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1.
Biol Trace Elem Res ; 200(1): 49-58, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33609234

RESUMO

Nickel (Ni) is a frequently used metal in the production of many products, and Ni exposure occurs in humans through food, inhalation, and skin. Studies reported Ni as the most common allergen diagnosed in the serial patch test. The main purpose of our study was to determine the concentration of Ni and other elements in the urine samples of individuals with Ni-sensitivity and to determine the effect of lifestyle habits on these variables. This study was conducted with 388 participants; additionally, both Ni patch test and inorganic analysis (for 24 elements) method in urine with inductively coupled plasma-mass spectrometry (ICP-MS) were applied to all participants. Ninety-two (23.7%) of the participants were found to have nickel sensitivity with a mean urine concentration of 4.475 µg/g creatinine (median=4.260; SD=2.527). The urine nickel concentration was significantly different between female and male participants (p =0.001). We found a significant correlation between Ni and other metals alongside various element pairs. The mean urine Ni concentration of the individuals with a positive Ni sensitivity test result was not different from that of the participants without Ni sensitivity (4.475 vs 4.256 µg/g creatinine, respectively; p = 0.068). The high accuracy, recovery, and repeatability data obtained from the analyses indicate that this study is efficient and appropriate for the quantitative determination of nickel and other elements in urine samples. Ni-containing objects and Ni-rich foods should be of concern for individuals with hypersensitivity reactions to the element.


Assuntos
Metais , Níquel , Feminino , Hábitos , Humanos , Estilo de Vida , Masculino , Testes do Emplastro
2.
Handb Exp Pharmacol ; 268: 227-246, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34236521

RESUMO

Skin lesions caused by allergic contact dermatitis are an important occupational and environmental disease. Patch testing is the gold-standard procedure used to diagnose allergic contact dermatitis.The present chapter summarizes aspects of patch testing for the diagnosis of contact allergy: important working definitions, relevance of treating contact dermatitis, materials, technique, test result and interpretation, and special consideration regarding individual factors which influence the patch test outcome or necessitate special attention.Performing and interpreting patch tests requires know-how. Knowing how to perform them and the particularities of specific cases is essential to correctly interpret the results. A correct evaluation and diagnosis will significantly impact the natural history of the disease and significantly improve the quality of life of the patient.


Assuntos
Dermatite Alérgica de Contato , Qualidade de Vida , Alérgenos , Dermatite Alérgica de Contato/diagnóstico , Humanos , Testes do Emplastro
3.
Handb Exp Pharmacol ; 268: 405-433, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34312717

RESUMO

This chapter summarises all relevant aspects of patch testing, closely following recommendations outlined in a recent European, and a German S3 guideline on diagnostic patch testing with contact allergens and medicinal products (drugs). Patch testing is indicated in patients suspected of suffering, or having been suffering, from delayed-type hypersensitivity leading to allergic contact dermatitis or other skin and mucosal diseases. Sections of this chapter include detailed indications, reasons for possibly postponing the test, considerations on choosing haptens (contact allergens) to test, various aspects of the application of patch test allergen preparations (storage, dosing) and of testing with individual materials provided by the patients. Special aspects of patch testing in cutaneous adverse drug reactions, children, or occupational contact dermatitis are outlined. Supplemental test methods, notably the repeated open application test, are briefly described. Finally, the final evaluation in terms of assessment of clinical relevance of reactions and patient counselling are outlined.


Assuntos
Dermatite Alérgica de Contato , Alérgenos , Criança , Dermatite Alérgica de Contato/diagnóstico , Humanos , Testes do Emplastro , Pele
4.
Cutis ; 108(2): 91-95, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34735319

RESUMO

This study investigated the utility of skin patch testing to identify delayed-type food hypersensitivities that trigger irritable bowel syndrome (IBS) symptoms. Using an extensive panel of type IV food allergens, patch testing was performed on individuals with IBS symptoms, after which patch test-directed avoidance diets were implemented in those patients with patch test reactions. All patients placed on avoidance diets were invited to participate in a questionnaire-based study assessing IBS symptom response to the diet. Primary end points included average abdominal pain during the more than 3-month food avoidance period and degree of improvement in overall IBS symptoms 3 or more months after initiation of the avoidance period. The results from this study add to the expanding body of evidence of a role for delayed-type food hypersensitivities in the pathogenesis of some cases of IBS. Skin patch testing to type IV food allergens offers a new approach to evaluating and managing these patients.


