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3.
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
4.
Eur J Pharm Sci ; 141: 105110, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-31654757

RESUMO

BACKGROUND: Allergic contact dermatitis (ACD) is a highly prevalent inflammatory and immune skin disease accompanied with persistent pruritus and pain. Oxymatrine (OMT) exhibits antipruritic and anti-inflammatory effects in squaric acid dibutyl ester (SADBE) induced ACD mice model, but the need for frequent administration stipulated by short half-life and low bioavailability limits clinical application. OBJECTIVE: To evaluate the analgesic and antipruritic effects of OMT gel (OG), OMT sustained release microgel powder (OMP) and OMT sustained release microgel cream (OMC) in SADBE induced ACD mice, with subsequent study of the mechanism and side effects (irritation) of optimal dosage form. METHOD: On day 11, the thickness of the right cheek skin of mice was measured and mice spontaneous behaviors were recorded for 1.5 h. In the OMC experiment, hematoxylin-eosin and toluidine blue staining were performed on the cheek skin, and the irritation of OMC was tested on the back skin of rabbits. Blood analyzer was used to measure the counts of inflammatory cells in peripheral blood. The mRNA expressions of IL-1ß, TNF-α, CXCR3, CXCL10, IL-6, IL-10, IL-17A and IL-31 in cheek skin, TRPA1 and TRPV1 channels in trigeminal ganglion (TG), IFN-γ in spleen and IL-17A in thymus were measured by RT-qPCR. RESULTS: OMC, OMP and OG significantly decreased wipes and scratching bouts, alleviated skin inflammation. OMC required less frequent administration and is easier to apply, while its antipruritic effect was stronger than the analgesic effect. OMC rescued the deficits in epidermal keratinization and inflammatory cell infiltration, decreased the leukocyte count in peripheral blood, had no irritation to the broken rabbit's skin. Furthermore, OMC significantly down-regulated the mRNA expression of IL-1ß, TNF-α, CXCR3, CXCL10, IL-6, IL-10, IL-17A and IL-31 in cheek skin, TRPA1 and TRPV1 channels in TG, IFN-γ in thymus and IL-17A in spleen. CONCLUSION: We have demonstrated that OMC exhibits advanced analgesic, antipruritic and anti-inflammatory effects when compared with OG and OMP in ACD mice by regulating inflammation, chemokines, immune mediators and inhibiting the mRNA expression of TRPA1 and TRPV1. OMC has no irritation to the intact and damaged skin of rabbits.


Assuntos
Alcaloides/administração & dosagem , Analgésicos/administração & dosagem , Anti-Inflamatórios/administração & dosagem , Antipruriginosos/administração & dosagem , Dermatite Alérgica de Contato/tratamento farmacológico , Dor/tratamento farmacológico , Prurido/tratamento farmacológico , Quinolizinas/administração & dosagem , Creme para a Pele/administração & dosagem , Animais , Comportamento Animal/efeitos dos fármacos , Citocinas/genética , Citocinas/imunologia , Preparações de Ação Retardada/administração & dosagem , Dermatite Alérgica de Contato/genética , Dermatite Alérgica de Contato/patologia , Modelos Animais de Doenças , Géis , Masculino , Camundongos Endogâmicos C57BL , Dor/genética , Dor/imunologia , Dor/patologia , Prurido/genética , Prurido/imunologia , Prurido/patologia , Coelhos , Pele/efeitos dos fármacos , Pele/imunologia , Pele/patologia
5.
Int J Nanomedicine ; 14: 7729-7741, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31806958

