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George H, Dendooven E, Aerts O. Old but not forgotten: Vesicular hand dermatitis from a copper-containing intrauterine device. Contact Dermatitis 2024; 90:431-433. [PMID: 38154452 DOI: 10.1111/cod.14496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 12/18/2023] [Indexed: 12/30/2023]
Affiliation(s)
- Hannelore George
- Department of Dermatology, University Hospital Antwerp (UZA), Research Group Immunology, University of Antwerp, Antwerp, Belgium
| | - Ella Dendooven
- Department of Dermatology, University Hospital Antwerp (UZA), Research Group Immunology, University of Antwerp, Antwerp, Belgium
| | - Olivier Aerts
- Department of Dermatology, University Hospital Antwerp (UZA), Research Group Immunology, University of Antwerp, Antwerp, Belgium
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2
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Ganguli MP, Dimov V. Chronic Urticaria Suspected to be Caused by a 13.5 mg Levonorgestrel Intrauterine Device (Skyla®). Cureus 2023; 15:e42287. [PMID: 37609103 PMCID: PMC10440827 DOI: 10.7759/cureus.42287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2023] [Indexed: 08/24/2023] Open
Abstract
Chronic urticaria (CU) is a hive-like rash lasting over six weeks. Common associations include low vitamin D, thyroid autoantibodies, and Helicobacter pylori (H. pylori) infection, among others. Progesterone has been documented to trigger CU, by endogenous or exogenous progesterone. The use of intrauterine devices (IUDs) has been a popular source of birth control, with many containing progesterone. Although rarely reported, some patients have been seen to have an urticarial reaction after implantation of an IUD. Here, we present a case of a patient with progesterone-induced chronic urticaria, likely triggered by implantation of a 13.5 mg intrauterine device implant (Skyla®, Bayer, Whippany, NJ, USA). To the best of our knowledge, this is the first case to report the association between Skyla® and chronic urticaria.
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Affiliation(s)
- Malika P Ganguli
- Internal Medicine, Ross University School of Medicine, Bridgetown, BRB
| | - Vesselin Dimov
- Allergy and Immunology, Cleveland Clinic Hospital of Florida, Weston, USA
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3
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FSRH Guideline (March 2023) Intrauterine contraception. BMJ Sex Reprod Health 2023; 49:1-142. [PMID: 37188461 DOI: 10.1136/bmjsrh-2023-IUC] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
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4
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Schwartz BL, Pithadia DJ, Chen JK. Hypersensitivity to Implanted Metal Devices. Curr Derm Rep 2023. [DOI: 10.1007/s13671-023-00381-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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5
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Pan Z, Yang Y, Zhang L, Zhou X, Zeng Y, Tang R, Chang C, Sun J, Zhang J. Systemic Contact Dermatitis: The Routes of Allergen Entry. Clin Rev Allergy Immunol 2021; 61:339-350. [PMID: 34338976 DOI: 10.1007/s12016-021-08873-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2021] [Indexed: 01/19/2023]
Abstract
Systemic contact dermatitis (SCD) is a generalized reactivation of type IV hypersensitivity skin diseases in individuals with previous sensitization after a contact allergen is administered systemically. Patients with SCD may consider their dermatitis unpredictable and recalcitrant since the causative allergens are difficult to find. If a patient has a pattern of dermatitis suggestive of SCD but fails to improve with conventional treatment, SCD should be taken into consideration. If doctors are not familiar with the presentations of SCD and the possible routes of allergen sensitization and exposure, the diagnosis of SCD may be delayed. In this work, we summarized all of the routes through which allergens can enter the body and cause SCD, including oral intake, local contact (through skin, inhalation, nasal spray and anal application), implants, and other iatrogenic or invasive routes (intravenous, intramuscular, intraarticular, and intravesicular). This will provide a comprehensive reference for the clinicians to identify the culprit of SCD.
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Affiliation(s)
- Zhouxian Pan
- Allergy Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China
| | - Yongshi Yang
- Allergy Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China
| | - Lishan Zhang
- Allergy Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China
| | - Xianjie Zhou
- Allergy Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China
| | - Yueping Zeng
- Dermatology Department, Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, PekingBeijing, 100730, China
| | - Rui Tang
- Allergy Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China.
| | - Christopher Chang
- Division of Rheumatology, Allergy and Clinical Immunology, University of California, Davis, Davis, CA, 95616, USA. .,Division of Pediatric Immunology and Allergy, Joe DiMaggio Children's Hospital, Hollywood, FL, USA.
| | - Jinlyu Sun
- Allergy Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China.
