Benzoyl peroxide contact allergy in leg ulcer patients.
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Biomedical subjects
Publications and source records attributed to M Agathos.
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Though infection with herpes simplex virus is one of the most common infections, there has not been causal topical treatment until now. Since 1973 tromantadine HCl (in the following briefly called tromantadine) has been offered as a topical virustatic agent. Only three years later, in 1976, there were the first reports of allergic contact dermatitis due to tromantadine. 19 patients with dermatitis after application of tromantadine ointment were patch-tested and in 14 of them a contact allergy to tromantadine was observed. In 119 patients who were patch-tested because of various dermatoses, tromantadine and the gel base were patch-tested additionally. Two positive reactions to the active substance and two to the gel base only were found. One of the latter patients also had a positive reaction to parabens. The results are discussed and compared with the results of other authors.
Eczema (dermatitis) of the hands of medical personnel is a common skin disease. Occupational dermatitis of the hands arises from frequent contact with irritants and sensitizing agents. Differential diagnosis in hand eczema is usually only possible from the case history. One diagnostic tool is the screening of relevant contact allergies by patch-testing. The most frequent allergen in 114 cases of eczema of the hands in medical personnel between 1976 and 1980 at the Department of Dermatology and Allergology of the Municipal Hospital Schwabing in Munich was formaldehyde in 24 instances (i.e. 21%), thiuram mix in 18 (i.e. 16%) and nickel sulfate in 15 (i.e. 13%).
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Forty patients who showed more than two positive reactions to a standard patch test series of 26 substances were retested subsequently with the allergens that had given positive responses; 13 of 151 reactions were negative in the repetition, that is, 8.6% in comparison with 42% in the investigations of Mitchell (1977) in which 38 of 90 reactions could not be reproduced. Possible causes of this difference are discussed.
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The most frequent localization of atopic dermatitis are the hands. In 1976--1979, 33% of 1696 patch tested patients in the City Hospital München-Schwabing suffered from a hand dermatitis, almost 5% from an atopic dermatitis of the hands. These figures are compared with corresponding data of other authors. Besides, criteria of diagnosis of the atopic dermatitis of the hands are discussed. A concomitant contact allergy is not rare.
In the present report the case of a toxic ulcerous contact dermatitis (cement burns) by pre-fabricated concrete is described. This can be clearly distinguished by anamnesis, findings and development from the allergic and cumulative-toxic contact dermatitis caused by cement and related substances. It is pointed out, that in the few cases of "cement burns" made known up to now, pre-fabricated concrete was always the triggering agent.