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PubMed2000

Expression of 27 KD, 65 KD and 72/73 KD heat shock protein in atopic dermatitis: comparison with those in normal skin and contact dermatitis.

The expression of Heat Shock Protein (HPS) 72/73, HSP65 and HSP27 in skin lesions of atopic dermatitis (n = 21) was studied and compared with that in contact dermatitis (n = 18) and normal skin (n = 9). Keratinocytes in the whole epidermis expressed both HSP65 and HSP72/73 with a membranous, cytoplasmic or nuclear/perinuclear staining pattern much more intensely in atopic dermatitis than in contact dermatitis and normal subjects. In approximately half of the subjects with atopic dermatitis, infiltrating cells in the dermis expressed HSP65 and HSP72/73; this was not observed in contact dermatitis. HSP27 was expressed in the upper epidermis with a cytoplasmic or nuclear/perinuclear staining pattern in all groups. HSP27 was not expressed by infiltrating cells. A clinical evaluation of atopic dermatitis showed that more severe types of atopic dermatitis expressed more intense expression of HSP65 and HSP72/73, but not HSP27, in their skin lesions. These findings suggested that HSP65 and HSP72/73 may play roles in the pathogenesis of atopic dermatitis.

Adolescent↗
PubMed2006

Autosensitization dermatitis associated with propolis-induced allergic contact dermatitis.

Propolis is a beehive product known for its anti-inflammatory properties. With its growing use, propolis-induced contact dermatitis is increasing. While the dermatitis mostly occurs on areas directly exposed to propolis, our case presented an additional eczema at a site distant from the primary propolis-induced contact dermatitis twice in the same individual. We diagnosed it as an autosensitization dermatitis associated with propolis-induced allergic contact dermatitis.

Autoimmunity↗
PubMed1980

Allergic contact dermatitis in veterinary surgeons.

Thirty-six of 37 veterinary surgeons with incapacitating dermatitis had allergic contact dermatitis, mainly from antibiotics such as spiramycin, Penethamate BP and tylosin. Eight were sensitive to rubber materials. Twenty of 36 had positive prick or scratch tests, mainly to animal hair. The atopic sensitivities were relevant to the contact dermatitis since most of those who have them develop contact reactions from cows' hair and from obstetric work with cows. Protein contact dermatitis seems to be an important predisposing factor for the development of incapacitating allergic contact dermatitis in veterinary surgeons.

Adult↗
PubMed2005

[Chromium-induced vasculitis-like purpuric allergic contact dermatitis].

INTRODUCTION: Purpuric allergic contact dermatitis is a rare and poorly understood condition. CASE REPORT: A 27-year-old male patient with a personal history of atopic dermatitis since childhood consulted for chronic papular-purpuric rash present for 7 years. Moderate pruritus was seen. Profuse lesions were observed on the palms and soles and on the upper and lower limbs, with sparing of the trunk. These lesions consisted of purpuric papules, in some cases with crusts, forming large plaques. The clinical picture was initially suggestive of vasculitis, but this diagnosis was ruled out by histological examination and laboratory tests. Skin patch tests were evocative of chromium-induced contact dermatitis. Retrospective directed history-taking confirmed the relevance of the latter test since it revealed regular wearing of leather clothing. Lasting cure was achieved following eradication of the allergen. DISCUSSION: Reports of contact purpuric dermatitis are rare. This condition has been described principally for allergens consisting of rubber or dyes used in clothing. Our case was notable on account of the severity of the lesions, mimicking vasculitis, as well as the novelty of the incriminated allergen, chromium, found in leather garments. It underlines the value of routine skin patch tests in the event of chronic non-specific dermatitis. To our knowledge, this is the first reported case of chromium-induced purpuric allergic contact dermatitis.

Adult↗
PubMed1984

Allergic contact dermatitis in children.

Allergic contact dermatitis accounts for up to 20% of all dermatitis in childhood. The major sources of contact allergy in childhood are metals, shoes, preservatives, and plants. There is considerable variability from region to region and country to country in the prevalence and causes of contact dermatitis in childhood. We suggest that patch testing be done more frequently in evaluating dermatitis in children. Topical or systemic glucocorticosteroids and allergen avoidance are the mainstays of therapy in childhood.

Allergens↗
PubMed2000

Allergic contact dermatitis to plant extracts in patients with cosmetic dermatitis.

