely in participants with symptoms compared to those without symptoms (p = 0.001), whereas no increase in symptoms was observed in participants with atopic diathesis. HCWs used facial skin care products significantly more often than non-HCWs (p = 0.001). CONCLUSION: Preventive and therapeutic measures should be established in order to avoid "face mask dermatitis", especially for people with underlying risk factors.
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COVID-19/prevención & control , Dermatitis por Contacto/etiología , Dermatitis Profesional/etiología , Dermatosis Facial/etiología , Personal de Salud , Máscaras/efectos adversos , Dermatitis por Contacto/epidemiología , Dermatitis Profesional/epidemiología , Dermatosis Facial/epidemiología , Alemania/epidemiología , HumanosRESUMEN
BACKGROUND: Psoriasis is a chronic, inflammatory disease that may differ in prevalence and clinical presentation among patients from various racial and ethnic groups. Two phase 3 studies demonstrated efficacy and safety of halobetasol propionate (HP) 0.01% lotion in the treatment of moderate-to-severe plaque psoriasis (NCT02514577, NCT02515097). These post hoc analyses evaluated HP 0.01% lotion in Hispanic participants. METHODS: Participants were randomized (2:1) to receive once-daily HP or vehicle lotion for 8 weeks, with a 4-week posttreatment follow-up. Post hoc efficacy assessments in Hispanic participants (HP, n=76; vehicle, n=43) included treatment success (≥2grade improvement in Investigator’s Global Assessment and score of ‘clear’ or ‘almost clear’), psoriasis signs, and affected body surface area (BSA). Treatment-emergent adverse events (TEAEs) were evaluated. RESULTS: At week 8, 38.8% of participants achieved treatment success with HP versus 10.3% on vehicle (P=0.001). HPtreated participants achieved greater improvements in psoriasis signs, compared with vehicle (P<0.01 all). HP group had a greater reduction in affected BSA versus vehicle (P=0.001). Treatment-related TEAEs with HP were application site infection and dermatitis (n=1 each). CONCLUSIONS: Once-daily HP 0.01% lotion was associated with significant reductions in disease severity in Hispanic participants with moderate-to-severe psoriasis, with good tolerability and safety over 8 weeks. J Drugs Dermatol. 2021;20(3):252-258. doi:10.36849/JDD.5698.
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Clobetasol/análogos & derivados , Dermatitis por Contacto/epidemiología , Fármacos Dermatológicos/administración & dosificación , Psoriasis/tratamiento farmacológico , Vasoconstrictores/administración & dosificación , Administración Cutánea , Adulto , Clobetasol/administración & dosificación , Clobetasol/efectos adversos , Dermatitis por Contacto/etiología , Fármacos Dermatológicos/efectos adversos , Método Doble Ciego , Esquema de Medicación , Femenino , Hispánicos o Latinos , Humanos , Masculino , Persona de Mediana Edad , Psoriasis/diagnóstico , Índice de Severidad de la Enfermedad , Resultado del Tratamiento , Vasoconstrictores/efectos adversosRESUMEN
BACKGROUND: Coronavirus Disease 2019 (COVID-19) is a viral illness caused by the novel coronavirus SARS-CoV-2 which spreads via droplets from an infected person. There has been an unprecedented rise in the use of personal protective equipment and practice of personal hygiene measures against COVID-19. The extended use of protective measures (PM) can lead to ill effects on the skin. Our aim was to investigate PM-induced dermatoses amongst healthcare workers and the general population during the COVID-19 pandemic. METHODS: A cross-sectional study was conducted over a period of 2 months. The study subjects were patients who presented to dermatology outpatient clinics or sought teleconsultation for skin problems related to the use of PMs against COVID-19. A detailed history was obtained and cutaneous examination was documented for all the patients in a pre-set proforma. Diagnoses of the adverse skin effects were formulated based upon history and clinical examination. RESULTS: A total of 101 cases with cutaneous adverse effects due to the use of PMs against COVID-19 were included in the study. The general population and healthcare workers were affected similarly, comprising of 54.5% and 45.5%, respectively. The mean age of the study participants was 36.71 ± 15.72 years. The most common culprit material was soap and water (56.4%). Contact dermatitis was found to be the most common adverse effect in the majority of our patients (72.3%). The most common symptom reported was pruritus (45.5%). The wearing of personal protective equipment for a longer duration was significantly associated with multiple symptoms (P = 0.026). CONCLUSION: The enhanced use of different PMs against COVID-19 can result in a variety of adverse skin effects. In our study, the use of soap and water was the most common culprit PM, and contact dermatitis was the most common adverse effect noted.
