Contact Sensitivity Research Articles

In vitro human T cell responses to diphencyprone.

The experimental contact sensitizer Diphencyprone (DPCP) is used both for topical immunotherapy and investigation of the human immune system. Analysis of mechanisms underlying altered immune responses requires in vitro systems. We have developed a method for detecting human T cell responses to DPCP in vitro. Twenty subjects were sensitized with DPCP (30?g/cm2) and 4 weeks later, were challenged with doses from 0.48 to 3.125?g. Responses at 48h showed all 20 were allergic. Peripheral blood mononuclear cells were cultured with a range of concentrations of DPCP for 6 days and proliferation quantified (3H thymidine uptake). The subjects were exposed repeatedly to DPCP (topical immunotherapy for warts or alopecia areata) or as repeated patch test challenges. Eight subjects gave positive lymphocyte proliferation responses (LPR), maximal responses being elicited with 16 or 32?M DPCP. Positive LPR became detectable from 20 weeks after sensitization and progressively more people become responsive over time to 40 weeks. The different time courses for manifestation of allergic reactivity in skin and blood probably reflects absence of memory T cells in blood due to their recruitment to skin as resident memory T cells. This assay can now be developed for analysis of components of the immune response.

Corrigendum to “Epicutaneous immunization with hapten-conjugated protein antigen alleviates contact sensitivity mediated by three different types of effector cells” [Pharmacol. Rep. 64 (2012) 919–926

Corrigendum to “Epicutaneous immunization with hapten-conjugated protein antigen alleviates contact sensitivity mediated by three different types of effector cells” [Pharmacol. Rep. 64 (2012) 919–926

Contact sensitization of children: a two-decade years history in Naples

Contact sensitization (CS) and allergic contact dermatitis (ACD) were once thought to be rare in children. The aim of our study was to assess CS and ACD in children affected by eczematous conditions referring to our contact and occupational dermatoses service, and to compare the obtained data to the results of a similar study performed in our Department in late Eighties. A retrospective analysis of Patch Test data from the Database of Contact Allergy of the Department of Dermatology, University Federico II of Naples, was performed. Moreover results were compared to previous data recorded and analyzed in our center. Of the 416 examined patients, tested during 2005-2010 with the pediatric series, 37.5% developed at least one positive reaction, 15.4% was diagnosed with ACD. The most common allergen was nickel sulphate (16.8%) and the most frequently involved body sites were head and neck (16.3%). Compared to the 1989 study data, our current results highlighted an increase of CS (P<0.001) and ACD diagnosis (P<0.01). ACD and CS are significantly increased during the last 20 years in our young patients population. The widespread chemical use and premature adult-like attitude may be responsible for earlier and extended exposure to sensitizers.

Pilot study of contact sensitization to rubber allergens and bisphenol A amongst dental students.

The aim of this study has been to evaluate the rate of contact sensitization to some rubber allergens and to bisphenol A (BPA) amongst students of dental medicine and dental patients. A total of 50 participants were included in the study: 40 students of dental medicine exposed to the studied rubber allergens and BPA-based dental materials during the course of their education; 10 dental patients without occupational exposure to the latter substances served as a control group. All of them were patch-tested with the studied rubber allergens and bisphenol A. Highest was the sensitizing action of carba mix, followed by benzoyl peroxide and mercapto mix. The sensitization rate for carba mix was significantly higher for dental students as well as for the whole studied population, if compared to the one for thiuram mix (Chi2 = 12.9, p < 0.001; Chi2 = 13.9, p < 0.001), bisphenol A (Chi2 = 8.9, p < 0.001; Chi2 = 11.9, p < 0.001), toluenesulfonamide formaldehyde resin (Chi2 = 10.7, p < 0.001; Chi2 = 13.9, p < 0.001) and benzoyl peroxide (Chi2 = 4.7, p = 0.03; Chi2 = 5.8, p = 0.016), and for dental patients, if compared to the one for mercapto mix (Chi2 = 7.07, p = 0.008). Concomitant positive skin patch-test reactions to carba mix and to benzoyl peroxide, and to all the studied allergens were established. Carba mix could be outlined as a sensitizer of paramount importance for dental students as well as for dental patients. Benzoyl peroxide was the second ranked sensitizer for dental students. Positive skin patch-test reactions to bisphenol A and toluenesulfonamide formaldehyde resin were established only among the group of dental students. Int J Occup Med Environ Health 2017;30(3):397-405.

