ABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Child , Adolescent , Young Adult , Adult , Middle Aged , Dermoscopy , Foot Diseases/diagnostic imaging , Nevus, Pigmented/diagnostic imaging , Nevus, Pigmented/congenital , Nevus, Pigmented/pathology , Foot Diseases/congenital , Foot Diseases/pathologyABSTRACT
No disponible
Subject(s)
Skin Diseases/epidemiology , Emergency Medical Services/statistics & numerical data , Severity of Illness Index , Age and Sex Distribution , Diagnosis, DifferentialSubject(s)
Anti-Allergic Agents/therapeutic use , Hepatitis C, Chronic/complications , Omalizumab/therapeutic use , Urticaria/drug therapy , Anti-Allergic Agents/adverse effects , Chronic Disease , Drug Therapy, Combination , Female , Histamine H1 Antagonists, Non-Sedating/therapeutic use , Humans , Loratadine/analogs & derivatives , Loratadine/therapeutic use , Middle Aged , Omalizumab/adverse effects , Urticaria/complicationsABSTRACT
La combinación de metilcloroisotiazolinona (MCI) con metilisotiazolinona (MI) es ampliamente empleada como conservante tanto en productos de higiene y domésticos como industriales. Desde 2005 está permitido el uso de MI a 100 ppm en cosméticos. En los últimos años se está detectando un aumento considerable de los casos de dermatitis de contacto a los 2 conservantes, por lo que es necesaria una monitorización estrecha por parte de las autoridades y probablemente unas medidas legislativas más estrictas. De hecho, MI a 2000 ppm se ha incluido recientemente en la batería estándar Europea. La forma de presentación clínica es muy variable, y en ocasiones es difícil sospechar una alergia a MCI/MI y MI. MCI/MI se testa en la batería estándar del GEIDAC a 100 ppm, pero con esta concentración se podría estar dejando de diagnosticar hasta la mitad de los casos. Además, según nuestros datos MCI/MI a 200 ppm permite diagnosticar más casos con alergia a MI. Para llegar a un buen diagnóstico consideramos que se debería aumentar la concentración del parche de MCI/MI a 200 ppm e incluir MI en la batería estándar del GEIDAC
The combination of methylchloroisothiazolinone (MCI) and methylisothiazolinone (MI) is widely used as a preservative in cosmetics, household, and industrial products. Furthermore, MI at a concentration of 100 ppm has been permitted in cosmetic products since 2005. Recently, a considerable increase in cases of contact dermatitis to both MCI and MI have been noted, and this warrants closer monitoring by relevant authorities and, probably, stricter legislation. In fact, MI at a test concentration of 2000 ppm was recently included in the European baseline patch test series. The clinical manifestations of allergy to MCI/MI and MI are highly variable and diagnosis is often missed. In the standard patch test series of the Spanish Contacto Dermatitis and Skin Allergy Research Group (GEIDAC), MCI/MI is tested at 100 ppm, but at this concentration, up to 50% of cases might go undetected. Furthermore, our data indicate that MCI/MI at 200 ppm would make it possible to diagnose more cases of contact allergy to MI. To improve the diagnosis of contact allergy to MCI/MI and MI, we believe that the test concentration of MCI/MI should be increased to 200 ppm in the GEIDAC standard series and that MI should be added in the GEIDAC standard series
Subject(s)
Humans , Dermatitis, Allergic Contact/diagnosis , Additives in Cosmetics , Cosmetics/adverse effects , Skin Diseases, Eczematous/prevention & control , Risk Factors , Sanitizing ProductsABSTRACT
The combination of methylchloroisothiazolinone (MCI) and methylisothiazolinone (MI) is widely used as a preservative in cosmetics, household, and industrial products. Furthermore, MI at a concentration of 100 ppm has been permitted in cosmetic products since 2005. Recently, a considerable increase in cases of contact dermatitis to both MCI and MI have been noted, and this warrants closer monitoring by relevant authorities and, probably, stricter legislation. In fact, MI at a test concentration of 2000 ppm was recently included in the European baseline patch test series. The clinical manifestations of allergy to MCI/MI and MI are highly variable and diagnosis is often missed. In the standard patch test series of the Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC), MCI/MI is tested at 100 ppm, but at this concentration, up to 50% of cases might go undetected. Furthermore, our data indicate that MCI/MI at 200 ppm would make it possible to diagnose more cases of contact allergy to MI. To improve the diagnosis of contact allergy to MCI/MI and MI, we believe that the test concentration of MCI/MI should be increased to 200 ppm in the GEIDAC standard series and that MI should be added in the GEIDAC standard series.
