Cases Of Contact Dermatitis Research Articles

ALLERGIC CONTACT DERMATITIS WITH AN UNUSUAL CONFIGURATION AFTER PREOPERATIVE POVIDONE-IODINE DISINFECTION. A CLINICAL CASE

Contact dermatitis is an inflammatory skin reaction resulting from skin contact with exogenous substances that act as allergens and/or irritants. Epicutaneous testing is the gold standard for diagnosing allergic contact dermatitis and differentiating it from irritant contact dermatitis. We present a clinical case of allergic contact dermatitis after preoperative povidone-iodine disinfection.

Characteristics of Litigations Involving Contact Dermatitis: An Exploratory Analysis.

Background: Contact dermatitis (CD) is one of the most common skin disorders, occurring in >20% of patients worldwide. Estimated cost burden for CD in the United States approaches $1 billion annually. Objective: To describe characteristics of litigation among patients with CD. Methods: Westlaw legal database for U.S. lawsuits was queried for lawsuits between the years 1983 and 2021 containing the keywords "dermatitis or eczema." Each lawsuit associated with CD was analyzed by plaintiff demographics, verdict, prosecution reason, payouts, and allergen implicated. Results: Of 98 cases, 61 met the inclusion criteria. Verdicts issued favored plaintiffs (42.6%) more than defendants (32.8%) with the remaining cases decided through settlements. If payout occurred, the mean was $246,310 (standard deviation [SD] = $798,536), the median was $20,000 (Q1 = $8,500, Q3 = $88,725, interquartile range = $80,225). The top reason for litigation was toxic exposure (n = 38, 62.2%), and common contact allergens associated with lawsuits were latex (n = 4, 20%), surgical tape (n = 4, 20%), and beauty products (n = 4, 20%). Conclusion: Common allergens associated with lawsuits include latex, surgical tape, and beauty products. Most CD cases adjudicated in the United States since 1983 are associated with toxic exposures.

Epidemiological Investigation of a Cluster of Contact Dermatitis Cases in a Tertiary Healthcare Hospital in New Delhi

Epidemiological Investigation of a Cluster of Contact Dermatitis Cases in a Tertiary Healthcare Hospital in New Delhi

Honey flower dermatitis: Contact allergy to ellagic acid in Melianthuscomosus.

A case study is reported whereby a patient with no prior allergies developed a strong and spreading delayed-type hypersensitivity reaction to Melianthus plants, nectar and synthetic pigment derived from it after frequent handling of these substances. The lesions improved after treatment with topical steroids and allergen avoidance within 1-2 weeks. Subsequent patch testing with the plants, nectar and synthetic ingredients identified ellagic acid (EA) as the sensitizing agent. This is the first proven case of allergic contact dermatitis to EA, a phenolic substance present in numerous plants, fruits, and nuts regularly consumed by humans. Melianthus use is growing worldwide as an ornamental plant. Moreover, it is used in traditional South African medicine for its anti-inflammatory effects. In recent years, these extracts and EA have been added to natural, plant-based topical formulations for the treatment of inflammatory skin disorders. Our observation that the EA found in Melianthus can induce severe contact allergy should caution for the possible dangers of specific allergic sensitizations to these increasingly used additives in natural medicines.

Prayer-Related Dermatoses in Muslims.

Prayer rituals are an integral part of the daily lives of Muslims worldwide. This comprehensive review aims to explore the common dermatoses associated with prayer among Muslims and provide insights for dermatologists to facilitate accurate diagnosis and reduce unnecessary investigations. A systematic literature search returned 367 published articles, of which 21 met the inclusion criteria. Friction-induced dermatitis was the most frequently reported dermatosis, primarily affecting the forehead, knees, dorsum of the feet, and lateral malleoli. Friction-related marks often present as hyperpigmented lichenified plaques, and are more common in elderly individuals and males. Cases of contact dermatitis and fungal infections were also reported. Allergic contact dermatitis was linked to perfume application before Friday prayers, whereas fungal infections were attributed to increased water retention between toe webs, possibly related to communal ablution and prayer areas. Awareness of these prayer-related dermatoses enables dermatologists to provide holistic care for diverse populations and targeting specific interventions with respect for patients' religious beliefs. For example, Muslim patients with symptomatic frictional dermatoses may benefit from use of padded prayer rugs, especially diabetic patients whose lesions carry an increased risk of progressing to neuropathic ulcers.

Self-Reported Allergic Occupational Contact Dermatitis among Dental Healthcare Professionals in United Arab Emirates -A Cross Sectional Study.