Comparing reliabilities of strip and conventional patch testing.

The standardized protocol for performing the strip patch test has proven to be valid, but evidence on its reliability is still missing. To estimate the parallel-test reliability of the strip patch test as compared with the conventional patch test. In this multicentre, prospective, randomized, investigator-blinded reliability study, 132 subjects were enrolled. Simultaneous duplicate strip and conventional patch tests were performed with the Finn Chambers® on Scanpor® tape test system and the patch test preparations nickel sulfate 5% pet., potassium dichromate 0.5% pet., and lanolin alcohol 30% pet. Reliability was estimated by the use of Cohen's kappa coefficient. Parallel-test reliability values of the three standard patch test preparations turned out to be acceptable, with slight advantages for the strip patch test. The differences in reliability were 9% (95%CI: -8% to 26%) for nickel sulfate and 23% (95%CI: -16% to 63%) for potassium dichromate, both favouring the strip patch test. The standardized strip patch test method for the detection of allergic contact sensitization in patients with suspected allergic contact dermatitis is reliable. Its application in routine clinical practice can be recommended, especially if the conventional patch test result is presumably false negative.

Contact sensitization in patients with suspected textile allergy. Data of the Information Network of Departments of Dermatology (IVDK) 2007-2014.

Textile dyes, rubber, elements or textile resins carry the risk of inducing allergic contact sensitization. To assess clinical data and patch test results for dermatitis patients with suspected textile allergy. A retrospective analysis of Information Network of Departments of Dermatology data of the years 2007-2014 of patients patch tested because of suspected textile allergy was performed. Patients of the study group (n = 3207) suffered more frequently from leg, trunk and generalized dermatitis than patients of the control group (n = 95210). Among the allergens of the textile dye series, the highest frequency of positive reactions was observed for p-aminoazobenzene (5.1%) and p-phenylenediamine (PPD) (4.5%), followed by Disperse Orange 3 (3.1%), Disperse Blue 124 (2.3%), Disperse Blue 106 (2.0%), Disperse Red 17 (1.1%), and Disperse Yellow 3 (1.1%), partly with concomitant reactions. Patch testing with the patients' own textiles was performed in 315 patients, with positive reactions in 18 patients. These were mostly elicited by blue or black textiles with tight skin contact. Only 2 of these patients also reacted to textile dyes from the German Contact Dermatitis Research Group series. For the comprehensive diagnosis of contact sensitization in patients with suspected textile dermatitis, combined patch testing is indicated, with (i) PPD and a textile dye series and (ii) patients' own clothing.

Dendritic cells' death induced by contact sensitizers is controlled by Nrf2 and depends on glutathione levels

Dendritic cells (DC) are known to play a major role during contact allergy induced by contact sensitizers (CS). Our previous studies showed that Nrf2 was induced in DC and controlled allergic skin inflammation in mice in response to chemicals. In this work, we raised the question of the role of Nrf2 in response to a stress provoked by chemical sensitizers in DC. We used two well-described chemical sensitizers, dinitrochlorobenzene (DNCB) and cinnamaldehyde (CinA), known to have different chemical reactivity and mechanism of action. First, we performed a RT-qPCR array showing that CinA was a higher inducer of immune and detoxification genes compared to DNCB. Interestingly, in the absence of Nrf2, gene expression was dramatically affected in response to DNCB but was slightly affected in response to CinA. These observations prompted us to study DC's cell death in response to both chemicals. DNCB and CinA increased apoptotic cells and decreased living cells in the absence of Nrf2. The characterization of DC apoptosis induced by both CS involved the mitochondrial-dependent caspase pathway and was regulated via Nrf2 in response to both chemicals. Oxidative stress induced by DNCB, and leading to cell death, was regulated by Nrf2. Unlike CinA, DNCB treatment provoked a significant reduction of intracellular GSH levels and up-regulated bcl-2 gene expression, under the control of Nrf2. This work underlies that chemical reactivity may control Nrf2-dependent gene expression leading to different cytoprotective mechanisms in DC.