Cosmetic contact allergy is commonly seen in patients undergoing patch testing, with fragrance one of the most frequently implicated ingredients. Many cosmetics contain plant extracts either as a fragrance or for medicinal properties. With a vogue for natural products there is an increase in their use. We have performed a prospective study over a 2-year period looking at the prevalence of contact allergy to plants in patients diagnosed with cosmetic dermatitis. In addition, we have performed a review of the products of two popular cosmetic companies, examining product labelling and the prevalence of use of plant extracts. We suggest that patients allergic to fragrance be advised to avoid plant extracts, which are separately labelled, in their personal care products.

Adolescent↗
PubMed2002

Role of different valence states of chromium in the elicitation of allergic contact dermatitis.

Chromium, a known contact sensitizer, is present at high levels in certain detergent bars (40-50 p.p.m.) sold in India. A concern was whether chromium present in such detergent bars could sensitize users or their use lead to the elicitation of allergic contact dermatitis. Chromium present in detergent bars was analyzed for its valence state. It was found to be trivalent [Cr (III)] and not hexavalent [Cr (VI)]. An elicitation test on normal volunteers, as well as on volunteers who were sensitive to chromium, was carried out to determine the elicitation potential of chromium (III) in the bars. Of the 48 volunteers who completed the study, 30 did not show any positive response to either potassium dichromate, the positive control, or the detergent bar containing chromium (III). 18 volunteers who were identified as chromium-sensitive showed a positive response to potassium dichromate but not to the detergent bar containing trivalent chromium. This study clearly showed that the detergent bar with 40-50 p.p.m. of trivalent chromium did not elicit any allergic contact dermatitis even in individuals known to be chromium-sensitive. Hexavalent chromium (potassium dichromate) did however, elicit allergic contact dermatitis in these subjects.

Chromium↗
PubMed1992

[Toxic contact dermatitis].

Two types of irritant contact dermatitis are described: the acute and the cumulative toxic contact dermatitis. The acute contact dermatitis causes many different lesions on the skin. The most frequent irritants are acids and alkaline solutions. Chemical burns by hydrofluoric acid are the most dangerous of all injuries caused by acids and need special treatment. Cumulative toxic dermatitis is often observed on the back of the hands and forearms after exposure of several weeks or months. Repeated skin contact by harmless products can also cause cumulative toxic dermatitis. Xerodermatitis is the most frequent type of cumulative toxic dermatitis. Phototoxic reactions of the skin are not caused by immunologic factors, and they are only observed at sun-exposed areas. Drugs can cause frequently phototoxic reactions. The lesions on the UV-A-exposed skin are mainly erythema and blisters.

Acids↗
PubMedDate not supplied

Neutrophil chemiluminescence following exposure to formaldehyde in healthy subjects and in patients with contact dermatitis.

13 formaldehyde-sensitive contact dermatitis patients and 5 healthy subjects were exposed to formaldehyde (FM) at a concentration 0.5 mg/m3, in an exposure chamber for 2 hours. There was no significant decrease of the ventilatory parameters either in healthy subjects or in contact dermatitis patients following the exposure Bronchial hyperreactivity to histamine (PC20) increased in one healthy and two patients with contact dermatitis. Neutrophils were isolated from whole venous blood before the test and 30 minutes and 24 hours after the exposure. All subjects with allergic contact dermatitis had chemiluminescence higher before the FM provocation in a comparison with the healthy ones. It increased significantly 30 minutes post the exposure and was much higher 24 hours after the exposure in the comparison with the neutrophil chemiluminescence before the test.

Adult↗
PubMed2004

Impaired responses of peripheral blood mononuclear cells to nickel in patients with nickel-allergic contact dermatitis and concomitant atopic dermatitis.

BACKGROUND: Allergic contact dermatitis (ACD) is pathogenetically dependent on cell-mediated immune responses mediated by type 1 T lymphocytes. Atopic dermatitis (AD), in contrast, occurs as a result of sustained activation of type 2 subsets of T cells. Although atopic patients may become sensitized to various contact allergens, little is known about the influence of atopy on delayed-type hypersensitivity. OBJECTIVES: To investigate the in vitro responses of peripheral blood mononuclear cells (PBMC) to nickel stimulation in groups of atopic and nonatopic patients with patch test-verified nickel ACD. METHODS: Ten nonatopic patients with nickel ACD, 10 patients with nickel ACD and concomitant AD, 10 patients with AD but with no contact allergy, and 10 healthy persons participated in the study. PBMC were cultured in the presence or absence of nickel sulphate, phytohaemagglutinin (PHA) or tetanus toxoid (TT). [(3)H]thymidine incorporation was used to measure the rate of antigen-induced DNA synthesis and enzyme-linked immunosorbent assay was used to measure the production of interleukin (IL)-2 (type 1 cytokine) and IL-5 (type 2 cytokine). RESULTS: Nickel-stimulated PBMC of nickel-allergic patients with AD proliferated significantly less and secreted significantly lower amounts of IL-2 than cells of nonatopic nickel-allergic patients. IL-5 production was also lower in the former group, although the difference was nonsignificant. Moreover, neither the nickel-specific DNA synthesis nor the cytokine production by PBMC of atopic nickel-allergic patients differed significantly from those of healthy control persons and AD patients without contact allergy. Proliferative and secretory responses of PBMC to PHA or TT stimulation differed nonsignificantly between the groups. Nickel-induced IL-2 production correlated well with IL-5 production in nickel-allergic patients regardless of their atopic status. CONCLUSIONS: Our results indicate that PBMC of nickel-allergic patients with concomitant AD are characterized by impaired in vitro proliferative and secretory responses to the contact allergen nickel but not to the mitogen PHA or the recall antigen TT. The type 2 cytokine IL-5 may play a role in the development of ACD.

