Natural rubber latex allergy in a health-care population in Wales.

BACKGROUND: Type 1 natural rubber latex (NRL) allergy prevalence rates quoted vary due to the different populations studied and methodologies used for assessment and investigation of NRL allergy. OBJECTIVES: To investigate the rate of type 1 allergy to NRL in health-care workers (HCWs) in a single NHS trust in Wales. METHODS: A response rate of 3716 of 5548 (67%) of the employees was obtained with a latex allergy questionnaire administered by the occupational health departments. Type 1 NRL allergy was diagnosed by correlating clinical symptoms, skin prick testing and IgE RAST to latex in the dermatology department. RESULTS: The period prevalence (1998-2001) for type 1 clinical latex allergy in HCWs was 25 of 4439 (0.56%). Of the 25 positive HCWs, 18 (72%) were nurses. CONCLUSIONS: The low prevalence rate of type 1 NRL allergy should not lead to underestimating the importance of clinically significant NRL allergy and the risks that need to be minimized.

Facial cutaneous tuberculosis: an unusual presentation.

Periocular cutaneous tuberculosis is a rare occurrence. We describe a 75-year-old Caucasian woman with tuberculosis of the left periocular region which responded completely to standard antituberculosis therapy. We hypothesize this unusual presentation may be due to minor trauma followed by inoculation.

Quantification of the nail fold capillary abnormalities in systemic sclerosis and Raynaud's syndrome.

Measurements were made of capillary luminal diameters and capillary numbers in four groups: 19 normal controls 10 patients with 'idiopathic' Raynaud's disease, 12 patients with Raynaud's phenomenon with an underlying connective tissue disease other than systemic sclerosis, and 18 patients with systemic sclerosis. There was a significant reduction of capillary numbers in all three patient groups compared with the normal controls. Both the afferent and efferent luminal diameters were also increased in each patient group. Patients with Raynaud's phenomenon, either on its own or associated with connective tissue disease, gave results intermediate between normal controls and patients with systemic sclerosis. There were no significant correlations between either the reduction in capillary numbers or increase in luminal diameter with disease severity or duration in systemic sclerosis. It is unlikely that capillary microscopy will provide useful prognostic information for an individual patient with systemic sclerosis; its predictive value in Raynaud's disease must await the outcome of long term follow-up studies.