Analysis of Contact Allergens in Polyvinyl Chloride Examination Gloves in the United States.

Background: Polyvinyl chloride (PVC) gloves are recommended as a safe alternative for patients with rubber accelerator allergy. However, allergic contact dermatitis to other chemicals in PVC gloves has been reported. Objective: To analyze single-use PVC medical examination gloves in the United States for the presence of potential contact allergens. Methods: Using liquid chromatography-mass spectrometry, 20 unique PVC gloves were analyzed in triplicate for 6 chemicals: benzisothiazolinone, bisphenol A, mono(2-ethylhexyl) maleate, tricresyl phosphate, triphenyl phosphate, and triphenyl phosphite. Results: All 20 PVC gloves contained detectable quantities of benzisothiazolinone (range, 0.001-1.48 parts per million [ppm]), bisphenol A (0.01-0.11 ppm), triphenyl phosphate (0.01-2.11 ppm), and triphenyl phosphite (0.001-0.22 ppm). Eighteen (90%) gloves contained mono(2-ethylhexyl) maleate (0.001-0.14 ppm) and 3 (15%) contained tricresyl phosphate (0.001-0.002 ppm). Conclusions: Known allergens were present in all 20 PVC gloves. However, the detected levels were mostly low and their relationship with sensitization and elicitation thresholds requires further study.

A Survey of Skin Reactions Associated With Acrylic Nail Cosmetics, With a Focus on Home Kits: Is There a Need for Regulation?

Background: Sensitization to (meth)acrylates, the most common nail cosmetic allergens, is rising. In recent years, home acrylic nail kits have become easily available. Objective: To investigate the characteristics of individuals reporting skin reactions associated with acrylic nail cosmetics, particularly home kits. Methods: Cross-sectional survey of Facebook nail allergy support groups. Inclusion criteria were self-reported skin reactions associated with acrylic nails and age ≥18 years. Results: There were 199 respondents, nearly all female (99%), mostly white (83%), and 25-54 years old (83%). Seventy-eight percent reported using home acrylic kits, more than half for the first time during COVID-19. They predominantly learned about kits through social media (68%) and received training through websites/online videos (74%). Most home users (83%) first developed skin reactions after starting to use home kits. Compared with nonhome users, significantly more home users reported skin reaction onset within 1 year of use, as well as nail damage (P < 0.05). Conclusions: Among online nail allergy support group members, home acrylic nail kit use was common and associated with earlier development of skin reactions and more frequent nail damage than professional acrylic manicures. These findings raise important questions about the need to regulate home acrylic nail kits.

Psychiatric comorbidities on an inpatient dermatology consultation service: A cross-sectional analysis.

Despite the high prevalence of psychiatric illness in hospitalised dermatology patients, characterisation of psychiatric comorbidities on an inpatient dermatology consultation service in the United States has yet to be performed. To fill this gap in knowledge, we investigated the prevalence of and factors associated with psychiatric illness on the inpatient dermatology consultation service at the University of Southern California. Of the 429 patients seen by the dermatology consultation service between June 2021 to July 2022, 147 (34%) had psychiatric illness (defined as having at least 1 psychiatric diagnosis). Increasing age was associated with a decreased likelihood of psychiatric illness, while housing instability, chronic dermatologic disease, drug reaction, and pruritus without rash were associated with an increased likelihood of psychiatric illness. The high prevalence of psychiatric illness observed in hospitalised dermatology patients emphasises the importance of collaboration between consultant dermatologists and mental health specialists, particularly when specific sociodemographic or disease factors are present.

Kaposi's Varicelliform Eruption After Treatment With Ixekizumab in a Patient With Pityriasis Rubra Pilaris.

Pityriasis rubra pilaris (PRP) is a rare condition characterized by red-orange plaques with islands of sparing with follicular and palmoplantar hyperkeratosis. The disease can be difficult to treat and often requires patients to trial multiple therapeutic options. In recent years, targeted biologic therapies have increasingly been trialed due to their relative efficacy and favorable safety profile. Ixekizumab, an interleukin-17 inhibitor, is one such therapy that has demonstrated efficacy in PRP with few reported adverse events. We present a PRP patient who developed Kaposi's varicelliform eruption followed by a pseudomonal superinfection three months after initiation of ixekizumab.