Assuntos
Hipersensibilidade Alimentar , Síndrome do Intestino Irritável , Alérgenos , Dieta , Hipersensibilidade Alimentar/diagnóstico , Humanos , Síndrome do Intestino Irritável/diagnóstico , Testes do Emplastro
5.
Cutis ; 108(3): 124-127, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34826273

RESUMO

Plants can cause allergic contact dermatitis (ACD), mechanical irritant contact dermatitis, chemical irritant contact dermatitis, light-mediated dermatitis, and pseudophytodermatitis. Allergic contact dermatitis to chemicals in the Toxicodendron genus, which includes poison ivy, poison oak, and poison sumac, is the most common cause of plant ACD; however, many other plants, such as Compositae, Alstroemeriaceae, and Rutaceae plants also are important causes of dermatitis. In individuals with recurrent ACD from plants other than Toxicodendron, patch testing can be used to identify the source of allergic reactions to plant species. This article provides an overview of the various plant dermatoses, common culprits of plant dermatitis, and diagnostic and therapeutic options for plant dermatoses.


Assuntos
Dermatite Alérgica de Contato , Dermatite por Toxicodendron , Toxicodendron , Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/etiologia , Dermatite por Toxicodendron/diagnóstico , Dermatite por Toxicodendron/etiologia , Dermatite por Toxicodendron/terapia , Humanos , Testes do Emplastro , Plantas , Toxicodendron/efeitos adversos
6.
Medicina (Kaunas) ; 57(11)2021 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-34833457

RESUMO

INTRODUCTION: The most common clinical manifestation of mango allergy is contact dermatitis, which can be localized or systemic. The sensitising substances that have long been suspected are alk(en)yl catechols and/or alk(en)yl resorcinols. METHODS: We reviewed the original articles published on Pubmed, Embase and Cochrane Library before 15 September 2021, on the topic of contact allergy induced by mango and we synthesized the key data. RESULTS: We found 12 case reports and four case series, with a total of 37 patients. Only seven of these cases were reported in patients from mango-cultivating countries, the other 30 were from countries where mango cultivation does not occur, and 26 were also from countries where poison ivy/oak are commonly found. We found that contact dermatitis may occur on the first exposure to mango due to previous sensitisation to urushiol-containing plants. The diagnosis was confirmed by patch testing in some of the cases. There was great heterogeneity between the reagents used. CONCLUSION: Mango fruit is frequently consumed, but mango induced contact dermatitis, the main hypersensitivity reaction induced by mango, is rare. Further data is necessary for a better understanding of sensitising substances and, consecutively, standardization of patch test reagents.


Assuntos
Dermatite Alérgica de Contato , Mangifera , Toxicodendron , Alérgenos , Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/etiologia , Humanos , Testes do Emplastro
7.
Clin Dermatol ; 39(4): 580-590, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34809764

RESUMO

Patch testing is the gold standard diagnostic tool for cell-mediated type IV hypersensitivity reactions like allergic contact dermatitis. Sensitized individuals have primed antigen-specific T lymphocytes that cause a reaction when antigens are applied to the skin owing to prior sensitization. Patch testing can be used in the adult and pediatric populations, but it is contraindicated in patients with a known history of severe allergic reactions to suspected allergens, generalized active dermatitis, or extensive eczema. Patch test systems can be a comprehensive panel (70-80 allergens), but they can also be targeted and limited to a more common allergen series (35 allergens). The decision for allergen selection should be based on an accurate patient history, physical examination, and availability of allergens. Measurement and interpretation of the test results requires training and experience, as well as consideration of relevance and clinical history. Patch testing is generally considered safe with just a few known complications: excited skin syndrome, active sensitization, and rarely anaphylaxis or other cutaneous complications. Appropriately pretesting patient education can help to mitigate some of these complications. Based on patch testing results, patients should be educated regarding proper allergen avoidance measures to resolve symptoms of allergic contact dermatitis.


Assuntos
Dermatite Alérgica de Contato , Eczema , Alérgenos , Criança , Dermatite Alérgica de Contato/diagnóstico , Humanos , Testes do Emplastro , Medição de Risco
8.
Cent Eur J Public Health ; 29(3): 191-194, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34623118

