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1.
An Bras Dermatol ; 95(2): 194-199, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32156503

RESUMO

BACKGROUND: Kathon CG, a combination of methylchloroisothiazolinone and methylisothiazolinone, is widely used as preservative in cosmetics, as well in household cleaning products, industrial products such as paints and glues. It has emerged as an important sensitizing agent in allergic contact dermatitis. OBJECTIVES: This study evaluated the reactivity to this substance in patients subjected to patch tests at the Dermatology Institute in Bauru, São Paulo from 2015 to 2017 and its correlation with other preservatives, the professional activity and location of the lesions. METHODS: The patients were submitted to standard series of epicutaneous tests, standardized by the Brazilian Group Studies on Contact Dermatitis. RESULTS: Out the 267 patients tested, 192 presented positivity to at least one substance and 29 of the patients (15.10%) presented reaction to Kathon CG, with predominance of the female gender (n=27); main professional activity associated with Kathon CG sensibilization was cleaning (17.24%), followed by aesthetic areas (13.79%) and health care (10.34%). The most prevalent sensitizations among the substances tested were nickel sulphate (56.3%), followed by cobalt chloride (23.4%), neomycin (18.2%), potassium dichromate (17.7%), thimerosal (14.5%), formaldehyde (13.2%), paraphenylenediamine (9.3%), and fragrance mix (8.3%). STUDY LIMITATIONS: We do not have data from patients that were submitted to patch test a decade ago in order to confront to current data and establish whether or no sensitization to Kathon CG has increased. CONCLUSION: High positivity to Kathon CG corroborates the recent findings in the literature, suggesting more attention to concentration of this substance, used in cosmetics and products for domestic use.


Assuntos
Dermatite Alérgica de Contato/diagnóstico , Testes do Emplastro/métodos , Tiazóis/análise , Adulto , Brasil , Cosméticos/efeitos adversos , Cosméticos/química , Dermatite Alérgica de Contato/etiologia , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Testes do Emplastro/estatística & dados numéricos , Conservantes Farmacêuticos/efeitos adversos , Conservantes Farmacêuticos/química , Estudos Retrospectivos , Estatísticas não Paramétricas , Tiazóis/efeitos adversos
2.
PLoS One ; 15(1): e0217192, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31945067

RESUMO

BACKGROUND: Dermatological services in Laos, South East Asia are limited to the capital and patch testing is currently not available, so no data exists regarding the common cutaneous allergens in this population. OBJECTIVES: The aim of this study was to document positive patch tests in medical students without evidence of contact dermatitis in Laos. PATIENTS/MATERIALS/METHODS: One hundred and fifty medical students were patch tested using TRUE Test® panels 1 to 3 (35 allergens). Readings were taken at Days 2 and 4. RESULTS: Thirty-eight students (25.3%) had a positive reaction to at least one allergen, accounting for 52 reactions in total. The proportion of the students with positive patch test reading was significantly higher in the female [33/96 (34%)] than in the male [5/54 (9%)], p<0.001. The most common allergens were: nickel (10%), gold (6.6%), thiomersal (6.6%), cobalt dichloride (2%) and p-tert-Butylphenol formaldehyde resin (2%). Balsam of Peru (0.66%), black rubber mix (0.66%), Cl+Me-Isothiazolinone (0.66%), fragrance mix 1 (0.66%), quinolone mix (0.66%), methyldibromo glutaronitrile (0.66%), mercapto mix (0.66%), epoxy resin (0.66%), paraben mix (0.66%), thiuram (0.66%) and wool alcohols (0.66%) accounted for all of the other positive reactions. CONCLUSION: This study represents the first documented patch test results in Lao medical students and in the adult Lao population. The results of this study will inform any future research into contact allergy in Laos and give an insight into the background level of contact sensitivity in this population.


