1
|
Scherrer MAR, Abreu ÉP, Rocha VB. Neomycin: sources of contact and sensitization evaluation in 1162 patients treated at a tertiary service. An Bras Dermatol 2023:S0365-0596(23)00070-3. [PMID: 37003899 DOI: 10.1016/j.abd.2022.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/29/2022] [Accepted: 07/19/2022] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND Neomycin is used in several over-the-counter pharmaceutical formulations in Brazil. In Europe and Canada, where it is not freely available, its sensitization frequency is lower than in the United States, where this does not occur. OBJECTIVE To present the frequency of sensitization to neomycin observed in a tertiary hospital and the pharmaceutical formulations sold in Brazil containing neomycin. METHOD Retrospective analysis of positive results to neomycin, obtained through patch tests performed in a tertiary hospital, from 2009 to 2018 and investigation of topical drugs and vaccines containing neomycin in Brazilian databases available on the internet. RESULTS Among 1,162 patients, 71 (6%) had positive reactions to neomycin, 65% female and 35% male individuals, 46% were over 50 years old, and 24% had a personal history of atopy. The dermatitis lasted from four months to 20 years. Lesions were located in 69% of the patients on the upper limbs, in 55% they were on the lower limbs, and in 42% they were disseminated in more than 4 sites. Polysensitization was detected in 55% of cases. Of these, 28% were linked to sensitization to rubber allergens and 27% to potassium bichromate. A total of 158 topical presentations of neomycin were found: 79 ointments, 58 creams, 10 ophthalmic solutions, seven otological solutions, one oral solution, two nasal solutions, and one antiseptic powder, in addition to 11 types of vaccines. STUDY LIMITATIONS Retrospective study. CONCLUSION Sensitization to neomycin occurred in 6% of the studied population, affecting more females aged over 50 years, with skin lesions located mainly on the upper and lower limbs, in the context of chronic contact dermatitis. Neomycin was found in 135 formulations, most of them available over the counter, as well as in 11 miscellaneous vaccines.
Collapse
Affiliation(s)
| | - Érica Possa Abreu
- Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Vanessa Barreto Rocha
- Department of Internal Medicine, Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
| |
Collapse
|
2
|
Contact Allergy in the Elderly: A Study of 600 Patients. Life (Basel) 2022; 12:life12081228. [PMID: 36013408 PMCID: PMC9410419 DOI: 10.3390/life12081228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/05/2022] [Accepted: 08/08/2022] [Indexed: 11/17/2022] Open
Abstract
The proportion of elderly in the general population is increasing. Ageing of the skin and immune system can modify the features of contact hypersensitivity (CH). The number of epidemiological studies according to the age-related features of CH is very limited. We aimed to analyse the clinical characteristics of CH in an elderly patient population. A total of 600 patients (patient age > 60 years old) were patch tested with the European Environmental Baseline Series (EEBS) and 440 of them with the Complementary Fragrance Series (CFS) at the same time according to the actual international methodological standards in the Allergy Outpatient Unit of Department of Dermatology, Venereology and Dermato-Oncology of Semmelweis University between 2015−2019. Out of 600 tested patients, 54.8% had at least one allergen positivity. Female predominance was observed (78.7%). The most common diagnosis was contact dermatitis (63.7%), followed by psoriasis (6.2%). Most of the cases (58.0%) were found in the age group of 60−69. The five most common contact allergens were benzoic acid, methylisothiazolinone (MI), wood tar, nickel, and balsam of Peru. Allergic skin symptoms are present in all ages and also in the elderly. According to our data, the most common contact allergens are preservatives, followed by balsam of Peru among men and nickel among women. In case of contact dermatitis, stasis dermatitis, rosacea, and atopic dermatitis are worth patch testing to verify CH even in those above 60 years old.
Collapse
|
3
|
Bilgic A, Bozca B, Subası G, Dicle Ö, Uzun S, Yılmaz E, Alpsoy E, Akman-Karakas A. Standard patch test results and clinical relevance: A cross-sectional study of 10-year retrospective experience. Indian J Dermatol 2022; 67:258-264. [PMID: 36386088 PMCID: PMC9644757 DOI: 10.4103/ijd.ijd_965_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background: Allergic contact dermatitis (ACD) is a type IV hypersensitivity reaction, and The European Standard Series (ESS) Patch Test (PT) is widely used in determining the possible responsible allergens causing ACD. The dynamic nature of the industrial products, socioeconomic and environmental factors cause the frequency of common allergens to change over the years and among different regions. Aims and Objectives: This study aimed to retrospectively evaluate the results of ESS PT of our centre in the last decade, and determine the current spectrum of allergens and their clinical relevance. Materials and Methods: The data of patients who underwent ESS PT in our clinic between January 2010 and March 2020 were included in the study. The patient files were examined retrospectively. The clinical relevance was evaluated according to the COADEX system. Statistical analysis used: SPSS for Windows version 23.0 software program. Results: The data of 1037 patients [623 (60.1%) female, 414 (39.9%) male] were analysed. The mean age was 38.34 ± 14.55 years. The five most common allergens were nickel sulphate (23.1%), cobalt chloride (12%), potassium dichromate (9.5%), Fragrance mix II (7.3%) and balsam of Peru (5.7%). According to the COADEX coding system, current relevance was detected in 319 (49.3%) of 646 patients who had a positive reaction to any substance in the patch test. Conclusion: Our study showed that with increasing awareness in society, the tendency to avoid some well-known allergenic substances and consumer products causes changes in common allergens. These results prove the value of long-term surveillance of contact allergy.
