Sensitization to textile dyes in Spain: Epidemiological situation (2019-2022).

BACKGROUND: Current frequency and features for positivity to textile dye mix (TDM) in Spain are unknown. OBJECTIVES: To study the frequency, clinical features and simultaneous positivity between TDM, para-phenylenediamine (PPD) and specific disperse dyes. MATERIALS AND METHODS: We analysed all consecutive patients patch-tested with TDM from the Spanish Contact Dermatitis Registry (REIDAC), from 1 January 2019 to 31 December 2022. Within this group, we studied all selected patients patch-tested with a textile dye series. RESULTS: Out of 6128 patients analysed, 3.3% were positive to the TDM and in 34% of them, the sensitization was considered currently relevant. TDM positivity was associated with working as a hairdresser/beautician and scalp, neck/trunk and arm/forearm dermatitis. From TDM-positive patients, 57% were positive to PPD. One hundred and sixty-four patients were patch-tested with the textile dye series. Disperse Orange 3 was the most frequent positive dye (16%). One of every six cases positive to any dye from the textile dye series would have been missed if patch-tested with the TDM alone. CONCLUSIONS: Positivity to TDM is common in Spain and often associated with PPD sensitization. TDM is a valuable marker of disperse dyes allergy that should be part of the Spanish and European standard series.

Polysensitization in the Spanish Contact Dermatitis Registry (REIDAC): A 2019-2022 prospective study with cluster and network analysis.

BACKGROUND: There is still limited clinical-practice data on specific clinical and patch test features, as well as on allergen clusters in polysensitization (PS). OBJECTIVES: To determine the frequency, relevance, symptoms duration and risk factors in polysensitized patients and to assess possible allergen aggregation. METHODS: Prospective multicentric study (January 2019-December 2022) conducted in setting of the Spanish Contact Dermatitis Register (REIDAC). Clinical and patch test data of polysensitized and oligosensitized patients were compared, and risk factors of PS were investigated with logistic multivariate regression. Unsupervised hierarchical clustering and network analysis were used to study allergen aggregation in PS. RESULTS: A total of 10,176 patients were analysed. PS was found in 844 (8.3%). Current relevance was significantly higher in polysensitized patients (p < 0.01). Risk factors for PS were atopic dermatitis (OR: 1.58, 95% CI: 1.24-2.02), age (≥60 years vs. ≤24 years, OR: 1.75, 95% CI: 1.25-2.44) and some special locations (legs vs. face OR: 1.54, 95% CI: 1.05-2.25, hands vs. face OR: 1.46, 95% CI:1.15-1.85, arms vs. face OR: 1.49, 95% CI:1.01-2.20, trunk vs. face OR: 1.40, 95% CI:1.06-1.85). Cluster and network analyses revealed specific-allergen clusters and significant associations, including allergens belonging to metals group, fragrances and botanicals group, topical drugs group, rubber allergens and biocides. CONCLUSIONS: This study confirms that PS is structured by discernible patterns of specific-allergen clusters and reinforces significant allergen associations in PS. Cross-reactivity and/or concomitant sensitization could explain the formation of allergen clusters in PS.

Plantar keratoderma-like crusted scabies in an immunocompetent infant after topical steroids.

A healthy 6-month-old girl presented with plantar keratoderma-like lesions unresponsive to topical corticosteroids. Nocturnal pruritus in 13 relatives, presence of burrows on clinical exam, and the positive scabies preparation led to the diagnosis of crusted scabies. She was successfully treated with topical and oral scabicides. Crusted scabies is a severe form of Sarcoptes scabiei infection uncommon in immunocompetent subjects, in whom previous corticosteroid use may favor its occurrence.

Belimumab treatment in rhupus: A case report with severe skin involvement.

Patients with rhupus characteristically exhibit symmetric polyarthritis and clinical manifestations suggestive of systemic lupus erythematosus (malar rash, photosensitivity, hematological manifestations, serositis, and/or skin involvement) and positive anti-dsDNA. Treatment is unclear and it can include disease-modifying rheumatic drugs like hydroxyl chloroquine, or methotrexate or, in refractory cases, rituximab or abatacept. We report a case of 31-year-old female who present with rhupus with skin acute lesions treated with belimumab. This is the first case of rhupus treated with this drug described in the literature.

