Hypersensitivity Dermatitis Research Articles

Temporary Tattoo Associated Type IV Delayed Hypersensitivity Dermatitis in a Child – A Case Report and Call for Parental Caution in Singapore

Dear Editor, Case Report A 5-year-old, previously healthy French Caucasian boy was seen at a Paediatric Emergency Department for a skin rash over his left forearm. The child had a temporary “black scorpion” tattoo painted on his left forearm while in Singapore. The temporary tattoo disappeared after a few days. However a week later, the parents noted that the skin erupted in an erythematous papulovesicular lesion which was in the shape of the scorpion tattoo (Fig. 1). The following lesion was observed.

Alopecia in Rhesus macaques correlates with immunophenotypic alterations in dermal inflammatory infiltrates consistent with hypersensitivity etiology

Although alopecia is a commonly recognized problem affecting many captive Rhesus macaque colonies, there is no consensus as to the underlying etiology or appropriate course of management. We performed skin biopsies to assess underlying pathology in alopecic Rhesus macaques and performed immunohistochemical and metachromatic staining of these biopsies to assess the cellular infiltrates. Alopecia is associated with superficial dermal perivascular mononuclear cell infiltrates and skin pathology consistent with chronic hypersensitivity dermatitis. The inflammation is primarily composed of CD4+ cells admixed with histiocytes and mast cells. Inflammation is correlated with degree of alopecia. Further analysis in different groups of macaques revealed that animals born outdoors or infected with lung mites had reduced dermal inflammatory cell infiltrates and a lower incidence of alopecia. These findings support a hypothesis that an altered housing status resulting in decreased pathogen burden in Rhesus macaque colonies may contribute to dermal immunophenotypic alterations and subsequent development of dermatitis with resultant alopecia.

Contact hypersensitivity and allergic contact dermatitis among school children and teenagers with eczema

Contact hypersensitivity and allergic contact dermatitis among school children and teenagers with eczema

Effects of Genetic Polymorphisms of N-Acetyltransferase on Trichloroethylene-Induced Hypersensitivity Dermatitis among Exposed Workers

The hypersensitivity dermatitis induced by trichloroethylene (TCE) exposure was influenced by individual genetic susceptibility factors. In this paper, a case-control study was conducted to investigate effects of various genotypes and phenotypes of N-Acetyltransferases (NATs) on individual susceptibility to the disease. The study consists of 111 patients with hypersensitivity dermatitis and 154 healthy TCE-exposed workers. Polymerase chain reaction-restriction fragment length polymorphism was used to detect the polymorphic sites of NAT1 at nt 1095 and 1088 and the sites of NAT2 at nt 481, 590, and 857. Logistic regression was used to calculate the odds ratios (ORs) and 95% confidence intervals (95%CI). The results reveal that subjects with intermediate or slow acetylators of NAT2 have a 2.01 fold (95%CI=1.14-3.54) higher risk for the disease than subjects with the fast acetylators. When non-fast NAT2 phenotype (intermediate and slow acetylators) and a slow NAT1 phenotype were combined, the risk for the disease was significantly increased (OR=2.71, 95%CI 1.29-5.70) to the level higher than that observed for NAT2 non-fast acetylators phenotype alone. These findings suggest that slow metabolic phenotype of NAT2 maybe one of risk factor for TCE-induced hypersensitivity dermatitis and combined slow acetylator phenotypes of NAT1 and NAT2 further increase such risk.

Severe Hypersensitivity Dermatitis and Liver Dysfunction Induced by Occupational Exposure to Trichloroethylene

Trichloroethylene-induced hypersensitivity dermatitis is one of the serious occupational health events in China, however, little is known about the clinical features and possible mechanism of this disorder. The objective of the present study was to report some typical trichloroethylene-induced dermatitis patients and investigate their occupational exposure as well as the clinical features. We sampled and tested some cleaning agents from the companies where TCE-induced skin disorder occurred, the trichloroethylene concentrations were also monitored in the workplace air. Additionally, the symptoms, signs and laboratory test results of patients were collected. TCE concentrations varied from 10.2% to 91.4% in the cleaning agent by gas chromatography-mass chromatography analysis, and TCE levels in the workplace air ranged between 18 mg/m(3) and 683 mg/m(3), at most sampled sites TCE levels were higher than China national health standard for TCE. The trichloroethylene exposure time of the patients was 5-90 days (average 38.2 d), the patients with headache, dizziness, skin itch, fever were 90.5%, 100%, 100%, and 61.9%, respectively. 85.7% patients had skin erythema, 90.5% with rashes, and 38.1% with blisters. In addition, liver enlargement occurred in 3 patients, the abnormal rate of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (T-Bil) were 90.5%, 85.7% and 76.2%, respectively. 6 out of 15 patients were with abnormal electrocardiogram, and trichloroacetic acid (TCA) elevated in 14 patients (66.7%). Taken together, the major detrimental effect of trichloroethylene was to induce hypersensitivity dermatitis and liver dysfunction, the occurrence of this disorder is likely related to the individual hypersensitivity to trichloroethylene exposure.