Collapse
|
4
|
Abstract
ABSTRACT Allergic contact dermatitis from topical drugs is frequent and is seen in 10% to 17% of patients patch tested for suspected contact dermatitis. More than 360 drugs have been implicated as contact allergens, of which-generally-antibiotics, corticosteroids, local anesthetics, and nonsteroidal anti-inflammatory drugs are the most frequent culprits. This article provides an overview of allergic contact dermatitis to topical drugs, discussing their prevalence of sensitization, predisposing factors, clinical manifestations (both typical and atypical), the drugs described as allergens, cross-reactivity and coreactivity, and diagnostic procedures.
Collapse
|
5
|
Soriano LF, Buckley DA. Sudocrem ® dermatitis: easily missed. Clin Exp Dermatol 2021; 46:1308-1310. [PMID: 33864275 DOI: 10.1111/ced.14690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2021] [Indexed: 11/27/2022]
Affiliation(s)
- L F Soriano
- Department of Dermatology, Poole Hospital, Poole, UK
| | - D A Buckley
- Department of Dermatology, Circle Hospital, Bath, UK
| |
Collapse
|
6
|
Contact Allergy to Topical Drugs. Contact Dermatitis 2021. [DOI: 10.1007/978-3-030-36335-2_38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
7
|
Mizutani H, Nixon RL. The Australian Baseline Series. Contact Dermatitis 2021. [DOI: 10.1007/978-3-030-36335-2_68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
8
|
Abstract
Topical antibacterials are commonly used for superficial pyodermas such as impetigo and treatment or prevention of infections following minor cuts, abrasions, burns, and surgical wounds. Several antibiotics and antiseptics are available for use in different indications. One of the major uses of topical antibacterials is acne in which benzoyl peroxide is the drug of the first choice either singly or in combination with antibiotics or retinoids. Mupirocin and fusidic acid are the two most commonly used antibiotics for the treatment of superficial pyodermas and eradication of staphylococcal carrier state. Bacterial resistance to topical antibiotics is a growing concern and topical antiseptics such as gentian violet are getting renewed interest as alternatives. Incidence of contact dermatitis is a limiting factor for the use of several topical antibacterials. Although many botanical products have demonstrated in vitro activities against skin pathogens, their clinical utilities remain to be established by good-quality clinical trials.
Collapse
Affiliation(s)
- Debabrata Bandyopadhyay
- Department of Dermatology, Venereology, and Leprosy, Medical College and Hospitals, Kolkata, 88, College Street, Kolkata, West Bengal, India
| |
Collapse
|
9
|
Rubins A, Romanova A, Septe M, Maddukuri S, Schwartz RA, Rubins S. Contact dermatitis: etiologies of the allergic and irritant type. ACTA DERMATOVENEROLOGICA ALPINA PANNONICA ET ADRIATICA 2020. [DOI: 10.15570/actaapa.2020.37] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
10
|
Tas B. Demographic and clinical features and subsectoral differences in occupational contact allergens in clothing manufacturing workers. Am J Ind Med 2020; 63:1008-1016. [PMID: 32914884 DOI: 10.1002/ajim.23178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 08/22/2020] [Accepted: 08/24/2020] [Indexed: 01/30/2023]
Abstract
BACKGROUND Epidemiologic data on the occurrence of contact dermatitis (CD) and the contact allergens involved in clothing manufacturing and its subsectors are scarce. This study aimed to determine the extent of occupational contact allergy and differences between work subsectors in clothing employees with CD. METHODS A cross-sectional study was conducted with 272 clothing employees, who complained of CD and were diagnosed with occupational allergic contact dermatitis (OACD). Participants worked in accessory, dyeing, sewing, cutting, knitting, packing, cleaning, and ironing subsectors. Data on demographics, working-subsector, working-duration, and lesion-duration were collected, and participants were examined and patch tested. RESULTS Participants included 173 females and 99 males. Dyeing workers were most frequently diagnosed with OACD, whereas cutting workers were least. Lesions were mostly located on the hands only. The most frequently detected allergens were nickel sulfate in accessory work; disperse blue-106 in dyeing, sewing, cutting, and knitting; cobalt chloride in packing; p-phenylenediamine in cleaning; and budesonide in ironing. CONCLUSIONS Contact allergens show significant differences in frequency by work subsectors in clothing employees. Careful monitoring of workers for excessive exposures and for early signs of CD is warranted.