RESUMO

OBJECTIVE: Allergic contact dermatitis (ACD) in the healthcare sector is a major occupational health hazard. There are many reasons for a higher frequency of ACD in healthcare personnel compared to other populations: among others, simultaneous exposure to multiple substances, use of aggressive detergents and wet work. However, studies that systematically correlate skin symptoms with the presence of sensitization investigated through patch tests in specific categories of health workers are very rare and conflicting. Although some studies have reported a correlation between skin disease and night shift, the strength of the evidence is rather limited. The purpose of our study was to investigate by means of patch testing the skin sensitization (SS) to common allergens in the hospital setting in a group of healthcare workers (HCW) reporting symptoms related to dermatitis, according to their job activity and their shift status. METHODS: 132 HCWs visiting a health surveillance centre were investigated by means of specific questionnaire for dermatitis, followed by patch test evaluation including 40 haptens of the SIDAPA 2016 series. RESULTS: Skin sensitization was observed in 1/3 of the subjects investigated by patch tests. The nursing job was strongly associated with cutaneous reactivity after controlling for the confounding of gender, age and other factors. Shift work was related to the prevalence of SS. CONCLUSIONS: In our study, the nurse's role and shift work were significantly associated with the risk of cutaneous sensitization, in particular for common antigens.


Assuntos
Dermatite Alérgica de Contato , Dermatite Ocupacional , Estudos Transversais , Dermatite Alérgica de Contato/epidemiologia , Dermatite Alérgica de Contato/etiologia , Pessoal de Saúde , Humanos , Testes do Emplastro
9.
An Bras Dermatol ; 96(6): 706-711, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34629194

RESUMO

BACKGROUND: Despite being widely used in different areas of dermatology, there have been few studies evaluating the benefit of dermoscopy in the interpretation of patch tests, especially in weak and doubtful reactions. OBJECTIVES: To evaluate the role of dermoscopy in the interpretation of patch tests and describe the main findings of the reactions. METHOD: Prospective study, carried out in dermatology reference centers in southern Brazil, which evaluated the final results of patch tests analyzed with the aid of dermoscopy. RESULTS: 77 patients and 160 reactions were included. The most prevalent substances were nickel sulphate (23.8%), kathon CG (9.4%), and perfume mix (8.8%). The main dermoscopic findings were reaction area​​ greater than half of the chamber site (90%), homogeneous erythema (86.9%), vesicles (30%), crusts (21.3%), perifollicular erythema (35%), pore reaction (19.4%) and pustules (8.8%). Dermoscopy was found to facilitate the definition of erythema in reactions on black skin and when due to substances with deposition of pigment. Of the 64 weak or doubtful reactions, 36 (56.25%) showed a change in the final result after dermoscopy evaluation; of the 36 doubtful reactions, 33 (91.6%) showed a change in the final result after dermoscopy evaluation (p < 0.001). STUDY LIMITATIONS: The probable limitation of the study is its sample size. Though certain significance levels have been reached, other possible relationships may not have been observed. CONCLUSION: Dermoscopy improves significantly the interpretation of patch tests, especially in weak and doubtful reactions.


Assuntos
Dermatite Alérgica de Contato , Dermoscopia , Eritema , Humanos , Testes do Emplastro , Estudos Prospectivos
10.
Acta Derm Venereol ; 101(11): adv00591, 2021 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-34664078

RESUMO

The chemical composition of propolis varies with geographical origin; however, it is not known whether this affects the frequency of contact allergy to propolis. In order to study the frequency of contact allergy to propolis of different geographical origins and concomitant reactions, 1,470 consecutive patients with dermatitis from Denmark, Lithuania and Spain were patch tested with propolis from China, Lithuania, North America and Sweden, and with a baseline series. Patch test reactions to any type of propolis ranged from 1.3% to 5.8%. There were no statistically significant differences in the frequency of positive reactions between the 4 types of propolis in the respective countries. Testing with a single commercially available type of propolis detects only approximately half of propolis-allergic patients. In patients allergic to propolis, concomitant reactions to Myroxylon pereirae resin, colophonium and Fragrance mix I were common, ranging from 12.5% to 50.0%.


Assuntos
Dermatite Alérgica de Contato , Perfumes , Própole , Alérgenos/efeitos adversos , Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/epidemiologia , Humanos , Testes do Emplastro , Própole/efeitos adversos
11.
Clin Podiatr Med Surg ; 38(4): 561-568, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34538434

RESUMO

Shoe dermatitis is a type of contact dermatitis precipitated by allergens or irritants found in shoes. Potassium dichromate, commonly used in leather processing, is one of the most prevalent agents responsible for shoe dermatitis; however, it is not the only one. Shoe dermatitis caused by an allergen or an irritant may affect a person of any age, sex, or ethnicity. Numerous treatments exist for shoe dermatitis, the most simple yet important being avoidance of causative agents. Pharmaceutical agents commonly used are emollients, humectants, and topical corticosteroids. In more severe cases, topical calcineurin inhibitors and phototherapy may be used.


