Cases Of Contact Dermatitis Research Articles

A Case of Allergic Contact Dermatitis due to Temple Tips of Plastic Spectacle Frames

A Case of Allergic Contact Dermatitis due to Temple Tips of Plastic Spectacle Frames

Epidemiological Pattern of Contact Dermatitis among Urban and Rural Patients Attending a Tertiary Care Center in a Semi-urban Area in Eastern India.

Background:There is a trend of increase in number of contact dermatitis cases. Studies on the prevalence and epidemiological pattern of allergic skin disorders in Indian scenario are not much available. The present study was designed to assess the epidemiological pattern of contact dermatitis in rural and urban areas in a peripheral district in eastern India.Aims and Objectives:This study was undertaken to find the prevalence of contact dermatitis and to assess the epidemiological pattern of contact dermatitis both in rural and urban community.Materials and Methods:The study was conducted in a medical college located at a semi-urban area in eastern India with written informed consent obtained from each participant. This hospital-based cross-sectional study was done from May 2017 to April 2018. Study population consisted of patients attending the dermatology OPD and having lesions clinically suggestive of contact dermatitis and there were 268 such patients. Patients attending the OPD were divided into urban and rural as per their address. Data analysis was done using suitable, standard, and appropriate statistical methods.Results:The prevalence of contact dermatitis was 4.38% among the dermatology OPD attendees. Urban prevalence was statistically significantly (P < 0.05) higher than rural prevalence. Contact dermatitis was common in the age group of 41–50 years. In urban areas, females were more affected than those in rural areas. Occupationally, the difference between urban and rural patients of contact dermatitis was statistically significant (P < 0.05). Cosmetic history in the urban group was significantly more (P < 0.05).Conclusions:Contact dermatitis prevalence and patient profile in certain factors showed a statistically significant difference between urban and rural patients.

Contact dermatitis: etiologies of the allergic and irritant type

The term contact dermatitis describes an inflammatory process of the skin that occurs in response to contact with exogenous substances and involves pruritic and erythematous patches. Approximately 80% of all contact dermatitis is primary irritant contact dermatitis (ICD), whereas allergic contact dermatitis (ACD) makes up only 20% of contact dermatitis cases, the estimated prevalence of contact dermatitis in the United States being 1.4%. Among patch-tested patients, nickel has been identified as the most common allergen. Cobalt is the second most common metal allergen and is found in various dental alloys, paints, and coloring components of porcelain and glass. The average prevalence of dermatitis due to p-phenylenediamine (PPD) was found to be 4.3% in Asia, 4.0% in Europe, and 6.2% in North America. Rubber gloves are a major cause of occupational ACD in healthcare workers. Occupations involving frequent handwashing, between 20 and 40 times per day, have shown an increased incidence in cumulative ICD. The prevalence of occupational hand dermatitis was 69.7% in workers that reported a handwashing frequency exceeding 35 times per shift. The use of alcohol-based sanitizers is much more prevalent among today's healthcare workers than frequent handwashing. Both allergic and ICD are worldwide problems.

Expression of Fas Receptor and Fas Ligand in Eczematous Dermatitis

Background: The principal role of epidermal keratinocytes (KCs) in inducing and maintaining eczematous dermatitis has been rather neglected. Objectives: The study aimed to assess the expression of Fas receptor (FasR) and Fas ligand (FasL) in the skin of eczematous dermatitis patients to examine T-cell mediated KC apoptosis. Methods: The population included 35 patients with eczematous dermatitis, as well as 15 age- and sex-matched healthy controls. The cases group included 13 eczema, five atopic dermatitis (AD) and 17 contact dermatitis (CD) patients. Tissue levels of FasR and FasL were estimated using a quantitative real time-polymerase chain reaction. Results: FasR and FasL were upregulated in the cases group compared to the control group (P < 0.001). Moreover, FasR and FasL were upregulated in the eczema cases compared to the cases with CD and AD (P = 0.001). On the contrary, there was downregulation of FasR and FasL in the CD cases in comparison to the cases having eczema and AD (P = 0.001). Conclusions: The study concluded that the upregulation of FasR and FasL may be involved in the pathogenesis of eczema through induction of KC apoptosis. This might help in the future use of anti-apoptotic therapy for prevention and treatment of eczematous dermatitis.

