1/111. Contact allergy to calcipotriol does exist. Report of an unequivocal case and review of the literature.A 64-year-old woman developed an itchy papulovesicular dermatitis at the periphery of psoriatic plaques on the lower legs after the daily application of calcipotriol ointment (Psorcutan Salbe) for 2 weeks. She had used the same ointment for 4 weeks 6 months before. Patch testing revealed strongly positive reactions to the marketed product and to the active ingredient calcipotriol in a concentration series (2.0, 10.0 and 50.0 microg/ml in isopropyl alcohol). A repeated open application test (ROAT) on the forearms showed a vesicular dermatitis after 4 days on the side that received the calcipotriol ointment, whereas the control with the placebo ointment remained completely negative. Histologic examination of the patch test reaction was in line with the picture of contact allergy. Retesting after 6 months confirmed the hypersensitivity, with a positive reaction even at 0.4 microg/ml. For comparison, the ROAT with calcipotriol ointment was performed for 2 weeks on both forearms of 15 volunteers never exposed to calcipotriol before. Only 2 subjects developed a slight reaction on days 5 and 11, respectively. Based on this case and on previous reports in the literature, calcipotriol must now be regarded as both a contact allergen and an irritant. For patch testing, a concentration of 2 microg/ml in isopropyl alcohol is the most suitable. If the reaction is only weakly positive and not reproducible after some time, it might be of the irritant type. In unclear cases, a ROAT should be performed. A severe papulovesicular dermatitis within 1 week will confirm the presence of contact allergy.- - - - - - - - - - ranking = 1keywords = sensitivity (Clic here for more details about this article) |
2/111. Facial dermatitis, contact urticaria, rhinoconjunctivitis, and asthma induced by potato.BACKGROUND: Potato contains multiple heat-labile proteins which can induce immediate hypersensitivity reactions. Rhino-conjunctivitis, asthma, contact urticaria and protein contact dermatitis have been described in association with potato exposure. OBJECTIVE: A patient with possible airborne facial dermatitis to potato is described. RESULTS: A middle-aged atopic housewife with pre-existent atopic dermatitis suffered from rhino-conjunctivitis, asthma, and contact urticaria when pealing raw potatoes, but her main complaint was intense, treatment-resistant dermatitis of the face. The investigations showed a positive prick test, a positive patch test, and positive specific serum IgE to raw potato. Potato avoidance led not only to the resolution of the immediate symptoms, but also of the facial dermatitis, suggesting she had dermatitis due to this vegetable. CONCLUSIONS: Potato may induce contact dermatitis with positive immediate and delayed hypersensitivity tests.- - - - - - - - - - ranking = 2keywords = sensitivity (Clic here for more details about this article) |
3/111. Contact hypersensitivity to mercury in amalgam restorations may mimic oral lichen planus.Oral lichenoid lesions caused by hypersensitivity to mercury in amalgam fillings may mimic oral lichen planus on clinical and histologic examination. A positive patch test reaction to more than one mercurial allergen increases confidence in the diagnosis and justifies the removal and replacement of all amalgam fillings with those made of other materials. A complete remission may be expected about 3 months after the last amalgam filling is removed.- - - - - - - - - - ranking = 5keywords = sensitivity (Clic here for more details about this article) |
4/111. Identification of coumarin as the sensitizer in a patient sensitive to her own perfume but negative to the fragrance mix.The aim of this study was to identify the chemicals responsible for the sensitivity of a 44-year-old woman to her own perfume, but showing negative patch test results to the fragrance mix. For this purpose, the perfume concentrate from the eau de toilette was chemically fractionated. Each fraction obtained was afterwards tested on the patient using a ROAT and/or a patch test. Only 1 fraction gave a positive ROAT result. This fraction was analyzed and found to contain coumarin and ethyl vanillin. Coumarin, one of the most widely used fragrance compounds that is not present in the fragrance mix, was confirmed as being the sensitizer.- - - - - - - - - - ranking = 1keywords = sensitivity (Clic here for more details about this article) |
5/111. The allergens of Dendropanax trifidus Makino and Fatsia japonica Decne. et Planch. and evaluation of cross-reactions with other plants of the araliaceae family.cis-9,17-Octadecadiene-12,14-diyne-1,16-diol (I), an analog of falcarinol has been identified in our previous report as an active component of Dendropanax trifidus and a strong sensitizer. In this report, 16-hydroxy-cis-9,17-octadecadiene-12,14-diynoic acid (II) and cis-9,trans-16-octadecadiene-12,14-diynoic acid (III) were elucidated as 2 other active components of the plant. Compound I, however, presented with the highest concentration and showed a stronger reaction on patch testing. The leaves of Fatsia japonica Decne. et Planch. were also found to contain compound I, but the amount was found to be 7x more in Dendropanax trifidus than in Fatsia japonica. 5 subjects with hypersensitivity to Dendropanax trifidus and compound I showed positive reactions when patch tested with the leaves of hedera helix L. and Schefflera arboricola. 1 of these also showed a positive reaction to the extract of panax ginseng root powder diluted 1% in ethanol. There was cross-reaction among these plants, which all belong to the araliaceae family.- - - - - - - - - - ranking = 1keywords = sensitivity (Clic here for more details about this article) |