In dentistry, occupational contact dermatitis may affect dental professionals along with technicians, nurses, and patients. Changes to dental practice in recent years have altered the reported frequencies of allergens causing contact dermatitis in both dental professionals and dental patients. In the current cross-sectional study, we used a structured questionnaire and clinical examinations to examine the prevalence of self-reported hand eczema among United Arab Emirates (UAE). The relationship between subjective skin discomfort and latex, composite/bonding, or other dental materials also was explored. A structured questionnaire was designed to analyze the prevalence of skin conditions among dental professionals and study its implication in gender, occupation, and age groups. The questionnaire included information about skin symptoms, atopy, occupational experience, and other background factors like respiratory symptoms, work history and methods, and exposure at work. It was distributed to 550 randomly selected dental healthcare professionals. Out of 550 dental healthcare workers contacted, 434 responded giving a response rate of 79%. The prevalence of dry and rough skin on the hands was highest (45%). There was a total of 29 cases of allergic contact dermatitis, 15 cases of contact urticaria, 12 cases of irritating contact dermatitis, and 1 incidence of onychomycosis among the 100 dental healthcare professionals who reported having dermatitis on their hands, forearms, or faces due to their daily dental chores. Rubber chemicals and natural rubber latex (NRL) in protective gloves used by dentists, as well as dental-restorative plastic materials (methylacrylates), were the most common causes of allergy. Dry skin and hand eczema were more common among dental healthcare professionals. Plastic gloves or NRL gloves with a low protein content are recommended for dental work. Skin exposure to methylacrylates or latex should be avoided.

Vesicular contact dermatitis following sulfacetamide eye drop instillation raising the specter of vesiculobullous mucocutaneous syndrome – Case presentation

Allergic reactions to ocular drops are a well-known side effect and usually present as eczematous dermatitis localized to periocular skin. However, rarely, the reactions can be severe and present with systemic involvement leading to vision or even life-threatening consequences. We report a case of vesicular allergic contact dermatitis following instillation of an over-the-counter sulfacetamide eye drop in right eye with involvement of oral mucosa, raising a threat of mucocutaneous vesiculobullous disorders. Prompt discontinuation of ocular drops followed by treatment with systemic and topical steroids, topical lubrication, and fornix glass rod sweeping prevented vision- and life-threatening sequalae.

Systemic Allergic Reaction to a Spinal Cord Stimulator Trial: A Case Report

BACKGROUND: Spinal cord stimulation (SCS) is commonly used for the management of chronic pain conditions, such as intractable axial and radicular back pain, complex regional pain syndrome, and painful peripheral vascular disease. Patients have had adverse complications with SCS trials and permanent implants. Cases of contact dermatitis from SCS devices have been reported, but a systemic allergic reaction to an SCS trial has not yet been published to date. CASE REPORT: A 52-year-old woman with complex regional pain syndrome type II and a history of a presumed infectious reaction to a previous SCS trial 8 years prior presented with chronic right L5, S1 radicular pain. Having failed conservative measures, she underwent a repeat SCS trial. The lead was placed at the T8 vertebral body, migrated several days later to the T9 vertebral body, and was subsequently adjusted back to T8 under fluoroscopic guidance. The patient reported improvement in her back and leg pain. Three days later, she presented to the emergency department with subjective fever, headache, rigors, chills, diaphoresis, nausea, vomiting, and diarrhea. The lead was removed, and the patient’s acute symptoms resolved within 48 hours. CONCLUSIONS: Systemic allergic reactions to SCS can be significant and lead to device removal despite improvement in pain symptoms. Further case reports and studies are needed to elucidate the risks associated with SCS placement, such as allergic reaction, infection, and neurologic injury. KEY WORDS: Case report, spinal cord stimulator, chronic pain, allergic reaction

Contact dermatitis to acrylates and secondary nail fungal infection in 22 year old female patient – a case report

Contact dermatitis is an inflammatory skin disease resulting from repeated contact with allergens or irritants. Prevalence of adverse reactions to acrylates monomers is still rising due to their wide use in medical and cosmetics industry. The nail symptoms, including e.g. onycholysis, hyperkeratosis or nail plate discoloration can be indicative of different diagnoses like psoriasis, mycobacterial infections or contact dermatitis. Diagnosis is not always obvious, as exemplified by the patient’s history. The aim of the study was to describe a case of contact dermatitis to acrylates associated with secondary fungal nail infection. Moreover article reviews the pathogenesis, clinical manifestation, diagnosis and treatment methods of contact dermatitis induced by acrylates.