The T Cell Response to the Contact Sensitizer Paraphenylenediamine Is Characterized by a Polyclonal Diverse Repertoire of Antigen-Specific Receptors

Paraphenylenediamine (PPD) is a common component of hair dyes and black henna tattoos and can cause skin sensitization and allergic contact dermatitis (ACD). The cutaneous inflammatory reaction associated with ACD is driven by both CD4+ and CD8+ T cells. However, the characteristics of such responses with respect to clonal breadth and magnitude are poorly defined. In this study, we have characterized the in vitro recall response of peripheral blood T cells prepared from PPD-allergic individuals to a PPD–human serum albumin (HSA) conjugate (PPD–HSA). Quantitative high throughput sequencing was used to characterize the changes in the repertoire of T cell receptor (TCR) α and β genes after exposure to antigen in vitro. The PPD conjugate induced expansion of T cells carrying selected TCRs, with around 800 sequences (around 1%) being 8 or more times as abundant after culture than before. The expanded sequences showed strong skewing of V and J usage, consistent with an antigen-driven clonal expansion. The complementarity-determining region 3 sequences of the expanded TCRs could be grouped into several families of related amino acid sequence, but the overall diversity of the expanded sample was not much less than that of a random sample of the same size. The results suggest a model in which PPD–HSA conjugate stimulates a broad diversity of TCRs, with a wide range of stimulation strengths, which manifest as different degrees of in vitro expansion.

The current spectrum of contact sensitization in patients with chronic leg ulcers or stasis dermatitis - new data from the Information Network of Departments of Dermatology (IVDK).

Patients with lower leg dermatitis, chronic venous insufficiency or chronic leg ulcers have a high prevalence of contact sensitization. To identify the current spectrum of contact allergens in these patients. Data of the Information Network of Departments of Dermatology on 5264 patients with the above diagnoses from the years 2003 to 2014 (study group) were compared with data on 4881 corresponding patients from 1994 to 2003 (historical control group) and with a current control group without these diagnoses (n = 55 510). Allergic contact dermatitis was diagnosed less frequently in the study group than in the historical control group (25.9% versus 16.9%; p < 0.001), and contact sensitization to most allergens had declined. The allergen spectrum, however, was largely unchanged. Important allergens are Myroxylon pereirae (balsam of Peru) (14.8% positive reactions), fragrance mix I (11.4%), lanolin alcohol (7.8%), colophonium (6.6%), neomycin sulfate (5.0%), cetearyl alcohol (4.4%), oil of turpentine (3.1%), and paraben mix (2.6%). Patch testing with additional series showed sensitization to Amerchol L-101 (9.7%), tert-butyl hydroquinone (8.7%), framycetin sulfate (5.0%), and gentamicin sulfate (3.1%). Topical preparations for treating the above-mentioned conditions should not contain fragrances, Myroxylon pereirae, and colophonium. The special allergen spectrum has to be considered in patch testing.

Development of an in vitro method to estimate the sensitization induction level of contact allergens