Adolescent↗
PubMed1997

Lymphomatoid contact dermatitis caused by nickel.

Lymphomatoid contact dermatitis is a rarely reported entity consisting of allergic contact dermatitis that resembles mycosis fungoides pathologically. Although the histopathology has been previously described, there have been no attempts to reproduce the dermatitis for pathologic evaluation. A 68-year-old woman presented with a papular rash on her neck after exposure to a nickel-containing necklace. A biopsy specimen was suspicious for mycosis fungoides. However, the dermatitis responded quickly to topical steroids and avoidance of the necklace. A patch test to nickel was positive, and a biopsy specimen from the patch test site had no findings of mycosis fungoides. Although we were able to reproduce the contact dermatitis at a distant site, the disease was dissimilar. Lymphomatoid contact dermatitis has an excellent prognosis and resolves completely simply by avoiding the offending agent.

Administration, Topical↗
PubMed2003

Quality of life in patients with allergic contact dermatitis.

BACKGROUND: Allergic contact dermatitis (ACD), a common dermatological disorder, often results in ongoing disease and disability. However, relatively little has been published quantifying the quality of life (QoL) of patients with ACD. OBJECTIVES: This study was conducted to investigate the impact of ACD on QoL and explore prognostic factors that influence outcomes. METHODS: A total of 428 subjects with ACD were, at varying times after diagnosis, mailed a QoL questionnaire modified from Skindex-16 to include an additional 5 items pertaining to occupational impact. The QoL scores were correlated with subject demographics, disease characteristics, and management techniques to ascertain factors that impact QoL in subjects with ACD. RESULTS: The response rate was 35%, with 149 subjects returning the postal survey. Responders reported being bothered most by itching, skin irritation, and persistence of the condition. Of the four scales included in the QoL questionnaire, the emotions scale had the worst composite QoL score, followed by symptoms, functioning, and occupational impact. Patients with ACD of the face were significantly more bothered by the appearance of their skin. Hand involvement and occupationally related ACD were associated with worse QoL scores within the occupational impact and functioning scales. Subjects that had changed jobs because of ACD had more severe QoL impairment than any other group analyzed, with significantly worse scores on 17 of the 21 QoL items. A history of atopic eczema seemed to impart improved outcomes on patients with ACD, and these subjects were less worried about being fired from their jobs. Subjects diagnosed by patch testing more than 36 months after disease onset seemed to have worse QoL scores than those diagnosed earlier in the natural history of the disease. Patients diagnosed by patch testing within the last 6 months had the worst QoL scores, while the best outcomes were reported in subjects patch tested 6 to 12 months ago. A slight decline in QoL was observed 12 months after patch testing, but scores did not diminish back to the level seen immediately after diagnosis. CONCLUSIONS: ACD has an appreciable effect on QoL, especially when it affects the hands, the face, or is occupationally related. Of the four scales included in our study, the emotions scale suffered the greatest effect. Emotional impact is therefore an important measure of QoL in ACD patients. Outcomes in patients with ACD were improved by early diagnosis and subjects enjoyed their best QoL at 6 to 12 months after patch testing. However, individuals who elected to change jobs because of their skin condition reported significantly worse QoL than those who retained their current positions.

Adult↗
PubMed2002

Vascular endothelium express CS-1 fibronectin in allergic contact dermatitis.

