Systemic contact dermatitis medicamentosa occurring after intravesical dimethyl sulfoxide treatment for interstitial cystitis.
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OBJECTIVE: To investigate the susceptibility of trichloroethylene-induced medicamentosa like dermatitis by comparing the frequency of HLA-DMA and HLA-DMB in patients with trichloroethylene-induced medicamentosa like dermatitis and in normal controls. METHODS: The DNA of lymphocytes in 61 patients with trichloroethylene-induced medicamentosa like dermatitis and in 60 people as the normal control were abstracted by using touchdown PCR amplification of HLA-DMA and HLA-DMB. Then through restriction fragment length polymorphism (RFLP) and sequence base typing, the alleles and genotypes were confirmed. The frequency of HLA-DMA and HLA-DMB in the two groups was compared. RESULTS: The HLA-DMA*0101 allele frequency in patients with trichloroethylene-induced medicamentosa like dermatitis was significantly higher than in the control group (71.3% vs 55.0%, P < 0.05). The allele frequency of HLA-DMA*0103 was significantly higher in the patient group than in the control group (11.5% vs 3.3%, P < 0.05). The ratio of *0102 homozygotes of HLA-DMA*0102 in the patient group was significantly higher than in the control group (25.0% vs 8.2%, P < 0.05). The ratio of *0102 heterozygotes of HLA-DMB*0101 in the patient group was lower than in the control group (P < 0.05). CONCLUSION: The polymorphisms of DMA may be related to the susceptibility of the patients with trichloroethylene-induced medicamentosa like dermatitis.
OBJECTIVE: Investigate the genetic polymorphisms of aldehyde dehydrogenase (ALDH) and alcohol dehydrogenase (ADH), major enzymes involving the trichloroethylene (TCE) metabolism, associated with susceptibility to TCE-induced medicamentosa-like dermatitis. METHODS: The study included 108 patients with TCE-induced medicamentosa-like dermatitis and 145 healthy controls exposed to TCE who were engaged in the same workplace, and frequency matched by sex and age. The genotypes of ADH2, ADH3 and ALDH2 were analyzed by polymerase chain reaction-restricted fragment length polymorphism (PCR-RFLP), and distribution of genotype and odds ratio were calculated. RESULTS: There were no differences in the frequencies of genotypes of ADH2 and ADH3 between cases and exposed controls. The frequency of heterozygous ALDH2 * 1/ * 2 plus homozygous ALDH2 * 2/ * 2 in cases was significantly lower than that in exposed controls (27.8% vs 43.4%, P = 0.011), and it decreased the risk of TCE-induced medicamentosa-like dermatitis (OR = 0.50, 95% CI = 0.29-0.85). CONCLUSION: The active ALDH2 might be one of the factors influencing the individual susceptibility to TCE-induced medicamentosa-like dermatitis.
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OBJECTIVE: To investigate the clinical manifestations, complications and treatment of medicament-like dermatitis due to trichloroethylene (TCE), so as to provide basis for studying its etiology and mechanism. METHODS: Fifty patients with dermatitis due to TCE from 1997 to 2000 were analysed retrospectively. RESULTS: The occurrence of the dermatitis was not parallel to TCE exposure levels, without significant dose-effect relationship. This disease could be caused by both inhalation and skin exposure. The latency period of TCE dermatitis ranged from 5 to 66 days, and the average was 31.5 d (Medium). The major clinical manifestations included skin lesions, fever, superficial lymph node swelling and liver dysfunction. Infection was the major complication. Glucocorticoid was effective for treatment of this disease. CONCLUSION: The clinical manifestations due to TCE exposure were similar to dermatitis medicamentosa. The major clinical types of TCE dermatitis included exfoliative dermatitis and erythema multiforme. The dermatitis is considered to be mediated by delayed-type (IV) hypersensitivity. The key factors to treat this disease successfully included the use of glucocorticoid in time with sufficient dose and full course, professional skin care, active treatment to protect the liver and to avoid infection.