Allergic contact dermatitis from propylene glycol: A case series from Australia.

Propylene glycol (PG) is used in a variety of cosmetics, food and pharmaceuticals. PG is a known sensitizer but also irritating when patch tested (PT). The aims were to investigate the frequency of contact sensitization to PG and to identify cases of allergic contact dermatitis (ACD). A retrospective study was performed on patients PT at the Skin Health Institute (SHI), Victoria, Australia to PG 5% pet. and PG 10% aq. between 1 January 2005 and 31 December 2020. In all, 6761 patients were PT to PG and 21 (0.31%) reacted. Of those 21 individuals, 9 (42.9%) had a relevant reaction. 75% of relevant positive reactions were in patients PT to PG 10% aq. The most common source of PG exposure was topical medicaments (77.8% of relevant reactions) and moisturizers, with the largest group being topical corticosteroids. Contact sensitization to PG in the patch test population remains uncommon, although it is possible that testing with concentrations of 5%-10% PG did not identify all reactions. Topical corticosteroids were the most important cause. Patients with suspected contact dermatitis to topical corticosteroids should be PT to PG.

Sofa dermatitis: Value of patch test with 2-(thiocyanomethylthio)benzothiazole.

In 2008, numerous cases of allergic contact dermatitis caused by leather chairs (sofa dermatitis) were reported, with dimethylfumarate being the culprit allergen. However, octylisothiazolinone, methylisothiazolinone and cobalt have also been associated with cases of sofa dermatitis. An antifungal agent, 2-(thiocyanomethylthio)benzothiazole (TCMTB), has also previously been described as a contact allergen in leather. Seven patients were referred to the Department of Dermatology of the Cliniques universitaires Saint-Luc, Brussels, Belgium with suspicion of allergic contact dermatitis caused by leather sofas. They were patch tested with the European Baseline Series, additional series (according to the patients' history and clinical aspect of the eruption), dimethylfumarate (4/7 patients) and with TCMTB. All seven patients presented a positive reaction to TCMTB and only one presented a concomitant positive reaction to dimethylfumarate. All patients showed clinical improvement after avoiding contact with their leather sofa. 2-(Thiocyanomethylthio)benzothiazole (TCMTB) is probably an underestimated allergen present in leather chairs (responsible for the so-called 'sofa dermatitis'), and more generally in leather objects. It is, therefore, important to test with TCMTB 0.1% petrolatum in case of contact dermatitis related with leather products.

Delayed-onset contact dermatitis caused by olanexidine gluconate antiseptic solution: effect of wiping off the remaining drug solution in two cases

BackgroundOlanexidine glucuronide (Olanedine®), an antiseptic solution may cause skin dermatitis around one week after disinfection. Although removal after the procedure is recommended to avoid skin dermatitis, whether it is effective for preventing skin dermatitis has not been documented in detail in the literature.Case presentationWe encountered two cases of delayed-onset contact dermatitis by Olanedine®. In both cases, the patient’s back was disinfected with Olanedine® and was covered with a surgical drape for epidural catheterization. After catheterization and removal of the surgical drape, the insertion site of the catheter was covered with a film dressing, then the epidural catheter was taped to the back. On the third postoperative day, the epidural catheter was removed. On the seventh postoperative day, the patients reported pruritus on the back, where an erythematous papule rash was observed. However, it was not observed at the site covered by the tape to secure the epidural catheter or by the tape of the surgical drape. Symptoms were relieved with oral or topical steroids by the time of discharge.ConclusionWiping off the remaining Olanedine® even a few days after disinfection may be helpful not only for reducing symptoms but also for preventing the development of contact dermatitis.

Retrospective quantitative risk assessment of skin sensitization caused by an antimicrobial agent used in a consumer product: 2,3,5,6-Tetrachloro-4-(methylsulfonyl) pyridine.