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COVID-19/prevención & control , Dermatitis por Contacto/epidemiología , Dermatitis Profesional/epidemiología , Higiene de las Manos/normas , Pandemias/prevención & control , Equipo de Protección Personal/efectos adversos , Adulto , COVID-19/epidemiología , COVID-19/transmisión , COVID-19/virología , Control de Enfermedades Transmisibles/instrumentación , Control de Enfermedades Transmisibles/normas , Estudios Transversales , Dermatitis por Contacto/etiología , Dermatitis Profesional/etiología , Femenino , Higiene de las Manos/métodos , Humanos , Masculino , Persona de Mediana Edad , Equipo de Protección Personal/normas , SARS-CoV-2/patogenicidad , Jabones/efectos adversos , Adulto JovenRESUMEN
Numerous unexplained pneumonia cases were reported to the World Health Organization (WHO) by Wuhan, China, in December 2020. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), a zoonotic pathogen, came into sight, spreading coronavirus disease 2019 (COVID-19) all over the globe. Association of cutaneous signs and symptoms with COVID-19 is being studied worldwide, principally, to determine if these dermatoses can help in early recognition of SARS-CoV-2 infection. These dermatological manifestations can range from erythematous rash, urticaria to livedo reticularis, and acrocyanosis in patients of all age groups. Correspondingly, dermatologists treating COVID-19 patients, suffering from inflammatory dermatoses, with biologics or immunomodulators should exert caution and use specific protocols to adjust the doses of these medications. Prevention of person-to-person transmission of COVID-19 is being promoted universally, with the use of personal protective equipment (PPE), hand washes, and hand sanitizers around the clock. However, an array of cutaneous adverse effects such as contact dermatitis, irritant contact dermatitis, friction blisters, contact urticaria, acne, and infections are associated with the use of PPE. Extra-pulmonary manifestations of COVID-19 are still emerging in the community, and physicians and researchers are working together globally to strengthen the clinical management of these patients. Cases of COVID-19 continue to rise across the world, and an unprecedented approach has been taken to develop effective vaccines and therapeutic strategies against existing and forthcoming mutagenic strains of SARS-CoV-2.
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Betacoronavirus/patogenicidad , Infecciones por Coronavirus/epidemiología , Dermatitis por Contacto/epidemiología , Dermatología/tendencias , Neumonía Viral/epidemiología , Enfermedades Cutáneas Infecciosas/epidemiología , Betacoronavirus/aislamiento & purificación , COVID-19 , Control de Enfermedades Transmisibles/instrumentación , Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/normas , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/prevención & control , Dermatitis por Contacto/diagnóstico , Dermatitis por Contacto/etiología , Dermatología/normas , Higiene de las Manos/normas , Humanos , Pandemias/prevención & control , Equipo de Protección Personal/efectos adversos , Equipo de Protección Personal/normas , Neumonía Viral/complicaciones , Neumonía Viral/diagnóstico , Neumonía Viral/prevención & control , SARS-CoV-2 , Enfermedades Cutáneas Infecciosas/diagnóstico , Enfermedades Cutáneas Infecciosas/virologíaRESUMEN
BACKGROUND: Previous results from two phase 3 studies demonstrated efficacy and safety of fixed combination halobetasol propionate 0.01%/tazarotene 0.045% (HP/TAZ) lotion in participants with moderate-to-severe plaque psoriasis. This post hoc analysis evaluated sex-specific efficacy and safety of HP/TAZ lotion. METHODS: In two randomized, double-blind, phase 3 studies, participants were randomized (2:1) to receive HP/TAZ or vehicle lotion once daily for 8 weeks. Male and female participants were evaluated separately in this pooled analysis. Efficacy assessments included treatment success (at least 2grade improvement in Investigator's Global