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Warshaw EM, Peterson MY, Atwater AR, DeKoven JG, Pratt MD, Taylor JS, Belsito DV, Silverberg JI, Reeder MJ, DeLeo VA, Houle MC, Dunnick CA, Yu J, Adler B, Mowad C, Botto NC. Patch Testing to Paraphenylenediamine: The North American Contact Dermatitis Group Experience (1994-2018). Dermatitis 2023; 34:536-546. [PMID: 37523239 DOI: 10.1089/derm.2023.0140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
Background/Objectives: Paraphenylenediamine (PPD) is an aromatic amine dye that may cause allergic contact dermatitis. This study examines the epidemiology of allergic patch test reactions to PPD. Methods: This retrospective analysis characterizes individuals tested to PPD (1% petrolatum) by the North American Contact Dermatitis Group (1994-2018). Demographics and dermatitis site(s) were compared between PPD-allergic and PPD-negative patients. PPD reactions were analyzed by reaction strength, clinical relevance, occupational relatedness, and source as well as coreactivity with structurally related compounds. Results: Of 54,917 patients tested to PPD, 3095 (5.6%) had an allergic patch test reaction. Compared with PPD-negative patients, PPD-allergic patients had significantly greater odds of age >40 years (odds ratio [OR] 1.55 [95% confidence interval; CI 1.43-1.69]) and female gender (OR 1.52 [95% CI 1.41-1.66]), but lower odds of being White (OR 0.66 [95% CI 0.60-0.71]). The most common primary anatomic sites of dermatitis were face (25.5%), hands (21.9%), and scattered/generalized pattern (15.5%). Over half (55.3%) of PPD reactions were ++ or +++ at the final reading and 60.9% were currently relevant. Common exposure sources included hair dye (73.5%) and clothing/shoes/apparel (3.9%). Occupationally related reactions occurred in 8.3%, most commonly in hairdressers/cosmetologists (72.8%). The most common coreactions were benzocaine (11.3%), N-isopropyl-N'-phenyl-p-phenylenediamine (6.7%), disperse dye mix (6.5%), and black rubber mix (5.1%). Conclusions: The 24-year percentage of allergic reactions to PPD was 5.6%. PPD allergy was associated with female gender and age >40 years. PPD allergic patients were less likely to be White. Allergic reactions were usually clinically relevant and hair dye was the most frequently identified source.
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Affiliation(s)
- Erin M Warshaw
- From the Department of Dermatology, Park Nicollet/Health Partners Health Services, Minneapolis, Minnesota, USA
- Department of Dermatology, University of Minnesota Medical School, Minneapolis, Minnesota, USA
- Department of Dermatology, Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota, USA
| | - Malina Yamashita Peterson
- From the Department of Dermatology, Park Nicollet/Health Partners Health Services, Minneapolis, Minnesota, USA
- University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Amber R Atwater
- Department of Dermatology, Duke University Medical Center, Durham, North Carolina, USA
| | - Joel G DeKoven
- Division of Dermatology, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada
| | - Melanie D Pratt
- Division of Dermatology, University of Ottawa, Ontario, Canada
| | - James S Taylor
- Department of Dermatology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Donald V Belsito
- Department of Dermatology, Columbia University Irving Medical School, New York, New York, USA
| | - Jonathan I Silverberg
- Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - Margo J Reeder
- Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Vincent A DeLeo
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Marie-Claude Houle
- Division of Dermatology, Centre Hospitalier Universitaire de Québec, Laval University, Québec, Canada
| | - Cory A Dunnick
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Jiade Yu
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Brandon Adler
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Christen Mowad
- Department of Dermatology, Geisinger Medical Center, Danville, Pennsylvania, USA
| | - Nina C Botto
- Department of Dermatology, University of California San Francisco, San Francisco, California, USA
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2