Collapse
Affiliation(s)
- Betul Tas
- Department of Dermatology and Venereology, Istanbul Bagcilar Research and Training Hospital University of Health Sciences Istanbul Turkey
| |
Collapse
|
11
|
Thomas B, Benedikt M, Alamri A, Kapp F, Bader R, Summer B, Thomas P, Oppel E. The role of antibiotic-loaded bone cement in complicated knee arthroplasty: relevance of gentamicin allergy and benefit from revision surgery - a case control follow-up study and algorithmic approach. J Orthop Surg Res 2020; 15:319. [PMID: 32787962 PMCID: PMC7425164 DOI: 10.1186/s13018-020-01855-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 07/31/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Antibiotic-loaded (particularly gentamicin) bone cement (BC) is widely used in total joint arthroplasty (TJA) to prevent periprosthetic infections (PPIs), but may itself cause implant failure. In light of a complete lack in literature, the objective was to assess the clinical relevance of gentamicin allergy for failure of cemented total knee arthroplasties in 25 out of 250 patients with positive patch test reactions to gentamicin and otherwise unexplained symptoms by evaluating benefits from revision with change to gentamicin-free cement. METHODS Fifteen of these 25 patients and their treating orthopaedic surgeons agreed to a re-assessment. They were surveyed regarding interim course of therapy and symptoms, including re-assessment of the Knee Injury and Osteoarthritis Outcome Score (KOOS), and underwent follow-up clinical and radiographic investigations. The initial use of gentamicin-loaded BC was reaffirmed by review of the primary implantation operative reports and respective implant passports. Primary and follow-up KOOS scores were analyzed regarding benefits from revision surgery by comparing nine patients with revision to six without revision. RESULTS Mean follow-up time was 38 months. The entirety of patients experienced an improvement of self-reported symptoms, with revision surgery (i.e., switching to gentamicin-free BC or uncemented total knee arthroplasty) yielding significantly greater improvement (p = 0.031): the nine revised patients reported a significant symptom relief (p = 0.028), contrary to the six unrevised patients (p = 0.14). Interestingly, the decision to proceed with revision surgery was significantly correlated with higher symptom severity (p = 0.05). CONCLUSION In symptomatic total knee arthroplasty with gentamicin allergy, uncemented revision arthroplasty or change to gentamicin-free BC provides significant symptom relief.
Collapse
Affiliation(s)
- Benjamin Thomas
- Department of Dermatology and Allergology, Ludwig-Maximilians-University Munich, Frauenlobstrasse 9-11, 80337, Munich, Germany. .,Department of Hand, Plastic, and Reconstructive Surgery, Burn Center, BG Trauma Center, University of Heidelberg, Ludwig-Guttmann-Strasse 13, 67071, Ludwigshafen, Germany.
| | - Maria Benedikt
- Department of Dermatology and Allergology, Ludwig-Maximilians-University Munich, Frauenlobstrasse 9-11, 80337, Munich, Germany.,Department of Anesthesiology and Intensive Care, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany
| | - Ali Alamri
- Department of Dermatology and Allergology, Ludwig-Maximilians-University Munich, Frauenlobstrasse 9-11, 80337, Munich, Germany
| | - Florian Kapp
- Department of Dermatology and Allergology, Ludwig-Maximilians-University Munich, Frauenlobstrasse 9-11, 80337, Munich, Germany
| | - Rainer Bader
- Department of Orthopaedics, University of Rostock, Doberaner Strasse 142, 18057, Rostock, Germany
| | - Burkhard Summer
- Department of Dermatology and Allergology, Ludwig-Maximilians-University Munich, Frauenlobstrasse 9-11, 80337, Munich, Germany
| | - Peter Thomas
- Department of Dermatology and Allergology, Ludwig-Maximilians-University Munich, Frauenlobstrasse 9-11, 80337, Munich, Germany
| | - Eva Oppel
- Department of Dermatology and Allergology, Ludwig-Maximilians-University Munich, Frauenlobstrasse 9-11, 80337, Munich, Germany
| |
Collapse
|
12
|
Boyvat A, Kalay Yildizhan I. Patch test results of the European baseline series among 1309 patients in Turkey between 2013 and 2019. Contact Dermatitis 2020; 84:15-23. [PMID: 32618364 DOI: 10.1111/cod.13653] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 06/23/2020] [Accepted: 07/01/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Prevalences of sensitivity to contact allergens change over time as a result of variations in allergen exposure. OBJECTIVES The aim of the study was to describe trends in sensitisation to allergens of the European baseline series in Turkey between 2013 and 2019. METHODS The patch test results of 1309 patients with suspected allergic contact dermatitis (ACD) were analysed retrospectively, and the prevalence of contact allergies to European baseline series allergens was compared with previous data (for 1998-2005). RESULTS A total of 534 (40.8%) patients exhibited one or more positive patch test reaction. The five most frequent allergens were nickel sulfate (19.6%), potassium dichromate (6.5%), cobalt chloride (6%), Myroxylon pereirae resin (5%), and p-phenylenediamine (PPD; 3.7%). Statistically significant increases in the prevalence of sensitisation to methylchloroisothiazolinone/methylisothiazolinone (MCI/MI; P < .001), Myroxylon pereirae resin (P < .001), PPD (P = .008), and fragrance mix I (P = .036) were observed in the 2013 to 2019 period compared with the 1998 to 2005 period. Conversely, positive reactions to neomycin sulfate (P = .029), clioquinol (P = .031), and primin (P = .001) decreased significantly. CONCLUSION This study provides a comprehensive profile of ACD in Turkey. The remarkable increase in the MI and MCI/MI contact allergy observed underlines the urgent need for regulatory measures to reduce exposure to MI and MCI/MI in Turkey.
Collapse
Affiliation(s)
- Ayse Boyvat
- Department of Dermatology, School of Medicine, Ankara University, Ankara, Turkey
| | | |
Collapse
|
13
|
The Australian Baseline Series. Contact Dermatitis 2020. [DOI: 10.1007/978-3-319-72451-5_68-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
14
|
Topical Drugs. Contact Dermatitis 2020. [DOI: 10.1007/978-3-319-72451-5_38-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
15
|
Goossens A, Gonçalo M. Contact Allergy to Topical Drugs. Contact Dermatitis 2020. [DOI: 10.1007/978-3-319-72451-5_38-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
16
|
Chastain DB, Hutzley VJ, Parekh J, Alegro JVG. Antimicrobial Desensitization: A Review of Published Protocols. PHARMACY 2019; 7:E112. [PMID: 31405062 PMCID: PMC6789802 DOI: 10.3390/pharmacy7030112] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 08/05/2019] [Accepted: 08/07/2019] [Indexed: 12/21/2022] Open
Abstract
Antimicrobial desensitization represents a last-line option for patients with no alternative therapies, where the benefits of this intensive process must outweigh the potential harm from drug exposure. The goal of antimicrobial desensitization procedures is to establish a temporary state of tolerance to drugs that may otherwise cause hypersensitivity reactions. While no universal antimicrobial desensitization protocols exist, this review critically analyzes previously published desensitization protocols. The purpose of this review is to provide a greater insight for clinicians and institutions to ensure desensitization procedures are efficacious while minimizing potential for patient harm. With an increasing rate of antimicrobial resistance and the critical need to preserve antimicrobial agents, desensitization may represent another option in our antimicrobial stewardship toolkit.
