Cases Of Contact Dermatitis Research Articles

The Importance of Pre-Emptive Scarified Patch Testing to Identify Safe, Alternative Ophthalmic Agents: A Case of Phenylephrine Contact Dermatitis.

The Importance of Pre-Emptive Scarified Patch Testing to Identify Safe, Alternative Ophthalmic Agents: A Case of Phenylephrine Contact Dermatitis.

The Relationship of Individual Characteristics and Farm Biosecurity Implementation with The Incident of Contact Dermatitis

Poultry workers risk contracting diseases due to physical or biological exposure. One such disease is contact dermatitis. This study aims to analyze the individual and the application of livestock biosecurity that can be associated with cases of contact dermatitis in cage workers. This study a descriptive-quantitative that uses a cross-sectional approach. The research was conducted at PT. X in June 2022. The sample of this study was 43 people who were taken through simple random sampling. Data was collected using questionnaires, interviews, and observations. The results were then tested using Chi-Square and Odds Ratio (OR) with a Confidence Level of 95%. The study showed that two variables were associated with contact dermatitis, namely cage ventilation (OR= 5.45; 95% CI: 1.21 - 24.43; P=0,020) and frequency of hand washing (OR= 2.70; 95% CI: 2.57 - 282.99; P=0,001). Meanwhile, variables that were not significantly related were age (P=0.306), gender (P=0.206), length of work (p=0.698), floor (P=1.000), and PPE usage (P=0.245). Poor environmental quality and personal hygiene practices could affect contact dermatitis in workers. Therefore, efforts are needed, such as occupational safety and health education for workers, routine health checks, and environmental inspections at PT. X.

Non-Target Screening of Chemicals in Selected Cotton Products by GC/MS and Their Safety Assessment.

Cotton is used for the production of textiles, hygiene and cosmetic materials. During cultivation and technological processes, various types of substances (surfactants, softeners, lubricants, etc.) penetrate cotton, which can have a harmful effect on both the human body and the environment. The aim of this study was to analyze selected cotton products in order to identify the substances contained and to describe the potential possibilities of inducing textile contact dermatitis (CD). The impact of the identified compounds on the aquatic environment was also taken into account. Nine samples of cotton clothing and seven samples of cotton pads from various manufacturers were tested. Samples after extraction using the FUSLE (Focused Ultrasonic Liquid Extraction) technique were analyzed with GC/MS. Qualitative analysis was based on comparing mass spectra with library spectra using the following mass spectra deconvolution programs: MassHunter (Agilent), AMDIS (NIST), and PARADISE (University of Copenhagen). The parameter confirming the identification of the substance was the retention index. Through the non-target screening process, a total of 36 substances were identified, with an average AMDIS match factor of approximately 900 ("excellent match"). Analyzing the properties of the identified compounds, it can be concluded that most of them have potential properties that can cause CD, also due to the relatively high content in samples. This applies primarily to long-chain alkanes (C25-C31), saturated fatty acids, fatty alcohols (e.g., oleyl alcohol), and fatty acid amides (e.g., oleamide). However, there are not many reports describing cases of cotton CD. Information on the identified groups of compounds may be helpful in the case of unexplained sources of sensitization when the skin comes into contact with cotton materials. Some of the identified compounds are also classified as dangerous for aquatic organisms, especially if they can be released during laundering.

Nine years of patch testing with isocyanates in a clinic of occupational dermatology.

Isocyanates are used as starting materials of polyurethane (PU) products. They are relatively important occupational skin sensitizers. To analyse results of a large isocyanate patch test series of 19 isocyanate test substances and 4,4'-diaminodiphenylmethane (MDA), a marker of 4,4'-diphenylmethane diisocyanate (MDI) hypersensitivity. Test files were screened for positive reactions in the isocyanate series. Patients with positive reactions were analysed for occupation, exposure and diagnosis. In 2010-2019, 53 patients had positive reactions in the series (16% of 338 patients tested). MDA, the well-established screening substance for MDI allergy, was positive in 30 patients, an in-house monomeric MDI test substance in 23 patients and 3 different polymeric MDI test substances in 19-21 patients. We diagnosed 16 cases of occupational allergic contact dermatitis (OACD) from MDI including 3 pipe reliners. Hexamethylene-1,6-diisocyanate (HDI) oligomers in paint hardeners caused 5 cases of OACD, more cases than 2,4-toluene diisocyanate (TDI; n = 3) and isophorone diisocyanate (IPDI; n = 1) put together. In contrast to previous studies, polymeric MDI test substances were not superior to a monomeric MDI. Pipe reliners may get sensitised not only by epoxy products and acrylates but also by MDI in hardeners of PU pipe coatings. HDI oligomers were the second most important causes of OACD after MDI.