Subject(s)
Dermatitis, Allergic Contact/etiology , Preservatives, Pharmaceutical/adverse effects , Thiazoles/adverse effects , Cosmetics , Dermatitis, Allergic Contact/diagnosis , Dermatitis, Allergic Contact/epidemiology , Dermatitis, Allergic Contact/prevention & control , Dermatitis, Occupational/diagnosis , Dermatitis, Occupational/epidemiology , Dermatitis, Occupational/etiology , Dose-Response Relationship, Drug , Drug Synergism , European Union , Household Products , Humans , Legislation, Drug , Manufactured Materials , Molecular Structure , Patch Tests/methods , Patch Tests/standards , Preservatives, Pharmaceutical/administration & dosage , Preservatives, Pharmaceutical/chemistry , Reference Standards , Thiazoles/administration & dosage , Thiazoles/chemistryABSTRACT
Omalizumab es un anticuerpo monoclonal anti-IgE únicamente aprobado para su uso en el asma grave refractario. En los últimos años han sido publicados un gran número de casos clínicos de urticaria crónica de difícil manejo terapéutico que han respondido de forma adecuada al tratamiento con omalizumab. Por ese motivo, se han puesto en marcha ensayos clínicos para ampliar la indicación a esta enfermedad, y recientemente el fármaco ha sido incluido en una guía de consenso para el tratamiento de la urticaria crónica como fármaco de tercera línea después de los antihistamínicos selectivos a dosis altas. El objetivo de este artículo es realizar una actualización integral de la aplicación de omalizumab en el tratamiento de la urticaria crónica: revisaremos su estructura, discutiremos los hipotéticos mecanismos de acción en esta enfermedad y expondremos su modo de empleo y las diferentes posologías empleadas en las series de casos publicados hasta el momento. Por otro lado, también enumeraremos sus efectos secundarios y daremos las pautas de prevención a seguir para minimizar su efecto secundario más temible, la anafilaxia. En definitiva, y según la experiencia de muchos investigadores, omalizumab se perfila como un fármaco novedoso que ha mostrado resultados prometedores en algunos tipos de urticaria crónica espontánea resistente con un buen perfil de seguridad, aunque con la principal limitación de su elevado coste económico
Omalizumab is a monoclonal anti-immunoglobulin E antibody currently only approved for use in severe, refractory asthma. In recent years, many authors have reported satisfactory results with omalizumab in patients with difficult-to-treat chronic urticaria. As a result, clinical trials were undertaken to broaden the indication of omalizumab to include chronic urticaria, and the drug was recently cited as a third-line treatment after selective antihistamines at high doses in a consensus document on the treatment of chronic urticaria. In this article our aim is to provide a comprehensive update on the use of omalizumab in the treatment of chronic urticaria. The structure of this biologic agent and its possible mechanisms of actions in this setting will be presented. Treatment strategies and the different dosage regimens used in the series of cases published to date will also be reviewed. Finally, we will discuss the adverse effects that may arise with treatment and the recommended strategies for minimizing the most feared effect, anaphylaxis. Based on the experience of many researchers, omalizumab is emerging as a novel treatment for certain types of spontaneous refractory chronic urticaria and has shown promising results in this setting. The drug has a good safety profile and the main limitation is its high cost
Subject(s)
Humans , Male , Female , Urticaria/complications , Urticaria/pathology , Urticaria/therapy , Fever/pathology , Anaphylaxis/pathology , Pharyngitis/pathology , Headache/pathology , Asthma/pathology , Asthma/therapyABSTRACT
Omalizumab is a monoclonal anti-immunoglobulin E antibody currently only approved for use in severe, refractory asthma. In recent years, many authors have reported satisfactory results with omalizumab in patients with difficult-to-treat chronic urticaria. As a result, clinical trials were undertaken to broaden the indication of omalizumab to include chronic urticaria, and the drug was recently cited as a third-line treatment after selective antihistamines at high doses in a consensus document on the treatment of chronic urticaria. In this article our aim is to provide a comprehensive update on the use of omalizumab in the treatment of chronic urticaria. The structure of this biologic agent and its possible mechanisms of actions in this setting will be presented. Treatment strategies and the different dosage regimens used in the series of cases published to date will also be reviewed. Finally, we will discuss the adverse effects that may arise with treatment and the recommended strategies for minimizing the most feared effect, anaphylaxis. Based on the experience of many researchers, omalizumab is emerging as a novel treatment for certain types of spontaneous refractory chronic urticaria and has shown promising results in this setting. The drug has a good safety profile and the main limitation is its high cost.