Collapse
Affiliation(s)
| | | | - Jay Parekh
- Roosevelt University College of Pharmacy, Schaumburg, IL 60173, USA
| | - Jason Val G Alegro
- Mount Sinai Hospital, Chicago, IL 60608, USA.
- Roosevelt University College of Pharmacy, Schaumburg, IL 60173, USA.
| |
Collapse
|
17
|
Corazza M, Forconi R, Toni G, Scuderi V, Mantovani L, Borghi A. Systemic allergic dermatitis due to gentamicin. Contact Dermatitis 2019; 81:402-403. [PMID: 31291007 DOI: 10.1111/cod.13352] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 07/09/2019] [Indexed: 12/01/2022]
Affiliation(s)
- Monica Corazza
- Section of Dermatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Riccardo Forconi
- Section of Dermatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Giulia Toni
- Section of Dermatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Valeria Scuderi
- Section of Dermatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Lucia Mantovani
- Section of Dermatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Alessandro Borghi
- Section of Dermatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| |
Collapse
|
18
|
Prevalence of Atopic Dermatitis Criteria among Textile Workers with Occupational Allergic Contact Dermatitis and Effects of Having Atopic Dermatitis on Contact Antigenic Diversity. MEDICAL BULLETIN OF SISLI ETFAL HOSPITAL 2019; 53:58-69. [PMID: 33536829 PMCID: PMC7847731 DOI: 10.14744/semb.2018.67365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 08/16/2018] [Indexed: 11/20/2022]
Abstract
Objectives: Contact dermatitis (CD) is a common skin disease. Occupational contact dermatitis (OCD) is the most frequently seen occupational skin disease and includes both occupational allergic CD (OACD) and occupational irritant CD (OICD). One of the most common sources of OACD is textile products. Individuals with atopic dermatitis (AD) have an increased risk for development of allergic contact dermatitis (ACD). However, the role of AD in the etiopathogenesis of the development of OACD among textile industry workers is not well known. The aim of the present study was to determine the prevalence of AD among textile workers with OACD and to analyze contact antigenic diversity between the workers with and without AD. Methods: A prospective, cross-sectional study was conducted with 352 textile workers who had previously been diagnosed with OACD. The patients were questioned and examined with respect to AD criteria, demographic features, disease duration, duration of employment until first symptoms, phototype, workplace (subsectors), and location of lesions at control visits. Immediate skin test reactivity was evaluated with a commercial skin prick test panel. The data obtained and the patients’ previously recorded patch test results were compared in OACD groups with and without a diagnosis of AD. The results were statistically evaluated with a significance level of p value <0.05. Results: The study population consisted of 124 males and 227 females. The mean age was 35.69±13.65 years. The most commonly seen employment duration, phototype, subsector, and location were 4 to 8 months (26.14%), 9 to 12 months (34.66%), Fitzpatrick type-III (37.50%), dyeing (33.52%), and exclusively the hands (60.51%), respectively. In all, 193 patients (54.83%) met the criteria for the diagnosis of AD. In the OACD group with AD, there was a significant number with 4 major and 16 minor criteria, as well as positivity for 14 contact allergens. Conclusion: Most AD criteria, or a diagnosis of AD, are highly detectable among workers with textile-related OACD. The results for patch test allergens may be significantly higher than those of individuals without AD. Textile workers with AD should be warned about the possibility of the early development of OACD.
Collapse
|
19
|
Ladd R, Becevic M, Misterovich H, Edison K. Dermatology ECHO: A case presentation demonstrating benefits of specialty telementoring in primary care. J Telemed Telecare 2018; 25:506-509. [PMID: 29933723 DOI: 10.1177/1357633x18780562] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Allergic contact dermatitis (ACD) is a common dermatologic disorder that is estimated to affect 15-20% of the general population. Because of its prevalence, it may be expected that ACD should be easily recognized. However, it can present with many clinical variations that may complicate diagnosis. Although ACD is a treatable condition, patients from rural and underserved areas suffer if timely access to specialty care is limited. Dermatology Extension for Community Healthcare Outcomes (Dermatology ECHO) telemedicine sessions were created to mentor rural primary care providers (PCPs). To illustrate their benefit, we present the case of a 19-year-old female patient who suffered from worsening undiagnosed ACD for over nine months following a laparoscopic appendectomy. During that time, the surgeon and multiple PCPs treated her with antibiotics, antivirals, and Scabicide without improvement in her condition. The de-identified patient case was presented by her PCP during the Dermatology ECHO session. The Dermatology ECHO specialty team mentored and educated the PCP in the diagnosis and treatment of ACD. After making the diagnosis, the patient received new treatment and her condition improved significantly. Dermatology ECHO provides a knowledge-sharing network for participating PCPs that may improve patient outcomes and reduce patient suffering.