CD06 Beryllium is back: a case of culinary contact dermatitis

CD06 Beryllium is back: a case of culinary contact dermatitis

Identification of the pigments used in permanent makeup and their ability to elicit allergic contact dermatitis

Decorative tattoos are known to contain ingredients that may elicit allergic contact dermatitis; it is less well-known if permanent makeup pigments carry the same risk. Identify pigments used in permanent makeup inks sold in the United States and review cases of allergic contact dermatitis to these pigments. Using internet searches, permanent makeup inks sold in the United States were identified. Safety data sheets were used to catalog pigments used in permanent makeup. A subsequent literature search was performed to identify cases of allergic contact dermatitis to these pigments. A total of 974 permanent makeup inks were reviewed, and 79 unique pigments were identified. The average product contained 4 pigments. Twenty of the pigments were inorganic metals, including carbon, iron, chromium, manganese, and molybdenum. Fifty-nine pigments were organic, of which most were azo, quinacridone, or anthraquinone dyes. A literature search revealed that 10 of the 79 pigments were associated with allergic contact dermatitis. Permanent makeup primarily uses organic pigments, although some metallic pigments are still used. Physicians should also be aware that some of these pigments-both organic and inorganic-are known causes of allergic contact dermatitis. Of note, patch testing to these ingredients can be negative.

Artificial nail modelling systems in healthcare workers: An emerging risk of contact sensitization to a well-known occupational allergen in an alternative way.

Artificial nail modelling systems (ANMS) pose a significant risk for nail stylists and their clients regarding acrylate sensitization, which might jeopardize the use of acrylate-containing medical devices. To evaluate the frequency of artificial nail practices among female healthcare workers (HCWs) compared with controls and assess ANMS-related side effects. In this comparative, cross-sectional, single-centre study, a face-to-face interview with 200 female HCWs and 200 age-matched female dermatology patients (controls) was conducted regarding the use of ANMS between March and November 2023. Among 400 participants (median age: 25), 85 (21.3%) have applied ANMS at least once. The prevalence of ANMS application was significantly higher in HCWs (n = 54/200, 27%) compared with controls (n = 31/200, 15.5%) (p < 0.05). Long-lasting nail polish was the most commonly preferred technique (n = 82/85, 96.5%). ANMS were mainly performed in nail studios by nail stylists (n = 79/85, 92.9%), while three participants were using home kits. Nail brittleness was the most frequently reported side effect (n = 19/85, 22.4%). No case of allergic contact dermatitis (ACD) was detected. The popularity of ANMS among young female HCWs is growing. This striking trend might further put these individuals not only at risk of medical device-related adverse events but also occupational ACD.

First case of protein contact dermatitis after botulinum toxin injection, related to a human albumin's allergy.

First case of protein contact dermatitis after botulinum toxin injection, related to a human albumin's allergy.

Allergic contact dermatitis caused by topical corticosteroids: A review for clinicoepidemiological presentation, evaluation, and management aspects

