The Rising Incidence of Allergic Contact Dermatitis to Acrylates.

BACKGROUND: Allergic contact dermatitis (ACD) caused by (meth)acrylates used in nail products is being increasingly reported in nail technicians and consumers. OBJECTIVES: The aim of the study was to assess the incidence of sensitization to (meth)acrylates in technicians and users of nail products with ACD, referred for patch testing in a tertiary center, during the last 10 years. METHODS: All patients with ACD, who reported a profession associated with cosmetic nail procedures or use of such services and were referred for patch tests in our department between January 2009 and December 2018, were identified. The incidence of positive sensitization to (meth)acrylates was assessed. RESULTS: Contact allergy to 1 or more (meth)acrylates was found in 116 (74.4%) of 156 nail technicians or nail product users, all women. One hundred thirty-eight (88.5%) were occupationally exposed, and 18 (11.5%) were consumers. In addition, there was a statistically significant increase in (meth)acrylate ACD during 2014-2018 (100/127 cases [79%]) when compared with 2009-2013 (16/29 cases [55%]). The most common sensitizer among the 156 allergic individuals was ethylene glycol dimethacrylate, which was positive in 113 cases (72.4%), and among patients with acrylate-positive patch test, the rate was 97.4%. CONCLUSIONS: Our experience confirms the worldwide changing landscape of rising (meth)acrylate sensitization in nail technicians and nail products users with ACD. Efforts to improve prevention are needed, and clinicians should have a high index for suspicion in this occupational group.

Norwegian scabies presenting as erythroderma in HIV: A case report.

Crusted scabies is a rare and extreme manifestation of scabies that is observed mainly among immunosuppressed patients. We describe the case of a 55-year-old patient with a history of HIV infection and injection drug use. The patient was not on any antiretroviral therapy during the previous year, was malnourished and was living in unsanitary conditions. He had extensive, generalized, thick, hyperkeratotic, crusting, papular lesions, which had evolved over the previous month. Hyperkeratotic areas were fissured and linear excoriations were noted diffusely. The rash was distributed on the entire body from the scalp to the toes, with mild itching. Microscopic examination of the scale revealed numerous scabies mites and eggs. The patient was treated with topical scabicidal agents, which resulted in complete resolution. Because of the extremely contagious nature of crusted scabies, as well as its potential for complete cure with an appropriate therapy, there should be a high degree of suspicion for this disease in patients with AIDS, even when the lesions do not have the classical appearance. Nosocomial transmission of scabies from patients with AIDS is a risk, and protective measures, early diagnosis, and therapy are essential.