Janus Kinase Inhibitors: A Promising Therapeutic Option for Allergic Contact Dermatitis.

Janus kinase (JAK) inhibitors represent a promising class of small molecule inhibitors that treat a range of inflammatory skin diseases, such as atopic dermatitis (AD), psoriasis, and alopecia areata. Although the evidence for their use in allergic contact dermatitis (ACD) remains limited, early results from animal studies and case reports are promising. Herein, we provide an overview of JAK inhibitors and the evidence for their use in ACD.

Treatment Options for Juvenile Pityriasis Rubra Pilaris.

Pityriasis rubra pilaris represents a group of familial and acquired disorders of cornification that affect both adult and pediatric patients. Treatment options are difficult to assess through clinical trials, given the rarity of the disorder and its tendency for spontaneous remission. Case reports and case series are therefore the primary means of assessment. Because of the heterogeneity of the disease, there is no universal approach to treatment, and multiple agents may need to be trialed to achieve disease control. At present, topicals are used for most pediatric patients, though monotherapy with topicals is only effective for less severe disease. Despite concerns over their side-effect profiles, oral retinoids are generally accepted as a first-line systemic therapy. However, interleukin-17 inhibitors and ustekinumab, an interleukin-12 and interleukin-23 inhibitor, may soon become first-line systemic treatment as well, given their efficacy and relative safety in trials thus far. Ustekinumab, in particular, is emerging as a first-line agent for patients with pityriasis rubra pilaris with CARD14 gene variations. When these therapies fail, second-line and adjunctive therapies to consider include tumor necrosis factor-alpha inhibitors, methotrexate, and phototherapy. However, further investigation is necessary to assess the safety and efficacy of many of these agents in juvenile pityriasis rubra pilaris.

Photoallergic Contact Dermatitis: No Fun in the Sun.

Photoallergic contact dermatitis (PACD) is a form of allergic contact dermatitis that occurs due to the interaction between a topically applied chemical and exposure to UV radiation. It can be difficult to identify and requires photopatch testing (PPT) for definitive diagnosis. In this article, we provide an overview of PACD, including clinical features, the most common photoallergens, and why cases may go undiagnosed.

Twin-twin transfusion syndrome and the definition of recipient polyhydramnios.

BACKGROUND: Controversy exists regarding the threshold of recipient twin polyhydramnios required to diagnose twin-twin transfusion syndrome at a gestational age of ≥20 weeks. One criterion set (Quintero staging) requires the amniotic fluid maximum vertical pocket for the recipient twin to measure ≥8 cm, whereas another (European) system uses a maximum vertical pocket for the recipient twin of ≥10 cm. OBJECTIVE: This study aimed to characterize the patients with twin-twin transfusion syndrome who were treated with laser surgery and would be excluded from laser surgery according to the European criteria. STUDY DESIGN: A total of 366 monochorionic diamniotic twins diagnosed with twin-twin transfusion syndrome from 20 to 26 weeks' gestation who underwent laser surgery at our center were studied. A maximum vertical pocket for the recipient twin of ≥8 cm was used to diagnose twin-twin transfusion syndrome. Patients were retrospectively divided into the following 2 groups: group A with a maximum vertical pocket for the recipient twin of ≥8 cm and <10 cm and group B with a maximum vertical pocket for the recipient twin of ≥10 cm. The association of each of the groups with the survivorship outcomes was tested. Bivariate associations between the patient characteristics and the 30-day donor twin and dual survivorship outcomes were evaluated. Tests used in the analysis were chi-square or Fisher exact tests as appropriate for categorical variables and Kruskal-Wallis tests for continuous variables. Multiple logistic regression models for each of the survivorship outcomes were then assessed. The results are reported as mean±standard deviation. RESULTS: Of the 366 studied patients, 53 (14.5%) had a maximum vertical pocket for the recipient twin of ≥8 and <10 cm (group A) and 313 (85.5%) had a maximum vertical pocket for the recipient twin of ≥10 cm (group B). Groups A and B did not differ in the Quintero stage. Notably, 60.4% (32 of 53) of group A patients were stage III or IV. When compared with group B, group A was diagnosed with twin-twin transfusion syndrome at an earlier gestational age (21.7±1.6 vs 22.3±1.6 weeks; P=.0037) and had a higher prevalence of donor growth restriction (81.1% [43 of 53] vs 65.5% [205 of 313]; P=.0260). Rates of at least 1 twin and dual twin survival between group A and B were similar (98.1% [52 of 53] vs 95.8% [300 of 313]; P=.7023, and 79.2% [42 of 53] vs 83.4% [261 of 313]; P=.4369, respectively). Logistic regression models adjusted for perioperative characteristics showed no difference in the outcomes between the groups (group B as reference) (donor twin survival odds ratio, 0.64; 95% confidence interval, 0.29-1.42; P=.2753; and dual survivor odds ratio, 0.90; 95% confidence interval, 0.42-1.91; P=.7757). CONCLUSION: Restriction of the definition of twin-twin transfusion syndrome to a maximum vertical pocket for the recipient of ≥10 cm beyond 20 weeks gestational age would potentially exclude 14.5% of patients from laser surgery, the majority of whom had advanced stage twin-twin transfusion syndrome. A unifying criterion of a maximum vertical pocket for the recipient of ≥8 cm regardless of gestational age would allow inclusion of these patients and access to surgical management.