Serious cases of allergic contact dermatitis (ACD) caused by exposure to 3,5,6-tetrachloro-4-(methylsulfonyl)pyridine (TCMSP; CAS no. 13108-52-6) used as an antimicrobial agent for desk mats have been reported in Japan. A quantitative risk assessment (QRA) of TCMSP contained in desk mats was performed retrospectively. A local lymph node assay (LLNA): BrdU-ELISA was conducted to determine a reliable EC1.6 value for TCMSP. The acceptable exposure level (AEL) for TCMSP was derived from the EC1.6 value by applying sensitization assessment factors (SAFs). The exposure level was estimated based on the assumption referring to the use conditions of thiabendazole in the same purpose. Then, the estimated exposure level was compared with the AEL to evaluate the skin sensitization risk. The AEL was calculated as 0.00458 μg/cm2 based on the EC1.6 value (0.011%, 2.75 μg/cm2 ) by applying a composite SAF of 600. The estimated TCMSP exposure level from the desk mat was 500 times greater than the AEL, indicating a serious skin sensitization risk. Assessments of skin sensitization potencies of chemicals to be used in consumer products are strongly recommended, and QRAs should be performed at the pre-marketing stage to avoid the skin sensitization risk in consumers.

Contact Dermatitis Follow-up Care in a Comorbid, Elderly Woman Using Patient-assisted Teledermatology Consultation in Covid-19 Era

Teledermatology is a boon in the current situation considering the ongoing COVID-19 pandemic. The use of teledermatology with the available technology for follow-up care in a comorbid, geriatric and COVID-19 situation is reported. An elderly female with comorbidities presented to us with acute history of itchy red lesions over the face and scalp after application of hair dye. She was diagnosed with a case of contact dermatitis and was treated with topical corticosteroids and antihistamines after routine investigations. Considering her status of being elderly, comorbidities and no caretakers, we offered patient-assisted teledermatology consultation (PATC) through mobile messenger app for her follow-up. We were able to assess the serial images sent by the patient on days 3, 5, and 7 and observed improvement. Mobile messenger apps are convenient for the patients and reduce 75% of follow-up visits. It achieves both patient and physician satisfaction. We suggest PATC for follow-up, especially in the elderly with comorbidities. It minimizes multiple follow-up visits, save time, and cost.

Allergic Contact Dermatitis: Sensitization to 2-Hydroxyethyl Methacrylate

Acrylate polymers are an important cause of allergic contact dermatitis. Over the last decades, the vector of allergy to methacrylic acid esters has shifted from industrial products to the beauty and medical industries. In the described clinical case, the potential risk of sensitization to 2-hydroxyethyl methacrylate, a component of medical products, is emphasized, particularly in patients working in the cosmetology field. The authors present a clinical case of allergic contact dermatitis caused by 2-hydroxyethyl methacrylate, a component of the adhesive in a medical plaster. Basic diagnostic measures, including allergodiagnostics using a patch test, were conducted. Based on the collected data, the diagnosis was verified, and therapy for allergic contact dermatitis was prescribed according to the international clinical treatment protocol. The increasing number of cases of allergic contact dermatitis caused by acrylate compounds in medical materials requires further investigation and the implementation of effective preventive measures to ensure patient safety.

2-Octyl cyanoacrylate, a hidden allergen, a common cause of postsurgical allergic contact dermatitis.

Background: 2-Octyl cyanoacrylate, a topical adhesive used for wound closure, is becoming a common cause for rashes in postsurgical patients. There is an increased number of cases of postsurgical contact dermatitis attributable to 2-octyl cyanoacrylate. Localized skin reactions to 2-octyl cyanoacrylate have been described in different case reports, but there are limited case reports of diffuse cutaneous allergic reactions. Objective: The aim of the study was to review our experience in patch testing with cyanoacrylates. Methods: We reported five cases of allergic contact dermatitis to 2-octyl cyanoacrylate, confirmed by a patch test. All the patients experienced a skin reaction a few days after surgery. The patients described an erythematous pruritic rash initially localized over the incision and that subsequently spread to surrounding areas. Two of the five patients developed a more widespread rash, which required a longer duration of systemic steroids. 2-Octyl cyanoacrylate remains an agent of low diagnostic suspicion as the possible cause of contact dermatitis after a surgical procedure. Results: All the patients, but one had a positive reaction to 2-octyl cyanoacrylate on PT. Four had a positive PT result, with one patient having a positive scratch test after a negative PT result. Testing on abraded skin further increased yield. Conclusion: Postsurgical patients should be evaluated by using a patch test if there is a clinical picture suggestive of contact dermatitis.

