[Time to limit the use of antibiotics in rosacea!] / Dags att minska användningen av antibiotika vid rosacea - Isotretinoin bör övervägas vid frekventa recidiv ­ lokalbehandling fortfarande förstahandsterapi.

Rosacea is a chronic inflammatory disease with facial erythema and papulopustules. It is common in middle-aged/elderly persons and often affects self-perception and social well-being. It is generally classified into four subtypes. Improved understanding of pathophysiology has resulted in novel treatment approaches, but routine management in health care usually follows old trails. Most patients are managed in primary care. Greater attention to the reduced skin barrier, avoidance of exacerbating factors, better topicals and encouragement to topical maintenance treatment should reduce the use of oral tetracyclines. Low-dose isotretinoin is reserved for treatment-resistant patients, but relapses are frequent unlike its use in acne. In order to reduce antibiotic use, we propose that patients should be referred to a dermatologist for optimization of therapy including consideration of isotretinoin following tetracycline treatment of a maximum of 4-6 months.

Several cases of undesirable effects caused by methacrylate ultraviolet-curing nail polish for non-professional use.

BACKGROUND: Ultraviolet (UV)-curing nail polishes based on acrylates or methacrylates are currently also available for non-professional use. The Swedish Medical Products Agency recently prohibited one brand of UV-curing polish, because several consumers reported undesirable effects after using it. OBJECTIVES: To investigate whether consumers with undesirable effects after using the UV-curing nail polish that was later prohibited were contact allergic to the polish and its individual ingredients. MATERIALS/METHODS: Eight patients who had reported severe skin reactions after the use of the UV-curing polish were patch tested with two coatings of the nail polish and its ingredients at five dermatology departments in Sweden. RESULTS: All patients tested except one showed contact allergic reactions to one or several of the acrylate-based or methacrylate-based ingredients in the nail polish. CONCLUSIONS: The non-professional use of UV-curing nail polishes poses a risk of sensitization from acrylates and methacrylates.

A positive cobalt spot test falsely indicating an occupational allergic contact dermatitis caused by cobalt.

BACKGROUND: For investigation of chemical exposure in allergic individuals, spot tests are invaluable. A reagent may react with a specific compound to give a specific typical colour, and thus indicate the presence of the specific substance. Spot tests can give both false-negative and false-positive reactions. To confirm the presence of the substance and quantify it, more sophisticated methods are required. On the basis of a positive cobalt spot test result, a woman was initially diagnosed with an occupational allergic contact dermatitis caused by cobalt. OBJECTIVES: To investigate cobalt release from three different metal weaves to which our patient was occupationally exposed. METHODS: The cobalt gel test and atomic absorption spectroscopy (AAS) were used to investigate the metal weaves. Two types of extract based on artificial sweat and nitric acid, respectively, were investigated with AAS. RESULTS: No cobalt release was demonstrated with AAS. CONCLUSIONS: When a diagnosis of allergic contact dermatitis caused by a sensitizer based on a positive spot test result will have far-reaching consequences, such as change of work, retraining, and claim on and payment of worker's compensation, conformational analysis must be performed.