[Skin diseases among workers engaged into copper-nickel and aluminium production in Far North]

The article covers materials obtained in study of skin diseases in workers engaged into non-ferrous metals production. The authors specified suggestions on prevention of metal allergies among major professions of metallurgy complex in Far North.

Pattern of use of skin care products in children with and without eczematous skin lesions

OBJECTIVE

To compare the pattern of use of skin care products between children with eczematous skin lesions and those without.

DESIGN

Case control study.

SETTING

Two well baby clinics at the Kenyatta National Hospital and the Mbagathi District Hospital in Nairobi.

SUBJECTS

Eighty nine infants with eczematous skin lesions and 89 age and sex matched controls without skin lesions.

MAIN OUTCOME MEASURES

Presence and severity of skin lesions related to the type of skin care products used by the child.

RESULTS

Exposure to various products was not significantly different between infants with skin lesions and those without. However, more mothers whose children had a skin rash had made a change in the type of soap and or skin cream used for their child (p<0.0001). The principal reason for changing products was skin rash in the baby and most mothers made changes away from scented baby soap products.

CONCLUSION

The study found no significant difference between the cases and controls regarding the type of skin care products used.

Clinical sequelae associated with squaric acid dibutylester topical sensitization

BACKGROUND

Squaric acid dibutylester (SADBE) is a potent topical sensitizer used in the treatment of various cutaneous conditions. Currently, there are no standardized protocols defining safe sensitization methods or treatment regimens following sensitization.

OBJECTIVE

This is a literature review of the clinical use of SADBE and a report of our experience with SADBE therapy and its potential hazards.

METHODS

SADBE was applied with a cotton swab to the forearm of 14 patients to induce contact dermatitis.

RESULTS

Ten of 14 patients (71%) had severe eczematous reactions at the site of sensitization, and 9 of 14 (64%) developed disseminated reactions.

CONCLUSION

Standard protocols delineating safe methods of sensitization and treatment with SADBE need further development.

Exposure to selected fragrance materials. A case study of fragrance-mix-positive eczema patients

The aim of the present study was to assess exposure to constituents of the fragrance mix from cosmetic products used by fragrance-mix-positive eczema patients. 23 products, which had either given a positive patch and/or use test in a total of 11 fragrance-mix-positive patients, were analyzed. In all cases, the use of these cosmetics completely or partly explained present or past episodes of eczema. Between 1 to 6 constituents of the fragrance mix were found in 22 out of 23 products. The cosmetics of all the patients sensitive to hydroxycitronellal, eugenol, cinnamic alcohol and alpha-amylcinnamic aldehyde were found to contain the respective substances. Exposure concentrations were seen to cover a large range. The content of hydroxycitronellal was, on average, 5 x higher in cosmetics from hydroxycitronellal-sensitive patients, compared to cosmetics from hydroxycitronellal-negative patients. It is concluded that exposure to constituents of the fragrance mix is common in fragrance-allergic patients with cosmetic eczema, and that the fragrance mix is a good reflection of actual exposure.

Eczematous-like drug eruption induced by synergistins

The authors report 4 cases of eczematous-like drug eruption after oral ingestion of synergistins, pristinamycin (3 cases) and virginiamycin (1 case). The lesions occurred after contact sensitization with topical virginiamycin. The clinical symptoms appeared a few hours after ingestion: a generalized maculopapular eruption, sometimes with general symptoms of anaphylactic reaction. Eczema appeared again on initial areas of contact dermatitis. There is a common allergenic group between these 2 antibiotics, which is a macrocyclic lactone. Physiopathology of this drug eruption is not clear: allergic reaction of the delayed type or anaphylactic reaction. Patients allergic to virginiamycin should be strongly cautioned against oral pristinamycin.

Suspected cutaneous drug toxicity in rheumatoid arthritis--an evaluation

Cutaneous toxicity from drugs used to treat RA is a major perceived problem. Over a 2-yr period we have prospectively reviewed 114 patients with a suspected adverse cutaneous reaction to anti-rheumatic drugs. In 71 (62%), the rash was thought to be unrelated to drug therapy. This group included 10 in whom the rash had resolved before review (usually < 1 week), 38 with a rash related to their rheumatoid disease and 23 with eruptions unrelated to either drugs or arthritis. Forty-three (38%) patients had rashes thought to be related to their drug therapy. Gold therapy (both oral and intramuscular) was implicated most frequently (31 patients). However, the majority of these (23) had a pityriasiform/discoid eczematous eruption that responded to potent topical steroids occasionally with a reduction in gold dosage. In this sample it was possible to continue drug therapy in 82% of patients with what were initially thought to be cutaneous adverse drug reactions. Careful evaluation should allow a majority of patients to continue drug therapy from which they are often gaining benefit.

Generalized eczematous skin rash possibly due to HMG-CoA reductase inhibitors

We report on 3 patients who developed a generalized eczematous skin rash under treatment with simvastatin and pravastatin for hypercholesterolemia. These drugs are 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors and suppress cholesterol synthesis in the liver. Based on experimental data from the literature that showed eczematous changes in mice treated topically with the HMG-CoA reductase inhibitor lovastatin, we suspect that the rash observed in our patients may be a consequence of skin barrier dysfunction following inhibition of cholesterol biosynthesis.