Assessment [IGA] score and score of clear/almost clear), impact on individual signs of psoriasis, and affected Body Surface Area (BSA). RESULTS: The analysis included 272 males (HP/TAZ, n=175; vehicle, n=97) and 146 females (HP/TAZ, n=101; vehicle, n=45). Significantly more participants achieved overall treatment success at week 8 with HP/TAZ versus vehicle in both male (38.4% vs 9.8%) and female (44.5% vs 9.9%) subgroups (P<0.001, both). Erythema, plaque elevation, and scaling were also reduced by week 8 in both males and females, with significantly more HP/TAZ-treated participants achieving at least 2grade improvement in each sign of psoriasis than vehicle-treated participants (P<0.001 each, both groups). Mean reductions in affected BSA were significantly greater with HP/TAZ versus vehicle lotion in both males and females (P≤0.001, both). The most frequent treatment-related adverse events were contact dermatitis, pruritis, and application site pain (each 4.0%) in females and contact dermatitis (7.6%) in males. CONCLUSION: HP/TAZ lotion was highly effective and safe in both males and females with moderate-to-severe psoriasis over 8 weeks of once-daily use. J Drugs Dermatol. 2020;19(5): doi:10.36849/JDD.2020.5021.
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Clobetasol/análogos & derivados , Ácidos Nicotínicos/administración & dosificación , Psoriasis/tratamiento farmacológico , Crema para la Piel/administración & dosificación , Adulto , Anciano , Clobetasol/administración & dosificación , Clobetasol/efectos adversos , Dermatitis por Contacto/epidemiología , Dermatitis por Contacto/etiología , Método Doble Ciego , Combinación de Medicamentos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Ácidos Nicotínicos/efectos adversos , Dolor/epidemiología , Dolor/etiología , Prurito/epidemiología , Prurito/etiología , Psoriasis/diagnóstico , Índice de Severidad de la Enfermedad , Factores Sexuales , Crema para la Piel/efectos adversos , Resultado del TratamientoRESUMEN
BACKGROUND: To date, medical history and dedicated questionnaires are the fastest and easiest way to assess risks of joint metal hypersensitivity. No published studies determined the overall prevalence of hypersensitivity to metals in patients with shoulder pathologies. The purpose of this study was therefore to estimate the prevalence of metal hypersensitivity reported by patients with shoulder pathologies, and to identify patients at risk of joint metal hypersensitivity based on a dedicated questionnaire. METHODS: The authors prospectively asked all adult patients consulting for shoulder pathologies between September 2018 and February 2019 at 10 centers to fill in a form. The main outcome was "reported hypersensitivity to metals," comprising belt buckles, coins, earrings, fancy jewelry, keys, leather, metallic buttons, piercings, spectacles, watch bracelets, or zips. RESULTS: A total of 3217 patients agreed to fill in the survey, aged 55 ± 16 (range, 18-101) with equal proportions of men (51%) and women (49%), and a majority of patients consulting for cuff pathology (55%). A total of 891 (28%) patients had professions considered at risk for metal hypersensitivity. The most frequently reported metal hypersensitivities were fancy jewelry (15%), earrings (13%), and watch bracelets (9%). A total of 629 (20%) patients, of which the vast majority were women, reported hypersensitivity to 1 or more metals. CONCLUSIONS: This survey of 3217 patients identified 20% who reported metal hypersensitivities, though only 2.2% had done patch tests. Matching profiles of those with positive patch tests to those with no patch tests revealed that 9.4% of the total cohort had similar sex and self-reported metal hypersensitivities. Factors associated with a positive patch test were female sex, self-reported cutaneous allergy, and self-reported metal hypersensitivity. The clinical applicability of these estimates remains uncertain as there is insufficient evidence that allergy to metal implants can be predicted by questionnaires or patch tests.