Overview of the QCD phase diagram: Recent progress from the lattice.

In recent years there has been much progress on the investigation of the QCD phase diagram with lattice QCD simulations. In this review we focus on the developments in the last two years. Especially the addition of external influences or new parameter ranges yields an increasing number of interesting results. We discuss the progress for small, finite densities from both extrapolation-based methods (Taylor expansion and analytic continuation for imaginary chemical potential) and complex Langevin simulations, for heavy quark bound states (quarkonium), the dependence on the quark masses (Columbia plot) and the influence of a magnetic field. Many of these conditions are relevant for the understanding of both the QCD transition in the early universe and heavy ion collision experiments, which are conducted for example at the LHC and RHIC.

QCD Crossover at Finite Chemical Potential from Lattice Simulations.

We provide the most accurate results for the QCD transition line so far. We optimize the definition of the crossover temperature T_{c}, allowing for its very precise determination, and extrapolate from imaginary chemical potential up to real µ_{B}≈300 MeV. The definition of T_{c} adopted in this work is based on the observation that the chiral susceptibility as a function of the condensate is an almost universal curve at zero and imaginary µ_{B}. We obtain the parameters κ_{2}=0.0153(18) and κ_{4}=0.00032(67) as a continuum extrapolation based on N_{t}=10, 12, 16 lattices with physical quark masses. We also extrapolate the peak value of the chiral susceptibility and the width of the chiral transition along the crossover line. In fact, both of these are consistent with a constant function of µ_{B}. We see no sign of criticality in the explored range.

Drag of Clean and Fouled Net Panels--Measurements and Parameterization of Fouling.

Biofouling is a serious problem in marine aquaculture and it has a number of negative impacts including increased forces on aquaculture structures and reduced water exchange across nets. This in turn affects the behavior of fish cages in waves and currents and has an impact on the water volume and quality inside net pens. Even though these negative effects are acknowledged by the research community and governmental institutions, there is limited knowledge about fouling related effects on the flow past nets, and more detailed investigations distinguishing between different fouling types have been called for. This study evaluates the effect of hydroids, an important fouling organism in Norwegian aquaculture, on the forces acting on net panels. Drag forces on clean and fouled nets were measured in a flume tank, and net solidity including effect of fouling were determined using image analysis. The relationship between net solidity and drag was assessed, and it was found that a solidity increase due to hydroids caused less additional drag than a similar increase caused by change in clean net parameters. For solidities tested in this study, the difference in drag force increase could be as high as 43% between fouled and clean nets with same solidity. The relationship between solidity and drag force is well described by exponential functions for clean as well as for fouled nets. A method is proposed to parameterize the effect of fouling in terms of an increase in net solidity. This allows existing numerical methods developed for clean nets to be used to model the effects of biofouling on nets. Measurements with other types of fouling can be added to build a database on effects of the accumulation of different fouling organisms on aquaculture nets.