MOMMY RN DERMATITIS

<h3>Introduction</h3> The COVID-19 pandemic has highlighted the importance of hand hygiene and led to the increased use of sanitizing gels and wipes. Here we describe a case of contact dermatitis due to sanitizing gels and wipes which was misdiagnosed as eczema for 3 years. <h3>Case Description</h3> A 40-year-old Guyanese female presented for evaluation of pruritic rash. She has seen several dermatologists and diagnosed with eczematous dermatitis. She has been prescribed topical 0.1% triamcinolone and a course of oral steroids with temporary improvement in symptoms. She had tried oral antihistamines with no improvement. On interview, she reported a rash predominantly on her hands which began in early 2020 and had worsened in the past year. Social history is significant for working as a registered nurse and having a baby 9 months ago. She admitted to frequent use of Clorox wipes without gloves at home since her baby was born. On exam she had numerous small papules with flare on bilateral dorsal hand, forearm, right orbit, and upper back. Patch testing was done and positive for benzyl alcohol. We recommended she use soap and water to clean her hands, avoid alcohol gels, and use gloves when using antiseptic wipes. She had abrupt improvement in symptoms. <h3>Discussion</h3> This case emphasizes the importance of cleaning gels and wipes as a cause of contact dermatitis. It particularly important to remember in the context of healthcare workers who frequently clean their hands, new parents who may using sanitizing wipes more often, and people with darker colored skin.

Presentations to emergency departments in Melbourne, Australia diagnosed as allergic contact dermatitis.

This study investigated cases diagnosed as allergic contact dermatitis (ACD) in emergency departments (EDs) and management. A multisite retrospective study of patients attending EDs in metropolitan Melbourne between July 2017 and June 2018 was performed. Using International Statistical Classification of Disease-10 (ICD-10) codes, the Victorian Agency for Health Information generated a list of cases of contact dermatitis (CD). Demographic and clinical data were analysed. Two hundred twenty-eighty patients from 14 different sites were diagnosed with ACD. Hair dyes caused the most cases, and one such case was admitted to hospital. It was apparent from the specified causes that cases of irritant CD were misdiagnosed as ACD. There were significant differences in management with dermatology input, with dermatologists more often advising oral corticosteroids (33.3% vs. 14.5%, P=0.004) topical corticosteroids (92.9% vs. 38.7%, P < 0.01), emollients (38.1% vs. 20.4%, P=0.01) and less often advising antihistamines (16.7% vs. 44.6%, P < 0.001). With dermatology input, potent or very potent steroids were more likely to be prescribed (69.3% vs. 11.1%, P < 0.001); without, a mild potency steroid was more likely to be prescribed (63.9% vs. 4%, P=0.01). Improved understanding, diagnosis and management of CD are needed in EDs.

Allergic contact dermatitis from vitamins: A systematic review.

Background and AimsVitamins are bioactive compounds naturally found in many different types of food and required by the human body for many biological functions and enzymatic activities. Due to their antioxidant properties, certain vitamin derivatives have been synthesized for inclusion in many cosmetics, thus leading to an increasing incidence of allergic contact dermatitis (ACD) cases. Therefore, the present review may be helpful to provide an insight into the sensitizing role of at least certain vitamins and may also offer possible patch test alternatives for definitive diagnosis.MethodsThis study was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta‐Analyses (PRISMA) guidelines. Literature search regarding ACD cases to vitamins was performed using the Medline, PubMed, Scopus, EMBASE, and Google Scholar databases from January 1940 up to June 2021.ResultsA total of 4494 articles matched the keywords used for the researched. Records removed before screening included 15 duplicate articles and 3429 not eligible articles (e.g., not written in English, studies on animals, not relevant to the topic). A total of 1050 articles underwent the screening phase and 258 were therefore excluded as they were not primary studies. Subsequentially, 792 articles were considered eligible for the review and 688 of them were finally excluded as they did not report the outcome of interest. Therefore, 104 articles were definitely included in the present review.ConclusionACD to vitamins is still probably an underestimated issue in cosmetology, as many vitamins are considered “natural” and therefore “safe” ingredients. On the contrary, according to current literature, almost all vitamins contained in topical products are able to induce allergic reactions, with the exception of vitamin B2 and vitamin B9. Patch tests are not standardized, thus leading to difficulties in diagnosis.

Bilateral allergic contact dermatitis due to Netarsudil

Netarsudil is a rho-associated coiled-coil-containing protein kinase inhibitor and norepinephrine transporter inhibitor, which decreases the intra-ocular pressure by increasing the aqueous outflow and decreasing the aqueous production. However, netarsudil has been reported to cause adverse effects attributed to its vasodilator property. The common side effects associated with its use are conjunctival hyperemia, corneal verticillata, and conjunctival hemorrhages. This report describes a case of allergic contact dermatitis 3 months after initiating netarsudil eye drops in a 78-year-old man.