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Reeder MJ, Warshaw E, Aravamuthan S, Belsito DV, Geier J, Wilkinson M, Atwater AR, White IR, Silverberg JI, Taylor JS, Fowler JF, Maibach HI, DeKoven JG, Buhl T, Botto N, Giménez-Arnau AM, Gallo R, Mowad C, Lang CCV, DeLeo VA, Johnston G, Pratt MD, Brockow K, Adler BL, Houle MC, Dickel H, Schuttelaar MLA, Yu J, Spiewak R, Dunnick C, Filon FL, Valiukeviciene S, Uter W. Trends in the Prevalence of Methylchloroisothiazolinone/Methylisothiazolinone Contact Allergy in North America and Europe. JAMA Dermatol 2023; 159:267-274. [PMID: 36652228 PMCID: PMC9857829 DOI: 10.1001/jamadermatol.2022.5991] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Importance The common use of isothiazolinones as preservatives is a global cause of allergic contact dermatitis. Differences in allowable concentrations of methylisothiazolinone (MI) exist in Europe, Canada, and the US. Objective To compare the prevalence of positive patch test reactions to the methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) combination and MI alone in North America and Europe from 2009 to 2018. Design, Setting, and Participants This retrospective analysis of North American Contact Dermatitis Group, European Surveillance System on Contact Allergies (ESSCA), and the Information Network of Departments of Dermatology (IVDK) databases included data from patients presenting for patch testing at referral patch test clinics in North America and Europe. Exposures Patch tests to MCI/MI and MI. Main Outcomes and Measures Prevalence of allergic contact dermatitis to MCI/MI and MI. Results From 2009 to 2018, participating sites in North America and Europe patch tested a total of 226 161 individuals to MCI/MI and 118 779 to MI. In Europe, positivity to MCI/MI peaked during 2013 and 2014 at 7.6% (ESSCA) and 5.4% (IVDK) before decreasing to 4.4% (ESSCA) and 3.2% (IVDK) during 2017 and 2018. Positive reactions to MI were 5.5% (ESSCA) and 3.4% (IVDK) during 2017 and 2018. In North America, the frequency of positivity to MCI/MI increased steadily through the study period, reaching 10.8% for MCI/MI during 2017 and 2018. Positive reactions to MI were 15.0% during 2017 and 2018. Conclusions and Relevance The study results suggest that in contrast to the continued increase in North America, isothiazolinone allergy is decreasing in Europe. This trend may coincide with earlier and more stringent government regulation of MI in Europe.
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Affiliation(s)
- Margo J Reeder
- Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison
| | - Erin Warshaw
- Department of Dermatology, Park Nicollet Health Services, Minneapolis, Minnesota.,Department of Dermatology, University of Minnesota, Minneapolis.,Department of Dermatology, Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota
| | - Srikanth Aravamuthan
- Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison
| | - Donald V Belsito
- Department of Dermatology, Columbia University Irving Medical Center, New York, New York
| | - Johannes Geier
- Information Network of Departments of Dermatology, Institute at the University Medical Center Göttingen, Göttingen, Germany
| | - Mark Wilkinson
- Department of Dermatology, Leeds Teaching Hospitals National Health Service Trust, Chapel Allerton Hospital, Leeds, England
| | - Amber Reck Atwater
- Department of Dermatology, Duke University Medical Center, Durham, North Carolina
| | - Ian R White
- St John's Institute of Dermatology, Guy's Hospital, London, England
| | - Jonathan I Silverberg
- Department of Dermatology, George Washington University School of Medicine, Washington, DC.,Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - James S Taylor
- Department of Dermatology, Cleveland Clinic, Cleveland, Ohio
| | - Joseph F Fowler
- Division of Dermatology, University of Louisville, Louisville, Kentucky
| | - Howard I Maibach
- Department of Dermatology, University of California, San Francisco
| | - Joel G DeKoven
- Division of Dermatology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Timo Buhl
- Department of Dermatology, Venereology and Allergology, Georg August University, Göttingen, Germany
| | - Nina Botto
- Department of Dermatology, University of California, San Francisco
| | | | - Rosella Gallo
- Clinica Dermatologica, IRCCS-AOU San Martino-IST and Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Christen Mowad
- Division of Dermatology, Geisinger Medical Center, Danville, Pennsylvania
| | - Claudia C V Lang
- Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland
| | - Vincent A DeLeo
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles
| | - Graham Johnston
- Department of Dermatology, Leicester Royal Infirmary, Leicester, England
| | - Melanie D Pratt
- Division of Dermatology, University of Ottawa, Ottawa, Ontario, Canada
| | - Knut Brockow
- Department of Dermatology and Allergology Biederstein, Faculty of Medicine, Technical University Munich, Munich, Germany
| | - Brandon L Adler
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles
| | - Marie-Claude Houle