No standardized in vitro methods to assess potency of skin sensitizers are available. Recently, we standardized a procedure which combines the epidermal equivalent potency assay with assessment of IL-18 to provide a single test for identification and classification of skin sensitizers. This current study aimed to extend tested chemicals, and to provide a simple in vitro method for estimation of the expected sensitization induction level interpolating in vitro EC50 and IL-18 SI2 values to predict LLNA EC3 and/or human NOEL from standards curves generated using reference contact allergens. Reconstituted human epidermis was challenged with 14 chemicals not previously tested benzoquinone, chlorpromazine, chloramine T, benzyl salicylate, diethyl maleate, dihydroeugenol, 2,4-dichloronitrobenzene, benzyl cinnamate, imidazolidinyl urea, and limonene as contact sensitizers while benzyl alcohol, isopropanol, dimethyl isophthalate and 4-aminobenzoic acid as non-sensitizers in the LLNA. Where for benzyl salicylate and benzyl cinnamate no sensitization was observed in human predictive studies, positive responses to benzyl alcohol and dimethyl isophthalate were reported. The proposed method correlates better with human data, correctly predicting substances incorrectly classified by LLNA. With the exception of benzoquinone (interference with both MTT and IL-18 ELISA), and chloramine T (underestimated in the interpolation), a good estimation of LLNA EC3 and in vivo available human NOEL values was obtained.

Topical immunotherapy with diphencyprone (DPCP) for in-transit and unresectable cutaneous melanoma lesions: an inaugural Canadian series

ABSTRACTBackground: Diphencycprone (DPCP) is an immune contact sensitizer applied to melanoma lesions. Early studies show favorable efficacy. We present the first North-American series of patients treated with DPCP.Methods: A single center retrospective study of patients with in-transit or unresectable melanoma lesions treated with DPCP from December 1,2014 to December 31,2015 was completed. Primary objectives were response rate and toxicity. Secondary objective was health-related quality of life assessment with the Functional Assessment of Cancer Therapy-Melanoma (FACT-M) questionnaire.Results: Fifteen consecutive patients were identified with median age of 78 (range 43–92). 73% of patients had prior treatment. Two patients (13%) had a complete response after 25 and 32 weeks, respectively. Four patients (27%) had a partial response with a mean treatment time of 30 weeks (range 6–51 weeks). Six (40%) had stable disease. Six patients stopped DPCP – three from systemic progression and three from toxicity. The most common toxicity was blisters; one patient had significant skin ulceration that resolved on stopping DPCP. Median FACT-M score was 142.95 (possible total 172). Mean overall follow-up time was 22.7 weeks.Conclusion: DPCP is a feasible option for in-transit and other melanoma cutaneous lesions ineligible/refractory to surgery and may delay need for systemic therapy.

Long-term Performance of Refurbished Amalgam Restorations: 10-year Follow-up.

This prospective, blinded clinical trial assessed the performance of amalgam restorations that were refurbished, replaced, or not treated. Twenty-three patients were included, ages 18-80 years, with 63 amalgam restorations that had one or more defects in their clinical features, such as defective anatomic form, roughness and/or luster according to United State Public Health Service (USPHS) criteria. Restorations were randomly assigned to either refurbishment (A: n = 21), replacement (B: n = 21) or untreated (C: n = 21) groups. Two calibrated examiners evaluated the restorations at baseline (Kappa = 0.74) and after 10 years (Kappa = 0.84), according to eight parameters: anatomy, roughness, luster, secondary caries, marginal adaptation, occlusal contact, marginal staining and tooth sensitivity. Wilcoxon tests were performed for within-group comparisons, and Friedman tests were used for multiple within-group comparisons. The Mantel-Cox test was used to compare survival curves. After 10 years, 49 restorations (77.8%) were assessed (group A: n = 19; group B: n = 13; group C: n = 17). Over a decade, the three groups showed similar clinical performances for all studied parameters: anatomy (p = 0.410), roughness (p = 0.930), luster (p = 0.984), secondary caries (p = 1.0), marginal adaptation (p = 0.433), occlusal contact (p = 0.33), marginal staining (p = 0.470), and tooth sensitivity (p = 0.784). Amalgam restorations that have defective anatomic form, roughness and/or luster performed similarly for all studied parameters, whether they were refurbished, replaced or left untreated after 10 years in patients with low and intermediate caries risk. Most of the restorations were classified as clinically acceptable after ten years. Restorations in all three groups tended to deteriorate over time.

