1,721,041 research outputs found
Rosacea and contact allergy to cosmetics and topical medicaments - retrospective analysis of multicentre surveillance data 1995-2002
No full textThe role of contact allergy in rosacea has rarely been investigated. In this retrospective study, 361 out of 76 697 patients tested and documented by the Information Network of Departments of Dermatology between 1995 and 2002 had rosacea. Patch tests included standard series and constituents of cosmetics and topical medicaments. 118/361 had additionally been patch tested with their own cosmetics/medicaments. Positive reactions occurred to nickel (II) sulfate in 9.3%, fragrance mix in 8.8%, thimerosal in 6.9%, Myroxylon pereirae resin in 5.9%, potassium dichromate in 4.6% and propolis in 2.8%. Whereas rosacea patients had a significantly higher risk of contact allergy to propolis compared to the remaining patients, in an age- and sex-adjusted analysis, contact allergy to nickel was significantly less frequent in this group. For Lyral((R)), the risk was elevated, albeit not significantly. Only 2/329 patients were positive to neomycin sulfate and 1/100 to gentamicin sulfate, among the panel of (topical) antibiotics tested. Among 118 patients tested with their own products, 3 were tested to metronidazole, 1 reacting positively. Irritant or doubtful patch test reactions were provoked by various substances (vehicles, oxidants and preservatives of various creams), which might also be clinically important, considering the heightened sensitivity of rosaceous skin
Frequency of sensitization to antimicrobials in patients with atopic eczema compared with nonatopic individuals: analysis of multicentre surveillance data, 1995-1999
No full textBackground Atopic eczema, a multifactorial disease, is influenced by bacterial factors, particularly Staphylococcus aureus . Consequently, treatment includes therapy with antibiotics and nonantibiotic antimicrobials. Objectives In our study the sensitizing potential of some topical antimicrobials was investigated by comparing proportions sensitized to various antibiotics and antiseptics between patients with current or past atopic eczema, and patients who had never had atopic eczema. Methods Data of all patients patch tested in the Departments of Dermatology participating in the Information Network of Departments of Dermatology (IVDK) between 1995 and 1999 were analysed. Patients with a current leg ulcer or stasis dermatitis that might cause a confounding effect were excluded. Results Controlling for the additional confounding effect of sex and particularly age, we did not find that patients with atopic eczema had a generally higher risk compared with nonatopic individuals. Conclusions While the risk of sensitization should always be considered when applying topical therapy, our data-within the methodological limitations of this type of study-would not support a very restrictive use of these agents in the management of atopic eczema
Contact vitiligo following a strong patch test reaction to triglycidyl-p-aminophenol in an aircraft industry worker: case report and review of the literature
No full textEpoxy resin systems (ERSs) are a frequent cause of occupational allergic contact dermatitis. A 50-year-old patient developed eczematous skin lesions on the back of his hands, lower arms and eye lids, 2 months after he had started working in aircraft construction. Patch tests showed positive reactions at day 3 to nickel sulfate, epoxy resin based on diglycidyl ether of bisphenol F (DGEBF) and 1,4-butanediol diglycidyl ether (1,4-BDDGE). The chemical triglycidyl-p-aminophenol (TGPAP) applied at 1% and 0.1% induced the strongest (+++ positive) reaction. About 4 months after the patch test with TGPAP, the patient presented with 2 circular depigmented spots in the former TGPAP-patch test areas. Dermatohistopathology confirmed the diagnosis of contact vitiligo
Contact allergy in patients with rosacea: a clinic-based, prospective epidemiological study
No full textBackground Rosacea is a relatively common inflammatory skin disease of unknown prevalence. The proportion of contact allergy complicating rosacea and its therapy, respectively, is largely unknown. Objective To estimate the prevalence of specific contact allergy in rosacea patients and to compare this with the prevalence observed in the general population and in general patch test patients. Patients/methods In this prospective monocentre study, 78 patients with rosacea were investigated for contact sensitizations via patch testing the standard series, constituents of topical formulations, preservatives, fragrances, topically applied drugs and, if available, patient's own products. Results Positive reactions occurred to nickel (II) sulphate (12 of 78, 15.4%), fragrance mix I (4 of 77, 5.2%), balsam of Peru (8 of 77, 10.4%; significantly elevated prevalence compared to that observed in the population-based KORA study), potassium dichromate (4 of 78, 5.1%) and Lyral (3 of 78, 3.8%). Regarding topical antibiotics, only 1 of 78 (1.3%) patients was positive to neomycin sulphate, and none to metronidazole; however, 6 of 75 (8%) patients were positive to gentamicin sulphate, and 4 of 76 (5.3%) patients were positive to framycetin sulphate. No allergic but irritant patch test reactions, instead, were provoked by various patients' own products as well as by the irritant sodium lauryl sulphate (SLS) even in low concentrations. Conclusion Despite the limited power of the study, a strikingly high prevalence of contact allergy to gentamicin sulphate was observed, which is probably due to antibiotic treatment of rosacea-associated eye symptoms. The reactions to the irritant SLS probably mirror the extreme skin sensitivity in rosacea
: concomitant reactions