Dermatitis medicamentosa or contact dermatitis to topically applied medicaments, active ingredients or excipients, is encountered frequently in clinical practice and should be suspected in patients showing resistance to treatment despite adequate therapy and in patients, who complain of intolerance to a particular treatment. Topical corticosteroids are prescribed mostly in dermatology for their anti-inflammatory, antiproliferative, and immunosuppressive actions to treat various inflammatory dermatoses. These may act as allergens and produce immunoglobulin E-mediated immediate hypersensitivity (anaphylaxis, urticaria, angioedema, bronchospasm, vomiting, and cardiovascular collapse) or T-cell-mediated allergic contact dermatitis (ACD). Although it occurs less often and is not life threatening, ACD negatively impacts the quality of life by worsening preexisting dermatitis. The prevalence of hypersensitivity to these allergens varies across regions and periods of time depending on the clinical practice, prescribing habits, and types of cases studied. Over-the-counter availability of corticosteroids in multiple formulations in recent years may further compound the problem due to their indiscriminate and extensive use. Although about one-third of all cases of contact dermatitis are initiated or perpetuated by topical medicaments, the occurrence of contact dermatitis due to corticosteroids remains undersuspected. This is perhaps due to their anti-inflammatory and immunosuppressive properties that make it difficult to doubt and prove contact sensitivity that may be from a corticosteroid itself or to the additives and vehicles in the formulation. Patch testing can help identify the culprit agents in ACD but early diagnosis depends on clinical suspicion. Sensitization in contact dermatitis exhibits cross-reactivity patterns based on corticosteroid structure. Clinicoepidemiological presentation, evaluation, and management aspects of contact hypersensitivity reactions to corticosteroids are reviewed.

(310) Severe Delayed Skin Reaction to Antiseptic Irrigation Solution Managed with Pinch Skin Grafting After Inflatable Penile Prosthesis Surgery: A Case Report

Abstract Introduction Inflatable penile prosthesis (IPP) surgery is a common procedure for treating erectile dysfunction, and skin preparation with antiseptic solutions is a standard practice to reduce infection risk. However, some antiseptic solutions, such as chlorhexidine-based Irrisept, have been associated with severe skin reactions. Several studies have reported cases of contact dermatitis, blistering, and chemical burns following the use of chlorhexidine-based antiseptic solutions before surgery. Objective This case report aims to highlight the potential risk of severe skin reactions when using Irrisept and other chlorhexidine antiseptic solutions during penile prosthesis surgery. It also explores the novel technique of pinch skin autografting used to salvage the implant and achieve successful wound healing after delayed skin necrosis. Methods 61-year-old male with a history of prostate cancer and erectile dysfunction who underwent insertion of an IPP. Results The patient's penile shaft developed blisters 3 weeks post-implantation, which progressed to full-thickness necrosis despite conservative treatment. The distribution and location of the reaction led to the hypothesis that it was caused by the chlorhexidine-based Irrisept antiseptic. The antiseptic solution used copiously throughout the case and 10CC was injected under pressure into the drain which also may explain the reaction observed. The patient underwent wound debridement and was treated with pinch skin autografts from the bilateral thighs. The autografts resulted in 95% epithelialization with excellent cosmetic outcomes with no other complications. To the best of our knowledge, this is the first reported case of Irrisept-induced delayed skin necrosis and the use of pinch skin grafting to salvage the implant after penile prosthesis surgery. Conclusions Skin reactions to Irrisept antiseptic solution during penile prosthesis surgery are rare but can be severe. Surgeons should be cautious and consider alternative skin preparation methods in patients with a history of skin allergies or sensitivities. This case also highlights the potential of pinch skin autografting as a salvage technique for post-IPP skin reactions. A multidisciplinary approach involving reconstructive burn surgeons and specialty wound care teams may be beneficial in optimizing outcomes in such cases. Disclosure No.

Evaluation of disposable protective garments against epoxy resin permeation and penetration from anti-corrosion coatings.

