Patch testing in patients with perianal eczema.

INTRODUCTION AND OBJECTIVES: Reports show that between 25% and 78% of patients with anogenital dermatitis have positive patch test results. Consequently, patch testing would appear to be warranted in patients presenting with eczema in the anogenital region. The objectives of the present study were to identify the most common allergens in patients with perianal eczema and to determine which allergen series are most useful for patch testing in patients with this condition. MATERIAL AND METHODS: We performed a retrospective review of patch test results in patients with only perianal eczema between 2001 and 2012. RESULTS: Of the 37 patients with perianal eczema, 16 had a positive reaction; methylchloroisothiazolinone/methylisothiazolinone was the main allergen involved. With the exception of 1 case of sensitization to gentamicin, all the positive results with present relevance were to allergens from the standard series of the Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC) or to the patient's own products. CONCLUSIONS: In our experience, methylchloroisothiazolinone/methylisothiazolinone is the main allergen involved in perianal eczema, and sensitization often results from using wet wipes. Patch testing in perianal eczema should be based on the GEIDAC standard series and the patient's own products.

[Photocontacs dermatitis due to dexketoprofen. Report of 2 cases]. / Fotodermatitis de contacto por dexketoprofeno. Descripción de dos casos.

Dexketoprofen is the active isomer of ketoprofen and likewise belongs to the group of non-steroidal anti-inflammatory drugs (NSAIDs) derived from propionic acid. We have recently studied, using patch and photopatch tests, two women with a characteristic clinical picture of contact photodermatitis who had used topical dexketoprofen (Enangel) in the days before onset of the rash. In both cases we used the standard series of GEIDC, a series for NSAIDs, the product itself (Enalgel) and its excipients. On examination of the photopatches of both patients at 96 hours we found positive reactions to dexketoprofen and Enalgel. Furthermore, in one of the women we observed simultaneous photosensitivity to other NSAIDs and to several excipients of Enangel. Reviewing the literature we have found only three references on contact photodermatitis due to dexketoprofen. We describe two new cases, with multiple photosensitivities in one of them. We consider that such patients should be patch tested with dexketoprofen at 0.1-1 % petrolatum, concentrations that are notably inferior to those used in previous publications.

[Ofuji's disease: description of a case]. / Enfermedad de Ofuji: descripción de un caso.

Eosinophilic pustular folliculitis (EPF) is a rare, chronic disease of unknown cause, characterized by itchy papules or pustules and an infiltration of eosinophiles in the biopsy. EPF occurs rarely outside Japan and very few cases have been described in non-Japanese race people. The causes of the disease and its definitive treatment have not yet been established. In our patient, the presence of subcorneal pustules in the biopsies initially favored a diagnosis of pustulosis and several biopsies were necessary before a diagnosis of EPF was reached. A new case of EPF recently presented at our clinic and we have carried out an extensive revision of the disease.

Pruebas epicutáneas en pacientes con eczema perianal / Patch Testing in Patients With Perianal Eczema

INTRODUCCIÓN Y OBJETIVOS: La prevalencia de parches positivos en los pacientes afectados por una dermatitis anogenital oscila según las series entre un 25-78%, justificándose por tanto la realización de pruebas epicutáneas ante eczemas de esta localización. Los objetivos del presente estudio son por un lado determinar los alérgenos más frecuentes en los pacientes con eczema perianal y, por otro, establecer las baterías de alérgenos más útiles para el estudio con pruebas epicutáneas de esta afección. MATERIAL Y MÉTODOS: Se han revisado retrospectivamente (años 2001-2012) los resultados obtenidos al estudiar con pruebas epicutáneas a aquellos pacientes que presentaban exclusivamente un eczema perianal. RESULTADOS: De los 37 pacientes con esta clínica en 16 se observó alguna reacción positiva, siendo el metilcloroisotiazolinona/metilisotiazolinona el principal alérgeno implicado. Excepto un caso con sensibilización a gentamicina, todas las positividades con relevancia presente correspondieron a alérgenos de la batería estándar del Grupo Español de Investigación en Dermatitis de Contacto y Alergia Cutánea (GEIDAC) o a productos propios del paciente. CONCLUSIONES: En nuestra experiencia la metilcloroisotiazolinona/metilisotiazolinona es el principal alérgeno implicado en los eczemas perianales, procediendo esta sensibilización frecuentemente del uso de toallitas higiénicas. El estudio epicutáneo de un eczema perianal deberá realizarse básicamente con la batería estándar y los productos propios

