Protein contact dermatitis--case report.

Protein contact dermatitis is a skin condition not well known and underdiagnosed by dermatologists, resulting from an IgE-mediated allergic reaction. Clinically it presents as a chronic hand and/or forearms eczema of occupational origin, especially in professionals who work as food handlers. Epicutaneous tests are negative, and to diagnose this condition it is necessary to perform immediate-type allergy tests. The most sensitive and practical is the prick-by-prick test with food that the patient refers to cause intense itching after immediate skin contact. Treatment is symptomatic, and it is mandatory to avoid the responsible allergen, wearing plastic gloves and even sometimes leaving the workplace for symptom resolution.

Protein contact dermatitis - case report / Dermatite de contacto proteinica - relato de caso

Protein contact dermatitis is a skin condition not well known and underdiagnosed by dermatologists, resulting from an IgE-mediated allergic reaction. Clinically it presents as a chronic hand and/or forearms eczema of occupational origin, especially in professionals who work as food handlers. Epicutaneous tests are negative, and to diagnose this condition it is necessary to perform immediate-type allergy tests. The most sensitive and practical is the prick-by-prick test with food that the patient refers to cause intense itching after immediate skin contact. Treatment is symptomatic, and it is mandatory to avoid the responsible allergen, wearing plastic gloves and even sometimes leaving the workplace for symptom resolution.

A dermatite de contacto proteínica é uma condição pouco conhecida e infra-diagnosticada pelos dermatologistas, resultante de uma resposta alérgica de tipo imediato, mediada por IgE. Clinicamente apresenta-se como um eczema crónico em mãos e/ou antebraços de origem ocupacional, sobretudo em profissionais que trabalham manipulando alimentos. As provas epicutâneas são negativas e para realizar o diagnóstico desta condição há que realizar testes alérgicos de tipo imediato, sendo o mais sensível e rápido, o prick-by-prick test com os alimentos que o paciente refere causar-lhe prurido intenso e imediato ao seu contacto. O tratamento é sintomático, sendo necessário evitar o alérgeno responsável, utilizar luvas de plástico e em ocasiões abandonar o posto de trabalho para a sua resolução.

Facial contact dermatitis and the irritant potential of mobile phone screens.

A teenager with atopic dermatitis presented with a 12-month history of recurrent, pruritic, round and polygonal patches on her face. Patch tests using the European standard series (including nickel, chromium, and cobalt chloride), a plastic and glue series of allergens, polyester components, and personal and environmental products in contact with the patient were conducted. For the patient and 3 of 14 healthy volunteers, positive reactions were observed to the patient's mobile phone touchscreen (TS), an extract solution from the TS, and a non-TS phone of another brand. Accordingly, the patient's dermatitis disappeared when contact with mobile phone screens was avoided.

Development and validation of a questionnaire on 'Satisfaction with dermatological treatment of hand eczema' (DermaSat).

OBJECTIVE: To develop a self-administered short questionnaire to assess patient satisfaction with medical treatment for hand eczema (dermatitis) with good psychometric properties. METHOD: The content of the questionnaire was determined on the basis of clinical consultation with groups of patients, from studying the existing instruments, and from discussions with a panel of seven experts. A first draft version containing 38 items organised in six dimensions was tested on a pilot sample of patients to assess its legibility. The extended version was then tested on a sample of 217 patients of both genders enrolled at 18 hospitals representative of the national distribution. The questionnaire was supplied together with the Morisky-Green compliance questionnaire, the health-related quality of life (HRQL) SF-12 questionnaire, and a visual analogue scale (VAS) of perceived health status to assess concurrent validity. The dimensionality was reduced by means of exploratory factor analysis, and reliability was evaluated on the basis of internal consistency and two halves reliability estimates. Item discriminant capability and questionnaire discriminant validity with respect to known groups of patients (by gender, principal diagnosis, age, disease severity and treatment) were also assessed. RESULTS: The reduction and validation sample was composed of 54% women and 46% men, of various educational levels with an average age of 43 years (SD = 13.7). Of those who responded, 26% were diagnosed with hyperkeratotic dermatitis of the palms and 27% of the fingertips, and 47% with recurring palmar dyshidrotic eczema. The questionnaire was shortened to a version containing 17 items grouped in six dimensions: effectiveness, convenience, impact on HRQL, medical follow-up, side effects, and general opinion. Cronbach's alpha coefficient reached a value of 0.9. The dimensions showed different degrees of correlation, and the scores had a normal distribution with an average of 58.4 points (SD = 18.01). Treatment satisfaction scores attained correlations between 0.003 and 0.222 with the HRQL measures, and showed higher correlations with the effectiveness (r = 0.41) and tolerability (0.22) measures, but very low correlation with compliance (r = 0.015). Significant differences were observed between some diagnoses and treatments. CONCLUSIONS: The shortened questionnaire proved to have good psychometric properties, providing excellent reliability, satisfactorily reproducing the proposed structure and supplying evidence of validity.