Assuntos
Dermatite Alérgica de Contato , Dermatoses do Pé , Alérgenos , Dermatoses do Pé/diagnóstico , Dermatoses do Pé/etiologia , Dermatoses do Pé/terapia , Humanos , Testes do Emplastro , Sapatos
13.
Cutis ; 108(1): 10-12, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34397351

RESUMO

Allergic contact dermatitis (ACD) is a common dermatologic condition that presents with unique features in patients with skin of color (SOC). Additionally, the types of allergens that most frequently cause ACD vary in Black and White patients and are attributed to cultural differences between these 2 groups. Similarly, accurate patch testing in the SOC demographic requires an understanding of the morphologic differences between a positive patch test result in darker skin types compared to lighter skin types. Knowledge of these differences is essential to effectively diagnose and evaluate patients with ACD. There are identifiable disparities in duration of dermatitis affecting patients with ACD who live more than 50 miles from a patch testing center as well as those who live in impoverished areas. Dermatologists should be aware of these factors that impact patient care in appreciable ways so they are better prepared to serve these populations.


Assuntos
Dermatite Alérgica de Contato , Pigmentação da Pele , Alérgenos , Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/etiologia , Humanos , Testes do Emplastro
14.
Occup Med (Lond) ; 71(6-7): 298-300, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34455439

RESUMO

We present a 29-year-old non-atopic male apprentice power lineman and recreational cowboy with a case of allergic contact dermatitis due to both occupational and recreational exposure. He presented with a 4-month history of a pruritic, steroid-responsive, intermittent hand, foot and leg dermatitis. Patch testing was positive for chromium, cobalt and a piece of leather from his cowboy boots. His leather work gloves, inner lining of work harness, work boots and cowboy boots were assessed for chromium and cobalt content with handheld fluorescence x-ray spectrometry. Upon replacement of all leather items including the items tested and his leather cowboy saddle, the rash resolved. This case demonstrates the clinical relevance of using a handheld fluorescence x-ray spectrometer to assess for chromium and leather content.


Assuntos
Cromo , Dermatite Alérgica de Contato , Adulto , Cromo/análise , Cobalto/efeitos adversos , Cobalto/análise , Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/etiologia , Humanos , Masculino , Testes do Emplastro , Espectrometria por Raios X
15.
Occup Med (Lond) ; 71(6-7): 294-297, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34455441

RESUMO

BACKGROUND: Allergic contact dermatitis is a common occupational skin disease among healthcare workers (HCWs). AIMS: This study describes causes of allergic contact dermatitis in New Zealand HCWs. METHODS: All HCWs undergoing patch testing between July 2008 and January 2020 at a public hospital patch test clinic and between June 2019 and January 2020 at a private dermatology clinic were included. Data collected included patient demographics, occupation, results of patch testing and pre- and post-patch test diagnoses. RESULTS: Out of 837 patients tested, 67 were HCWs. The mean age of HCWs was 41 years (SD 14) and 58 (87%) were female. The most common occupations were nurses (40%), allied health (22%) and doctors (18%). Forty-six (69%) patients had a background of atopic dermatitis. Hand dermatitis was the most common presentation (49%), followed by facial/neck dermatitis (25%). Thirty-eight (57%) had at least one positive reaction on patch testing, including 19 (28%) with a positive result of current relevance. There were 16 relevant reactions to rubber accelerators, 11 to fragrances, 10 to preservatives and 6 to corticosteroids. The most frequent relevant allergens were methylisothiazolinone/methylchloroisothiazolinone (4%), hydroxyisohexyl 3-cyclohexene carboxaldehyde (4%) and methylisothiazolinone (4%). CONCLUSIONS: The most common allergens in HCWs were rubber chemicals, fragrances, preservatives and topical corticosteroids. Important allergens for patch testing HCWs are outlined, in particular, those with hand dermatitis should be tested to a rubber series.


Assuntos
Dermatite Alérgica de Contato , Dermatite Ocupacional , Adulto , Alérgenos , Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/epidemiologia , Dermatite Alérgica de Contato/etiologia , Dermatite Ocupacional/diagnóstico , Dermatite Ocupacional/epidemiologia , Dermatite Ocupacional/etiologia , Feminino , Pessoal de Saúde , Humanos , Testes do Emplastro
16.
Cutis ; 107(5): 238-240, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34288849

RESUMO

The American Contact Dermatitis Society chose acetophenone azine (AA) as the 2021 Allergen of the Year. Acetophenone azine is an emerging contact allergen that often is associated with the use of sports equipment and footwear. The pattern of dermatitis initially starts locally at the site of contact but can develop into a generalized dermatitis. Strong suspicion is necessary to diagnose AA allergy, and patch testing should be completed with AA and to potentially relevant sports equipment and/or shoes. Acetophenone azine is not yet available as a commercial patch-test preparation, but the optimal concentration is 0.1% in acetone or petrolatum. This column serves as an introduction to AA as an emerging allergen and highlights diagnosis, management, and patch testing for AA contact allergy.