Assuntos
Alérgenos/efeitos adversos , Dermatite Alérgica de Contato/diagnóstico , Testes do Emplastro , 2-Naftilamina/efeitos adversos , 2-Naftilamina/análogos & derivados , Adolescente , Adulto , Alérgenos/imunologia , Bálsamos/efeitos adversos , Cobalto/efeitos adversos , Dermatite Alérgica de Contato/imunologia , Dermatite Alérgica de Contato/patologia , Resinas Epóxi/efeitos adversos , Feminino , Ouro/efeitos adversos , Humanos , Laos , Masculino , Pessoa de Meia-Idade , Níquel/efeitos adversos , Fenilenodiaminas/efeitos adversos , Resinas Sintéticas/efeitos adversos , Estudantes de Medicina , Timerosal/efeitos adversos
3.
Hautarzt ; 71(3): 182-189, 2020 Mar.
Artigo em Alemão | MEDLINE | ID: mdl-31950209

RESUMO

BACKGROUND: In the case of a contact allergy, there is only allergen avoidance instead of causal therapy. If the allergen is not identified, dermatitis persists, which is a major burden for patients. Patch testing is the diagnostic standard for detecting contact sensitization. Based on a systematic literature search, the German patch test guideline was updated and methodologically upgraded. OBJECTIVES: The most important practical aspects of patch testing with contact allergens and drugs are presented. MATERIALS AND METHODS: Current consensus guidelines for performing patch tests as well as the results of a supplementary selective literature search are summarized. RESULTS: According to the patch test guideline (AWMF registry no. 013-018, 2019), the baseline series, special series and, if necessary, test preparations prepared from the patient's own contact substances should be tested routinely. A new evidence-based recommendation is a late reading after 7-10 days, as otherwise numerous patch test reactions will be missed. Antihistamines may weaken the cellular reactions of the patch test and should be discontinued with a latency of 5 half-lives. Finally, if a false-negative patch test result is suspected, it is recommended to perform a strip patch test according to the validated protocol. CONCLUSIONS: All patients with a suspected contact allergy should receive a guideline-based patch test at an early stage. Targeted patch testing identifies clinically relevant allergens and provides suggestions for further systematic investigations.


Assuntos
Alérgenos/efeitos adversos , Dermatite Alérgica de Contato/diagnóstico , Guias de Prática Clínica como Assunto , Humanos , Testes do Emplastro , Sistema de Registros
4.
Hautarzt ; 71(3): 197-204, 2020 Mar.
Artigo em Alemão | MEDLINE | ID: mdl-31965209

RESUMO

BACKGROUND: Fragrances are regarded as the most common contact allergens after nickel. In this context, the frequency of positive patch test reactions to fragrance mix is often presented as proof. According to EU regulation No. 1223/2009, 26 fragrances that are regarded as significant allergens have to be declared on cosmetic products. OBJECTIVES: The frequency of patch test reactions to fragrances and differentiation between frequently and rarely sensitizing fragrances were evaluated. MATERIALS AND METHODS: Data from the Information Network of Departments of Dermatology (IVDK), mostly of the years 2016-2018, were retrospectively analyzed. RESULTS: Frequency of positive reactions to fragrance mix I in the departments of dermatology joining the IVDK reached a historical low of 5.4% in 2018. Since 2013, positive reactions to fragrance mix II have been declining, yielding 3.2% in 2018. Of fragrance mix I, the allergen with the most positive test reactions is no longer oakmoss absolute, but isoeugenol. In fragrance mix II, hydroxyisohexyl 3­cyclohexene carboxaldehyde (HICC) is still leading. Only 11 of the 26 fragrances subject to mandatory declaration elicited allergic test reactions in more than 1% of the patients tested. DISCUSSION: The decline of positive test reactions to the fragrance mixes is mainly due to the reduced use of oakmoss containing atranol and chloroatranol, and HICC. Use of these substances in cosmetic products was prohibited within the EU starting in August 2019. Therefore, a further decline of the sensitization frequencies can be expected. A differentiated consideration of the individual fragrances under allergological aspects is urgently required.


Assuntos
Dermatite Alérgica de Contato/diagnóstico , Odorantes , Perfumes/efeitos adversos , Alérgenos/efeitos adversos , Dermatite Alérgica de Contato/etiologia , Humanos , Testes do Emplastro , Estudos Retrospectivos
5.
Contact Dermatitis ; 82(1): 24-30, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31400016