BACKGROUND: Allergic contact dermatitis (ACD) is a common human dermatosis in which not all the mechanisms involved in its pathogenesis have been elucidated. OBJECTIVE: To study the expression of CS-1 fibronectin, TARC and Th1-associated chemokine receptors in biopsies from allergic patch test reactions. MATERIAL AND METHODS: Thirteen patients already diagnosed with ACD were challenged on the back with the antigen responsible of the disease and macroscopic responses and biopsies taken after 48 h. Skin biopsies from negative control challenge sites, AD and ICD were also taken. Samples were fixed, embedded in paraffin wax and processed in order to perform histological and immunohistochemical studies. RESULTS: All subjects with ACD showed a positive clinical response and a perivascular mononuclear cell infiltration at 48 h, which was not seen in the negative controls. The majority of skin-infiltrating cells were CD4+ and CD8+ and up to 54% or 40% of them expressed CXCR3 or CCR5, respectively. We also showed expression of CS-1 fibronectin in inflamed endothelial cells not only in ACD but also in AC and ICD. In contrast TARC was only expressed in ACD and AC. CONCLUSION: We showed for the first time that CS-1 fibronectin is expressed in dermal vessels from allergic patch tests positive reactions, as well as irritant and atopic skin lesions.

Adolescent↗
PubMed1999

Contact dermatitis II. Clinical aspects and diagnosis.

Contact dermatitis (CD) is an altered state of skin reactivity induced by exposure to an external agent. "Eczema" and "dermatitis" are often used synonymously to denote a polymorphic pattern of inflammation of the skin characterized, at least in its acute phase, by erythema, vesiculation and pruritus. Substances that induce CD after single or multiple exposures may be irritant or allergic in nature. The clinical presentation may vary depending on the identity of the triggering agent and the reactivity of the subject, but in all cases the lesions are primarily confined to the site of contact. According to the mechanism of elicitation, the following types of contact reactions may be distinguished: (1) allergic contact dermatitis (ACD); (2) irritant contact dermatitis (ICD); (3) phototoxic and photoallergic contact dermatitis, and (4) immediate type contact reactions. The present review will focus on allergic contact dermatitis. ACD is the clinical presentation of contact sensitivity in humans. The pathophysiology of the contact sensitivity reaction has been reviewed in a preceding issue of this journal [1].

Dermatitis, Allergic Contact↗
PubMed1999

Screening patch tests for pigmented contact dermatitis in Israel.

Pigmented contact dermatitis has been found to be caused by fragrances, cosmetics, washing powders, azo dyes in textiles, and rubber products in selected groups of patients. The aim of this study was to run screening patch tests in an unselected group of patients with pigmented contact dermatitis (n=29) encountered in our center over a 2-year period. The test series included the European standard, cosmetics, fragrance, Scandinavian photo, and personal products. 21 patients had a positive reaction in at least 1 of the series (total, 29 reactions): 16 - standard, 3 - cosmetics, 1 fragrance, 9 photo, and 1 - personal products; 16 (55%) had relevant results. We conclude that the highest yield for screening for pigmented contact dermatitis is achieved with the standard and photo series.

Adolescent↗
PubMed1998

Contact dermatitis to foods and spices.

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.

Dermatitis, Contact↗
PubMed2000

Epidemiology of occupational contact dermatitis in a North Italian population.

Occupational contact dermatitis (OCD) is a very important skin disease both for its high frequency and for its social and economic implications. The aim of our work is to evaluate the epidemiology of occupational contact dermatitis in a north-Italian population and the possibility of a correct etiological diagnosis using the patch test standard series of GIRDCA (Italian Group of Resarch on Contact Dermatitis). We patch tested 1,565 out-patients affected by dermatitis with standard series GIRDCA and with other specific professional haptens. The manifestations were suspected of being of occupational origin by a dermatologist on the basis of clinical and anamnestic data. Of all the recorded professions we have considered only the more numerically significant: food industry, building industry, textile industry, employees, cleaners, hospital personnel, hairdressers, housewives, mechanics and metallurgists. Sixty-nine percent of contact dermatitis was found in women, the hairdressers had the greatest number of patients in the younger group (68.7% in the 11-20 years age group) and the textile industry workers in older group (100% in the 41-50 years age group). A positive allergological anamnesis emerged in 32.3% of allergic contact dermatitis. Irritant contact dermatitis (10.6%) was more frequent than allergic contact dermatitis (8.4%). The hands are the most common localization (94. 4%). The allergen with the highest frequency of positive reactions is p-phenylenediamine (25.3%). We discuss the frequency of positives to various groups of allergens in each profession and the principal means of contact. Because of the frequency of this type of occupational skin disease, we stress the importance of prevention. The standard series GIRDCA was found to be adequate for recognizing occupational contact dermatitis in most of our patients (74%).

Adolescent↗