The fouling hydroid Ectopleura larynx: a lack of effect of next generation antifouling technologies.

The hydroid Ectopleura larynx is one of the main fouling organisms on salmon aquaculture cages in Norway; this study investigated novel surface materials and microtopographies to deter its settlement. The settlement preferences of hydroid larvae for 12 materials with wettabilities ranging from hydrophobic (54°) to hydrophilic (112°) were tested in a no-choice bioassay. Although settlement differed between materials, with the highest average settlement on polytetrafluoroethylene (95%) and the lowest on untreated polyurethane (53%), no trend regarding the tested wettabilities could be found and none of the tested materials was able to reduce average settlement below 50%. Furthermore, nine high-density polyethylene (HDPE, 100-600 µm microtopographies) and seven polydimethylsiloxane (PDMS; 40-400 µm microtopographies) microtextured surfaces were tested. There was no systematic effect of microtopography on the settlement of E. larynx larvae. However, there was a preference for settlement in channels on PDMS microtopographies between 80 and 300 µm. Similarly, there were no preferences for any of the examined microtopographies in a 12-day field test using PDMS surfaces at a commercial fish farm. The study indicated that neither surface wettability (hydrophilicity-phobicity) nor microtopographies were effective at deterring the settlement of the hydroid E. larynx. The high plasticity of the aboral pole and the hydrorhiza of the hydroids may explain settlement even under unfavourable conditions, highlighting the successful colonisation traits of this dominant biofouling species.

The impact and control of biofouling in marine aquaculture: a review.

Biofouling in marine aquaculture is a specific problem where both the target culture species and/or infrastructure are exposed to a diverse array of fouling organisms, with significant production impacts. In shellfish aquaculture the key impact is the direct fouling of stock causing physical damage, mechanical interference, biological competition and environmental modification, while infrastructure is also impacted. In contrast, the key impact in finfish aquaculture is the fouling of infrastructure which restricts water exchange, increases disease risk and causes deformation of cages and structures. Consequently, the economic costs associated with biofouling control are substantial. Conservative estimates are consistently between 5-10% of production costs (equivalent to US$ 1.5 to 3 billion yr(-1)), illustrating the need for effective mitigation methods and technologies. The control of biofouling in aquaculture is achieved through the avoidance of natural recruitment, physical removal and the use of antifoulants. However, the continued rise and expansion of the aquaculture industry and the increasingly stringent legislation for biocides in food production necessitates the development of innovative antifouling strategies. These must meet environmental, societal, and economic benchmarks while effectively preventing the settlement and growth of resilient multi-species consortia of biofouling organisms.

Potential antifouling strategies for marine finfish aquaculture: the effects of physical and chemical treatments on the settlement and survival of the hydroid Ectopleura larynx.

The hydroid Ectopleura larynx is a common fouling organism on aquaculture nets. To contribute to the development of novel cleaning methods, laboratory and field studies determined the effects of heat (30, 40, 50 and 60°C for immersion times of 1 and 3 s) and acetic acid (0.2 and 2.0% for immersion times of 1, 3 and 10 s, 1 and 5 min) on the settlement of actinulae and the survival of juvenile and adult E. larynx. Laboratory studies showed that, regardless of immersion time, a temperature of 50°C was effective in preventing the settlement of actinulae and the survival of juveniles, while ≤12% of adult hydroids could survive. A temperature of 60°C killed all adult hydroids. For an acetic acid concentration of 0.2%, an immersion time of 1 min substantially reduced the settlement of actinulae and the survival of juvenile and adult hydroids, and none of the juvenile and adult hydroids survived after 5 min. For an acetic acid concentration of 2.0%, all immersion times were effective and reduced the mean settlement of actinulae and the survival of juvenile and adult hydroids to ≤10%. Field studies with fouled net panels exposed to selected heat or acetic acid treatments showed small reductions in mean wet weight and net aperture occlusion of the net panels 2 and 5 days after treatment. Visual inspections of the net panels showed that hydranths of the hydroids were shed, but the dead stolons of the hydroids remained on the treated net panels. Novel cleaning methods and devices may utilise these results to effectively kill E. larynx on aquaculture nets, while further studies are needed to determine the necessity of removing the dead hydroids before further biofouling accumulates on the nets.