RESUMO

Background: Recently, several studies demonstrate the possible role of zinc oxide (ZnO) in the protection of several skin diseases, but less is known about the role of ZnO nanoparticles in the inflammatory skin disease. So, this study was designed to confirm the pivotal role of the nano zinc oxide cream in the alleviation of lead oxide (PbO) induced-allergic dermatitis in rats. Materials and methods: Two concentrations (1% and 6%) of ZnONPs creams were prepared and characterized prior to being used in the study. A total number of 30 male Wistar rats were randomly divided into six groups. Group 1 (negative control), groups 2&3 (either 1% or 6% ZnONPs control groups), group 4 (PbO), groups 5&6 (co-treatment of each ZnONPs concentration+PbO). All rats in different groups were observed daily to determine the severity of dermal gross lesions. Histopathological studies, mRNA analysis, and oxidative stress evaluations were performed on the affected skin tissue. Immunohistochemical studies were performed to evaluate the expression of cluster of differentiation CD4, CD8 and intercellular adhesion molecules ICAM-1 in different groups. Results: PbO caused extensive skin oxidative damage manifested by a significant increase in MDA level with a decrease in GSH content and CAT activity. The results of histopathological and immunohistochemical examinations revealed that topical application of PbO for 14 days led to severe allergic dermatitis with remarkable elevations in the number of CD4+ T-helper, CD8+ T-cytotoxic lymphocytes, and ICAM-1 expression. On the other hand, noticeable improvements were recorded in all the previous toxicopathological parameters among the groups treated by either 1% or 6% ZnO-NPs cream. However, the best results were observed in the group treated with 1% ZnO-NPs cream. Conclusion: Our findings suggest that 1% of ZnO-NPs cream is safe when applied topically on the inflamed skin. Moreover, it had anti-inflammatory and antioxidant effects so that, it is recommended to use the 1% ZnO-NPs cream to avert the dermal toxicity-induced by PbO.


Assuntos
Dermatite Alérgica de Contato/tratamento farmacológico , Chumbo/toxicidade , Nanopartículas Metálicas/uso terapêutico , Óxidos/toxicidade , Substâncias Protetoras/farmacologia , Óxido de Zinco/farmacologia , Administração Tópica , Animais , Antioxidantes/química , Antioxidantes/farmacologia , Dermatite Alérgica de Contato/etiologia , Dermatite Alérgica de Contato/patologia , Modelos Animais de Doenças , Masculino , Malondialdeído/metabolismo , Nanopartículas Metálicas/química , Pomadas/química , Pomadas/farmacologia , Estresse Oxidativo/efeitos dos fármacos , Substâncias Protetoras/administração & dosagem , Substâncias Protetoras/química , Ratos Wistar , Óxido de Zinco/administração & dosagem , Óxido de Zinco/química
6.
Zhongguo Zhong Yao Za Zhi ; 44(16): 3454-3459, 2019 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-31602909

RESUMO

The present study was aimed to explore the dose-toxicity-effect relationship of Tripterygium wilfordii Hook f( TW) processed by liquorice,to establish the safe and effective therapeutic window,and further to provide scientific reference for the clinical use of TW. The toxicity and anti-inflammatory effect of six doses of raw TW and TW processed by liquorice( 0. 78,1. 56,3. 12,6. 24,12. 48,15. 60 g·kg-1) in 1-fluoro-2,4-dinitrobenzene( DNFB)-induced allergic contact dermatitis( ACD) model were mainly examined by histopathology and serum biochemistry. The liver biochemical parameters including ALT and AST,related inflammatory factors including TNF-α and IL-2,together with liver index,kidney index and the other pharmacodynamic indicators,were examined and compared. The results showed that compared with the control group,the serum levels of TNF-α and IL-2 of the model group were significantly increased( P<0. 01),which proved that the ACD model was successful. The comprehensive analysis of liver biochemical indexes,serum inflammatory factors and the other indexes showed that the safe and effective therapeutic window of TW processed by liquorice was 3. 12-12. 48 g·kg-1. The results showed the therapeutic window of TW processed by liquorice was much broader than that of raw TW. And it could provide scientific reference for the clinical rational use of TW.


Assuntos
Dermatite Alérgica de Contato/tratamento farmacológico , Medicamentos de Ervas Chinesas/farmacologia , Glycyrrhiza/química , Extratos Vegetais/farmacologia , Tripterygium/química , Animais , Citocinas/sangue
7.
Int J Mol Sci ; 20(21)2019 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-31661848

RESUMO

A history of allergies doubles the risk of vulvodynia-a chronic pain condition of unknown etiology often accompanied by increases in numbers of vulvar mast cells. We previously established the biological plausibility of this relationship in mouse models where repeated exposures to the allergens oxazolone or dinitrofluorobenzene on the labiar skin or inside the vaginal canal of ND4 Swiss Webster outbred mice led to persistent tactile sensitivity and local increases in mast cells. In these models, depletion of mast cells alleviated pain. While exposure to cleaning chemicals has been connected to elevated vulvodynia risk, no single agent has been linked to adverse outcomes. We sensitized female mice to methylisothiazolinone (MI)-a biocide preservative ubiquitous in cosmetics and cleaners-dissolved in saline on their flanks, and subsequently challenged them with MI or saline for ten consecutive days in the vaginal canal. MI-challenged mice developed persistent tactile sensitivity, increased vaginal mast cells and eosinophils, and had higher serum Immunoglobulin E. Therapeutic and preventive intra-vaginal administration of Δ9-tetrahydrocannabinol reduced mast cell accumulation and tactile sensitivity. MI is known to cause skin and airway irritation in humans, and here we provide the first pre-clinical evidence that repeated MI exposures can also provoke allergy-driven genital pain.