No full textBackground. Beside the basic resins, reactive diluents and hardeners are important sensitizers in epoxy resin systems (ERSs). Because of chemical similarities, immunological cross-reactivity may occur. Objectives. To analyse concomitant reactivity among reactive diluents and hardeners in the patients concerned, as one integral part of a research project on the sensitizing capacity of ERSs (FP-0324). Methods. Aretrospective analysis of data from the Information Network of Departments of Dermatology (IVDK), 2002-2011, was performed. Results. There was close concomitant reactivity to 1,6-hexanediol diglycidyl ether and 1,4-butanediol diglycidyl ether (1,4-BDDGE), and to phenyl glycidyl ether (PGE) and cresyl glycidyl ether (CGE), whereas reactions to p-tert-butylphenyl glycidyl ether occurred more independently from those to PGE and CGE. Concomitant reactions to butyl glycidyl ether and 1,4-BDDGE may point to a common allergenic compound derived from the metabolism of 1,4-BDDGE. Among the structurally more diverse group of hardeners, there was no evidence of immunological cross-reactions. Conclusions. More detailed knowledge of cross-reactivity among ERS components facilitates the interpretation of patch test results and will allow safer ERSs to be composed in the future.German statutory accident insurance (DGUV) [FP-0324
: reaction frequencies
No full textBackground. Epoxy resin systems (ERSs), consisting of resins, reactive diluents, and hardeners, are indispensable in many branches of industry. In order to develop less sensitizing ERS formulations, knowledge of the sensitizing properties of single components is mandatory. Objectives. To analyse the frequency of sensitization in the patients concerned, as one integral part of a research project on the sensitizing potency of epoxy resin compounds (FP-0324). Methods. Aretrospective analysis of data from the Information Network of Departments of Dermatology (IVDK), 2002-2011, and a comparison of reaction frequencies with (surrogate) exposure data, were performed. Results. Almost half of the patients sensitized to epoxy resin were additionally sensitized to reactive diluents or hardeners. Among the reactive diluents, 1,6-hexanediol diglycidyl ether was the most frequent allergen, followed by 1,4-butanediol diglycidyl ether, phenyl glycidyl ether, and p-tert-butylphenyl glycidyl ether. Among the hardeners, m-xylylene diamine (MXDA) and isophorone diamine (IPDA) were the most frequent allergens. According to the calculated exposure-related frequency of sensitization, MXDA seems to be a far more important sensitizer than IPDA. Up to 60% of the patients sensitized to hardeners and 15-20% of those sensitized to reactive diluents do not react to epoxy resin. Conclusions. In cases of suspected contact allergy to an ERS, a complete epoxy resin series must be patch tested from the start.DGUV [FP-0324
Allergic contact dermatitis due to beta-blockers in eye drops: a retrospective analysis of multicentre surveillance data 1993-2004
No full textTopically applied ophthalmic drugs are a potential cause of allergic contact dermatitis of the periorbital region. The objectives of this study were to assess the frequency and spectrum of contact allergy to topically applied beta-blocker containing eye drops. Data of the Information Network of Departments of Dermatology (IVDK) collected between 1993 and 2004 was analysed. Out of 112,430 patch-tested patients, 332 had been tested with their own topical anti-glaucoma eye drops containing different beta-blockers because of suspected allergic contact dermatitis. The frequency of positive test reactions was related to exposure intensity, as estimated by annual prescription rates in Germany. A total of 43/332 (12.95%) showed at least one positive patch test reaction. Positive reactions were observed to products containing timolol (n = 21), metipranolol (n = 13) and levobunolol (n = 11) without conceivable cross-reactivity. Whereas exposure to beta-blocker-containing eye drops remained stable over the years, as estimated by the prescription rates, a slight, non-significant increase in positive patch-reactions to these substances was noted. This is the first systematic analysis of a large set of data on patients' own beta-blocker topical medications, the results indicating that contact allergy should be considered as important, if rare, adverse event caused by this family of drugs
Validität von anamnestischen Angaben auf eine Betalaktam-Antibiotikaallergie
Get PDFAnamnestischen Angaben zufolge sollen ca. 10 % der Bevölkerung von einer Penicillinallergie betroffen sein [5]. Dies wird jedoch oft nicht kritisch hinterfragt und eine klinische Testung in den meisten Fällen nicht durchgeführt. Infolge dessen ist die Wahl einer antibiotischen Behandlung eingeschränkt und infolge dessen wird auf alternative Antibiotika wie beispielsweise Makrolide, Chinolone oder Glykopeptide ausgewichen, welche ein geringeres Wirkungspotential haben und stärkere Nebenwirkungen hervorrufen können. Des Weiteren können sie mögliche bakterielle Resistenzen fördern und sind kostenintensiver[43,69].
Die vorliegende Studie untersucht die Validität von anamnestischen Angaben auf eine Antibiotikaallergie, um zu prüfen, wie oft sich eine echte Allergie nachweisen lässt und ob mit einer gezielten allergologischen Diagnostik eine Antibiotikatherapie optimiert werden kann.
106 Patienten mit der Angabe einer Betalaktam-Antibiotikaallergie wurden mittels standardisierter Tests überprüft. Zur Erfassung der wesentlichen klinischen und anamnestischen Allergiemerkmale diente ein Fragebogen. Weiterhin erfolgten eine serologische Untersuchung auf spezifische IgE-Antikörper und ein Hauttest in Form eines Prick-Tests. Eine systemische Provokationstestung wurde nicht durchgeführt.
Nur bei fünf von 106 Patienten ließ sich eine Allergie verifizieren. Somit konnte nachgewiesen werden, dass ein Großteil der anamnestischen Angaben zur Allergie nicht valide sind. Daraus lässt sich schlussfolgern, dass es sinnvoll ist, Betalaktam-Antibiotikaallergien gezielt zu hinterfragen
Identification and characterization of house dust mite allergens influencing the allergic phenotype and improvement of allergy diagnosis in clinical routine
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