Bartonelosis (Fiebre de la Oroyao verruga peruana) ¿Enfermedad ocupacional? / No disponible

La Bartonella bacilliformis es un parásito bacterianointracelular facultativo de los eritrocitos humanos y de las células endoteliales. La enfermedad de Carrión, fiebre de La Oroya y Verruga Peruana son todos términos que describen las consecuencias patológicas de la infección humana por Bartonella bacilliformis. (1)Aunque las infecciones que involucran especies deBartonella, tales como Bartonella henselae y Bartonellaquintana, ocurren en todo el mundo, la enfermedad deCarrión es endémica únicamente en Sudamérica. (14)Las infecciones por B. bacilliformis son un problemade salud en numerosas áreas rurales de Sudamérica y paralos viajeros que visitan esas regiones. Se han reportadobrotes de bartonelosis en las regiones montañosas de Perú, Ecuador y Colombia. (1)La Lutzomyia verrucarum es el principal vector para latransmisión de la bacteria al ser humano; la hembra delmosquito transmite el patógeno durante su alimentaciónnocturna de sangre humana. Presumiblemente el insecto sealimenta de sangre de un individuo infectado y disemina el patógeno por medio de su saliva durante la siguiente ingesta de sangre. La bacteria no es contagiosa entre humanos.(1)Presentamos un enfoque laboral de la enfermedad entrabajadores que realizan desplazamientos continuos azonas endémicas y analizamos sus posibles consecuencias

Bartonella bacilliformis is a facultative intracellularbacterial parasite of human erythrocytes and endotelialcells. Carrion’s disease, Oroya fever and Peruvian wart are all terms describing the pathological consequences ofhuman infection with Bartonella bacilliformis. (1) Although infections involving the Bartonella species, such as Bartonella henselae and Bartonella Quintana occur worldwide, Carrion’s disease is uniquely endemic to South America.(14)Bartonella baciliformis infections are a health problemin many rural areas of South America and to travellers who visit these regions.Outbreaks of Bartonellosis have been reported in themountainous regions of Peru, Ecuador and Colombia.(1)The Lutzomyia verrucarum is the main vector fortransmission of the bacteria to humans. The female sandfly transmits the pathogen during nocturnal blood feeding on humans. Presumably the insects feed on the blood of an infected individual and spread the pathogen via saliva during a subsequent meal.The bacterium is not transmitted from person to person.(1)Let's sense beforehand a labour approach of the diseasein workers who realize constant displacements to endemiczones and we analyze your possible consequences

Isotiazolinas: Importancia en el desarrollo de dermatitis de contacto profesional / No disponible

El Kathon es un conservante resultante de la mezcla de dos isotiazolinonas. Se utiliza preferentemente en la industria cosmética a concentraciones 3-15 ppm. También se ha impuesto su presencia en productos de limpieza de uso doméstico y actualmente a concentraciones más altas en preparados de uso industrial como aceites de corte, emulsiones de látex, pinturas al temple, reveladores de fotografía y radiografía, aceites para motores Diesel. Todo ello hace que sea un sensibilizante importante en nuestra vida privada y profesional. Objetivos: 1. Demostrar la relación del Kathon como sustancia sensibilizante en el desarrollo de dermatitis de contacto. 2. Demostrar la relación entre Kathon y dermatitis de contacto de origen laboral y determinadas profesiones. Metodología: Estudio descriptivo: revisión de las historias clínicas de los pacientes que fueron vistos por el Servicio de Dermatología Laboral del Instituto Nacional de Medicina y Seguridad en el Trabajo durante los años 2004-2006; 2333 pacientes, remitidos por diferentes lesiones dermatológicas con posible relación laboral. Buscaremos los sensibilizados a Kathon y analizaremos las variables: sexo, edad, profesión, enfermedades dermatológica de base, localización de las lesiones, manejo de productos que contengan Kathon. Realizaremos el análisis estadístico con el programa SPSS. Resultados: De las 110 positividades a Kathon, 32 son relacionadas con el trabajo (37,2%). Podemos sumarles otros 13 casos dudosos (15,11%) y de estos casos positivos, el 46,6% fueron varones. Conclusiones: El Kathon es un conservante muy utilizado en el mundo laboral, y son precisamente las profesiones que más productos con Kathon usan, las que mayor número de casos registran