Triclosen and Its Alternatives in Antibacterial Soaps.

In 2017, the Food and Drug Administration banned the marketing of triclosan and triclocarban in antibacterial soaps, citing inefficacy and concerns of systemic absorption and antibacterial resistance. As a result, there is an anticipated decrease in the number of triclosan-containing products on the market with an associated increase in antibacterial alternatives (eg, benzalkonium chloride, benzethonium chloride, chloroxylenol, chlorhexidine) and cases of allergic and irritant contact dermatitis. The aims of the study were to determine the extent that triclosan and triclocarban are being used in the consumer and medical industries after the Food and Drug Administration marketing ban and to appraise the risk of allergic contact dermatitis to triclosan alternatives. The National Drug Code Directory (NDCD), Google, Amazon, Target, Walgreens, Walmart, CVS, and Colorado hospitals were surveyed for antibacterial soap use. Antibiotics surveyed include triclosan, triclocarban, benzalkonium chloride, benzethonium chloride, chloroxylenol, and chlorhexidine. The most common antibiotics reported by the NDCD, consumer sites, and Colorado hospitals were benzalkonium chloride, chloroxylenol, and triclosan, respectively. Triclosan accounted for the second most prevalent antibacterial in the NDCD- and consumer site-surveyed products. The triclosan marketing ban may instigate increased exposure to triclosan alternatives. The addition of antibacterial products to hand soaps does not improve soap effectiveness and may cause harm by contributing to antibiotic resistance and the development of allergic conditions. Additional studies are needed to elucidate the benefits and harms of antibacterial soaps.

Contact allergy to isothiazolinones epidemic: Current situation.

Since 2009, an increasing number of published cases of allergic contact dermatitis (ACD) from isothiazolinones in Europe was observed, amounting to an epidemic. However, only few studies have assessed the current situation after changes in European regulation. To analyze the incidence of isothiazolinone-related ACD in our area in the last decade. A retrospective study analyzed all patients patch tested in the allergy unit in a tertiary hospital in Spain between January 2010 and June 2019. Positive patch-test reactions to methylchloroisothiazolinone (MCI)/methylisothiazolinone (MI) and/or MI alone were recorded. A total of 243 patients (9.55%) with positive patch-test reactions to MCI/MI and/or MI alone among 2544 consecutively patch-tested patients were recorded. An initial increase in the prevalence of MCI/MI allergy was observed, from 4.5% in 2010 reaching a peak in 2015, which was followed by a significant decrease until July 2019 with 3.1% prevalence in 2019. As shown in our data, regulatory interventions have resulted in a dramatic decrease in the prevalence of MCI and MI ACD, reaching a pre-epidemic level of 3.1% in 2019.

Allergic contact dermatitis caused by isobornyl acrylate in the Enlite glucose sensor and the Paradigm MiniMed Quick‐set insulin infusion set

The FreeStyle Libre glucose sensor has caused many cases of allergic contact dermatitis, and isobornyl acrylate (IBOA) in this sensor has been identified as one of the culprit allergens. To report on the presence of IBOA in devices produced by Medtronic, namely, the Enlite sensor and the insulin infusion set Paradigm MiniMed Quick-set. Five patients reacting to the glucose sensor Enlite and/or the insulin infusion set Paradigm MiniMed Quick-set observed in three clinics (two Belgian and one Swedish) were patch tested with the baseline and other series, as well as with IBOA; four of them also with pieces of adhesive patches from the devices, and two with a thin layer chromatogram of Enlite glucose sensor extracts. Gas chromatography-mass spectrometry (GC-MS) analyses were performed. Four patients reacted to IBOA and one to colophonium, a known allergen in Enlite, and three to the adhesive part of the sensor or the insulin infusion set. IBOA was identified in the sensor by GC-MS, and its presence was indicated in the infusion set. IBOA is a contact allergen in Enlite glucose sensor, and likely also in the infusion set. Therefore, these devices are not suitable alternatives for patients sensitized to the FreeStyle Libre sensor.