Pitiriasis liquenoide: no todo es varicela. A propósito de un caso / Pityriasis lichenoides. Not everything is chickenpox. A case report

La pitiriasis liquenoide es una entidad inflamatoria benigna de etiología aún desconocida. Existen dos subtipos dentro de esta entidad, la forma aguda (pitiriasis liquenoide varioliforme aguda) y la forma crónica (pitiriasis liquenoide crónica). Ambas son comunes en niños y adultos jóvenes. Describimos un caso de pitiriasis liquenoide aguda y discutimos su presentación clínica, diagnóstico y tratamiento: un escolar de 8 años que presenta un brote agudo de exantema papular pruriginoso con lesiones de distribución centrípeta, las cuales no variaron durante 3 semanas, aparecieron nuevas lesiones durante dicho periodo. La biopsia de las lesiones confirmó el diagnóstico de pitiriasis liquenoide. Tras completar el tratamiento con macrólidos y corticoide tópico se produjo remisión de las lesiones. La pitiriasis liquenoide aguda es una entidad poco frecuente que supone un reto diagnóstico para el pediatra. Su diagnóstico se basa en la sospecha clínica y la confirmación histopatológica. No tiene un tratamiento específico

Pityriasis lichenoides is a benign inflammatory disease of unknown etiology. There are two types of this entity: an acute form (pityriasis lichenoides et varioliformis acuta) and a chronic one (pityriasis lichenoides chronica). Both are common in children and young adults. We describe a case of pityriasis lichenoides, discuss its clinical presentation, diagnosis and treatment. An eight-year-old child who presented erythematous papular lesions in centripetal distribution, these lesions didn't improve in 3 weeks, and new lesions appeared in that period. The biopsy of the lesions confirmed pityriasis lichenoid. After antibiotic and corticosteroid treatment all lesions disappeared. Pityriasis lichenoides acute is a rare design that represents a diagnostic and therapeutic challenge to the physician. The diagnosis of this condition is suspected clinically and confirmed by histology. It does not have specific treatment

Modelo de fotocarcinogénesis cutánea en ratones SKH-1 por radiación ultravioleta / An experimental model of ultraviolet radiation-induced cutaneous photocarcinogenesis in SKH-1 mice

Antecedentes. La exposición crónica a las radiaciones solares provoca el envejecimiento patológico de la piel (fotoenvejecimiento) y es uno de los principales factores etiológicos implicados en el desarrollo del cáncer cutáneo. Métodos. Para el presente experimento, hemos expuesto 20 ratones SKH-1 a radiaciones ultravioleta, que se aplicaban tres veces a la semana durante 60min (80 sesiones). Las zonas expuestas a las radiaciones han sido estudiadas macro y microscópicamente. Resultados. El 100% de los animales tratados desarrollaron neoplasias malignas, así como los signos típicos del fotoenvejecimiento. Conclusiones. Debido a la gran similitud de las lesiones desarrolladas por los animales, con las que tienen lugar en la piel humana tras la exposición crónica a las radiaciones ultravioleta, consideramos este modelo, idóneo para el estudio del fotoenvejecimiento y la fotocarcinogénesis, así como para el ensayo de sustancias antioxidantes y fotoprotectoras(AU)

Introduction. Chronic exposure to solar radiation leads to pathological aging of the skin (photoaging) and is one of the principal etiological factors of skin cancer. Methods. For the present experiment, twenty SKH-1 mice were exposed to ultraviolet radiation three times a week for 60min (a total of 80 sessions). The areas exposed to radiation were subsequently examined macroscopically and microscopically. Results. All the experimental animals developed malignant neoplasias (skin carcinomas) as well as signs typical of photoaging. Conclusions. Given the great similarity between the lesions found in the experimental animals and those appearing in human skin following extensive exposure to ultraviolet radiation, we consider this model suitable for the study of photoaging and photocarcinogenesis and for the assessment of antioxidants and photoprotectors(AU)