The Kathon is a preservative obtained of the mixture of two isothiazolinones. It is preferently used in the cosmetic industry at 3-15 ppm concentrations. Its presence has increased from the end of the 70's in Europe and from the middle of the 80's in USA. The product presence has also imposed in house-cleaning use and at higher concentrations in the industrial use as motor oils, latex emulsions, painting oils, revealers for photography and x-ray, oils for diesel engines. All of these make it to be an important irritating product in our private and professional life. Objectives: 1. To demonstrate the relation of the Kathon like irritating substance in producing contact dermatitis. 2. To demonstrate to the relation between Kathon and contact dermatitis of labor origin and certain professions. Methodology: Descriptive study: revision of clinical histories of the patients who have been observed in the Department of Labor Dermatology of the National Institute of Medicine and Labor Security during years 2004-2006; 2333 patients, found with different dermatological injuries with possible labor relation. We will look for the Kathon-sensitive persons and we will analyze the variables: sex, age, dermatological profession, dermatological diseases, location of the injuries, product handling that contains Kathon. We will make the statistical analysis with program SPSS. Results: Of the 110 positive reactions to Kathon, 32 are related to the labour activities (29.09%). We can add other 13 doubtful cases to them (11.81%) and of these positive cases, 46.6% were men. Conclusions: The Kathon is an additive very used in the labour ambit. The professions that are using more products with Kathon are those with greater number of cases registered

Sensitization to acrylates in varnishes.

Varnishes are liquid products that solidify when exposed to air. They are used to cover, protect, and embellish surfaces. Varnishes contain agglutinants and volatile solvents. The main agglutinants are epoxy resins and acrylates, and these acrylates are the substances that produce sensitization most of the time. We explain the use and handling of these varnishes and present four cases of occupational sensitization to acrylic resins present in wood varnishes used by four workers.

Frecuencia de alergia al látex en trabajadores del Hospital Militar Central de la ciudad de Bogotá en el año 2005 / Latex allergy in workers on Hospital Militar Central in Bogotá during 2005

La hipersensibilidad al látex es un problema médico que cada vez afecta más pacientes. Desde el punto de vista ocupacional, más de la mitad de los casos pertenecen al sector salud y como no tenemos conocimiento de estudios en Latinoamérica o en Colombia, consideramos importante determinar la frecuencia en nuestra población hospitalaria. El protocolo de investigación para este trabajo fue presentado y aprobado por la Facultad de Medicina de la Universidad Militar Nueva Granada y por el Comité de Ética del Hospital Militar Central. Se diseñó un formato de recolección de datos para encuestar 808 pacientes y previo consentimiento informado, se seleccionaron de manera aleatoria 205 pacientes a quienes se les realizó la prueba de pinchazo con alergeno de látex de ALK-ABELLO, usando como control positivo histamina y como negativo solución salina. De los 808 encuestados, el 61 por ciento se refería síntomas cutáneos al contacto con guantes y el 31 por ciento a síntomas respiratorios. El 55,5 por ciento tenía antecedentes personales de atopia, el 60 por ciento antecedentes familiares y 4,95 por ciento síntomas a frutas tropicales. La prueba de pinchazo al látex fue positiva en el 1,5 por ciento de los trabajadores sanitarios, en el 1,6 por ciento de los trabajadores de quirófanos, en el 2,8 pro ciento de los auxiliares de enfermería y en el 4,8 por ciento de las instrumentadoras. Todos los pacientes positivos a la prueba de pinchazo desarrollaron sintomatología con el uso de guantes, predominando xerodermia asociada a dermatitis irritativa. Este puede ser el primero de diferentes estudios a nivel nacional, con el objetivo de encontrar la frecuencia de esta alergia en nuestra población y evitar las complicaciones asociadas a su exposición

[Brief history of Actas Dermo-Sifiliográficas]. / Breve historia de Actas Dermo-Sifiliográficas.