Assuntos
Cosméticos/toxicidade , Dermatite Alérgica de Contato/etiologia , Mastócitos/efeitos dos fármacos , Conservantes Farmacêuticos/toxicidade , Tiazóis/toxicidade , Vagina/efeitos dos fármacos , Alérgenos , Animais , Dermatite Alérgica de Contato/tratamento farmacológico , Dermatite Alérgica de Contato/epidemiologia , Dronabinol/uso terapêutico , Feminino , Humanos , Imunoglobulina E/sangue , Mastócitos/metabolismo , Camundongos , Membrana Mucosa , Dor/induzido quimicamente , Pele , Vagina/imunologia
8.
BMC Complement Altern Med ; 19(1): 268, 2019 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-31615568

RESUMO

BACKGROUND: Long-term use of most immunosuppressants to treat allergic contact dermatitis (ACD) generates unavoidable severe side effects, warranting discovery or development of new immunosuppressants with good efficacy and low toxicity is urgently needed to treat this condition. Hispidulin, a flavonoid compound that can be delivered topically due to its favorable skin penetrability properties, has recently been reported to possess anti-inflammatory and immunosuppressive properties. However, no studies have investigated the effect of hispidulin on Th1 cell activities in an ACD setting. METHODS: A contact hypersensitivity (CHS) mouse model was designed to simulate human ACD. The immunosuppressive effect of hispidulin was investigated via ear thickness, histologic changes (i.e., edema and spongiosis), and interferon-gamma (IFN-γ) gene expression in 1-fluoro-2,4-dinitrobenzene (DNFB)-sensitized mice. Cytotoxicity, total number of CD4+ T cells, and percentage of IFN-γ-producing CD4+ T cells were also investigated in vitro using isolated CD4+ T cells from murine spleens. RESULTS: Topically applied hispidulin effectively inhibited ear swelling (as measured by reduction in ear thickness), and reduced spongiosis, IFN-γ gene expression, and the number of infiltrated immune cells. The inhibitory effect of hispidulin was observed within 6 h after the challenge, and the observed effects were similar to those effectuated after dexamethasone administration. Hispidulin at a concentration up to 50 µM also suppressed IFN-γ-producing CD4+ T cells in a dose-dependent manner without inducing cell death, and without a change in total frequencies of CD4+ T cells among different concentration groups. CONCLUSION: The results of this study, therefore, suggest hispidulin as a novel compound for the treatment of ACD via the suppression of IFN-γ production in Th1 cells.


Assuntos
Dermatite Alérgica de Contato/tratamento farmacológico , Flavonas/administração & dosagem , Imunossupressores/administração & dosagem , Animais , Linfócitos T CD4-Positivos/efeitos dos fármacos , Linfócitos T CD4-Positivos/imunologia , Dermatite Alérgica de Contato/genética , Dermatite Alérgica de Contato/imunologia , Modelos Animais de Doenças , Humanos , Interferon gama/genética , Interferon gama/imunologia , Ativação Linfocitária/efeitos dos fármacos , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Células Th1/efeitos dos fármacos , Células Th1/imunologia
10.
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
12.
Artigo em Inglês | MEDLINE | ID: mdl-31131754