Collapse
Affiliation(s)
- Ryan Ladd
- 1 School of Medicine, University of Missouri, Columbia, USA
| | - Mirna Becevic
- 2 Department of Dermatology, School of Medicine, University of Missouri, Columbia, USA.,3 Missouri Telehealth Network, University of Missouri, Columbia, USA
| | | | - Karen Edison
- 2 Department of Dermatology, School of Medicine, University of Missouri, Columbia, USA.,3 Missouri Telehealth Network, University of Missouri, Columbia, USA.,5 Center for Health Policy, University of Missouri, Columbia, USA
| |
Collapse
|
20
|
Moore NA, Czyz CN, Carter TD, Foster JA, Cahill KV. Neomycin, polymyxin B, and dexamethasone allergic reactions following periocular surgery. J Ophthalmic Inflamm Infect 2017; 7:15. [PMID: 28608297 PMCID: PMC5468176 DOI: 10.1186/s12348-017-0133-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 05/26/2017] [Indexed: 11/16/2022] Open
Abstract
Background The aim of this study was to evaluate the rate of periocular allergic skin reactions to topical neomycin, polymyxin B, and dexamethasone (NPD) ophthalmic ointment. Methods A consecutive patient prospective study was performed. A total of 522 patients who had a procedure involving incision of the periocular skin with subsequent postoperative application of NPD ophthalmic ointment were included. Patients were evaluated for signs of allergy at 1 week postoperatively or prior if the patient had complaints. A periocular allergic reaction was defined as any periocular skin pruritus, erythema, edematous papules, vesicles, or plaques at the site of ointment application beyond that of the typical postprocedure presentation. The patients continued to be monitored for 30 days postoperatively. Results Of the 522 patients who completed the study, eight (1.5%) had a definitive periocular allergic contact dermatitis to the NPD ophthalmic ointment. Allergic presentation ranged from postoperative day 3 to 14. Conclusions The rate of periocular allergic reactions to NPD ophthalmic ointment is significantly lower than reported in the literature for other topical preparations of neomycin and polymyxin B. The low rate of allergy in this study suggests that NPD ophthalmic ointment can safely be applied to the periocular skin with a very minimal risk of inciting an allergic reaction.
Collapse
Affiliation(s)
- Nicholas A Moore
- Department of Ophthalmology, Indiana University School of Medicine, 2022 Ruckle St., Indianapolis, IN, 46202, USA.
| | - Craig N Czyz
- Division of Ophthalmology, Oculofacial Plastic and Reconstructive Surgery, Doctors Hospital, Columbus, OH, USA.,Department of Ophthalmology, Oral and Maxillofacial Surgery, Grant Medical Center, Columbus, OH, USA
| | - Tracy D Carter
- Division of Ophthalmology, Oculofacial Plastic and Reconstructive Surgery, Doctors Hospital, Columbus, OH, USA
| | - Jill A Foster
- Ophthalmic Surgeons and Consultants of Ohio, Columbus, OH, USA
| | | |
Collapse
|
21
|
Lynch MD, McFadden JP, White JM, Banerjee P, White IR. Age-specific profiling of cutaneous allergy at high temporal resolution suggests age-related alterations in regulatory immune function. J Allergy Clin Immunol 2017; 140:1451-1453.e5. [PMID: 28606588 DOI: 10.1016/j.jaci.2017.03.054] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Revised: 02/18/2017] [Accepted: 03/15/2017] [Indexed: 11/24/2022]
Affiliation(s)
- Magnus David Lynch
- Department of Cutaneous Allergy, St John's Institute of Dermatology, Guy's Hospital, London, United Kingdom.
| | - John Paul McFadden
- Department of Cutaneous Allergy, St John's Institute of Dermatology, Guy's Hospital, London, United Kingdom
| | - Jonathan Michael White
- Department of Cutaneous Allergy, St John's Institute of Dermatology, Guy's Hospital, London, United Kingdom
| | - Piu Banerjee
- Department of Cutaneous Allergy, St John's Institute of Dermatology, Guy's Hospital, London, United Kingdom; Department of Dermatology, Lewisham Hospital, London, United Kingdom
| | - Ian Richard White
- Department of Cutaneous Allergy, St John's Institute of Dermatology, Guy's Hospital, London, United Kingdom
| |
Collapse
|
22
|
|
23
|
Gilissen L, Goossens A. Frequency and trends of contact allergy to and iatrogenic contact dermatitis caused by topical drugs over a 25-year period. Contact Dermatitis 2016; 75:290-302. [DOI: 10.1111/cod.12621] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 04/27/2016] [Accepted: 04/28/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Liesbeth Gilissen
- Department of Dermatology; University Hospitals KU Leuven; 3000 Leuven Belgium
| | - An Goossens
- Department of Dermatology; University Hospitals KU Leuven; 3000 Leuven Belgium
| |
Collapse
|
24
|
D'Erme AM, Iannone M, Dini V, Romanelli M. Contact dermatitis in patients with chronic leg ulcers: a common and neglected problem: a review 2000–2015. J Wound Care 2016; 25 Suppl 9:S23-9. [DOI: 10.12968/jowc.2016.25.sup9.s23] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
| | - M. Iannone
- Department of Dermatology, University of Pisa, Pisa, Italy
| | - V. Dini
- Department of Dermatology, University of Pisa, Pisa, Italy
| | - M. Romanelli
- Department of Dermatology, University of Pisa, Pisa, Italy
| |
Collapse
|
25
|
Galli E, Neri I, Ricci G, Baldo E, Barone M, Belloni Fortina A, Bernardini R, Berti I, Caffarelli C, Calamelli E, Capra L, Carello R, Cipriani F, Comberiati P, Diociaiuti A, El Hachem M, Fontana E, Gruber M, Haddock E, Maiello N, Meglio P, Patrizi A, Peroni D, Scarponi D, Wielander I, Eichenfield LF. Consensus Conference on Clinical Management of pediatric Atopic Dermatitis. Ital J Pediatr 2016; 42:26. [PMID: 26936273 PMCID: PMC4776387 DOI: 10.1186/s13052-016-0229-8] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 02/14/2016] [Indexed: 01/01/2023] Open
Abstract
The Italian Consensus Conference on clinical management of atopic dermatitis in children reflects the best and most recent scientific evidence, with the aim to provide specialists with a useful tool for managing this common, but complex clinical condition. Thanks to the contribution of experts in the field and members of the Italian Society of Pediatric Allergology and Immunology (SIAIP) and the Italian Society of Pediatric Dermatology (SIDerP), this Consensus statement integrates the basic principles of the most recent guidelines for the management of atopic dermatitis to facilitate a practical approach to the disease. The therapeutical approach should be adapted to the clinical severity and requires a tailored strategy to ensure good compliance by children and their parents. In this Consensus, levels and models of intervention are also enriched by the Italian experience to facilitate a practical approach to the disease.