6/111. Occupational allergic contact dermatitis from unsaturated polyester resin in a car repair putty.BACKGROUND: Unsaturated polyester (UP) resins are widely used as cements in car repair painting to produce a smooth surface before the final painting. We report two car painters with hand and face dermatitis who were sensitized to a UP resin used for car repair cements. methods: Patch testing with commercial substances and ingredients and extracts from UP resins was used to verify the sensitivity. RESULTS: Both patients showed an allergic patch test reaction to a UP resin. They also had an allergic patch test reaction to diethyleneglycol maleate (DEGM), an extract of a UP resin. CONCLUSIONS: Both patients had been patch tested elsewhere with negative results because UP resins had not been used for patch testing. Accordingly, patients with dermatitis who have been exposed to UP resins need to be patch tested with UP resins. The specific chemical causing allergic contact dermatitis in our patients was DEGM.- - - - - - - - - - ranking = 1keywords = sensitivity (Clic here for more details about this article) |
7/111. Allergic contact cheilitis due to effervescent dental cleanser: combined responsibilities of the allergen persulfate and prosthesis porosity.A 55-year-old man with a dental prosthesis for 3 years had had a chronic relapsing cheilitis for more than 1 year. He was patch tested with the European standard series, his own topicals, and the dental cleanser at 10% pet. A relevant positive reaction was found to the cleansing agent, which contained 20% potassium persulfate. The breakdown of the test confirmed sensitivity to this agent and to ammonium persulfate, both positive ( ) at 2.5% pet. The patient was free of symptoms after he had avoided the cleanser. Subsequent chemical investigations performed with a fragment of a used dental prosthesis revealed strong adsorption of persulfate, both on the resin and on the dental tartar. Cleansing agents, adsorbed on tartar and porous resins of worn dental prostheses, should be considered as potential sensitizers and consequently patch tested on such patients with chronic cheilitis.- - - - - - - - - - ranking = 1keywords = sensitivity (Clic here for more details about this article) |
8/111. Multiple corticosteroid orally elicited allergic contact dermatitis in a patient with multiple topical corticosteroid allergic contact dermatitis.Corticoid allergic contact dermatitis (ACD) may be topically or systemically elicited. Allergic contact dermatitis to topical corticosteroids is relatively common, whereas reports of orally elicited ACD to corticosteroids are rarer. patients allergic to one corticosteroid often exhibit cross-reactivity to other corticoids. We have previously reported a 46-year-old woman with contact allergy documented by patch and provocative use testing to multiple topical corticosteroids. On further testing, she was thought to have multiple corticoid orally elicited ACD to triamcinolone, methyl prednisolone, dexamethasone, and prednisone. Oral provocation tests were performed in a single-blind fashion following the method of Alanko and Kauppinen [diagnosis of drug eruptions: clinical evaluation and drug challenges. In, skin Reactions to Drugs (Kauppinen K, Alanko K, Hannuksela M, Maibach HI, eds). Boca Raton, FL, CRC Press, 1998.]. The five oral corticosteroids tested were triamcinolone, methyl prednisolone, dexamethasone, prednisone, and hydrocortisone. Four of the five challenged corticosteroids (i.e., triamcinolone, methyl prednisolone, dexamethasone, and prednisone) produced a generalized maculopapular eruption in a delayed manner. The fifth challenged corticoid, hydrocortisone, had no adverse effect on this patient. This patient was unusual in that she exhibited polysensitivity to a spectrum of oral and topical corticosteroids. hydrocortisone was identified as a corticosteroid for future clinical use. This is an important finding since corticosteroids are important emergency drugs.- - - - - - - - - - ranking = 1keywords = sensitivity (Clic here for more details about this article) |
9/111. Cutaneous pseudolymphoma, lymphomatoid contact dermatitis type, as an unusual cause of symmetrical upper eyelid nodules.We describe a 74-year-old woman who rapidly developed bilateral voluminous nodules on the upper eyelids, following 4 months' treatment for chalazion. Histological and immunohistochemical findings were suggestive of cutaneous pseudolymphoma (CPL), and extensive screening for malignant lymphoma (ML) remained negative. Cutaneous pseudolymphomas are inflammatory diseases that can simulate ML either clinically, histopathologically, or both. They are a rare cause of nodules of the upper eyelids, usually characterized by a benign evolution, that can be secondary to ultraviolet sensitivity, adverse reactions to systemic medications and contact sensitization, among others. In our case, epicutaneous patch tests were strongly positive for a series of allergens contained in the ophthalmological preparations used; therefore, they were suggestive that the patient had CPL, lymphomatoid contact dermatitis type. In addition, the patient had been treated previously with several drugs, known to cause CPL and immune dysregulation. Complete regression of the lesions required treatment with systemic steroids and chlorambucil. No relapse occurred within a 5-year follow-up period.- - - - - - - - - - ranking = 1keywords = sensitivity (Clic here for more details about this article) |
10/111. Severe allergic contact dermatitis induced by paraphenylenediamine in paint-on temporary 'tattoos'.Paraphenylenediamine (PPD) is a black dye with well known sensitizing properties. Its increasing use as a skin paint to produce temporary 'tattoos' has led to recent reports of allergic contact dermatitis. Hitherto, such cases of allergic contact dermatitis due to PPD have been localized to the original site of application of the skin paint. We report two cases of severe allergic reactions to paint-on 'tattoos'. Both of these patients had no prior history of sensitivity to PPD, although case 2 had previously used permanent hair dyes. In both cases, the primary eruption at the 'tattoo' site was followed within days by a generalized eruption which ultimately required treatment with oral corticosteroids, because the initially prescribed topical corticosteroids proved ineffective.- - - - - - - - - - ranking = 1keywords = sensitivity (Clic here for more details about this article) |
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