Acrylic sculpting nails, an occupational hazard for contact dermatitis. Case reports and review of the literature

Abstract Acrylates are plastic materials formed by the polymerization of monomers, which are recognized as powerful sensitizers that may cause allergic contact dermatitis both in occupational and non-occupational environment. In the occupational setting, the most exposed workers are the dentists, dental technicians, prosthesis technicians, printers, painters, fiberglass workers and nail technicians. We describe four cases of occupational allergic contact dermatitis in nail technicians caused by acrylic compounds that illustrate numerous clinical manifestations. Clinical manifestations ranged from edema, erythema, scaling and fissuring fingertips to erythematous patches around the chin, mandible and abdomen. Patch testing results revealed positive reaction to 2-hydroxyethyl methacrylate in all patients. Of the four patients, two changed jobs, one stopped exposure because of pregnancy and one patient continued working, showing no improvement, despite undergoing treatment. These cases underline the importance of improvement of preventive measures in the workplace.

Three cases of photoallergic contact dermatitis induced by the ultraviolet absorber benzophenone that occurred after dermatitis due to ketoprofen‐Investigation of cosensitization with other ultraviolet absorbers and patient background

AbstractObjectivesThree teenage patients developed dermatitis at the site of contact of a free‐pass wristband from an amusement park. Each had experienced dermatitis due to ketoprofen. A chemical analysis of the components of the wristband and patch testing determined that the cause of the dermatitis was benzophenone, and this reaction was considered to be due to the cross‐reaction of ketoprofen and benzophenone. Because those who are photosensitized to ketoprofen are often known to coreact with several ultraviolet absorbers, we investigated the presence of cosensitization to various ultraviolet absorbers in the three patients. We also wanted to explore the background of how photosensitization to ketoprofen can occur in such young individuals.MethodsThe three patients underwent patch testing and photopatch testing with various ultraviolet absorbers. We also conducted a questionnaire survey of patients using ketoprofen‐containing topical medications.ResultsPositive photoallergic reactions were observed only with benzophenone‐3, benzophenone‐4, and octocrylene. The frequency of positive reactions was higher than in previous studies of cases after ketoprofen sensitization. About half of patients using topical medications containing ketoprofen did not know that ketoprofen could cause photocontact dermatitis. Most patients did not know about the duration of avoidance of ultraviolet exposure.ConclusionsIt is possible that photocontact allergy to substituted benzophenones and octocrylene was strongly established by being sensitized twice to ketoprofen and benzophenone. Sensitization to ketoprofen sometimes occurs at a young age, probably because of insufficient communication of the risk of photosensitization.

Chemical Identification and Confirmation of Contact Allergens.

Identification of the etiological chemical agent(s) associated with a case(s) of allergic contact dermatitis (ACD) is important for both patient management and public health surveillance. Traditional patch testing can identify chemical allergens to which the patient is allergic. Confirmation of allergen presence in the causative ACD-associated material is presently dependent on labeling information, which may not list the allergenic chemical on the product label or safety data sheet. Dermatologists have expressed concern over the lack of laboratory support for chemical allergen identification and possibly quantification from patients' ACD-associated products. The aim of this review was to provide the clinician a primer to better understand the analytical chemistry of contact allergen confirmation and unknown identification, including types of analyses, required instrumentation, identification levels of confidence decision tree, limitations, and costs.