Epoxy-based resin formulations are a frequent cause of allergic and irritant contact dermatitis in the construction and painting industries. Cases of epoxy resin contact dermatitis continue to persist across many sectors and are likely attributable to the growing use of epoxy products, including epoxy-based anti-corrosion coatings and inadequate skin protection. There are no published performance data against epoxy resins for garment materials and gloves to guide proper material selection in the workplace. The objective of this study was to evaluate the resistance of 5 protective garment materials against permeation and penetration by bisphenol A diglycidyl ether and its higher oligomers found commonly in epoxy-based anti-corrosion coatings. Five disposable garment materials were evaluated for resistance to bisphenol A diglycidyl ether monomers and oligomers during contact with epoxy-based anti-corrosion coatings, including latex gloves, nitrile gloves, Tyvek coveralls, polypropylene/polyethylene (PP/PE) coveralls, and a cotton T-shirt. A permeation test cell system was used to evaluate each garment material against an epoxy-based zinc-rich primer and an epoxy-based intermediate coating using a realistic application method. Glass fiber filters were used to collect permeating and penetrating epoxy resin during a 120-min test period. Bisphenol A diglycidyl ether quantification was performed with high-performance liquid chromatography-electrospray ionization-tandem mass spectrometry. Paint loading, coating thickness, and homogeneity were assessed on polytetrafluoroethylene filters sprayed in series in permeation test cells. Latex gloves provided the least resistance to permeation by BADGE in coating formulations, with a maximum cumulative permeation over the 2-h test interval of 21.7 ng cm-2 with the primer and 513.8 ng cm-2 with the intermediate coating product. Nitrile gloves were not permeated by either coating formulation. The Tyvek coveralls provided greater protection as compared to the PP/PE coveralls. The cotton T-shirt was penetrated by bisphenol A diglycidyl ether more frequently than any of the tested garment materials and resulted in a maximum cumulative penetration of 128 ng cm-2 with the primer and 28.0 ng cm-2 with the intermediate coating. Although all the garment materials evaluated during this study provided sufficient protection to prevent cumulative permeation in excess of the established acceptable permeation thresholds, the use of nitrile gloves and Tyvek coverall is highly recommended to minimize skin exposure to bisphenol A diglycidyl ether. We recommend cotton T-shirts to be used under Tyvek coveralls as a secondary layer of skin protection and for added comfort, but not as a primary protection layer.

Exploring the relationship between allergic contact dermatitis and atopic dermatitis in children: insights from a retrospective patch testing analysis.

Recent years have seen significant exploration into the potential link between allergic contact dermatitis and atopic dermatitis, yielding contradictory findings. A retrospective cohort analysis of children aged 2 to 18 who underwent patch testing at the pediatric dermatology clinic at a tertiary medical center in Israel was conducted. Overall, 367 patients were included in the study, 31.6% of whom were diagnosed with atopic dermatitis. 160 children (43.6%) exhibited a positive reaction to at least one compound in the European baseline series. There was no statistically significant difference in reactivity between children with atopic dermatitis and those without (P = 0.848). Sub-analyses based on ethnicity, gender, and age did not reveal significant differences in overall European baseline series reactivity (P = 0.612, P = 0.446, P = 0.488, respectively). Sensitivity was notably higher when patch readings were conducted 72 h after application compared to 48 h [0.95 (CI: 0.91-0.97) vs. 0.60 (CI: 0.55-0.66)]. Patch testing is imperative for suspected cases of allergic contact dermatitis in all children, regardless of their atopic background. Further research is warranted to potentially replace the traditional 48-h reading with a single 72-h reading in future guidelines, contributing to enhanced efficiency and cost-effectiveness in clinical practice.

Contact allergy caused by acrylates in nail cosmetics: A pilot study from Greece.

The growing popularity of nail techniques based on acrylates has led to a higher frequency of sensitization in both nail technicians and users. The study aimed to assess cases of allergic contact dermatitis (ACD) caused by acrylates in individuals with occupational or non-occupational exposure to nail techniques. A preliminary study was conducted on 30 patients with ACD caused by acrylates in nail techniques, who were patch tested from September 2022 to March 2023 at the First Department of Dermatology and Venereology of Andreas Syggros Hospital, Athens, Greece. Thirty female patients with ACD to acrylates were documented (15 users and 15 nail technicians and users). The most common allergens were: 2-hydroxyethyl methacrylate (HEMA), 2-hydroxypropyl methacrylate (HPMA) and ethyleneglycol dimethacrylate (EGDMA), which tested positive in all 30 patients (100.0%). Twenty patients (66.7%) had been exposed to dental procedures involving acrylates, before the onset of ACD. Nail technicians exhibited extensive skin lesions, 40.0% experienced ACD within the first year of work and 13.3% during their professional practice. Three of them (20.0%) had to discontinue their work. Acrylates have been identified as potent allergens, necessitating the implementation of safety measures for the use of these chemicals in nail techniques.