Broad spectrum antibiotic enrofloxacin modulates contact sensitivity through gut microbiota in a murine model

Medical advances in the field of infection therapy have led to an increasing use of antibiotics, which, apart from eliminating pathogens, also partially eliminate naturally existing commensal bacteria. It has become increasingly clear that less exposure to microbiota early in life may contribute to the observed rise in "immune-mediated" diseases, including autoimmunity and allergy. We sought to test whether the change of gut microbiota with the broad spectrum antibiotic enrofloxacin will modulate contact sensitivity (CS) in mice. Natural gut microbiota were modified by oral treatment with enrofloxacin prior to sensitization with trinitrophenyl chloride followed by CS testing. Finally, adoptive cell transfers were performed to characterize the regulatory cells that are induced by microbiota modification. Oral treatment with enrofloxacin suppresses CS and production of anti-trinitrophenyl chloride IgG1 antibodies. Adoptive transfer experiments show that antibiotic administration favors induction of regulatory cells that suppress CS. Flow cytometry and adoptive transfer of purified cells show that antibiotic-induced suppression of CS is mediated by TCR αβ+CD4+CD25+FoxP3+ Treg, CD19+B220+CD5+ IL-10+, IL-10+ Tr1, and IL-10+ TCR γδ+ cells. Treatment with the antibiotic induces dysbiosis characterized by increased proportion of Clostridium coccoides (cluster XIVa), C coccoides-Eubacterium rectale (cluster XIVab), Bacteroidetes, and Bifidobacterium spp, but decreased segmented filamentous bacteria. Transfer of antibiotic-modified gut microbiota inhibits CS, but this response can be restored through oral transfer of control gut bacteria to antibiotic-treated animals. Oral treatment with a broad spectrum antibiotic modifies gut microbiota composition and promotes anti-inflammatory response, suggesting that manipulation of gut microbiota can be a powerful tool to modulate the course of CS.

Appropriate Testing of Isothiazolinones in Children.

The isothiazolinones methylchloroisothiazolinone (MCI) and methylisothiazolinone (MI) are prevalent pediatric contact sensitizers. MI allergic contact dermatitis (ACD) is underreported in the literature. The objective of the current study was to use a database of provider-reported U.S. pediatric patch test cases to evaluate the positive patch test (PPT) prevalence rates of the combined preservative test substrate MCI/MI and of MI alone. U.S. pediatric patch test providers in all 50 states who had joined the registry were invited to submit deidentified cases to the database. More than 1100 logged cases in the database were evaluated for PPTs to MCI/MI combination, MCI/MI and MI, and MI alone. Within 1 year of data collection, 96 cases with a PPT for MCI/MI, MCI/MI and MI, and MI alone were identified; 37 of these were positive to MCI/MI, with MI alone not tested or negative, and 39 were positive to MI only, with MCI/MI and MI tested. Fifteen (41%) of the MCI/MI cases were detected using an epicutaneous patch test alone and 22 cases (59%) using comprehensive patch testing. Only one case (3%) of MI alone sensitization was detected using T.R.U.E. plus a supplemental panel of tests; the remaining 38 cases (97%) were detected using comprehensive testing. Testing with only the combined MCI/MI preservative substrate may miss 51% of MI allergies. Appropriate testing of isothiazolinones is needed to clarify the true prevalence of sensitization to these allergens and the burden of pediatric ACD. Patch testing for MI alone in addition to MCI/MI combination is warranted in children with recalcitrant dermatitis.

Systemic Allergy to Corticosteroids: Clinical Features and Cross Reactivity.

Systemic hypersensitivity (HS) to corticosteroids (CS) is paradoxical but does exist. Some patients with a previous contact allergy to topical CS may develop a systemic contact dermatitis (SCD) while receiving CS orally or intravenously. However, a previous contact sensitization is not mandatory for developing a systemic HS to CS. Acute or delayed urticaria can occur in immediate HS. Immediate HS can be due to excipients, mainly carboxymethylcellulose or to CS themselves. Delayed reactions, mainly maculopapular rash and acute generalized exanthematous pustulosis can occur. Skin tests with systemic CS have to be standardized. It is necessary to determine if IDT with CS frequently induce skin atrophy or not and if such skin atrophy is transient by doing prospective studies using an standardized method and a limited injected volume (0.02 ml). Patch tests can be done in delayed HS, with readings at day 2, 4 and 7. In SCD, the Baeck's classification of CS in 3 chemical groups could explain cross reactivity between systemic CS. However, this classification is not applicable to explain cross-reactions between in systemic HS. According to the literature, 52/79 patients had a HS reaction to a group confirmed by a positive allergological investigations, but had a negative provocation test with another CS belonging to the same group. In case of non-severe cutaneous adverse reactions and when skin tests are negative, provocation tests have to be performed to find an alternative CS, even if it belongs to the same chemical group as those responsible for the initial reaction.

