203 research outputs found
Occupational MRSA Infection: Risk Factor, Disposition, Prevention, and Therapy
No full textBrans R, Kaup O, Schürer NY. Occupational MRSA Infection: Risk Factor, Disposition, Prevention, and Therapy. In: John SM, Johansen JD, Rustemeyer T, Elsner P, Maibach HI, eds. Kanerva’s Occupational Dermatology. Cham: Springer International Publishing; 2018: 1-12
Immunological Mechanisms in Allergic Contact Dermatitis
No full textPurpose of the review: The understanding of the cellular and molecular pathogenesis of allergic contact dermatitis (ACD) has increased dramatically. Recent findings: Besides CD4+ and CD8+ T cells, other cell types such as innate lymphoid cells, natural killer T cells (NKT), natural killer cells, and T regulatory cells have emerged as crucial key players. New immunological insights have unravelled that the predominant effector cell type determines the clinical pictures. Hence, a better understanding of the involvement of distinct effector cells has shed light on the diversity of ACD reactions and subsequent clinical pictures. Another new perspective has arisen in the elicitation phase. Here, Langerhans cells can play a role in the development of immune tolerance and not, as previously thought, exclusively in the allergen-driven hypersensitivity reaction. B cells also appear to play an important role in triggering ACD by secreting IgM antibodies in response to interleukin (IL)-4 produced by NKT cells, leading to complement activation and chemotaxis of immune cells. Summary: Allergic contact dermatitis is a delayed-type hypersensitivity reaction triggered by skin contact with the chemical of interest in individuals previously sensitised to the same or a chemically related substance. The understanding of the cellular and molecular pathogenesis of allergic contact dermatitis has improved considerably. In addition to CD4+ and CD8+ T cells, other cell types such as natural killer T cells (NKT) and regulatory T cells have emerged as important participants. The binding of haptens is the first step in the development of allergic contact dermatitis. Haptens are low molecular weight (mostly <500 Dalton) chemicals that are able to penetrate the stratum corneum of the skin or can enter the body upon systemic administration. Haptens are not immunogenic per se but can be effectively recognised by the immune system after binding to a protein carrier. In the clinically inapparent sensitisation phase, Langerhans cells and dendritic cells initiate an adaptive immune response by capturing and processing antigens and presenting them to naïve T cells in the paracortical regions of the lymph nodes. In the elicitation phase, the clinical manifestations of allergic contact dermatitis are the result of a T cell-mediated inflammatory response that occurs in the skin upon re-exposure to the bite and is mediated by the activation of bite-specific T cells in the skin or other organs
Prevalence of dermatitis including allergic contact dermatitis from medical devices used by children and adults with Type 1 diabetes mellitus: A systematic review and questionnaire study
No full textUse of medical devices (MDs), that is, glucose sensors and insulin pumps, in patients with Type 1 diabetes mellitus (T1D) has proven an enormous advantage for disease control. Adverse skin reactions from these MDs may however hamper compliance. The objective of this study was to systematically review and analyse studies assessing the prevalence and incidence of dermatitis, including allergic contact dermatitis (ACD) related to MDs used in patients with T1D and to compare referral routes and the clinical investigation routines between clinics being part of the European Environmental and Contact Dermatitis Research Group (EECDRG). A systematic search of PubMed, EMBASE, CINAHL and Cochrane databases of full-text studies reporting incidence and prevalence of dermatitis in persons with T1D using MDs was conducted until December 2021. The Newcastle–Ottawa Scale was used to assess study quality. The inventory performed at EECRDG clinics focused on referral routes, patient numbers and the diagnostic process. Among the 3145 screened abstracts, 39 studies fulfilled the inclusion criteria. Sixteen studies included data on children only, 14 studies were on adults and nine studies reported data on both children and adults. Participants were exposed to a broad range of devices. Skin reactions were rarely specified. It was found that both the diagnostic process and referral routes differ in different centres. Further data on the prevalence of skin reactions related to MDs in individuals with T1D is needed and particularly studies where the skin reactions are correctly diagnosed. A correct diagnosis is delayed or hampered by the fact that, at present, the actual substances within the MDs are not declared, are changed without notice and the commercially available test materials are not adequately updated. Within Europe, routines for referral should be made more standardized to improve the diagnostic procedure when investigating patients with possible ACD from MDs
Sensitization to palladium in Europe.
No full textBackground: Recently, sodium tetrachloropalladate (Na2 PdCl4 ) was found to be a more sensitive palladium patch test allergen than palladium dichloride (PdCl2 ).
Objectives: To determine the optimal test concentration of Na2 PdCl4 , to evaluate the prevalence of palladium sensitization with Na2 PdCl4 and PdCl2 , and to compare the results with nickel sensitization in a European multicentre study.
Materials and methods: In addition to the European or national baseline series including NiSO4 ·6H2 0 5% pet., consecutive patients were tested with PdCl2 and Na2 PdCl4 2%, 3% and 4% pet. in eight European dermatology clinics. The age and sex distributions were also evaluated in patients sensitized to nickel and palladium.
Results: In total, 1651 patients were tested. Relative to 3% Na2 PdCl4 , 4% Na2 PdCl4 did not add any information. Two per cent Na2 PdCl4 resulted in more doubtful reactions and showed suboptimal reactivity. The prevalence of palladium sensitization doubled with Na2 PdCl4 and was similar to that of nickel. Interestingly, in contrast to nickel sensitization, palladium sensitization was not related to female sex.
Conclusions: Three per cent Na2 PdCl4 pet. is the most suitable patch test concentration. Sensitization to palladium is almost as prevalent as sensitization to nickel. The sex distribution is different between nickel-sensitized and palladium-sensitized patients, suggesting different sources of exposure
Lack of cross-tolerance after oral administration of cross-reactive methacrylate contact sensitizers
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