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Dermatitis por Contacto/epidemiología , Hipersensibilidad/epidemiología , Metales/inmunología , Hombro/patología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Artroplastía de Reemplazo de Hombro/efectos adversos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pruebas del Parche , Prevalencia , Estudios Prospectivos , Prótesis e Implantes/efectos adversos , Riesgo , Autoinforme , Hombro/cirugía , Adulto JovenRESUMEN
Skin adhesives have become standard in wound closure as alternatives to traditional sutures or as sterile occlusive dressings after surgery of all types. The literature is replete with case reports of contact dermatitis following exposure to cyanoacrylate-based adhesives, such as 2-octyl cyanoacrylate. Nonetheless, it has been the impression of the senior author and others that the incidence of allergic and/or contact dermatitis is much higher than commonly considered. The authors prospectively studied 102 consecutive patients who underwent breast surgery performed by the senior author with 2-octyl cyanoacrylate placed over incisions as an occlusive dressing. Two patients with a known glue allergy did not receive cyanoacrylate at surgery but were scratch tested to confirm the diagnosis. All patients were followed postoperatively. Twelve patients went on to develop significant dermatitis postoperatively after glue placement. Cyanoacrylate was confirmed as the cause of all rashes by allergy scratch testing for a total incidence of 14 percent (14 patients). Given the popularity of cyanoacrylate products across emergency rooms, clinics, and operating rooms, awareness of the true incidence of these reactions may caution against their use in the future. CLINICAL QUESTION/LEVEL OF EVIDENCE:: Therapeutic, IV.
Asunto(s)
Cianoacrilatos/efectos adversos , Dermatitis por Contacto/epidemiología , Mamoplastia/métodos , Adhesivos Tisulares/efectos adversos , Técnicas de Cierre de Heridas/efectos adversos , Adulto , Anciano , Anciano de 80 o más Años , Dermatitis por Contacto/etiología , Femenino , Humanos , Incidencia , Persona de Mediana Edad , Estudios Prospectivos , Virginia/epidemiología , Adulto JovenRESUMEN
Previous studies demonstrated that delgocitinib ointment, a novel topical Janus kinase inhibitor, rapidly improved clinical signs and symptoms of atopic dermatitis (AD) in Japanese adult patients. We sought to evaluate the long-term safety and efficacy of delgocitinib 0.5% ointment in a 52-week study (QBA4-2). Japanese patients aged 16 years or older with AD received delgocitinib 0.5% ointment b.i.d. for up to 52 weeks. Topical corticosteroids for the treatment of worsening of AD could be used at the investigators' discretion during the treatment period. Safety end-points included the incidence and severity of adverse events (AEs). Pooled safety analyses included the data from the other long-term study (QBA4-1). Efficacy end-points included the percentage change from baseline in the modified Eczema Area and Severity Index (mEASI). A total of 506 patients were included in the pooled safety population. Overall, AEs were reported in 69.0% of patients; most AEs were mild and unrelated to delgocitinib ointment. The most common AE was nasopharyngitis, followed by contact dermatitis, acne, and application site folliculitis. No skin atrophy or telangiectasia was found at the application sites of delgocitinib ointment. Application site irritation symptoms were infrequent (<2%) and mild. The incidence of AEs did not increase over time, except for seasonal diseases. The improvement effects on AD as assessed by mEASI were maintained throughout the treatment period. Delgocitinib 0.5% ointment was well tolerated and effective when administrated to Japanese adult patients with AD for up to 52 weeks.