RESUMO

BACKGROUND: Health-care workers (HCWs) and professionals working in the pharmaceutical industry are at risk of developing occupational allergic contact dermatitis (OACD) from systemic drugs (or drug intermediates). OBJECTIVES: To study demographic characteristics and identify systemic drugs responsible for OACD in patients investigated for contact allergy during the period 2001-2019. METHODS: In the study period, 9780 patients were patch tested with the European baseline series, sometimes with additional series, and other relevant potential allergens. All patients with a positive patch-test reaction to systemic medication exposed to at work were included for further analysis. RESULTS: Of 1248 HCWs examined in our clinic, 201 suffered from OACD. In 26 (13%) dermatitis was caused by skin contact with a systemic drug: 19 nurses, five chemists working in the pharmaceutical industry, one physician, and one veterinarian. In total, 45 positive patch-test reactions to 20 different systemic drugs were found, with tetrazepam (n = 11), ranitidine hydrochloride (n = 5), and zolpidem (n = 4) being the most frequent. Three pharmaceutical chemists were sensitized to a drug intermediate. The lesions were mostly localized on the hands, but often also on the face, as airborne dermatitis. CONCLUSION: As much as 13% of OACD in HCWs, diagnosed in our tertiary referral center, was attributable to systemic drugs, most frequently in nurses.


Assuntos
Dermatite Alérgica de Contato/etiologia , Dermatite Ocupacional/etiologia , Indústria Farmacêutica , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/etiologia , Pessoal de Saúde , Exposição Ocupacional/efeitos adversos , Adulto , Dermatite Alérgica de Contato/diagnóstico , Dermatite Ocupacional/diagnóstico , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/diagnóstico , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Testes do Emplastro , Estudos Retrospectivos
6.
Contact Dermatitis ; 82(1): 18-23, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31483868

RESUMO

BACKGROUND: Both florists' chrysanthemums (Chrysanthemum cultivars) and marguerite daisies (Argyranthemum frutescens [L.] Sch.Bip. and its varieties and cultivars) are popular ornamental plants in Denmark. OBJECTIVES: To present results of aimed patch testing with chrysanthemum and marguerite daisy extracts in Danish patients with Compositae sensitization. METHODS: The results of patch testing with chrysanthemum extract 3% petrolatum (pet.) and marguerite daisy extract 3% pet. (and possibly 1% pet.) from 1998 to 2019 were analyzed. RESULTS: Altogether, 111/191 (58%) patients tested positive to chrysanthemum extract and 104/179 (58%) tested positive to marguerite daisy. The majority was recreationally exposed, and most reactions were considered relevant. Feverfew extract 1% pet., Compositae mix 5% or 6% pet., or parthenolide 0.1% pet. may cross-react with chrysanthemum; Compositae mix seems to be best at detecting sensitization to marguerite daisy. CONCLUSIONS: In areas where exposure to chrysanthemum or marguerite daisies is prevalent, it is suggested to include extracts of these plants in the plant series to improve diagnosis of, and advice to, Compositae-allergic patients.


Assuntos
Asteraceae/efeitos adversos , Dermatite Alérgica de Contato/etiologia , Dermatite Ocupacional/etiologia , Exposição Ambiental/efeitos adversos , Flores/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Chrysanthemum/efeitos adversos , Dinamarca/epidemiologia , Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/epidemiologia , Dermatite Ocupacional/diagnóstico , Dermatite Ocupacional/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes do Emplastro , Extratos Vegetais/efeitos adversos
7.
Contact Dermatitis ; 82(1): 31-38, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31566752

RESUMO

BACKGROUND: Citral is commonly used as a fragrance and flavor material and consists of the aldehydes geranial and neral. Citral is included in fragrance mix (FM) II. Geranial and neral have also been identified in autoxidation of geraniol, a fragrance compound present in FM I. OBJECTIVES: To study contact allergy to citral, geranial, and neral, and concomitant reactivity to oxidized geraniol and fragrance markers of the baseline series. METHODS: A total of 1476 dermatitis patients with suspected allergic contact dermatitis were patch tested using geranial, neral, and citral, all 3.5% petrolatum (pet.) as well as geraniol 6.0% and oxidized geraniol 11% pet. in addition to the Swedish baseline series. RESULTS: Frequencies of positive reactions to citral, geranial, and neral were 2.9%, 3.4% and 1.9%, respectively. Together, citral and geranial gave 4.2% positive patch test reactions in consecutive dermatitis patients. In patients with positive reactions to citral or its components, 25% to 34% reacted to FM II and 61% reacted to oxidized geraniol. CONCLUSIONS: Patch testing with citral, its components, or oxidized geraniol detects contact allergic reactions not detected using the baseline series. Patch testing with pure geraniol was shown to be of little value. Geranial and neral, although closely chemically related, are concluded to be separate haptens.