Contact allergy and intolerance to sulphite compounds: clinical and occupational relevance

Sulphites are widely used as preservatives and antioxidants, e. g., in the food, cosmetic, and pharmaceutical industries. They are known to trigger epidermal sensitizations and associated eczematous contact allergic skin reactions; to identify these, patch testing is performed using sodium disulphite (= sodium metabisulphite; CAS 7681-57-4). In addition to this, inhalation or oral exposure to sulphite can cause the clinical picture of sulphite intolerance, including bronchoconstriction, urticaria, cardiovascular, intestinal, and/or life-threatening anaphylactic reactions, the identification of which requires challenge testing. This review discusses the prevalence of sulphites, their chemical characteristics, statutory regulations and limit values; sulphite-related diseases and their diagnosis; the occupational significance of sulphites as contact allergens in the literature published between 1968 and 2015; and the current incidence of contact sensitizations in the patient collective at a dermatology practice. Individual cases of inhalative occupational sulphite intolerance were also analyzed. A reaction incidence of 3.1% (++ or +++ reaction on day 4) to sodium metabisulphite (1% in Vaseline) was determined in a 10-year collective comprising 780 patients tested at a dermatology practice; in none of these cases was occupational relevance identified. In contrast, the rate of positive test reactions to sulphite was 1.1–4.5% in eight large patch test collectives. Although occupational relevance in the positive test results (depending on selection criteria) was between 0 and 100%, it was predominantly (in six of eight studies) between 5 and 14%. Approximately 50 cases involving occupational allergic contact dermatitis due to sulphite have been published in the literature over the last 45 years, as well as a small number of cases of occupational sulphite intolerance. In summary, epidermal sensitizations to sulphite are rarely of occupational relevance. Despite the wide prevalence of sulphites in the form of preservatives and antioxidants, the low number of cases documented in an occupational dermatological context suggests that occupational sulphite exposure only rarely exists in disease-triggering form.

Dermal safety assessment of Arm & Hammer laundry products formulated for sensitive skin