Actas Dermo-Sifiliográficas was founded by Juan de Azúa in May 1909. The birth of the journal coincided with the founding of the Spanish Academy of Dermatology and Venereology, then known as the Spanish Society of Dermatology and Syphiligraphy, and it is this organization's official publication. Actas Dermo-Sifiliográficas gradually became established, until the year 1936, when its publication was interrupted for 14 months at the start of the Spanish Civil War. It resumed activity in October 1937 under Sainz de Aja, Gay Prieto and Eduardo de Gregorio. In the 1980's, it underwent a crisis that resulted in its exclusion from MEDLINE. Actas Dermo-Sifiliográficas gradually recovered under the management of Drs. Iglesias, Sánchez-Yus, Fernández-Herrera and Torrelo, and it has finally been included once again in the most consulted medical database in the world.

[Aquagenic syringeal acrokeratoderma. Presentation of two cases]. / Acroqueratodermia siríngea acuagénica.Presentación de dos casos.

Aquagenic syringeal acrokeratoderma is an infrequently described acquired, transitory keratoderma that is exacerbated when the palms and/or soles are immersed in water. It manifests as whitish or yellowish flattened, translucent papules and plaques, located in areas of pressure or trauma on the palms and/or soles. Involvement is usually bilateral. The histologic features are non-specific, showing a slight dilation of the intraepidermal portion of the eccrine sweat duct. The process tends to remit spontaneously. We present the case of two women, aged 20 and 21.

Acroqueratodermia siríngea acuagénica. Presentación de dos casos / Aquagenic syringeal acrokeratoderma. Presentation of two cases

La acroqueratodermia siríngea acuagénica es una queratodermia adquirida y transitoria que se exacerba tras sumergir en agua las palmas y/o las plantas. Se manifiesta como pápulas y placas blanquecinas o amarillentas, translúcidas y aplanadas localizadas en las zonas de presión o traumatismo de palmas y/o plantas. La afectación suele ser bilateral. La histología es inespecífica, mostrando una ligera dilatación de la porción intraepidérmica del conducto excretor ecrino. El proceso tiende a la remisión espontánea. Presentamos el caso de 2 mujeres de 20 y 21 años que presentaban un cuadro de acroqueratodermia siríngea acuagénica de largo tiempo de evolución

Aquagenic syringeal acrokeratoderma is an infrequently described acquired, transitory keratoderma that is exacerbated when the palms and/or soles are immersed in water. It manifests as whitish or yellowish flattened, translucent papules and plaques, located in areas of pressure or trauma on the palms and/or soles. Involvement is usually bilateral. The histologic features are non-specific, showing a slight dilation of the intraepidermal portion of the eccrine sweat duct. The process tends to remit spontaneously. We present the case of two women, aged 20 and 21

Breve historia de Actas Dermo-Sifiliográficas / Brief history of Actas Dermo-Sifiliograficas

Actas Dermo-Sifiliográficas fue fundada por Juan de Azúa en mayo de 1909. El nacimiento de la revista se produjo a la vez que la fundación de la Academia Española de Dermatología y Venereología, llamada entonces Sociedad Española de Dermatología y Sifiliografía, y de la que es el órgano oficial de expresión. Actas Dermo-Sifiliográficas se consolidó progresivamente hasta 1936. La publicación quedó interrumpida durante 14 meses al comienzo de la Guerra Civil. Recuperó su actividad en octubre de 1937 de la mano de Sainz de Aja, Gay Prieto y Eduardo de Gregorio. En la década de 1980 sufrió una cierta crisis que condicionó su exclusión del MEDLINE. La progresiva recuperación de Actas Dermo-Sifiliográficas en las sucesivas gestiones de los doctores Iglesias, Sánchez Yus, Fdez. Herrera y Torrelo han conseguido finalmente devolverla a la base de datos médica más consultada del mundo

Actas Dermo-Sifiliográficas was founded by Juan de Azúa in May 1909. The birth of the journal coincided with the founding of the Spanish Academy of Dermatology and Venereology, then known as the «Spanish Society of Dermatology and Syphiligraphy,» and it is this organization's official publication. Actas Dermo-Sifiliográficas gradually became established, until the year 1936, when its publication was interrupted for 14 months at the start of the Spanish Civil War. It resumed activity in October 1937 under Sainz de Aja, Gay Prieto and Eduardo de Gregorio. In the 1980's, it underwent a crisis that resulted in its exclusion from MEDLINE. Actas Dermo-Sifiliográficas gradually recovered under the management of Drs. Iglesias, Sánchez-Yus, Fernández-Herrera and Torrelo, and it has finally been included once again in the most consulted medical database in the world

Contact allergy to a cocobolo bracelet.