マスカラに含まれたカルナウバロウによる アレルギー性接触皮膚炎の 1 例

マスカラに含まれたカルナウバロウによる アレルギー性接触皮膚炎の 1 例

Twenty cases of allergic contact dermatitis due to benzoyl peroxide in acne patients in Japan

AbstractBackgroundBenzoyl peroxide is a topical antiacne drug, which also acts as a strong irritant and a weak allergen. Only a few acne patients with allergic contact dermatitis due to benzoyl peroxide gel have been diagnosed by patch testing in Japan. Therefore, the number of such patients is probably underestimated.ObjectivesTo correctly diagnose such cases by patch testing and to determine their characteristics and frequency.Patients and methodsTwenty acne patients that were diagnosed with allergic contact dermatitis between April 2015 and April 2018 were enrolled in this study. Patch tests were performed with acne gels containing benzoyl peroxide and 1% benzoyl peroxide in petrolatum. The patients' profiles and the frequency of dermatitis were analyzed.ResultsAll of the patients were female, and their mean age was 24.1 ± 9.3 years. Two patients were suffering from atopic dermatitis. The onset of allergic contact dermatitis occurred at 1 to 2 days, 9 to 28 days, and &gt;30 days (longest: up to 24 months) after the initial application of the causative substance in 3 patients, 9 patients, and 8 patients, respectively. The frequency of such cases was 4.5% at our clinic.ConclusionsBenzoyl peroxide gels for acne were demonstrated to often act as allergic contact allergens, and thus, dermatologists should be aware of their allergenicity and be apprehensive about markedly increasing the use of such gels in the future.

Allergic contact dermatitis of both eyes caused by alcaftadine 0.25%: a case report

BackgroundTo report the first case of allergic contact dermatitis (ACD) associated with alcaftadine 0.25% ophthalmic solution.Case presentationThe patient was a 51-year-old woman with no previous history of side effects to ophthalmic antihistamine agents. She had been prescribed alcaftadine 0.25% for allergic conjunctivitis. On first application of the medication, she did not experience any cutaneous reaction. One day later, after the second alcaftadine 0.25% application, both eyelids became swollen, and erythematous changes were evident. On slit-lamp examination, conjunctival injection was noted in the absence of conjunctival swelling or any other findings. Fundus examination was unremarkable. To evaluate the cause of ACD, a patch test was performed and 48 h later was noted to be positive for alcaftadine 0.25%. Based on the positive patch test, the patient was diagnosed with ACD caused by alcaftadine 0.25%. After 9 days of treatment, the swelling and erythema completely resolved.ConclusionsAlthough there have been no previous reports of alcaftadine 0.25%-associated ACD, it should be suspected in patients with swelling and erythematous change of both eyes after using alcaftadine 0.25%.

Allergic contact dermatitis from Solvent Orange 60 in spectacle frames

AbstractPotential allergens in plastic spectacle frames concern plasticizers, antioxidants, UV filters, and dyes. Among the latter, Solvent Orange 60 (SO 60) has been recognized as an important allergen, and presently 32 cases have been reported in Japan and Scandinavia. In Japan, the first case of allergic contact dermatitis (ACD) from SO 60 in spectacle frames was reported in 1999, and 17 similar cases followed until 2018. Since 2006, 14 cases, observed among plastic production workers, and spectacle and dental goggle users, were reported in Scandinavia. This review provides a summary of the 18 Japanese cases of ACD from SO 60, the clinical manifestations, diagnostic method and results, provenance of causative spectacle plastic plates, as well as some countermeasures to prevent contact allergy to it.

Pigments in American tattoo inks and their propensity to elicit allergic contact dermatitis

Tattoos have become increasingly common in the United States. Historically, tattoo inks were comprised of metallic pigments, which have the potential to cause allergic contact dermatitis. Data have been lacking on the current use of these pigments in tattoo ink. Identify pigments currently used in tattoo inks manufactured in or sold by wholesalers in the United States and investigate cases of allergic contact dermatitis caused by these pigments. Using specific key words, we performed an internet search. Pigment information listed in tattoo product inserts was collated and evaluated. In total, 1416 unique inks were surveyed. The average bottle of ink contained 3.0 pigments. We identified 44 distinct pigments, of which 10 contained metallic pigments, including iron, barium, zinc, copper, molybdenum, and titanium. The remaining 34 pigments contained carbon, azo, diketopyrrolopyrrole, quinacridone, anthraquinone, dioxazine, or quinophthalone dyes. A literature search revealed that 11 of the 44 (25%) pigments had been suspected to cause contact dermatitis. Five were confirmed by patch testing. These findings highlight the diversity of pigments currently used in tattoos. Relatively few inks contained metallic pigments to which allergic contact dermatitis has historically been attributed. Patch-test clinicians should be aware of these new pigments.