- Division of Dermatology, Centre Hospitalier Universitaire de Quebec, Laval University, Quebec, Quebec, Canada
| | - Heinrich Dickel
- Department of Dermatology, Venereology and Allergology, St Josef Hospital, University Medical Center, Ruhr University Bochum, Bochum, Germany
| | - Marie Louise A Schuttelaar
- Department of Dermatology, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | - JiaDe Yu
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Radoslaw Spiewak
- Department of Experimental Dermatology and Cosmetology, Jagiellonian University Medical College, Krakow, Poland
| | - Cory Dunnick
- Department of Dermatology, University of Colorado, Denver
| | - Francesca Larese Filon
- Department of Public Health, Occupational Medicine, University of Trieste, Trieste, Italy
| | - Skaidra Valiukeviciene
- Department of Skin and Venereal Diseases, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, Erlangen, Germany
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Krenitsky A, Ramsauer K, Hossler E, Mowad C. Allergic contact dermatitis following occupational exposure to various exotic and domestic woods. Contact Dermatitis 2019; 81:477-479. [DOI: 10.1111/cod.13379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 08/05/2019] [Accepted: 08/06/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Amanda Krenitsky
- Geisinger Commonwealth School of Medicine, Geisinger Scranton Pennsylvania
| | - Kelley Ramsauer
- Department of DermatologyGeisinger Medical Center Danville Pennsylvania
| | - Eric Hossler
- Department of DermatologyGeisinger Medical Center Danville Pennsylvania
| | - Christen Mowad
- Department of DermatologyGeisinger Medical Center Danville Pennsylvania
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4
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Rohr BR, Manalo IF, Mowad C. Acute hemorrhagic edema of infancy: guide to prevent misdiagnosis. Cutis 2018; 102:359-362. [PMID: 30566540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
We report the case of a 10-month-old previously healthy boy who presented with acute rash, edema, and low-grade fever in the setting of recent diarrhea. We differentiate between acute hemorrhagic edema of infancy (AHEI) and Henoch-Schönlein purpura (HSP).
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Affiliation(s)
- Bethany R Rohr
- Department of Dermatology, Geisinger Health System, Danville, Pennsylvania, USA
| | - Iviensan F Manalo
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Christen Mowad
- Department of Dermatology, Geisinger Health System, Danville, Pennsylvania, USA
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5
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Mowad C, Cohen SF, Flandry Fussell N, Martin RE, Ellison CA. Referral patterns to an osteoporosis clinic for dermatology patients undergoing prolonged corticosteroid therapy. J Am Acad Dermatol 2018; 78:591-592. [PMID: 29447676 DOI: 10.1016/j.jaad.2017.01.058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 01/26/2017] [Accepted: 01/31/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Christen Mowad
- Geisinger Medical Center, Department of Dermatology, Danville, Pennsylvania
| | - Stacy F Cohen
- Geisinger Medical Center, Department of Dermatology, Danville, Pennsylvania
| | | | - R Erin Martin
- Geisinger Medical Center, Department of Dermatology, Danville, Pennsylvania
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Kim JY, Kozlow JH, Mittal B, Moyer J, Olencki T, Rodgers P, Bichakjian C, Armstrong A, Baum C, Bordeaux JS, Brown M, Busam KJ, Eisen DB, Iyengar V, Lober C, Margolis DJ, Messina J, Miller A, Miller S, Mostow E, Mowad C, Nehal K, Schmitt-Burr K, Sekulic A, Storrs P, Teng J, Yu S, Huang C, Boyer K, Begolka WS, Alam M. Guidelines of care for the management of basal cell carcinoma. J Am Acad Dermatol 2018; 78:540-559. [DOI: 10.1016/j.jaad.2017.10.006] [Citation(s) in RCA: 192] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 10/02/2017] [Accepted: 10/02/2017] [Indexed: 01/05/2023]
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7
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Pfingstler LF, Maroon M, Mowad C. Guttate psoriasis outcomes. Cutis 2016; 97:140-144. [PMID: 26919501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Guttate psoriasis (GP) typically occurs following an acute infection such as streptococcal pharyngitis. It is thought to have a better prognosis than chronic plaque psoriasis (PP). This retrospective cohort study of 79 patients with GP aims to assess the likelihood of developing PP after the first episode of GP as well as compare clinical and laboratory data in patients with GP who do and do not develop PP.