Assuntos
Monoterpenos Acíclicos/efeitos adversos , Dermatite Alérgica de Contato/etiologia , Odorantes , Adulto , Dermatite Alérgica de Contato/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes do Emplastro
8.
Contact Dermatitis ; 82(1): 45-53, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31584201

RESUMO

BACKGROUND: Allergic contact dermatitis (ACD) caused by hexavalent chromium, Cr(VI), is often severe and difficult to treat. The most common source of exposure to Cr(VI) in Sweden used to be cement, and more recently leather. The contact allergy can be diminished or inhibited if the exposure is decreased or ceases. Barrier creams against different kinds of allergens have been investigated for their protective properties which may offer protection against Cr(VI) exposure. OBJECTIVES: To investigate the capacity of formulas containing glutathione (GSH) and iron sulfate to inhibit elicitation of ACD in Cr(VI)-allergic individuals when exposed to Cr(VI). METHODS: In 18 Cr(VI)-allergic volunteers the back was divided into eight patch test areas which were treated with preparations of possible barrier creams, prior to patch testing with a dilution series of potassium dichromate and a buffered extract of cement. RESULTS: A significant reduction in reactivity to Cr(VI) and cement extract on skin treated with formulas containing GSH or iron sulfate was noticed, compared with untreated skin. CONCLUSION: Formulas containing GSH or iron sulfate in barrier creams inhibit ACD in individuals allergic to Cr(VI) when applied before exposure to Cr(VI) and cement extract.


Assuntos
Alérgenos/efeitos adversos , Cromo/efeitos adversos , Dermatite Alérgica de Contato/prevenção & controle , Fármacos Dermatológicos/uso terapêutico , Compostos Ferrosos/uso terapêutico , Glutationa/uso terapêutico , Creme para a Pele/uso terapêutico , Administração Cutânea , Adulto , Idoso , Idoso de 80 Anos ou mais , Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes do Emplastro , Prevenção Secundária/métodos , Resultado do Tratamento
9.
Med Clin North Am ; 104(1): 61-76, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31757238

RESUMO

Allergic contact dermatitis is common, resulting in considerable morbidity. Diagnosis is based on a thorough history, physical examination, and patch testing. Several commercially available panels of patch testing are currently used. Allergens are found in a wide variety of daily products, occupational exposures, and foods. The mainstay of treatment is avoidance of the allergen, and databases like Contact Allergen Management Program and Contact Allergen Replacement Database help patients to select products that do not contain allergens to which they are sensitized. Topical corticosteroids can be used to treat exacerbations, but should be avoided in long-term treatment.


Assuntos
Alérgenos/análise , Dermatite Alérgica de Contato/diagnóstico , Testes do Emplastro/métodos , Administração Tópica , Corticosteroides/administração & dosagem , Dermatite Alérgica de Contato/tratamento farmacológico , Humanos
11.
Ned Tijdschr Geneeskd ; 1632019 09 16.
Artigo em Holandês | MEDLINE | ID: mdl-31556491

RESUMO

The most common side effects of transdermal patches are mechanical reactions caused by applying or removing the transdermal patch, or by excessive perspiration under the patch. Allergic contact dermatitis (type IV allergic reaction) is the most commonly occurring hypersensitivity reaction and can be caused by the active substance or by excipients. Type I allergic reactions such as urticaria, bronchospasm and angioedema are rare and usually caused by the active substance in the patch. Allergy testing to determine the allergen is indicated following a type I allergic reaction, or after a type IV allergic reaction that requires an alternative for the patch. It is important to document hypersensitivity reactions in the electronic patient records in order to prevent a hypersensitivity reaction in the future.