INTRODUCTION AND OBJECTIVES: Reports show that between 25% and 78% of patients with anogenital dermatitis have positive patch test results. Consequently, patch testing would appear to be warranted in patients presenting with eczema in the anogenital region. The objectives of the present study were to identify the most common allergens in patients with perianal eczema and to determine which allergen series are most useful for patch testing in patients with this condition. MATERIAL AND METHODS: We performed a retrospective review of patch test results in patients with only perianal eczema between 2001 and 2012. RESULTS: Of the 37 patients with perianal eczema, 16 had a positive reaction; methylchloroisothiazolinone/methylisothiazolinone was the main allergen involved. With the exception of 1 case of sensitization to gentamicin, all the positive results with present relevance were to allergens from the standard series of the Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC) or to the patient's own products. CONCLUSIONS: In our experience, methylchloroisothiazolinone/methylisothiazolinone is the main allergen involved in perianal eczema, and sensitization often results from using wet wipes. Patch testing in perianal eczema should be based on the GEIDAC standard series and the patient's own products

Dermatosis acantolítica papular del área genitocrural: ¿ forma localizada de Darier o Hailey-Hailey? / Papular Acantholytic Dermatosis in the Genito-Crural Region: A Localized Form of Darier Disease or Hailey-Hailey Disease?

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Complicaciones óseas en un paciente con lepra lepromatosa / Bone Complications in a Patient With Lepromatous Leprosy

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Fotodermatitis de contacto por dexketoprofeno. Descripción de dos casos / Photocontacs dermatitis due to dexketoprofen. Report of 2 cases

El dexketoprofeno es el isómero activo del ketoprofeno y como aquél pertenece al grupo de antiinflamatorios no esteroideos (AINE) derivados del ácido propiónico. Recientemente hemos estudiado con parches y fotoparches a dos mujeres con una clínica característica de fotodermatitis de contacto que habían usado los días previos dexketoprofeno tópico (Enangel®). En ambos casos se empleó la batería estándar del GEIDC, una batería de AINE, el producto propio (Enangel®) y sus excipientes. En las dos pacientes se observaron a las 96 horas fotoparches positivos frente a dexketoprofeno y Enangel®. Además, en una de ellas se evidenciaron fotosensibilizaciones simultáneas a otros AINE y a varios excipientes del Enangel®. Revisando la bibliografía, sólo hemos encontrado tres referencias sobre fotodermatitis de contacto por dexketoprofeno. Aportamos dos nuevos casos, en uno de los cuales se asociaron múltiples fotosensibilidades. Consideramos que estos pacientes deben parchearse con dexketoprofeno al 0,1-1 % vaselina, concentraciones sensiblemente inferiores a las usadas en publicaciones previas

Dexketoprofen is the active isomer of ketoprofen and likewise belongs to the group of non-steoidal anti-inflammatory drugs (NSAIDs) derived from propionic acid. We have recently studied, using patch and photopatch tests, two women with a characteristic clinical picture of contact photodermatitis who had used topical dexketoprofen (Enangel®) in the days before onset of the rash. In both cases we used the standard series of GEIDC, a series for NSAIDs, the product itself (Enangel®) and its excipients. On examination of the photopatches of both patients at 96 hours we found positive reactions to dexketoprofen and Enangel®. Furthermore, in one of the women we observed simultaneous photosensitivity to other NSAIDs and to several excipients of Enangel®. Reviewing the literature we have found only three references on contact photodermatitis due to dexketoprofen. We describe two new cases, with multiple photosensitivities in one of them. We consider that such patients should be patch tested with dexketoprofen at 0.1-1 % petrolatum, concentrations that are notably inferior to those used in previous publications

Enfermedad de Ofuji: descripción de un caso / Ofuji's disease: description of a case

La foliculitis pustulosa eosinofílica (FPE) es una enfermedad crónica, rara y de causa desconocida, que cursa con pápulas y/o pústulas pruriginosas y un infiltrado de eosinófilos en la biopsia. La FPE suele ocurrir con poca frecuencia fuera de Japón y son escasos los casos descritos en pacientes de raza no japonesa. Los factores causales de la enfermedad y su tratamiento definitivo no están establecidos todavía. En nuestra paciente, inicialmente, la presencia de pústulas subcorneales en las biopsias orientaba hacia un diagnóstico de dermatosis pustular; y fueron necesarias repetidas biopsias para obtener el diagnóstico de FPE. Presentamos un nuevo caso de FPE recientemente visto en nuestra consulta y hemos realizado una revisión extensa de la enfermedad

Eosinophilic pustular folliculitis (EPF) is a rare, chronic disease of unknown cause, characterized by itchy papules or pustules and an infiltration of eosinophiles in the biopsy. EPF occurs rarely outside Japan and very few cases have been described in non-Japanese race people. The causes of the disease and its definitive treatment have not yet been established. In our patient, the presence of subcorneal pustules in the biopsies initially favored a diagnosis of pustulosis and several biopsies were necessary before a diagnosis of EPF was reached. A new case of EPF recently presented at our clinic and we have carried out an extensive revision of the disease