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8
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Mowad C, Andreychik C, Murphy T. Umbilical endometriosis elucidates cause of recurrent pneumothorax. J Am Acad Dermatol 2014; 71:e79-80. [DOI: 10.1016/j.jaad.2014.02.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 02/11/2014] [Accepted: 02/18/2014] [Indexed: 11/30/2022]
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9
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Sivendran M, Mowad C. Hyperpigmented patches on shins, palms, and soles. JAMA Dermatol 2013; 149:223. [PMID: 23426481 DOI: 10.1001/2013.jamadermatol.652a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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11
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Cronin H, Mowad C, Ferringer T. Large nodular plaque on leg in the setting of chronic lymphedema--quiz case. Angiosarcoma in the setting of familial lymphedema. Arch Dermatol 2010; 146:337-342. [PMID: 20231513 DOI: 10.1001/archdermatol.2010.6-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
- Hyland Cronin
- Geisinger Medical Center, Danville, Pennsylvania, USA
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12
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Cronin H, Mowad C. Anaphylactic reaction to bacitracin ointment. Cutis 2009; 83:127-129. [PMID: 19363904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
We report a case of an 11-year-old boy who experienced an anaphylactic reaction after administration of bacitracin ointment. After falling and scraping his left elbow, bacitracin ointment was applied to the wound. Within minutes, he experienced an adverse reaction consisting of bilateral pruritus of the feet, which quickly progressed to his head; diaphoresis; nausea; vomiting; facial pallor; and hives. An epinephrine injection was administered and the boy immediately felt better. He was taken to the emergency department and given intravenous methylprednisolone sodium succinate and intravenous diphenhydramine hydrochloride. He was kept for observation, recovered well, and was discharged with prescriptions for prednisone and diphenhydramine hydrochloride. We discuss other similar cases so physicians continue to be aware of this rare yet potentially life-threatening reaction to a commonly used medication.
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Affiliation(s)
- Hyland Cronin
- Geisinger Health System, 100 N Academy Ave, MC 14-06, Danville, PA 17822, USA
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13
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Wilson M, Mowad C, Ferringer T, Miller FO, Elston D. Acquired Perforating Disorder after Exposure to Calcium Chloride in Ice-Melting Salt. Dermatitis 2008. [DOI: 10.2310/6620.2008.07079] [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: 11/18/2022]
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14
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Wilson M, Mowad C, Ferringer T, Miller OF, Elston D. Acquired perforating disorder after exposure to calcium chloride in ice-melting salt. Dermatitis 2008; 19:278-280. [PMID: 18845118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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15
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Wilson M, Mowad C. Chloroxylenol. Dermatitis 2007; 18:120-1. [PMID: 17498419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Affiliation(s)
- Morgan Wilson
- Division of Dermatology, Department of Medicine, Ohio State University, OSU Dermatology-East, 5965 East Broad Street, Suite 290 Columbus, OH 43213, USA.
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Abstract
A 76-year-old man developed progressive blanchable reticulate erythema at the implantation site of his third implantable cardioverter defibrillator (ICD). Despite reports of allergic contact dermatitis to implantable devices, extensive routine patch testing in our patient failed to identify a responsible allergen. The clinical presentation and pathologic evidence were consistent with reticular telangiectatic erythema that has been reported overlying pacemakers and, in the English literature recently, overlying ICDs in two patients. Reticular telangiectatic erythema is a benign reactive condition that is possibly due to a combination of aberrant local circulatory and physical forces such as heat, electric fields, or magnetic fields.