RESUMO

BACKGROUND: Fentanyl is primarily an opioid agonist. It is frequently used in general anesthesia as a potent analgesic. It can be administered either orally, transdermally or systemically. Adverse effects due to opium alkaloids are usually because of a non-specific histamine release. Only in a few cases, a true allergy mechanism could be involved. Immediate reactions to opioids are most frequent than delayed reactions. In the past years, delayed reactions have increased in frequency because of the wide use of Transdermal Therapeutic System (TTS) with several opioids for its potent analgesic properties. OBJECTIVE: The objective was to study delayed reaction to fentanyl TTS and cross-reactivity with other opioids. METHODS: A 52-year-old man with a diagnosis of pancreatic cancer who began treatment for a bone metastases pain with fentanyl TTS, at a dose of 50 micrograms per hour (mcg/h) is the subject of the study. After 10-15 days of treatment, he developed an itchy papulovesicular rash in the application site of the fentanyl TTS. Afterward, eczema and superficial desquamation just on the application site of the patch were observed. He changed several times the site of application, but always developing the same symptoms in every single application. Later on, he tolerated other opioids such as oral morphine or tramadol. An allergy workout was performed. We performed Patch Tests (PT) with fentanyl at a concentration of 10% in aqua (aq) and with buprenorphine 10% aq., in order to investigate probable crossreactivity among other topical opioids. RESULTS: Readings were recorded at day 2 (D2) and day 4 (D4), with positive PT only with fentanyl at D2 (+++) and D4 (+++). We decided to perform a single-blind challenge test with buprenorphine 35 mcg/h in TTS, with a negative result. At this moment, fentanyl TTS was replaced by buprenorphine TTS, with good tolerance. CONCLUSION: We present the case of Allergic Contact Dermatitis (ACD) due to hypersensitivity to fentanyl with good tolerance to buprenorphine. Positive PT in this patient suggests a type IV hypersensitivity mechanism. Allergic reactions to opioids are frequently immediate, but delayed reactions could appear, especially when the drug is administered topically.


Assuntos
Dermatite Alérgica de Contato/diagnóstico , Hipersensibilidade a Drogas/diagnóstico , Fentanila/efeitos adversos , Hipersensibilidade Tardia/diagnóstico , Neoplasias Pancreáticas/tratamento farmacológico , Administração Cutânea , Buprenorfina/uso terapêutico , Dermatite Alérgica de Contato/tratamento farmacológico , Hipersensibilidade a Drogas/tratamento farmacológico , Substituição de Medicamentos , Tolerância a Medicamentos , Exantema , Fentanila/uso terapêutico , Humanos , Hipersensibilidade Tardia/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Manejo da Dor , Neoplasias Pancreáticas/complicações , Testes Cutâneos
13.
J Cutan Med Surg ; 23(4): 442-448, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31053034

RESUMO

Pimecrolimus is a topical calcineurin inhibitor currently approved for second-line use in the management of mild-to-moderate atopic dermatitis in patients age 2 years and older. Given the safety profile and nonsteroidal mechanism of pimecrolimus, there has been significant interest in its use in the treatment of a variety of dermatological conditions. This article reviews research that has been published on the off-label uses of topical pimecrolimus, with a focus on published RCTs. Convincing evidence exists supporting pimecrolimus' efficacy in oral lichen planus and seborrheic dermatitis. For other conditions studied to date, pimecrolimus may prove to be a useful treatment alternative when conventional agents fail. Adverse events seen with its off-label use were typically application site reactions, the most common being a transient burning sensation. In summary, pimecrolimus appears to be an effective agent in the treatment of multiple dermatological conditions and may be worth considering as a pharmacologic alternative in several conditions when first-line treatment fails, or for areas that are more susceptible to the adverse effects of topical corticosteroids.


Assuntos
Inibidores de Calcineurina/uso terapêutico , Dermatopatias/tratamento farmacológico , Tacrolimo/análogos & derivados , Administração Tópica , Inibidores de Calcineurina/administração & dosagem , Inibidores de Calcineurina/efeitos adversos , Dermatite Alérgica de Contato/tratamento farmacológico , Dermatite Perioral/tratamento farmacológico , Dermatite Seborreica/tratamento farmacológico , Dermatoses da Mão/tratamento farmacológico , Humanos , Líquen Plano Bucal/tratamento farmacológico , Uso Off-Label , Psoríase/tratamento farmacológico , Ensaios Clínicos Controlados Aleatórios como Assunto , Rosácea/tratamento farmacológico , Tacrolimo/administração & dosagem , Tacrolimo/efeitos adversos , Tacrolimo/uso terapêutico , Vitiligo/tratamento farmacológico
15.
Dermatol Ther ; 32(4): e12947, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31025527

RESUMO

Allergic contact dermatitis (ACD) is a type IV, delayed-type reaction caused by skin contact with low-molecular-weight organic chemicals and metal ions that activate antigen-specific T cells, primarily T-helper 1 (Th1), in a sensitized individual, leading to skin eczema.First-line treatments are based on avoidance of causal agents and topical corticosteroids/immunomodulators. In recalcitrant cases, chronic oral immunosuppressive agents may be used, but they may have serious adverse effects and do not address the immunological disfunction. We report a case of severe ACD, unresponsive to topical or oral immunosuppressive therapy, which resolved itself after treatment with teriflunomide (TF) 14 mg/daily used for multiple sclerosis. TF is a once-daily, oral selective and reversible dihydroorotate dehydrogenase inhibitor, revealing a new treatment option for ACD.