Collapse
Affiliation(s)
- Elena Galli
- Pediatric Allergy Unit, Research Center, San Pietro Hospital - Fatebenefratelli, Rome, Italy.
| | - Iria Neri
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
| | - Giampaolo Ricci
- Pediatric Unit - Department of Medical and Surgical Sciences, S. Orsola Malpighi Hospital, University of Bologna, Pad. 16, Via Massarenti, 11 - 40138, Bologna, Italy.
| | - Ermanno Baldo
- Pediatric Department, "S. Maria del Carmine" Hospital of Rovereto, APSS (Provincial Agency for Health Services), Trento, Italy.
| | | | - Anna Belloni Fortina
- Pediatric Dermatology Unit, Department of Medicine, University of Padua, Padua, Italy.
| | | | - Irene Berti
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy.
| | - Carlo Caffarelli
- Pediatric Unit, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy.
| | - Elisabetta Calamelli
- Pediatric Unit - Department of Medical and Surgical Sciences, S. Orsola Malpighi Hospital, University of Bologna, Pad. 16, Via Massarenti, 11 - 40138, Bologna, Italy.
| | - Lucetta Capra
- Department of Medical Sciences, Section of Paediatrics, University of Ferrara, Ferrara, Italy.
| | - Rossella Carello
- Pediatric Allergy Unit, Research Center, San Pietro Hospital - Fatebenefratelli, Rome, Italy.
| | - Francesca Cipriani
- Pediatric Unit - Department of Medical and Surgical Sciences, S. Orsola Malpighi Hospital, University of Bologna, Pad. 16, Via Massarenti, 11 - 40138, Bologna, Italy.
| | | | - Andrea Diociaiuti
- Dermatology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | - Maya El Hachem
- Dermatology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | - Elena Fontana
- Pediatric Dermatology Unit, Department of Medicine, University of Padua, Padua, Italy.
| | - Michaela Gruber
- Department of Pediatrics, Central Hospital of Bolzano, Bolzano, Italy.
| | - Ellen Haddock
- Departments of Pediatrics and Dermatology, School of Medicine, University of California, San Diego, CA, USA.
| | - Nunzia Maiello
- Department of Woman, Child and General and Specialized Surgery, Second University of Naples, Naples, Italy.
| | - Paolo Meglio
- Primary Care Pediatrician, Health National Service, Rome, Italy.
| | - Annalisa Patrizi
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
| | - Diego Peroni
- Department of Medical Sciences, Section of Paediatrics, University of Ferrara, Ferrara, Italy.
| | - Dorella Scarponi
- Pediatric Unit - Department of Medical and Surgical Sciences, S. Orsola Malpighi Hospital, University of Bologna, Pad. 16, Via Massarenti, 11 - 40138, Bologna, Italy.
| | - Ingrid Wielander
- Department of Pediatrics, Central Hospital of Bolzano, Bolzano, Italy.
| | - Lawrence F Eichenfield
- Departments of Pediatrics and Dermatology, School of Medicine, University of California, San Diego, CA, USA.
| |
Collapse
|
26
|
Contact dermatitis to topical medicaments: A retrospective study from a medical center in Taiwan. DERMATOL SIN 2015. [DOI: 10.1016/j.dsi.2015.02.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
27
|
Abstract
Fragrances are a common cause of allergic contact dermatitis in Europe and in North America. They can affect individuals at any age and elicit a spectrum of reactions from contact urticaria to systemic contact dermatitis. Growing recognition of the widespread use of fragrances in modern society has fueled attempts to prevent sensitization through improved allergen identification, labeling, and consumer education. This review provides an overview and update on fragrance allergy. Part 1 discusses the epidemiology and evaluation of suspected fragrance allergy. Part 2 reviews screening methods, emerging fragrance allergens, and management of patients with fragrance contact allergy. This review concludes by examining recent legislation on fragrances and suggesting potential additions to screening series to help prevent and detect fragrance allergy.