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Affiliation(s)
- Tammie Ferringer
- Department of Dermatology, Geisinger Medical Center, Danville, PA 17822, USA
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18
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Sceppa J, Mowad C, Elenitsas R. Crusted plaques in the axillae. Arch Dermatol 2001; 137:1241-6. [PMID: 11559228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Affiliation(s)
- J Sceppa
- University of Pennsylvania School of Medicine, Philadelphia, USA
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19
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Shapiro M, Mowad C, James WD. Contact dermatitis due to printer's ink in a milk industry employee: case report and review of the allergen paraphenylenediamine. Am J Contact Dermat 2001; 12:109-12. [PMID: 11381347 DOI: 10.1053/ajcd.2001.20200] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Paraphenylenediamine is a common cause of occupational dermatoses in hairdressers, metallurgy workers, and others. Hand dermatitis developed in an employee of a milk packaging facility. The employee's hands were exposed to milk cartons embossed with wet printer's ink on a daily basis for 2 years. The worker was evaluated through a history, physical examination, and patch testing with 50 standard allergens. Patch testing revealed a positive reaction to paraphenylenediamine. The hand dermatitis resolved once the patient instituted protective measures. The worker's reaction might represent a delayed-type hypersensitivity reaction to printer's ink that contained this agent. More likely, the inciting agent was some other ingredient of the printer's ink that cross-reacts with paraphenylenediamine.
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Affiliation(s)
- M Shapiro
- Department of Dermatology, University of Pennsylvania Medical Center, Philadelphia, USA
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20
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Mowad C. Chloroxylenol causing hand dermatitis in a plumber. Am J Contact Dermat 1998; 9:128-9. [PMID: 9601902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Chloroxylenol use has increased and is found in many over-the-counter preparations. Although not a common sensitizer, chloroxylenol's role as a contact allergen and relevance, when positive patch tests are found, is often high. Pre-patch test assessment generally does not identify chloroxylenol as a causative agent. It is increasingly found in liquid soaps particularly in industry and specifically in the health care environment. Even as a wash-off product, this allergen can be a hidden cause of allergic contact dermatitis.
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Affiliation(s)
- C Mowad
- Department of Dermatology, University of Pennsylvania, Philadelphia, PA 19104, USA
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21
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Weiss RR, Mowad C. Contact urticaria from xylene. Am J Contact Dermat 1998; 9:125-7. [PMID: 9601901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Xylene is widely used in medical technology, but there are many concerns about its safety. A 52-year-old woman, employed as a histotechnician, presented with burning, swollen hands. Patch testing and a visit to her place of work confirmed exposure and sensitivity, in the form of contact urticaria, to xylene. The use of xylene-resistant gloves resulted in clearing of the dermatitis. Establishing the diagnosis of contact urticaria from xylene allowed the patient to be cured of her dermatitis and continue working.
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Affiliation(s)
- R R Weiss
- Department of Dermatology, University of Pennsylvania Medical Center, Philadelphia, PA 19104-4283, USA
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22
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Chan EF, Mowad C. Contact dermatitis to foods and spices. Am J Contact Dermat 1998; 9:71-9. [PMID: 9601906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Cutaneous reactions to foods and spices occur in both the workplace and at home in those who grow, handle, prepare, or cook food. As spices are also used in cosmetics and perfumes other exposures are found. Several patterns have been described upon contact with food including irritant contact dermatitis, allergic contact dermatitis, contact urticaria, phototoxic contact dermatitis, and protein contact dermatitis. The purpose of this article is to review the approach to a patient suspected of having a cutaneous reaction to food or spices, as well as discuss these reactions and the allergens that cause them.
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Affiliation(s)
- E F Chan
- Department of Dermatology, University of Pennsylvania, Philadelphia, PA 19104, USA
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23
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Sollecito TP, DeRossi S, Stewart JC, Ettlin D, Mowad C. Elephantiasis nostras of the lips: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997; 84:297-300. [PMID: 9377195 DOI: 10.1016/s1079-2104(97)90347-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Elephantiasis nostras (EN) is a clinical entity that usually presents as a persistent swelling of the lower extremities. It has been related to recurrent lymphangitis of bacterial origin that causes a fibrosis and thickening of both epidermal and connective tissue. Although very rare, EN has been previously reported in the lips. This is the first case reported in the oral medicine literature that describes EN involving the lips. We describe the clinical features and a differential diagnosis of the lip lesions and a treatment protocol to which this patient has responded. A diagnosis of EN should be entertained in patients with chronically edematous, scaling lip lesions.
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Affiliation(s)
- T P Sollecito
- University of Pennsylvania School of Dental Medicine, Philadelphia, USA
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