A case of allergic contact dermatitis presented with acquired vitiligo-like depigmentation developed persistent light reactivity: Unforeseen entity

Abstract Chemical leukoderma is an acquired depigmentary skin disorder, caused by repeated exposure to specific chemical compounds or secondarily to allergic contact dermatitis or through direct toxic effects, sharing similar clinical and histological features with vitiligo. We report a case of widespread allergic contact dermatitis with chemical leukoderma which later became a persistent light reactor.

Botanical Briefs: Contact Dermatitis Induced by Western Poison Ivy (Toxicodendron rydbergii).

"Leaves of three, leave it be" serves as an apt caution for avoiding poison ivy (Toxicodendron species) and its dermatitis-inducing sap. Toxicodendron contact dermatitis (TCD) poses a notable burden to the American health care system by accounting for half a million reported cases of allergic contact dermatitis (ACD) annually. Identifying and avoiding physical contact with the western poison ivy (Toxicodendron rydbergii) plant prevails as the chief method of preventing TCD. This article discusses common features of T rydbergii as well as clinical manifestations and treatment options following exposure to this allergenic plant.

Predictive factors of polysensitization to contact allergens: study conducted at the Dermato-Allergology Unit of the Farhat Hached University Hospital in Sousse, Tunisia

polysensitization is often defined as sensitization to three or more contact allergens. The objectives of our study were to determine the prevalence of polysensitization to allergens patch test and to analyze the factors associated with allergen polysensitization of the European Standard Battery in comparison with cases of oligosensitization. this is a retrospective descriptive cross-sectional study that included all patients who had undergone patch tests at the Department of Dermato-Allergology of the Department of Occupational Medicine of University Hospital Center Farhat Hached in Sousse spread over 10 years from January 1, 2009 to December 31, 2018. in total, we collected 464 cases of contact dermatitis during the study period. The average age of patients was 38.93 ± 12.52 years with a slight female predominance (52.8% of cases). Among all the patients who consulted during the study period (832 patients), 133 patients had positive reactions to 3 or more allergens 16% of patients. Concerning, the associations of the most frequently noted allergens were those of triplet (chromium, cobalt, and nickel) in 15 patients and triplet (mercaptobenzothiazole, thiuram mix, and IPPD) in 7 cases. The predictive factors of polysensitivity were the personal history of leg ulcers; the site of the lesions in the thorax and the erythematous squamous and dyshidrotic appearance of the lesions. this phenomenon is frequent polysensitization, and close collaboration between dermatologists and occupational physicians to prevent this type of multiple allergies through better management of personal and also professional risk factors.

Mupirocin–Induced Allergic Contact Dermatitis: A Case Report and a Review of the Literature

Background: Mupirocin, an antibiotic, is frequently used to treat special traumatic infected skin lesions, such as impetigo, methicillin-resistant Staphylococcus aureus (MRSA), burn, scratch after operation, etc. Topical use of mupirocin can lead to some adverse drug reactions (ADR). Objectives: To report a case of mupirocin-induced contact dermatitis and a review of the literature to identify the causative factors and clinical characteristics. Methods: We report a case of contact dermatitis in a 39-year-old woman which happened 2 days after mupirocin ointment application on her hand. Also, a review of the literature was done according to PRISMA guidelines. PubMed, Scopus, Web of Science, and Google Scholar were searched. Time or language filters were not used and all related reports were included. Results: In the mentioned case, mupirocin has a causative role in dermatitis. The review showed 10 cases of mupirocin-induced allergy. The clinical presentations included serum sickness, diffuse urticaria, fever, arthralgias, toxic epidermal necrolysis, pruritus, rash, breathlessness, palpitations, flushing, redness all over the body, low blood pressure, severe allergic contact dermatitis, pruritic papular eruption, extensive contact dermatitis, allergic contact hypersensitivities. All cases were improved after anti-allergic treatments except one who had been tracheostomy and was in serious condition. Conclusions: this is the first review of mupirocin-induced allergy. Although these incidences are rare, clinicians should be aware to prevent severe reactions with serious consequences.

Trends in occupational and work-related contact dermatitis attributed to nickel, chromium and cobalt in the UK: findings from The Health and Occupation Research network 1996-2019.