Collapse
|
28
|
|
29
|
Al-Nuaimi Y, Sherratt MJ, Griffiths CEM. Skin health in older age. Maturitas 2014; 79:256-64. [PMID: 25213594 DOI: 10.1016/j.maturitas.2014.08.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2014] [Accepted: 08/08/2014] [Indexed: 01/09/2023]
Abstract
As people age, their skin undergoes changes which result in reduced elasticity, increased fragility and an altered immune response; in essence it becomes frail. As life expectancy is increasing the health of older skin is becoming a progressively more important facet of overall care. In addition to the consequences of ageing for otherwise healthy skin, the relative incidence of some dermatological conditions is age-dependent. In particular, xerosis (dry skin), cutaneous malignancies and skin injuries are more common in older people. In this review we describe the functional consequences of skin ageing and discuss the current evidence on how skin health may be maintained and dermatological conditions prevented in an ageing population. The future of dermatological health-care provision in the older population relies on the development of coordinated pathways of care, which start from a young age. Better quality research coordinated by the establishment of institutions dealing with skin health and ageing would be a method of addressing these needs.
Collapse
Affiliation(s)
- Yusur Al-Nuaimi
- Manchester Academic Health Sciences Centre, The University of Manchester, Manchester M13 9PT, UK; The Dermatology Centre, Barnes Building, Salford Royal NHS Foundation Trust M6 8HD, UK.
| | - Michael J Sherratt
- Manchester Academic Health Sciences Centre, The University of Manchester, Manchester M13 9PT, UK; School of Biomedicine, The University of Manchester, Manchester M13 9PT, UK
| | - Christopher E M Griffiths
- Manchester Academic Health Sciences Centre, The University of Manchester, Manchester M13 9PT, UK; The Dermatology Centre, Barnes Building, Salford Royal NHS Foundation Trust M6 8HD, UK
| |
Collapse
|
30
|
Sánchez-Borges M, Thong B, Blanca M, Ensina LFC, González-Díaz S, Greenberger PA, Jares E, Jee YK, Kase-Tanno L, Khan D, Park JW, Pichler W, Romano A, Jaén MJT. Hypersensitivity reactions to non beta-lactam antimicrobial agents, a statement of the WAO special committee on drug allergy. World Allergy Organ J 2013; 6:18. [PMID: 24175948 PMCID: PMC4446643 DOI: 10.1186/1939-4551-6-18] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 09/18/2013] [Indexed: 01/12/2023] Open
Abstract
Antibiotics are used extensively in the treatment of various infections. Consequently, they can be considered among the most important agents involved in adverse reactions to drugs, including both allergic and non-allergic drug hypersensitivity [J Allergy Clin Immunol 113:832–836, 2004]. Most studies published to date deal mainly with reactions to the beta-lactam group, and information on hypersensitivity to each of the other antimicrobial agents is scarce. The present document has been produced by the Special Committee on Drug Allergy of the World Allergy Organization to present the most relevant information on the incidence, clinical manifestations, diagnosis, possible mechanisms, and management of hypersensitivity reactions to non beta-lactam antimicrobials for use by practitioners worldwide.
Collapse
Affiliation(s)
- Mario Sánchez-Borges
- Allergy and Clinical Immunology Department, Centro Médico-Docente La Trinidad, Caracas, Venezuela.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Contact dermatitis to topical medicaments: a retrospective chart review from the Ottawa Hospital Patch Test Clinic. Dermatitis 2013; 23:210-3. [PMID: 23010827 DOI: 10.1097/der.0b013e31826e443c] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Topical medicaments are a common cause of allergic contact dermatitis. This study will evaluate the prevalence of contact allergy to a wide array of topical medicaments at the Ottawa Patch Test Clinic. OBJECTIVES The objectives of this study are to report the results of positive patch testing to topical medicaments at the Ottawa Patch Test Clinic and identify common sensitizers in topical medicaments. METHODS Patients were tested with the standard North American Contact Dermatitis screening series of 70 allergens plus supplementary allergens when indicated. A retrospective chart review of patients positive to topical medicaments between January 1, 2000, and September 30, 2010, was undertaken. RESULTS The average age of patients was 49.5 years. Thirty-four percent were atopic. Common sensitizers included topical antibiotics (58%), steroids (30%), anesthetics (6%), and antifungals (6%). Patch testing showed that 61% of patients tested positive to antibiotics, 21% to topical steroids, 17% tested positive to topical anesthetics, and 1% tested positive to topical antifungals. The most common reactions were to bacitracin (44%) and neomycin (29%). The most common steroid screener was tixocortol-17-pivalate (group A) (19%), and the most common local anesthetic was lidocaine (12%). CONCLUSIONS Topical medicaments of all kinds are common causes of allergic contact dermatitis. Those that are more readily available, in over-the-counter preparations, are the most frequent culprits.