HLA-B*1301 as a Biomarker for Genetic Susceptibility to Hypersensitivity Dermatitis Induced by Trichloroethylene among Workers in China

BackgroundTrichloroethylene (TCE) is used extensively as an industrial solvent and has been recognized as one of the major environmental pollutants. To date, > 200 cases of TCE-induced hypersensitivity dermatitis among exposed workers have been reported worldwide, and TCE exposure has become one of the critical occupational health issues in Asia.ObjectivesThe study aimed to identify genetic susceptible biomarkers associated with the TCE-induced hypersensitivity dermatitis in genes located in the human leukocyte antigen (HLA) region.MethodsFrom 1998 to 2006, 121 cases with TCE-induced hypersensitivity dermatitis and 142 tolerant controls were recruited into the population-based case–control study. We determined HLA alleles B, DRB1, DQA1, and DQB1, by sequence-based typing. p-Values were corrected for comparisons of multiple HLA alleles. In addition, we compared and analyzed the structure character of amino acid residues of HLA molecules found in participants.ResultsWe obtained complete genotyping data of 113 cases and 142 controls. The allele HLA-B*1301 was present in 83 (73.5%) of 113 patients compared with 13 (9.2%) of 142 tolerant workers (odds ratio = 27.5; 95% confidence interval, 13.5–55.7; corrected p = 1.48 × 10−21). In addition, the HLA-B*44 alleles were present in 6.2% (7/113) of patients, but were absent in TCE-tolerant workers. Residue 95 shared by HLA-B*1301 and HLA-B*44 molecules formed a different pocket F than other residues.ConclusionsThe allele HLA-B*1301 is strongly associated with TCE-induced hypersensitivity dermatitis among exposed workers and might be used as a biomarker to predict high risk individuals to TCE.

Delayed‐type hypersensitivity dermatitis to ethylene oxide

Delayed‐type hypersensitivity dermatitis to ethylene oxide

Futtermittelhypersensitivitäts-Dermatitis beim Hund: Möglichkeiten der Diagnose

Dogs with food hypersensitivity usually develop chronic pruritic dermatoses virtually indistinguishable from atopic dermatitis. These reactions are often called food allergy but the pathogenesis is poorly characterized. Several studies have addressed the incidence of canine adverse reactions to food but the outcomes were conflicting. The gold standard for the diagnosis of such a condition is the restricted dietary trial and the subsequent provocation challenge. Some attempts have been made to develop serological tests but none of these tests accurately predicted canine food sensitivity. The aim of the present study was to determine the incidence of food hypersensitivity dermatitis and to evaluate a newly developed serological test for the diagnosis of food allergy in dogs. Only 9% of 55 dogs with dermatological signs compatible with food hypersensitivity or atopic dermatitis have been diagnosed as food hypersensitive dogs. The repeatability of the serological test has shown to be insufficient.

Expression of Major Histocompatibility Complex Class II molecules by dermal inflammatory cells, epidermal Langerhans cells and keratinocytes in canine dermatological disease

The distribution of Major Histocompatibility Complex (MHC) Class II molecules in skin biopsies from 42 dogs with primary skin disease and six control dogs was examined by indirect immunohistochemical methods. Canine epidermal Langerhans cells constitutively expressed MHC Class II and the number of such cells was increased in the epidermis of dogs with discoid lupus erythematosus (n = 10), hypersensitivity dermatitis (n = 10) or deep pyoderma (n = 13) but not in eight cases of pemphigus foliaceus. Expression of MHC Class II by epidermal and follicular keratinocytes was observed in a ninth dog with pemphigus foliaceus. Within dermal inflammatory infiltrates, Class II was expressed by macrophages, dendritic cells and fibroblasts but not by neutrophils, eosinophils, mast cells or plasma cells. Only occasional dermal lymphocytes expressed surface MHC Class II, but nodular aggregates of strongly Class II-positive lymphocytes were observed within the dermis of two dogs with discoid lupus erythematosus.

Tissue immunoglobulin G subclasses observed in immune-mediated dermatopathy, deep pyoderma and hypersensitivity dermatitis in dogs

A panel of monoclonal antibodies has been used to define three of the four subclasses of canine immunoglobulin G (IgG 2, IgG 3 and IgG 4) in formalin-fixed tissues. These reagents, together with a polyclonal antiserum specific for the Fc region of canine IgG, were used in an immunohistochemical study of biopsies of skin from five normal dogs and from the lesions of canine pemphigus foliaceus in seven dogs, discoid lupus erythematosus in eight dogs, bullous pemphigoid in one dog, cutaneous drug eruption in two dogs, deep pyoderma in 13 dogs and hypersensitivity dermatitis in eight dogs. IgG autoantibody was identified in the skin of all the dogs with immune-mediated dermatoses by using the polyclonal reagent, and antibody of the IgG 2 and/or IgG 4 subclass was identified in the epidermis of three of the dogs with pemphigus foliaceus, two of those with discoid lupus erythematosus and in the dog with bullous pemphigoid. In all the lesions, the infiltrate of dermal plasma cells consisted of similar numbers of IgG 2 and IgG 4 bearing cells, with relatively few IgG 3 positive cells. The total number of these cells was generally approximately the same as or greater than the number of cells labelled with the polyclonal reagent. There was no significant difference between the IgG-bearing plasma cell infiltrate in German shepherd dogs with deep pyoderma and that in dogs of other breeds. The infiltration of IgG 2 and IgG 4 bearing plasma cells into the skin of dogs with a range of cutaneous disorders was related to the selectively enhanced serum levels of these subclasses in the diseased dogs.