Occupational exposure to metals such as nickel, chromium and cobalt can be associated with contact dermatitis, which can adversely affect an individual's health, finances and employment. Despite this, little is known about the incidence of metal-related occupational contact dermatitis over prolonged periods of time. To investigate the medically reported trends in the incidence of work-related contact dermatitis attributed to nickel, chromium and cobalt in the UK. Incidence and trends in cases of occupational contact dermatitis caused by nickel, chromium or cobalt between 1996 and 2019 (inclusive), reported to the EPIDERM surveillance scheme, were investigated and compared with trends in the incidence of occupational contact dermatitis attributed to agents other than the aforementioned metals. A sensitivity analysis restricting the study cohort to cases attributed to only one type of metal was also conducted. Of all cases reported to EPIDERM during the study period, 2374 (12%) were attributed to nickel, chromium or cobalt. Cases predominantly comprised females (59%), with a mean (SD) age (males and females) of 38 (13) years. Cases were most frequently reported in manufacturing, construction, and human health and social activity industries. The most frequently reported occupations were hairdressing, and sales and retail (assistants, cashiers and checkout operators). The highest annual incidence rate of contact dermatitis was observed in females (2.60 per 100 000 persons employed per year), with the first and second peak seen in those aged 16-24 and ≥ 65 years, respectively. A statistically significant decrease in the incidence of occupational contact dermatitis attributed to metals over the study period was observed for all occupations (annual average change -6.9%, 95% confidence interval -7.8 to -5.9), with much of the decrease occurring between 1996 and 2007. Similar findings were obtained in the sensitivity analyses. Over a period of 24 years, there has been a statistically significant decline in the incidence of metal-related occupational contact dermatitis in the UK. This could be attributed not only to improvements in working conditions, which have reduced metal exposure, but could also be due to the closure of industries in the UK that might have generated cases of contact dermatitis owing to metal exposure.

A Case of Allergic Reaction to 0.5% Moxifloxacin Eye Drops

Purpose: We report a rare case of allergic contact dermatitis after the use of a non-preservative 0.5% moxifloxacin ophthalmic solution.Case summary: A 60-year-old male presented with bacterial corneal ulceration of the right eye. He was treated with 50 mg/mL of fortified cefazolin and 14 mg/mL of tobramycin that were tapered as the corneal lesion improved after 1 month, and 0.5% moxifloxacin application was started. After 2 weeks of moxifloxacin treatment, the patient developed conjunctival injection, lid swelling, redness, and itching in the right eye. An allergic reaction was suspected and moxifloxacin administration was immediately stopped. The symptoms improved after the administration of oral antihistamines, 0.5% loteprednol eye drops, and steroid combination ointment.Conclusions: Patients treated with 0.5% topical moxifloxacin should be monitored for allergic contact dermatitis, even if preservative-free eye drops are used.

Role of acrylates in the development of contact dermatitis in diabetic patients-A Polish dermatology tertiary centre experience.

In recent years, an increasing number of contact dermatitis cases triggered by acrylates contained in diabetes medical devices have been reported. Acrylates seem to play a major role in the development of irritant contact dermatitis and allergic contact dermatitis (ACD) in diabetic patients. To study a group of patients with contact dermatitis caused by diabetes medical devices with a focus on acrylates as possible allergens responsible for contact dermatitis. Fifteen patients with diabetes mellitus type 1 and contact dermatitis from diabetic devices were patch tested to 25 acrylate allergens. Three patients (20%) reacted to the following allergens: three patients reacted to isobornyl acrylate (IBOA) and one of them additionally to 2-hydroxyethyl acrylate (2-HEA); results were of clinical relevance. All three patients were using insulin pumps and glucose sensors (GS)-in one patient contact dermatitis was towards the insulin pump and the GS, in one patient only towards the insulin pump and in one patient only towards the GS. Twelve patients (80%) did not show any skin reaction towards the allergens tested. A majority of diabetic patients showed no reactions towards any acrylate allergen tested; yet, the presence of untested allergens must be kept in mind. IBOA proved to be a cause of ACD in diabetes patients. 2-HEA might be another culprit allergen, but its presence in the devices must first be confirmed.