Context: The prevalence of sensitive skin among the general population in industrialized countries is reported to be over 50%. Sensitive skin subjects often report significant reactions to contact with cosmetics, soaps and other consumer products.Objective: This paper describes the overall skin compatibility and mildness program for a newly developed, lightly fragranced, colorant free laundry product (i.e. Arm & Hammer™ Sensitive Skin plus Skin-Friendly Fresh Scent), specially formulated for individuals with sensitive skin. The skin mildness of the product was compared to Arm & Hammer™ Free & Clear liquid laundry detergent with no fragrance or colorant, and an established history of safe use by sensitive skin consumers.Materials and methods: The test material was a liquid laundry product with a light scent formulated for sensitive skin consumers (Arm & Hammer™ Sensitive Skin plus Skin-Friendly Fresh Scent). The product was compared to commercially marketed products for sensitive skin with a history of skin safety in the marketplace, including: a very similar product formulation (Arm & Hammer™ Free & Clear with no fragrance), and several selected competitors’ products. Studies were conducted among individuals with self-assessed sensitive skin (based on a questionnaire) using standard protocols for the Human Repeat Insult Patch Test (HRIPT), 10-Day Cumulative Irritation, the Wrist Band Wear test, and the Safety In-Use testing. Responses in all protocols were evaluated by visual scoring of potential dermatologic reactions, and recording any sensory effects at the time of the examination. In addition, sensory effects collected from panelists’ daily diaries were also evaluated.Results: The HRIPT confirmed that neither the fragrance alone, nor the product formulation with fragrance, induced contact sensitization in sensitive skin subjects. The 10-Day cumulative irritation study conducted using sensitive skin subjects showed highly favorable skin compatibility, and the test product was comparable to the control product (Arm & Hammer Free & Clear) and other nonirritant controls. In the Wrist Band Wear test, exposure to laundered fabrics under exaggerated conditions gave similar results for the test and control products, with no objective signs of skin irritation, and no self-reported persistent adverse sensory effects. Very mild, transient and isolated sensory effects were noted in daily diaries by a small proportion of subjects, and were similar for the test and control products. The Safety In-Use tests evaluated 4-week exposure to product and laundered fabrics under realistic use conditions. There were no clinically objective signs of skin irritation, and reports of transitory, mild sensory effects were minimal and similar for the test and controls.Discussion and conclusion: A comprehensive skin safety program on a lightly scented sensitive skin laundry formulation (i.e. Arm & Hammer™ Sensitive Skin plus Skin-Friendly Fresh Scent) conducted among panels of self-assessed sensitive skin subjects demonstrated that the presence of a light fragrance did not adversely impact skin compatibility in any of the testing protocols when the product was compared to a similar product with no fragrance. The lightly fragranced product demonstrated overall skin compatibility and mildness when tested in a self-assessed sensitive skin population, and compared favorably to currently marketed sensitive skin products.

Insect Repellents and Contact Sensitization: An Observational Study.

Insect Repellents and Contact Sensitization: An Observational Study.

Efficacy of homoeopathic remedies in irritant contact dermatitis

Background The skin is the organ that separates the human body from the external environment. This function exposes it to physical chemical and biological aggression that determines diseases such as eczema. Contact dermatitis can be caused by irritants irritant contact dermatitis or sensitizers allergic contact dermatitis. Objectives To evaluate usefulness of constitutional Homoeopathic remedies in Irritant contact dermatitis and to avoid the risk of sensitization to topical medications in patients suffering from ICD.Methods A prospective non comparable study was carried out from 01-01-2017 to 31-12-2018 at A.M. Shaikh Homoeopathic Medical College hospital and research center Belgaum Karnataka India. 30 Patients between the age group of 10 -16 years suffering from ICD were screened for the project. All 30 patients were given a constitutional remedy based on the totality of symptoms and results were analyzed.Results Result with the Homoeopathic treatment of ICD was quite satisfactory out of 30 patients 20 patients improved i.e. 66.66 3 patients partially improved i.e. 10 2 patients did not report after first prescription 6.66 5 patients did not show any change i.e. 16.6.Conclusion Majority of the patients were house wives or washer women probably they more exposed to detergents and soaps and cosmetics. Males have shown sensitivity to chemicals and paints. The common sites affected in many patients was palms of hands dorsum of hands Graphites has helped the patients to get their skin complaints completely recover.

Avoiding contact allergens: from basic research to the in vitro identification of contact allergens.

Allergic contact dermatitis (ACD) is a chemical-induced inflammatory skin disease. Contact allergens are low-molecular-weight chemicals that must react with proteins in order to become immunogenic. This interaction leads to the activation of innate immune and stress responses and to the formation of antigenic epitopes for T cells which are the effector cells of ACD. Due to the multitude of chemicals that surround us in our daily life and their potential sensitizing capacity, it is crucial to identify contact sensitizers before these chemicals are used in consumer products. Appropriate in vitro assays for hazard identification are urgently needed to replace animal-based assays. The EU-wide ban on sensitization testing of cosmetic ingredients in animals is in effect since March 2009 and the necessity to test more than 30,000 already marketed chemicals for their sensitizing potential under the EU regulation REACh has intensified the worldwide efforts to replace animal testing. We summarize here the current strategies to develop a battery of assays which allows the identification of contact allergens by in vitro alternatives to animal testing. Our main focus lies on the test systems recently developed within the EU project Sens-it-iv in which we participate.