Assuntos
Dermatite Alérgica de Contato/etiologia , Excipientes/efeitos adversos , Adesivo Transdérmico/efeitos adversos , Angioedema/etiologia , Dermatite Alérgica de Contato/diagnóstico , Feminino , Humanos , Masculino , Testes Cutâneos , Urticária/etiologia
12.
Hautarzt ; 70(10): 778-789, 2019 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-31506756

RESUMO

The head and hands are the two most common locations for allergic contact dermatitis manifestation. In hand eczema, contact with a contact allergen is a frequent (co-)factor in the triggering and maintenance of eczema. For all hand eczemas lasting longer than 3 months, an allergological examination by means of patch testing is recommended. In patients with allergic contact dermatitis of the hands, nickel, MCI/MI, fragrance mix I, cobalt, thiuram mix, Balsam of Peru, chromium and fragrance mix II have been described in a multicenter European study as the most common contact allergens of the standard series. In the information network of dermatological clinics (IVDK) a total of 56,170 patients were patch-tested in the years 2014 to 2018. In all, 16,807 of these patients (29.9%) suffered from hand eczema, of which 7725 (46.0%) had occupational dermatosis (OD) and 6820 (40.6%) had no OD. For the remaining patients this was unknown. The top 30-list of allergens in hand eczema patients without and with OD included 22 common contact allergens, but with different reaction frequency. In hand eczema patients without OD, the following contact allergens also belong to this list: octyl gallate, sorbic acid, tert-butylhydroquinone, propylene glycol, mercury (II) amide chloride, tolubalsam, jasmine absolute, and sandalwood oil. For hand eczema patients with OD, these are instead: tetramethylthiurammonosulfide, tetramethylthiuramdisulfide, 1,3-diphenylguanidine, p­phenylenediamine, p­toluylenediamine, iodopropinylbutylcarbamate, glutaraldehyde, and monoethanolamine. In the case of OD of the hands, early involvement of the responsible statutory accident insurance by initiating the dermatologist procedure ("Hautarztverfahren") is necessary in order to work together towards successful allergen avoidance by means of substitution and optimizing personal protective equiment.


Assuntos
Alérgenos/efeitos adversos , Dermatite Alérgica de Contato/diagnóstico , Eczema/induzido quimicamente , Dermatoses da Mão/induzido quimicamente , Testes do Emplastro/métodos , Dermatite Ocupacional , Eczema/diagnóstico , Dermatoses da Mão/diagnóstico , Humanos
13.
Dermatitis ; 30(5): 306-313, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31524759

RESUMO

BACKGROUND: The epidemiology of nickel allergy in occupational settings is not well understood. OBJECTIVE: The aim of the study was to characterize occupationally related nickel allergy (ORNA). METHODS: This is a retrospective cross-sectional analysis of 44,378 patients patch tested by the North American Contact Dermatitis Group from 1998 to 2016. Characteristics of individuals with ORNA were compared with those with non-ORNA (NORNA). RESULTS: A total of 7928 (18.2%) individuals were positive to nickel sulfate 2.5%. Two hundred sixty-eight (3.4%) had ORNA. As compared with NORNA, ORNA was statistically associated with the male sex (41.0% vs 12.9%, P < 0.001), a diagnosis of irritant contact dermatitis (22.4% vs 12.0%, P < 0.001), and no history of eczema (81.7% vs 75.7%, P = 0.0217). The most common sites of ORNA dermatitis were hand (39.9%) and arm (18.1%), which were significantly more common than in NORNA (P < 0.0001). Sixteen industry categories and 22 occupation categories were identified for ORNA; the most common industries were durable goods manufacturing (24.6%) and personal services (15.7%), and the most frequent occupations were hairdressers/cosmetologists/barbers (14.3%), machine operators (9.3%), and health care workers (7.1%). Overall 30% of ORNA occupations were in metalworking. Of 215 ORNA sources identified, instruments/phones/other equipment (16.3%), vehicles/machinery (15.8%), and tools (15.3%) were the most common. CONCLUSIONS: Occupational nickel allergy is distinct from nonoccupational nickel allergy.


Assuntos
Dermatite Alérgica de Contato/epidemiologia , Dermatite Alérgica de Contato/etiologia , Dermatite Ocupacional/epidemiologia , Dermatite Ocupacional/etiologia , Níquel/toxicidade , Exposição Ocupacional/efeitos adversos , Adolescente , Adulto , Fatores Etários , Braço , Estudos Transversais , Dermatite Alérgica de Contato/diagnóstico , Dermatite Ocupacional/diagnóstico , Feminino , Dermatoses da Mão/induzido quimicamente , Dermatoses da Mão/epidemiologia , Humanos , Indústrias/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , América do Norte/epidemiologia , Ocupações/estatística & dados numéricos , Testes do Emplastro , Estudos Retrospectivos , Fatores Sexuais , Adulto Jovem
14.
Dermatitis ; 30(5): 314-322, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31517667