| | - Jing Zhang
- Beijing Synchrotron Radiation Facility, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100049, China
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6
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Seki M, Okusa T, Takei H, Ogihara M, Suzuki M, Ito Y, Nakada T. Contact urticaria syndrome from copper. Contact Dermatitis 2021; 85:375-376. [PMID: 33864393 DOI: 10.1111/cod.13863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 04/13/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Marina Seki
- Department of Dermatology, SHOWA University Fujigaoka Hospital, Yokohama, Japan
| | - Takehiro Okusa
- Department of Dermatology, SHOWA University Fujigaoka Hospital, Yokohama, Japan
| | - Hanako Takei
- Department of Dermatology, SHOWA University Fujigaoka Hospital, Yokohama, Japan
| | - Mari Ogihara
- Department of Dermatology, SHOWA University Fujigaoka Hospital, Yokohama, Japan
| | - Marie Suzuki
- Department of Dermatology, SHOWA University Fujigaoka Hospital, Yokohama, Japan
| | - Yuta Ito
- Department of Dermatology, SHOWA University Fujigaoka Hospital, Yokohama, Japan
| | - Tokio Nakada
- Department of Dermatology, SHOWA University Fujigaoka Hospital, Yokohama, Japan
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7
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Gara S, Litaiem N, Bacha T, Jones M, Houas A, Zeglaoui F. Systemic allergic dermatitis caused by a copper-containing intra-uterine device. Contact Dermatitis 2020; 84:132-134. [PMID: 32876348 DOI: 10.1111/cod.13696] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 08/26/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Soumaya Gara
- Department of Dermatology, Charles Nicolle Hospital, Tunis, Tunisia.,Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Noureddine Litaiem
- Department of Dermatology, Charles Nicolle Hospital, Tunis, Tunisia.,Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Takwa Bacha
- Department of Dermatology, Charles Nicolle Hospital, Tunis, Tunisia.,Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Meriem Jones
- Department of Dermatology, Charles Nicolle Hospital, Tunis, Tunisia.,Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Akila Houas
- Cabinet de Dermatologie, Rue De L'inde, Bab Bhar, Tunis, Tunisia
| | - Faten Zeglaoui
- Department of Dermatology, Charles Nicolle Hospital, Tunis, Tunisia.,Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
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9
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Horton E, Montgomery R, Wilkinson M. Allergic contact dermatitis caused by copper in a malachite necklace. Contact Dermatitis 2018; 77:120-121. [PMID: 28703344 DOI: 10.1111/cod.12791] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 02/09/2017] [Accepted: 02/10/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Emma Horton
- Department of Dermatology, Leeds Teaching Hospitals NHS Trust, Chapel Allerton Hospital, Leeds, LS7 4SA, UK
| | - Rachel Montgomery
- Department of Dermatology, Leeds Teaching Hospitals NHS Trust, Chapel Allerton Hospital, Leeds, LS7 4SA, UK
| | - Mark Wilkinson
- Department of Dermatology, Leeds Teaching Hospitals NHS Trust, Chapel Allerton Hospital, Leeds, LS7 4SA, UK
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10
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Wunschel J, Poole JA. Intrauterine uterine contraception and chronic urticaria: a case series. Ann Allergy Asthma Immunol 2017; 118:378-380. [PMID: 28111112 DOI: 10.1016/j.anai.2016.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 11/18/2016] [Accepted: 12/13/2016] [Indexed: 10/20/2022]
Affiliation(s)
- Javen Wunschel
- Pulmonary, Critical Care, Sleep & Allergy Division, Department of Medicine, University of Nebraska Medical Center, Omaha, Nebraska
| | - Jill A Poole
- Pulmonary, Critical Care, Sleep & Allergy Division, Department of Medicine, University of Nebraska Medical Center, Omaha, Nebraska.
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11
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Ko LN, Schalock PC. Prosthetic and Device Surgery Considerations. Curr Treat Options Allergy 2016; 3:359-375. [DOI: 10.1007/s40521-016-0101-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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12
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Fonacier L, Bernstein DI, Pacheco K, Holness DL, Blessing-Moore J, Khan D, Lang D, Nicklas R, Oppenheimer J, Portnoy J, Randolph C, Schuller D, Spector S, Tilles S, Wallace D. Contact dermatitis: a practice parameter-update 2015. J Allergy Clin Immunol Pract 2016; 3:S1-39. [PMID: 25965350 DOI: 10.1016/j.jaip.2015.02.009] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 02/26/2015] [Indexed: 01/08/2023]
Abstract
This parameter was developed by the Joint Task Force on Practice Parameters, which represents the American Academy of Allergy, Asthma & Immunology (AAAAI); the American College of Allergy, Asthma & Immunology (ACAAI); and the Joint Council of Allergy, Asthma & Immunology. The AAAAI and the ACAAI have jointly accepted responsibility for establishing "Contact Dermatitis: A Practice Parameter-Update 2015." This is a complete and comprehensive document at the current time. The medical environment is changing and not all recommendations will be appropriate or applicable to all patients. Because this document incorporated the efforts of many participants, no single individual, including members serving on the Joint Task Force, are authorized to provide an official AAAAI or ACAAI interpretation of these practice parameters. Any request for information or interpretation of this practice parameter by the AAAAI or ACAAI should be directed to the Executive Offices of the AAAAI, the ACAAI, and the Joint Council of Allergy, Asthma & Immunology. These parameters are not designed for use by the pharmaceutical industry in drug development or promotion. Previously published practice parameters of the Joint Task Force on Practice Parameters for Allergy & Immunology are available at http://www.JCAAI.org or http://www.allergyparameters.org.
