Contact sensitization in patients with lower extremity dermatitis in the South Moravian region, Czech Republic.

OBJECTIVES: The aim of the study was to determine the frequency of contact sensitization in patients with lower extremity dermatitis. METHODS: Between the years 2001 and 2007, the authors investigated 462 patients (mean age 49.1 years, 196 men and 266 women) with the eczema/dermatitis localized on their lower extremities, including feet. The patients were investigated with epicutaneous tests of the European Standard Series and also with other special patch tests. RESULTS: The most frequent allergens were balsam of Peru, 44/462 (9.5%); wool alcohols, 41/462 (8.9%); nickel sulphate, 39/462 (8.4%); propolis, 35/462 (7.6%); fragrance mix, 34 (7.4%) and colophony, 29/462 (6.3%). CONCLUSIONS: In patients with lower extremity dermatitis the frequency of contact sensitization is still high, and therefore investigation with epicutaneous tests should belong to the routine dermatological diagnostic procedure in these patients.

Common contact sensitizers in the Czech Republic. Patch test results in 12,058 patients with suspected contact dermatitis*.

The patch test results of 12 058 patients (4416 male and 7642 female) referred to 9 clinics in the Czech Republic between January 1997 and December 2001 were evaluated. Patients were tested with the same series of allergens by using the standardized patch testing method. The current standard tool for diagnosing allergic contact dermatitis (ACD) in the Czech Republic is the Trolab test panel (Hermal, Reinbeck, Germany) which consists of 23 allergens. Only a few data exists on ACD in the Czech Republic. All patients were tested with the 23 allergen European standard series. Of these patients, 7661 (63.5%) had 1 or more positive reactions. On average, there were 2.8 positive reactions per patient. ACD, according to clinical relevance, was diagnosed in 5339 (69.7%) of these patients. The most frequent allergens were metals (22.9%), especially nickel sulfate (13.8%), and followed by Myroxylon pereirae resin (balsam of Peru) (7.3%), fragrance mix (5.8%), formaldehyde (4.2%) and lanolin alcohol (3.0%). Our results were compared with results from other countries. We conclude that the European standard series is suitable for detection of ACD in the Czech Republic.

[Contact sensitization to pharmaceutic aids in dermatologic cosmetic and external use preparations]. / Kontaktní senzibilizace na pomocné látky v dermatologických externech a kosmetických prípravcích.

From April 2001 to December 2002, a group of 514 patients (178 men, 336 women, average age 42.8 years) suffering from chronic eczema were tested by means of epicutaneous tests for contact hypersensitivity to selected auxiliary substances of dermatological external and cosmetic preparations. In 194 patients, the principal diagnosis was atopic eczema. Of the preservatives, the most frequently sensitizing agents were Thiomersal in 13.6%, phenylmercuric acetate in 7.8%, formaldehyde in 5.6%, Bronopol in 5.1%, chlorohexidine in 3.3%, dibromodicyanobutane/phenoxyethanol in 2.9%, chloroacetamide in 2.1%, Kathon CG and parabenes in 1.9%, imidazolidinyl urea and diazolidinyl urea in 1.4%, glutaraldehyde in 1.2%, DMDM-hydantoin in 1.0%, dichlorophen in 0.8%, sorbic acid, phenoxyethanol and triclosan in 0.6%, benzalkonium chloride, Quaternium-15 and chlorocresol in 0.4% and chloroquinaldol in 0.2% of the group of patients. Of antioxidizing agents, it was dodecyl gallate in 2.3%, butylhydroxyanisol in 1.2%, propyl gallate in 0.6%, butylhydroxytoluen in 0.4% of the group o patients and of emulsifiers, alcohols lanae in 5.1%, triethanolamine in 1.6% and propylene glycol in 0.4% of the group of patients. A complete list of contained substances in drug information sheets of both pharmaceutical and cosmetic preparations seems necessary particularly for patients suffering from eczema. The results of the test can serve as feed-back information for the manufacturers of both pharmaceutical and cosmetic preparations.

Polyvalent contact allergy to corticosteroids: a report of two cases.

Two cases of positive allergic reactions to eight patch-tested corticosteroid substances are reported. The patients were middle-aged women with a long history of contact dermatitis who had used topical corticosteroids for years. Pure corticosteroid substances were tested in therapeutic and 1% concentrations in ethanol and petrolatum. The intensity of reactions was different depending on the vehicle and concentration. Patients with hypersensitivity to several corticosteroid substances represent an important therapeutic problem.

[Occupational diseases of health care workers]. / Profesionální nemoci zdravotníku.

During the past years in Czechoslovakia some 5000 occupational diseases, intoxications and other occupational health damage was recorded. Per year about one fifth of the affected people were health workers. The authors made an analysis of occupational diseases in the South Moravian region in 1975 to 1990. A total of 1726 occupational diseases of health professionals were recorded. In 91.8% contagious diseases were involved, in 7.4% dermatoses--where the most frequent condition was contact eczema. In 0.5% other occupational diseases were involved such as asthma bronchiale, damage to haematopoiesis by ionizing radiation, damage of the nerves of the upper extremities by locally transmitted vibrations, epicondylitis of the humerus and dysphonia in a teacher in a school for health workers. Other health damage was found only in 0.3%. In three instances serious malignancies of the urinary system were found in oncologists who had been administering cytostatics for prolonged periods. The most frequent occupational disease of health workers was in 65.4% viral hepatitis, in recent years with a steadily declining trend. The paper indicates that health professions were during the past period, as compared with traditional ideas, associated with a considerable risk.