RESUMO

BACKGROUND: Cyanoacrylates are strong adhesives used for a variety of medical, industrial, and cosmetic applications and have been implicated as a cause of allergic contact dermatitis. OBJECTIVE: The aim of the study was to review our experience in patch testing with cyanoacrylates. METHODS: We reviewed patch test results of 38 patients with a clinical history of contact dermatitis due to a cyanoacrylate-containing adhesive (mostly Dermabond). Testing used cyanoacrylates of >99% purity diluted to 10% to 30% in petrolatum (pet.), undiluted octyl cyanoacrylate, and/or Dermabond Mini or Advanced "as is." Patch tests were also performed with methacrylates, formaldehyde (a cyanoacrylate impurity), benzalkonium chloride, and cyanoacrylate polymerization inhibitors. Three patients were also tested with Dermabond Mini on abraded skin. RESULTS: Commercial cyanoacrylate patch testing material (ethyl cyanoacrylate 10% pet.) detected 29% of Dermabond-allergic patients, whereas patch testing with octyl cyanoacrylate 10% pet. increased detection to 50%. Testing with higher concentrations and/or on abraded skin further increased yield. Thirteen (37%) of our 35 cyanoacrylate-allergic patients were also allergic to methacrylates or acrylates. CONCLUSIONS: Octyl cyanoacrylate is the usual allergenic ingredient in Dermabond. Patch testing with high concentrations is often required. Testing Dermabond on abraded skin further improves diagnostic sensitivity by more closely simulating clinical use.


Assuntos
Cianoacrilatos/efeitos adversos , Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/etiologia , Testes do Emplastro , Adesivos Teciduais/efeitos adversos , Humanos , Metacrilatos/efeitos adversos , Testes do Emplastro/métodos
16.
BMC Ophthalmol ; 19(1): 158, 2019 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-31340775

RESUMO

BACKGROUND: To report the first case of allergic contact dermatitis (ACD) associated with alcaftadine 0.25% ophthalmic solution. CASE PRESENTATION: The patient was a 51-year-old woman with no previous history of side effects to ophthalmic antihistamine agents. She had been prescribed alcaftadine 0.25% for allergic conjunctivitis. On first application of the medication, she did not experience any cutaneous reaction. One day later, after the second alcaftadine 0.25% application, both eyelids became swollen, and erythematous changes were evident. On slit-lamp examination, conjunctival injection was noted in the absence of conjunctival swelling or any other findings. Fundus examination was unremarkable. To evaluate the cause of ACD, a patch test was performed and 48 h later was noted to be positive for alcaftadine 0.25%. Based on the positive patch test, the patient was diagnosed with ACD caused by alcaftadine 0.25%. After 9 days of treatment, the swelling and erythema completely resolved. CONCLUSIONS: Although there have been no previous reports of alcaftadine 0.25%-associated ACD, it should be suspected in patients with swelling and erythematous change of both eyes after using alcaftadine 0.25%.


Assuntos
Benzazepinas/efeitos adversos , Dermatite Alérgica de Contato/etiologia , Imidazóis/efeitos adversos , Administração Oral , Benzazepinas/administração & dosagem , Conjuntivite Alérgica/tratamento farmacológico , Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/tratamento farmacológico , Feminino , Glucocorticoides/administração & dosagem , Antagonistas dos Receptores Histamínicos H1/administração & dosagem , Antagonistas dos Receptores Histamínicos H1/efeitos adversos , Humanos , Imidazóis/administração & dosagem , Metilprednisolona/administração & dosagem , Pessoa de Meia-Idade , Soluções Oftálmicas , Órbita/diagnóstico por imagem , Tomografia Computadorizada por Raios X
17.
BMC Dermatol ; 19(1): 10, 2019 07 10.
Artigo em Inglês | MEDLINE | ID: mdl-31291927