Anti-malarial, anti-algal, anti-tubercular, anti-bacterial, anti-photosynthetic, and anti-fouling activity of diterpene and diterpene isonitriles from the tropical marine sponge Cymbastela hooperi.

In an investigation into their potential ecological role(s), a group of mainly diterpene isonitriles, nine in total, isolated from the tropical marine sponge Cymbastela hooperi, and the sesquiterpene axisonitrile-3, isolated from the tropical marine sponge Acanthella kletra, were evaluated in a series of bioassays including anti-fouling, anti-algal, anti-photosynthetic, anti-bacterial (Gram +ve and -ve), anti-fungal, and anti-tubercular. The results of these assays showed that all of the tested compounds, with the exception of diterpene 9, were active in at least two of the applied test systems, with axisonitrile-3 (10) and diterpene isonitrile 1 being the two most active compounds overall, closely followed by diterpene isonitrile 3. Based on the results of the photosynthetic study a molecular modelling investigation was undertaken with all of the compounds used in that study. The results showed a positive correlation between reduction in photosynthetic activity and the interaction of the modelled compounds with a potential enzyme active site.

Fouling-resistant surfaces of tropical sea stars.

Qualitative evidence suggests sea stars are free of fouling organisms; however the presence of fouling-resistant surfaces of sea stars has not previously been documented. Field surveys were conducted in northern Queensland, Australia, during the wet and dry seasons and several tropical sea star species were examined for surface-associated micro- and macro-organisms. Mean bacterial abundances on seven sea star species were approximately 10(4) to 10(5) cells cm(-2) during both seasons. There were no consistent trends in bacterial abundances with season, species and aboral positions on sea star arms. No common generalist fouling organisms, such as algae, barnacles, serpulid polychaetes, bryozoans and ascidians, were found on any specimens of 12 sea star species. However, low numbers of parasitic and commensal macro-organisms were found on six sea star species. The gastropods Parvioris fulvescens, Asterolamia hians, Thyca (Granulithyca) nardoafrianti and Thyca crystallina were found exclusively on the sea stars Archaster typicus, Astropecten indicus, Nardoa pauciforis and Linckia laevigata, respectively. The shrimp Periclimenes soror was only found on Acanthaster planci, and the polychaete Ophiodromus sp. on A. typicus. The copepods Stellicola illgi and Paramolgus sp. were only found on L. laevigata and Echinaster luzonicus, respectively. As no common generalist fouling organisms were discovered, sea stars offer an excellent model to investigate the mechanisms driving fouling-resistant surfaces and the selective settlement of specialist invertebrates.

Surface microtopographies of tropical sea stars: lack of an efficient physical defence mechanism against fouling.

The role of surface topography as a defence against fouling in tropical sea stars was investigated. The sea stars Linckia laevigata, Fromia indica, Cryptasterina pentagona and Archaster typicus are not fouled and have paxillae (modified ossicles with a median vertical pillar) on their aboral surfaces, which varied in diameter, height and distance depending on species and position on the aboral surface, providing unique and complex surface microtopographies for each species. The surfaces of the sea stars L. laevigata, F. indica and A. typicus were moderately wettable, with their mean seawater contact angles, calculated from captive bubble measurements, being 60.1 degrees, 70.3 degrees and 57.3 degrees, respectively. The seawater contact angle of C. pentagona could not be measured. To evaluate the effectiveness of the surface microtopographies in deterring the settlement of fouling organisms, field experiments with resin replicas of the four sea star species were conducted at three sites around Townsville, Australia, for 8 weeks during the dry and wet seasons. The fouling community and total fouling cover did not differ significantly between replicas of L. laevigata, F. indica, C. pentagona, A. typicus and control surfaces at any site during the dry season. Significant differences between fouling communities on the replicas of the sea stars and control surfaces were detected at two sites during the wet season. However, these differences were transitory, and the total fouling cover did not differ significantly between replicas of sea stars and control surfaces at two of the three sites. In contrast to recent literature on the effects of biofouling control by natural surfaces in the marine environment, the surface microtopographies of tropical sea stars alone were not effective in deterring the settlement and growth of fouling organisms.