Assuntos
Crotonatos/uso terapêutico , Dermatite Alérgica de Contato/tratamento farmacológico , Eczema/tratamento farmacológico , Toluidinas/uso terapêutico , Dermatite Alérgica de Contato/patologia , Eczema/patologia , Inibidores Enzimáticos/uso terapêutico , Feminino , Humanos , Pessoa de Meia-Idade , Oxirredutases atuantes sobre Doadores de Grupo CH-CH/antagonistas & inibidores , Índice de Gravidade de Doença , Resultado do Tratamento
17.
J Am Acad Dermatol ; 81(1): 157-162, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30885752

RESUMO

BACKGROUND: Previous case reports and series suggested that dupilumab may be an effective treatment for allergic contact dermatitis (ACD). Little is known about the impact of dupilumab on patch test results and comorbid ACD in patients with atopic dermatitis (AD). OBJECTIVE: Determine the impact of dupilumab on patch testing results and improvement of ACD in patients with AD. METHODS: A retrospective study of patients with AD treated with dupilumab who underwent patch testing (n = 7) or had concomitant ACD (n = 6). RESULTS: In all, 7 patients with AD were patch tested while taking dupilumab; in all of these patients, at least 1 positive patch test reaction was observed, with a total of 25 different allergens having a reaction graded as 1+ or stronger and few irritant reactions. In 1 patient, multiple previously positive relevant patch test results were not duplicated upon repeat patch testing. In the 6 patients with AD and concomitant ACD, dupilumab and allergen avoidance resulted in substantial or complete resolution of AD signs and symptoms but resolution of ACD in only 3 patients. However, 3 patients had at least 1 flare of ACD upon re-exposure to relevant allergens. LIMITATIONS: Retrospective and uncontrolled study. CONCLUSIONS: Dupilumab had variable impact on patch testing results and resolution of comorbid ACD in adult patients with AD.


Assuntos
Anticorpos Monoclonais/uso terapêutico , Dermatite Alérgica de Contato/tratamento farmacológico , Dermatite Alérgica de Contato/epidemiologia , Dermatite Atópica/diagnóstico , Dermatite Atópica/epidemiologia , Adulto , Anticorpos Monoclonais Humanizados , Estudos de Coortes , Comorbidade , Dermatite Alérgica de Contato/diagnóstico , Relação Dose-Resposta a Droga , Esquema de Medicação , Feminino , Seguimentos , Humanos , Injeções Subcutâneas , Masculino , Pessoa de Meia-Idade , Testes do Emplastro , Estudos Retrospectivos , Medição de Risco , Resultado do Tratamento , Adulto Jovem
18.
Int J Dermatol ; 58(7): 806-810, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30724346

RESUMO

BACKGROUND: Patients with anogenital symptoms may delay before seeking medical attention. Attempted self-treatment with multiple topical preparations and excessive hygiene measures offer ideal conditions for sensitization. The aim of this study was to identify the common allergens detected on cutaneous allergy testing in patients presenting with anogenital symptoms. METHODS: A retrospective chart review of patients who underwent cutaneous allergy testing for perianal and/or genital symptoms over a 3-year period, January 2013 to December 2015, n = 99. Information was gathered from medical records, pretesting questionnaires, and cutaneous allergy testing records. RESULTS: At least one relevant allergen(s) was identified in 44/99 (45%) in our cohort, with allergic reactions to fragrances, Myroxylon pereirae, caine mix, sodium metabisulfite, and methylisothiazolinone most frequently observed. CONCLUSIONS: Cutaneous allergy testing is a useful investigation in patients presenting with anogenital symptoms, but advice regarding general skin care measures should not be omitted. The most commonly identified relevant allergens in our study were those present in over-the-counter cleansing and hemorrhoid preparations.


Assuntos
Alérgenos/imunologia , Dermatite Alérgica de Contato/diagnóstico , Testes do Emplastro , Automedicação/efeitos adversos , Administração Tópica , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Dermatite Alérgica de Contato/tratamento farmacológico , Dermatite Alérgica de Contato/imunologia , Feminino , Genitália , Humanos , Masculino , Pessoa de Meia-Idade , Períneo , Estudos Retrospectivos , Pele , Adulto Jovem
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