Asunto(s)
Dermatitis Atópica/tratamiento farmacológico , Inhibidores de las Cinasas Janus/administración & dosificación , Pirroles/administración & dosificación , Acné Vulgar/inducido químicamente , Acné Vulgar/diagnóstico , Acné Vulgar/epidemiología , Adolescente , Adulto , Dermatitis por Contacto/diagnóstico , Dermatitis por Contacto/epidemiología , Dermatitis por Contacto/etiología , Esquema de Medicación , Femenino , Foliculitis/inducido químicamente , Foliculitis/diagnóstico , Foliculitis/epidemiología , Humanos , Incidencia , Inhibidores de las Cinasas Janus/efectos adversos , Japón/epidemiología , Masculino , Nasofaringitis/inducido químicamente , Nasofaringitis/diagnóstico , Nasofaringitis/epidemiología , Pomadas , Pirroles/efectos adversos , Índice de Severidad de la Enfermedad , Factores de Tiempo , Resultado del Tratamiento , Adulto JovenRESUMEN
BACKGROUND: While clinical signs, symptoms, as well as etiology of sensitive skin in general populations have been extensively studied over the last decades, characteristics of sensitive skin in normal subjects, particularly gender-related characteristics, still remain unknown. OBJECTIVE: In the present study, we characterize facial sensitive skin in normal young Chinese. SUBJECTS AND METHODS: A questionnaire was given to each participant aged 10-30 years. Clinical signs, symptoms, and associated trigger factors of facial sensitive skin were compared in normal young Chinese males versus females. RESULTS: After excluding subjects with pre-existing skin disorders, 475 females and 429 males out of 954 responders were included in the analyzes. Prevalence of self-reported facial sensitive skin was significantly higher in females than in males. Yet, while more females experienced various symptoms, symptoms were more severe in males than in females. However, both the prevalence and severity of clinical signs were similar in females and males. Skin care products appeared to be the major contributors to facial sensitive skin in both genders. Moreover, it appeared that females were more sensitive to environmental factors such as low humidity and sun-exposure while males were more sensitive to emotional factors. Taken together, these results demonstrate that characteristics of sensitive skin are associated with gender, while the underlying mechanisms remain to be explored. CONCLUSIONS: There are gender differences in prevalence, symptoms, and trigger factors of facial sensitive skin in normal young Chinese.
Asunto(s)
Dermatitis por Contacto/epidemiología , Emociones/fisiología , Fenómenos Fisiológicos de la Piel , Luz Solar/efectos adversos , Adolescente , Adulto , Pueblo Asiatico/estadística & datos numéricos , China/epidemiología , Dermatitis por Contacto/etiología , Dermatitis por Contacto/fisiopatología , Cara , Femenino , Humanos , Masculino , Prevalencia , Factores de Riesgo , Autoinforme/estadística & datos numéricos , Factores Sexuales , Piel/fisiopatología , Piel/efectos de la radiación , Adulto JovenRESUMEN
BACKGROUND: Methylisothiazolinone (MI) has caused an unprecedented epidemic of contact allergy in Europe and elsewhere. Subsequently, regulatory action has been taken, at least in Europe, aiming at reducing risk of MI sensitization. OBJECTIVE: To follow-up on the prevalence of contact allergy to MI in consecutively patch tested patients and assess the spectrum of products containing MI or methylchloroisothiazolinone (MCI)/MI in patients positive to MI which elicited current allergic contact dermatitis. METHODS: A cross-sectional survey was performed in 2016 and 2017, including all adult patients patch tested with the baseline series (including MI 0.2% aq.) between 1 May and 31 October at 14 centres in 11 European countries. Patients with positive reactions (+ to +++) to MI were further examined regarding history, clinical characteristics and eliciting products, which were categorized into 34 types and 4 classes (leave-on, rinse-off, household, occupational). The results were compared with the reference year 2015. RESULTS: A total of 317 patients, n = 202 of 4278 tested in 2016 (4.72%) and n = 115 of 3879 tested in 2017 (2.96%), had positive reactions to MI; the previous result from 2015 was 5.97% (P < 0.0001). The share of currently relevant contact allergy among all positive reactions declined significantly as well (P = 0.0032). Concerning product classes, a relative decline of leave-on and a relative increase of rinse-off and household products was noted. CONCLUSION: The prevalence of MI contact allergy decreased by 50% from 2015 to 2017. As a consequence of regulation, the share of cosmetics products (leave-on in particular) eliciting allergic contact dermatitis is decreasing. The chosen method of analysing causative products in sensitized patients has proven useful to monitor effects of intervention.