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13
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Fage SW, Faurschou A, Thyssen JP. Copper hypersensitivity. Contact Dermatitis 2014; 71:191-201. [DOI: 10.1111/cod.12273] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 05/13/2014] [Accepted: 05/20/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Simon W. Fage
- Department of Dermato-Allergology; National Allergy Research Centre, Copenhagen University Hospital Gentofte; 2900 Hellerup Denmark
| | - Annesofie Faurschou
- Department of Dermato-Allergology; National Allergy Research Centre, Copenhagen University Hospital Gentofte; 2900 Hellerup Denmark
| | - Jacob P. Thyssen
- Department of Dermato-Allergology; National Allergy Research Centre, Copenhagen University Hospital Gentofte; 2900 Hellerup Denmark
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Abstract
Systemic contact dermatitis (SCD) refers to a skin condition where an individual who is cutaneously sensitized to an allergen will subsequently react to that same allergen or a cross-reacting allergen via the systemic route. It occurs to allergens including metals, medications, and foods. There has been recent interest in metal allergy as it relates to the implantation of devices such as orthopedic, dental, cardiac, and gynecologic implants. This review will briefly address all causes of systemic contact dermatitis with a special and expanded focus on metal implant allergy. We present literature on SCD to various metal biomedical devices, patch testing for diagnosis of metal allergy pre and post implantation and treatment.
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Abstract
Cutaneous reactions to metal implants, orthopedic or otherwise, are well documented in the literature. The first case of a dermatitis reaction over a stainless steel fracture plate was described in 1966. Most skin reactions are eczematous and allergic in nature, although urticarial, bullous, and vasculitic eruptions may occur. Also, more complex immune reactions may develop around the implants, resulting in pain, inflammation, and loosening. Nickel, cobalt, and chromium are the three most common metals that elicit both cutaneous and extracutaneous allergic reactions from chronic internal exposure. However, other metal ions as well as bone cement components can cause such hypersensitivity reactions. To complicate things, patients may also develop delayed-type hypersensitivity reactions to metals (ie, in-stent restenosis, prosthesis loosening, inflammation, pain, or allergic contact dermatitis) following the insertion of intravascular stents, dental implants, cardiac pacemakers, or implanted gynecologic devices. Despite repeated attempts by researchers and clinicians to further understand this difficult area of medicine, the association between metal sensitivity and cutaneous allergic reactions remains to be fully understood. This review provides an update of the current knowledge in this field and should be valuable to health care providers who manage patients with conditions related to this field.
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Affiliation(s)
- Liping Wen
- Department of Allergy, Peking Union Medical College Hospital, Beijing, China
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Abstract
Reports of immune hypersensitivity reactions of both the immediate and the delayed type following cutaneous or systemic exposure to copper are reviewed here in an endeavor to draw a comprehensive profile of the immunogenic potential of that metal and its compounds. The immunotoxic potential of the metal is also briefly reviewed. In principle, as noted for other transition metals, the electropositive copper ion is potentially immunogenic because of its ability to diffuse through biological membranes, forming complexes when in contact with tissue protein. Based on the results of the predictive guinea pig test and the local lymph node assay (LLNA), copper has a low sensitization potential. Reports of immune reactions to copper include immunologic contact urticaria (ICU), allergic contact dermatitis (ACD), systemic allergic reactions (SAR) and contact stomatitis (STO), but considering the widespread use of copper intrauterine devices (IUDs) and the importance of copper in coinage, items of personal adornment and industry, unambiguous reports of sensitization to the metal are extremely rare, and even fewer are the cases that appear clinically relevant. Most reports of immune reactions to copper describe systemic exposure as a cause--predominantly to intrauterine devices and to prosthetic materials in dentistry--implicitly excluding the induction of hypersensitivity from contact with the skin as a risk factor.
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Affiliation(s)
- Jurij J Hostynek
- Euromerican Technology Resources, Inc., Lafayette, California 94549, USA.
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18
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Abstract
BACKGROUND Positive patch tests to copper sulfate are regularly observed, although copper is reported as a rare allergen with a low sensitizing potential. Usually they are claimed to be irritant and unspecific. OBJECTIVE The aim of this study was to assess the relevance and the diagnostic value of positive reactions to copper. METHODS A total of 2660 routine patch tests were analyzed for positive reactions to copper and other metal allergens: copper, 3.53%; nickel, 21.02%; palladium, 5.90%; cobalt, 3.31%. RESULTS Reactions to copper and nickel were highly significantly associated with each other. Twenty-six patients with a positive routine test to copper were retested. The reproducibility was modest (38%), but again significantly associated with nickel sensitization. CONCLUSION These clinical data support a copper-nickel cross-reactivity concept on T-cell level based on recently published molecular data. We conclude that positive patch tests to copper are mostly specific; however, they are usually of low clinical relevance.
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Affiliation(s)
- S Wöhrl
- FAZ-Floridsdorf Allergy Centre, Vienna, Austria
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