Zinc diethyldithiocarbamateに感作された患者に生じた, 化粧用スポンジパフによるアレルギー性接触皮膚炎の１例:～被験物質を湿らせてパッチテストをすることの有用性～

Zinc diethyldithiocarbamateに感作された患者に生じた, 化粧用スポンジパフによるアレルギー性接触皮膚炎の１例:～被験物質を湿らせてパッチテストをすることの有用性～

A curious case of fungal contact dermatitis

A curious case of fungal contact dermatitis

Contact dermatitis in pediatric age group: Indian scenario

Contact dermatitis was previously considered to be rare in children except some forms of irritant contact dermatitis which were seen commonly in children. However, nowadays, there are an increasing number of cases of allergic contact dermatitis (ACD) being reported in children due to increased exposure to a variety of allergens at an earlier age. Various predisposing factors which influence the occurrence of contact dermatitis include age, sex, atopy, and presence of any concomitant skin disease. Nickel has been identified as leading cause of ACD in children. Other common allergens reported are cobalt, fragrance mix, rubber, lanolin, thiomersal, neomycin, gold, mercapto mix, balsam of Peru, and colophony. Clinical presentation in children is similar to that in adults with eczema of the hands, feet, wrists, face, forehead, scalp, eyelids, earlobes, neck, axilla, trunk, thighs, and anogenital area being seen. Disseminated lesions can as well be seen. When ACD is suspected, patch testing is the gold standard diagnostic procedure. However, patch testing in children differs from adults as some technical difficulties are encountered in children due to their smaller test area and frequent movements. However, the general opinion stands that children can be patch tested with the same methods and patch test concentrations as adults. For the prevention of recurrence, allergen elimination should be the aim of treatment; however, in many cases, it is not possible to completely eliminate the allergen from the patients environment. Topical steroids and calcineurin inhibitors form the mainstay of treatment in most cases.

Systemic Treatments for Allergic Contact Dermatitis.

Allergic contact dermatitis is a common disease within the family of delayed-type hypersensitivity reactions. In more severe cases of allergic contact dermatitis, topical steroids may prove insufficient, and systemic therapeutic agents are often used. Even when systemic therapies such as cyclosporine lead to improvement, withdrawal of these agents is challenging and can lead to undesirable morbidities. Currently, there are no systemic treatments indicated for the treatment of widespread recalcitrant contact dermatitis. This review discusses the targets of in-use off-label systemic medications and potential therapeutics in the pipeline.

THE CORRELATION OF CHEMICAL EXPOSURE AND PERSONAL HYGIENE WITH IRRITANT CONTACT DERMATITIS AMONG WORKERS IN THE PRODUCTION WORKER

Background: The production process at PT. X using oxalic acid as a mixture of Gum Rosin and Turpentine. Oxalic acid is corrosive and toxic and readily oxidized by water and oxygen that can cause irritation, rashes, burns, and damage to the skin and can cause irritant contact dermatitis. Irritant contact dermatitis cases reached 85% in the workplace. This is caused by direct exposure to chemicals, lack of attention to hygiene, sanitation and the lack of use of personal protective equipment. Purpose: This study aimed to study the correlation of chemicals exposure and personal hygiene with the incidence of irritant contact dermatitis on production workers of PT. X. Methods: This was a quantitative research with cross-sectional approach. The population was 35 workes of PT. X. The sampling technique used total sampling, while data analysis by using Pearson Correlation test. Results: The test results showed that there was a significant correlation between the exposure of the chemical with the occurrence of irritant contact dermatitis with p value = 0.047, whereas the correlation between personal hygiene with the incidence of irritant contact dermatitis with p value = 0.202 (insignificant). Conclusion: the exposure of chemicals significantly correlate with the occurence of contact dermatitis among the workers, while the personal hygiene had no correlation with the occurrence of irritant contact dermatitis of workers.