RESUMO

BACKGROUND: Patch testing with a baseline series is a common tool employed when the sensitizing agent in contact dermatitis is unclear. However, for Asian countries, there are no locally validated baseline series to utilize in screening. METHODS: We completed a retrospective analysis of all patients that had undergone patch testing with the European Baseline series, Shoe Series or Comprehensive International Baseline series, over 7 years from 2012 to 2018 in a tertiary care reference dermatology clinic in Sri Lanka to evaluate the suitability of these investigations to identify causes for contact dermatitis in the local study population. RESULTS: Out of 438 patients tested, 239 (54.8%) reacted to at least one substance in the series. The Shoe Series was significantly more likely to yield a positive result than the European Baseline Series (70.2% vs 46.9%, p < 0.05). The top three sensitizers identified by all series were nickel sulfate (16%, 70/438), p-phenylenediamine (12.3%, 54/438) and 2-mercaptobenzothiazole or mercapto mix (10.5%, 46/438). CONCLUSION: Shoe series has a comparatively high yield in the local population compared to European Baseline series. Since little less than half of the study population did not have any reactivity to any of the allergens tested it is important to develop or modify and validate a locally relevant, more suitable baseline series which is based on the Shoe Series in Sri Lanka. This is further evidence for the continuously changing nature of allergens in the environment and the need to modify existing patch testing standards accordingly.


Assuntos
Alérgenos/imunologia , Dermatite Alérgica de Contato/diagnóstico , Testes do Emplastro/estatística & dados numéricos , Centros de Atenção Terciária/estatística & dados numéricos , Administração Cutânea , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Alérgenos/administração & dosagem , Benzotiazóis/administração & dosagem , Benzotiazóis/imunologia , Dermatite Alérgica de Contato/imunologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Níquel/administração & dosagem , Níquel/imunologia , Testes do Emplastro/normas , Fenilenodiaminas/administração & dosagem , Fenilenodiaminas/imunologia , Estudos Retrospectivos , Sri Lanka , Centros de Atenção Terciária/normas , Adulto Jovem
18.
Dermatitis ; 30(4): 264-267, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31261221

RESUMO

BACKGROUND: Allergic contact dermatitis is an inflammatory condition that less commonly presents with scalp involvement. Recently, T regulatory cells have been documented to be residents of hair follicles, illuminating why contact allergens are less likely to elicit dermatitis in the scalp. OBJECTIVE: The aims of the study were to determine the prevalence of scalp symptoms, with and without other affected areas, in patients presenting for evaluation of allergic contact dermatitis and to determine the allergens most likely to be associated with scalp dermatitis. METHODS: We examined allergens commonly found in hair products and stratified positive patch test results by the following affected areas: face, eyelid, neck, or hands, where exposure by runoff is common, versus scalp. CONCLUSIONS: Para-phenylenediamine (PPD) is the most common allergen in patients with scalp dermatitis. The rate of PPD sensitization is higher in nonwhite compared with white patients. In the small number of patients with isolated scalp involvement, positive patch tests to PPD were documented in a minority. Other allergens found in hair products may present without scalp symptoms. Patients with dermatitis affecting areas other than the scalp should provide their hair product ingredients to guide patch test selection.


Assuntos
Dermatite Alérgica de Contato/etiologia , Tinturas para Cabelo/efeitos adversos , Fenilenodiaminas/efeitos adversos , Dermatoses do Couro Cabeludo/diagnóstico , Adulto , Alérgenos/efeitos adversos , Dermatite Alérgica de Contato/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes do Emplastro/métodos , Dermatoses do Couro Cabeludo/etiologia
19.
Gen Dent ; 67(4): 38-45, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31355763

RESUMO

Penicillin allergy, local anesthetic hypersensitivity, latex allergy, contact hypersensitivity, and anaphylaxis are among the allergic reactions encountered in dental practice. This article reviews the literature pertaining to these important areas of overlap between dentistry and allergy/immunology. The epidemiology, diagnosis, and management of penicillin allergy as it relates to dentistry are reviewed. The relevant literature regarding local anesthetic and latex hypersensitivity is discussed. In addition, the presentation, evaluation, and management of contact hypersensitivity, including that to metals, are addressed. Recognition and appropriate treatment of anaphylaxis also are reviewed. This article will help dentists understand potential areas of comanagement with allergists/immunologists to optimize patient care.


Assuntos
Hipersensibilidade Imediata , Hipersensibilidade ao Látex , Odontologia , Odontólogos , Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/etiologia , Humanos , Hipersensibilidade Tardia , Hipersensibilidade ao Látex/diagnóstico
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