Assuntos
Alérgenos , Dermatite Alérgica de Contato , Acetofenonas/efeitos adversos , Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/etiologia , Humanos , Testes do Emplastro , Equipamentos Esportivos , Estados Unidos
17.
J Eur Acad Dermatol Venereol ; 35(10): 1957-1962, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34286888

RESUMO

BACKGROUND: To our knowledge, an international consensus is lacking regarding the development of an adequate informed consent form for a patch test (PT) and the information that should be included in such document. OBJECTIVES: The aim of the study was to reach a consensus on the specific points that need to be addressed in a PT consent form. METHODS: A Delphi survey, comprising 2 rounds and 1 final discussion, was used to gather and analyse data, which was conducted over the Internet. Each statement that reached a consensus with the respondents (9 expert dermatologists from Europe) was defined as a median consensus score (MED) of ≥7 and agreement among panelists as an interquartile range (IQR) of ≤3. All study participants were members of the EADV task force on contact dermatitis. RESULTS: The expert panel addressed several topics that should be included in an informed consent form for a PT: introduction, preparation for PT, testing procedure, allowed activities, adverse events and additional authorizations. CONCLUSIONS: Our results assess recommendations regarding points to be contained in an informed consent form for a PR. Future actions towards standardization and harmonization of this specific consent form are needed.


Assuntos
Dermatite de Contato , Dermatologia , Venereologia , Termos de Consentimento , Humanos , Testes do Emplastro
18.
Immunol Allergy Clin North Am ; 41(3): 375-392, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34225895

RESUMO

Environmental, or exogenous, dermatitis is comprised of irritant and allergic contact dermatitis, which account for 80% and 20% of cases of contact dermatitis, respectively. Contact dermatitis is extremely common, and failure to diagnose this entity may result in overlooking a potentially curable driver of disease. In this review, we describe how clinical features, such as morphology or history, can assist in distinguishing exogenous from endogenous causes of dermatitis, and allergic from irritant contact dermatitis. Additionally, we provide an overview of common contact allergens and how dermatitis distribution can suggest possible culprit allergens. Patch testing is needed to confirm contact allergy.


Assuntos
Dermatite Alérgica de Contato , Dermatite Irritante , Alérgenos , Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/etiologia , Dermatite Irritante/diagnóstico , Dermatite Irritante/etiologia , Humanos , Testes do Emplastro
19.
Immunol Allergy Clin North Am ; 41(3): 393-408, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34225896

RESUMO

Allergic contact dermatitis (ACD) affects up to 20% of adults and children, although children are infrequently patch tested. Available data suggest that children and adults, with or without atopic dermatitis, have the same prevalence of ACD. Patch testing is the gold standard for evaluation of ACD. The Pediatric Baseline Series was recently published by expert consensus for use in pediatric patch testing, with additional allergens tested as guided by history. This article examines methods of patch testing and up-to-date data on pediatric ACD. The top allergens are reviewed, and avoidance strategies are discussed.


Assuntos
Dermatite Alérgica de Contato , Dermatite Atópica , Adulto , Alérgenos , Criança , Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/epidemiologia , Humanos , Testes do Emplastro , Prevalência
20.
Immunol Allergy Clin North Am ; 41(3): 409-421, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34225897

RESUMO

Allergic contact dermatitis (ACD) remains a globally prevalent disease for both children and adults. The silent ACD epidemic continues to be fueled by the introduction of novel allergens in industrial and household products and the continued presence of known allergens. In 1997, Allan Dillarstone noted a sinusoidal pattern to epidemics when allergenic preservatives were replaced by alternative chemicals within the market, which then similarly increased in allergenicity. A call for public health vigilance and prevention initiatives is needed to intervene in the ACD epidemic.


Assuntos
Dermatite Alérgica de Contato , Epidemias , Adulto , Alérgenos , Criança , Dermatite Alérgica de Contato/epidemiologia , Dermatite Alérgica de Contato/etiologia , Humanos , Testes do Emplastro , Saúde Pública
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