Collapse
|
32
|
Warshaw EM, Raju SI, Fowler JF, Maibach HI, Belsito DV, Zug KA, Rietschel RL, Taylor JS, Mathias CGT, Fransway AF, DeLeo VA, Marks JG, Storrs FJ, Pratt MD, Sasseville D. Positive patch test reactions in older individuals: Retrospective analysis from the North American Contact Dermatitis Group, 1994-2008. J Am Acad Dermatol 2012; 66:229-40. [DOI: 10.1016/j.jaad.2010.12.022] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2010] [Revised: 11/26/2010] [Accepted: 12/14/2010] [Indexed: 11/28/2022]
|
33
|
Schliemann S, Geier J, Elsner P. Fragrances in topical over-the-counter medicaments - a loophole in EU legislation should be closed. Contact Dermatitis 2011; 65:367-8. [DOI: 10.1111/j.1600-0536.2011.01977.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
34
|
Zhai H, Meier-Davis SR, Cayme B, Shudo J, Maibach H. Allergic contact dermatitis: effect of age. Cutan Ocul Toxicol 2011; 31:20-5. [DOI: 10.3109/15569527.2011.595749] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
|
35
|
|
36
|
|
37
|
Abstract
Contact dermatitis is a significant health problem affecting the elderly. Impaired epidermal barrier function and delayed cutaneous recovery after insult enhances susceptibility to both irritants and allergens. Exposure to more numerous potential sensitizers and for greater durations influences the rate of allergic contact dermatitis in this population. Medical co-morbidities, including stasis dermatitis and venous ulcerations, further exacerbate this clinical picture. However, while these factors tend to increase the degree of sensitization in the elderly, waning immunity can actually decrease such a propensity. This interplay of both intrinsic and extrinsic factors makes a generalization on trends for contact dermatitis in older adults challenging. The literature has varying reports on the overall incidence of allergic contact dermatitis with advancing age. Nevertheless, it does clearly show that sensitivity to topical medicaments increases with age. Irritant contact dermatitis studies are more consistent, with less reactivity (to irritants) in older compared with younger skin. Diagnosis of both irritant and allergic contact dermatitis is based on a thorough history, complete skin examination, and comprehensive patch testing. The mainstay of therapy is avoidance of the offending chemical substances and the use of topical along with systemic therapies, depending on the severity of the condition.
Collapse
Affiliation(s)
- Amy V Prakash
- Division of Dermatology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA
| | | |
Collapse
|
38
|
Nguyen JC, Chesnut G, James WD, Saruk M. Allergic contact dermatitis caused by lanolin (wool) alcohol contained in an emollient in three postsurgical patients. J Am Acad Dermatol 2010; 62:1064-5. [DOI: 10.1016/j.jaad.2009.10.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2009] [Revised: 10/19/2009] [Accepted: 10/20/2009] [Indexed: 10/19/2022]
|
39
|
|
40
|
Nardelli A, D’Hooghe E, Drieghe J, Dooms M, Goossens A. Allergic contact dermatitis from fragrance components in specific topical pharmaceutical products in Belgium. Contact Dermatitis 2009; 60:303-13. [DOI: 10.1111/j.1600-0536.2009.01542.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
41
|
Liippo J, Lammintausta K. Positive patch test reactions to gentamicin show sensitization to aminoglycosides from topical therapies, bone cements, and from systemic medication. Contact Dermatitis 2008; 59:268-72. [DOI: 10.1111/j.1600-0536.2008.01419.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
42
|
Fairhurst DA, Shah M. Comparison of patch test results among white Europeans and patients from the Indian subcontinent living within the same community. J Eur Acad Dermatol Venereol 2008; 22:1227-31. [DOI: 10.1111/j.1468-3083.2008.02787.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
43
|
Allergic contact dermatitis to topical antibiotics: Epidemiology, responsible allergens, and management. J Am Acad Dermatol 2008; 58:1-21. [PMID: 18158924 DOI: 10.1016/j.jaad.2007.07.050] [Citation(s) in RCA: 109] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2006] [Revised: 06/12/2007] [Accepted: 07/21/2007] [Indexed: 12/20/2022]
Abstract
UNLABELLED Topical antibiotics are widely used to treat cutaneous, ocular, and otic infections. Allergic contact dermatitis to topical antibiotics is a rare but well-documented side effect, especially in at-risk populations. The purpose of this article is to review the epidemiology, responsible allergens, and management of allergic contact dermatitis to topical antibiotics. LEARNING OBJECTIVE After completing this learning activity, participants should be able to describe the epidemiology of allergic contact dermatitis related to topical antibiotics; show knowledge of the most common allergenic topical antibiotics; and understand the allergenic cross-reactivity pattern amongst topical antibiotics.
Collapse
|
44
|
Cellulitis. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2008. [DOI: 10.1097/ipc.0b013e31815c0852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
45
|
Jankićević J, Vesić S, Vukićević J, Gajić M, Adamič M, Pavlović MD. Contact sensitivity in patients with venous leg ulcers in Serbia: comparison with contact dermatitis patients and relationship to ulcer duration. Contact Dermatitis 2007; 58:32-6. [DOI: 10.1111/j.1600-0536.2007.01253.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
46
|
Current World Literature. Curr Opin Allergy Clin Immunol 2007; 7:454-5. [PMID: 17873589 DOI: 10.1097/aci.0b013e3282f0cf23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
47
|
Brasch J. ‘New’ contact allergens. Curr Opin Allergy Clin Immunol 2007; 7:409-12. [PMID: 17873580 DOI: 10.1097/aci.0b013e3282a64241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Due to the continuously changing environmental conditions, it is necessary to regularly monitor and update the spectrum of contact allergens that elicit contact dermatitis. New contact allergens and known contact allergens with currently increasing importance need to be identified for diagnostic and preventive purposes. RECENT FINDINGS Within the last few years, allergic contact allergy to a number of substances derived from plants and other materials was reported for the first time. Furthermore, it has become obvious that dyes, especially paraphenylenediamine-related dyes, and fragrances are sources of contact allergens with increasing frequency. It is likely that within these groups of substances some as yet unidentified agents are relevant allergens. SUMMARY It is an ongoing challenge for clinicians to meticulously explore the exposure of eczema patients to possible new allergens. Dyes and fragrances, in particular, are of increasing significance not only because of their known ingredients but also because of new allergenic compounds.
Collapse
Affiliation(s)
- Jochen Brasch
- Department of Dermatology, University Clinics of Schleswig-Holstein, Campus Kiel, Kiel, Germany.
| |
Collapse
|