Tropical woods are highly valued because of their strength, hardness, and resistance to moisture. These characteristics make them easy to work with and extremely durable, and that is why they have been used in the manufacture of wooden jewelry, musical instruments, furniture, and handles of many different objects. We present a case of a 44-year-old man who developed pruritus, erythema, and blistering around his right wrist, corresponding exactly to the area where he had worn a wooden bracelet. Thin-layer chromatography performed with the extract of the shavings revealed (R)-4-methoxydalbergione and obtusaquinone (the main components of cocobolo wood) and (S)-4'-hydroxy-4-methoxydalbergione (in lower amounts). Patch-testing with sawdust from the bracelet resulted in a very strong reaction. Patch tests with the pure constituents yielded +++ reactions to the main sensitizers of cocobolo, including obtusaquinone, but also to sensitizers present in other rosewoods. This last fact can be explained by cross-reactivity between different dalbergiones. Contact dermatitis from tropical woods is more frequent than thought, owing to their high sensitizing properties. An exhaustive search can identify the allergen responsible in many cases.

Contact dermatitis in hairdressers, 10 years later: patch-test results in 300 hairdressers (1994 to 2003) and comparison with previous study.

BACKGROUND: In the last 20 years, the hairdressing profession has undergone important modifications, mainly because of a change in the substances and techniques used and improved occupational education. OBJECTIVE: To evaluate the modifications in the hairdressing profession and its actual risk of occupational allergic contact dermatitis (OACD). METHODS: We studied all 300 hairdressers seen in our department from 1994 to 2003 and compared the results with those of a previous study of 379 hairdressers who attended our department from 1980 to 1993. All were patch-tested with the European Standard series and specific hairdressing products. As previously, most of the workers were women (93%), with a mean age (23.7 years) slightly higher than that of the workers in our previous study. RESULTS: We found a significant increase in the frequency of positive patch-test responses (78.3% vs 58.8%) and OACD (58% vs 48.8%) with respect to our previous study. We also observed a significant increase in sensitization to most allergens, including p-phenylenediamine base (54% vs 45.9%), 4-aminobenzene (40.7% vs 31.9%), ammonium thioglycolate (2.7% to 12.3%), ammonium persulfate (7.9% to 14.3%), p-toluenediamine sulfate (6.8% to 15.3%), p-aminodiphenylamine (2.9% to 7.7%), o-nitro-4-phenylenediamine (2.1% to 7.3%), and aminophenols (0% to 9%), whereas a decrease was found in sensitization to Disperse Orange (17% vs 32.7%) and thioglycolic acid (15.3% to 3%). CONCLUSION: The high frequency and increase of sensitizations among hairdressers require urgent measures to improve protective measures and their application.

Batman dermatitis / Batman dermatitis

Se presenta el caso de una sensibilización a aminas antioxidantes en un actor especialista que utiliza una máscara representado a Batman en su trabajo. Las lesiones cutáneas que coincidían con la zona de contacto directo con la máscara, desaparecían al no trabajar. En el estudio realizado se observa una sensibilización a diversas aminas antioxidantes (IPPD; CPPD, DPPD) así como una positividad marcada a un trozo de la propia máscara. La casa comercial responsable de la fabricación de la máscara (Scott Gamble) se negó a dar su composición. La parte aportada por el enfermo no fue suficiente para poder realizar una cromatografía capa fina (CCF) y demostrar la existencia de los alergenos a los que estaba sensibilizado. Se trata de un caso original de eczema alérgico de contacto profesional con una nueva sensibilidad en artistas

We describe a case of contact dermatitis to antioxidant amines in an actor who played the rale of Batmen in an adventure park. The lesions coincided with the site of direct contact with the mask of his costume, which resolved when he left his job. On patch testing he presented a positive reaction to various antioxidant amines (lPPO, CPPO and OPPO) as well as a strong positive reaction to a piece of the mask. The company (Scott Gamble) which had manufactured the mask refused to facilitate its composition. The piece of the mask provided by the patient was insufficient to perform thin-Iayer chromatography which could have confirmed the presence of the allergens to which he was sentisized. In conclusion we present a new type of allergic occupational contact dermatitis in artists