Nickel dermatitis recall during disulfiram therapy for alcohol abuse

Nickel hypersensitivity dermatitis usually appears as an acute eczematous dermatitis with erythema, edema, and vesiculation. Lichenification and hyperpigmentation may be present. Dermatitis may be initiatedby contact with nickel on the skin and may be maintained by ingestion of metal from dietarysources.1-3Nickelispresentinfood, soil, and water as well as in jewelryand many metalobjects. Thereforeit may cause a systemic allergic dermatitis as well as a dermatitis by direct skincontact. I The dithiocarbamates chelate many metals includingnickel, cobalt,andcopper. Disulfiram (Antabuse) which has the chemical structure of tetraethylthiuramdisulfide that metabolizes to a dithiocarbamate,hasbeenusedinthe treatmentofchronic alcoholism and possesses antidotalproperties in the treatment of nickel poisoning. 5 It also is an effectivenickel chelatorin patients withnickel hypersensitivity dermatitis and has been used clinically to treat this dermatitis.f 7 Patients who receive disulfiram for treatment of nickel dermatitis may experience a flareof skindisease shortly after initiation of treatment.7 We describe a case of nickel dermatitis that developed at previously affected sites during initiation of disulfiram therapy for alcohol abuse.

Continuous dermoepidermal junction IgM detected by direct immunofluorescence: A report of nine cases

Although a linear IgM dermatosis of pregnancy has been reported, other authors have not found evidence for a distinct linear IgM dermatosis. We set out to determine whether or not continuous dermoepidermal junction IgM deposition detected by direct immunofluorescence was indicative of a specific disease. We collected nine cases during a 9-year period in which biopsy specimens for direct immunofluorescence revealed continuous linear IgM at the dermoepidermal junction in the absence of other immunoglobulins. In all of these cases the medical record was available for review. Clinical correlation revealed that these patients had a heterogeneous group of diseases with urticaria and leukocytoclastic vasculitis being most common. No diagnostic specificity could be ascribed to the linear IgM pattern, although six of our nine cases could be considered manifestations of a hypersensitivity response (e.g., urticaria, leukocytoclastic vasculitis, pigmented purpuric dermatosis, or hypersensitivity dermatitis). Pathologists and dermatologists should be aware that linear IgM can be seen in a variety of clinical settings. The etiopathogenic significance of this finding, if any, remains to be determined. At present, the finding must be viewed as nonspecific.

Food hypersensitivity and atopic dermatitis Something is changing?

Food hypersensitivity and atopic dermatitis Something is changing?

Disulfiram Hypersensitivity and Rubber Contact Dermatitis

DISULFIRAM is a valuable adjunct in the outpatient therapy of ethanol abuse. Persons taking maintenance doses of disulfiram avoid alcohol, as ingestion causes unpleasant symptoms such as flushing, dyspnea, headache, and vomiting. The danger of a severe reaction with tachycardia and hypotension has received much publicity and is minimized by lower disulfiram doses, abandonment of intentional challenge with ethanol, and careful screening of candidates for cardiopulmonary disability. It is little recognized that screening should also seek a history of rubber contact sensitivity. No such precaution is noted in the disulfiram prescribing information. This case illustrates the dangers of administering disulfiram to a patient with this history. Report of a Case A 32-year-old white male bartender requested disulfiram therapy as an aid to resist the temptation to drink at his job. He was otherwise well, with no history of major illnesses, and had abstained from alcohol for one week. A screening

Contact Urticaria due to Sensitivity to Spray Starch

Occasionally, agents that are applied to the skin produce an immediate wheal-and-flare reaction rather than the usual delayed-type hypersensitivity dermatitis. Open tests that are observed for 30 minutes detect the urticarial reaction, whereas standard closed patch tests that are removed after 48 hours are negative. In this article, we report contact urticaria due to sensitivity to formaldehyde and terpinyl acetate, which are found in a commercial spray starch. <h3>Report of a Case</h3> A 20-year-old woman had a one-year history of pruritus and hives that occurred within minutes of wearing spray-starched clothes. New "wash-and-wear" clothes produced similar symptoms, but washed, unstarched clothes were worn without difficulty. Personal and family histories were negative for atopy. Open tests were applied at different times to her forearm and back with the commercial spray starch and its ingredients (Table). Within 15 minutes, urticaria was observed resulting from the spray starch, formaldehyde, and perfume. Further testing