Raccoon-like periorbital leukoderma from contact with swim goggles

Chemical leukoderma induced by herbal oils

BACKGROUND

Chemical leukoderma (CL) may result from repeated exposure to specific chemical compounds such as industrial chemicals, cosmetics, and personal articles. The incidence of CL is reportedly increasing rapidly in developing countries.

OBJECTIVE

Two cases of chemical leukoderma arising out of use of herbal oils on the scalp and breasts are described.

CONCLUSION

We emphasize the importance of a detailed history regarding possible exposure to chemical agents in patients with depigmented lesions, mainly in adults.

Aquatic sports dermatoses: part 1. In the water: freshwater dermatoses

The first of this three-part series on water-related dermatoses involving the athlete will include sports occurring with the majority of time spent in the water. These sports include swimming, diving, scuba, snorkeling and water polo. Numerous authors have described dermatologic conditions commonly seen in swimmers. This series provides an updated and comprehensive review of these water dermatoses. In order to organize the vast number of skin conditions related to water exposure, we divided the skin conditions into groupings of infectious and organism-related dermatoses, irritant and allergic dermatoses and miscellaneous dermatoses. The vast majority of skin conditions involving the water athlete result from chemicals and microbes inhabiting each environment. When considering the effects of swimming on one's skin, it is also useful to differentiate between exposure to freshwater (lakes, ponds and swimming pools) and exposure to saltwater. This review will serve as a guide for dermatologists, sports medicine physicians and other medical practitioners in recognition and treatment of these conditions.

Contact dermatitis in athletes

Athletes face numerous hazards in their daily activities. An athlete's skin, in particular, endures repeated exposure to trauma, heat, moisture, and numerous allergens and chemicals. These factors combine with other unique and less well-defined genetically predisposing factors in the athlete's skin to cause both allergic contact dermatitis (ACD) and irritant contact dermatitis (ICD). As with other cases of contact dermatitis, these eruptions in athletes present as a spectrum of acute to subacute to chronic dermatitis. Recognizing the unique environmental irritants and allergens encountered by athletes is paramount to facilitate appropriate therapy and prevention. This review comprehensively examines the literature on contact dermatitis in athletes. The different types of contact dermatitis have been classified under sport-specific subheadings. Furthermore, within each subheading, both ACD and ICD types are discussed.

Severe allergic contact eyelid dermatitis caused by swimming goggles

BACKGROUND

Contact dermatitis of the eyelids is the most common cutaneous reaction that affects the eyelids. It is frequently caused by the cosmetics used on face, hair, and fingernails. Rarely, eyelid contact dermatitis can be caused by direct contact with either irritant or allergen.

OBJECTIVE

To report a case of severe eyelid dermatitis caused by swimming goggles.

METHODS

Patch skin tests were performed in duplicate using a small piece of black rubber foam padding from the swimming goggles. Allergy skin prick tests for inhalant aeroallergens were also performed.

RESULTS

The results of the patch skin tests were strongly positive. The results of allergy skin prick tests for inhalant aeroallergens were positive for both seasonal and perennial aeroallergens.

CONCLUSIONS

This case illustrates that sensitization to the black, foam rubber padding on swimming goggles can occur after long-term contact with the goggles and should be considered in the differential diagnosis of eyelid dermatitis in an appropriate setting.

Vitiligo: a manifestation of apoptosis?

Vitiligo is a common cutaneous disorder that has significant biological and social consequences for those affected. It is characterized by a loss of melanocytes from the epidermis, which results in the absence of melanin, i.e. depigmentation. There are numerous hypotheses about the etiology of vitiligo, but no data to definitively prove one theory over another. It is likely that there are numerous causes for the loss of these melanocytes. One way to approach the identification of the etiology is to determine the mechanism by which the melanocytes are destroyed. The two known mechanisms for the destruction of cells are necrosis and apoptosis. One purpose of this paper is to review the extant data that might suggest which of the two mechanisms is operative against melanocytes in patients with vitiligo. The histological data, and some laboratory data, support apoptosis, rather than necrosis, as the mechanism for removal of melanocytes. Apoptosis can be induced by a variety of factors, including immune cytokines, some environmental chemicals (for example substituted hydroquinones such as monobenzone) or other molecular mechanisms. Current therapies, such as corticosteroids and ultraviolet light, do affect apoptosis in a variety of ways. Confirmation of apoptosis as a mechanism, and identification of how apoptosis is initiated to produce vitiligo, can serve as a basis for devising medications that might stop the progression of the disorder. The problem of vitiligo would be essentially solved if there was a medication that is well tolerated in children, adults and pregnant women, and that would halt the progression of the depigmentation. The study of apoptosis, mechanisms of its induction, and the ways to block apoptosis, is one possible way to find both the causes of depigmentation and medications to prevent its progression.

Special skin symptoms seen in swimmers

Inherent in the nature of every form of athletic endeavor are certain characteristics of the sport that can potentially produce pathologic changes in the various organ systems, including the skin. Swimming is no exception. We review some of the more common dermatologic conditions likely to be encountered by swimmers in the aqueous medium of their activity. Specific suggestions for practitioners who care for these athletes, encompassing treatment plans and preventive recommendations, are elucidated.