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Roach K, Roberts J. A comprehensive summary of disease variants implicated in metal allergy. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2022; 25:279-341. [PMID: 35975293 PMCID: PMC9968405 DOI: 10.1080/10937404.2022.2104981] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Allergic disease represents one of the most prominent global public health crises of the 21st century. Although many different substances are known to produce hypersensitivity responses, metals constitute one of the major classes of allergens responsible for a disproportionately large segment of the total burden of disease associated with allergy. Some of the most prevalent forms of metal allergy - including allergic contact dermatitis - are well-recognized; however, to our knowledge, a comprehensive review of the many unique disease variants implicated in human cases of metal allergy is not available within the current scientific literature. Consequently, the main goal in composing this review was to (1) generate an up-to-date reference document containing this information to assist in the efforts of lab researchers, clinicians, regulatory toxicologists, industrial hygienists, and other scientists concerned with metal allergy and (2) identify knowledge gaps related to disease. Accordingly, an extensive review of the scientific literature was performed - from which, hundreds of publications describing cases of metal-specific allergic responses in human patients were identified, collected, and analyzed. The information obtained from these articles was then used to compile an exhaustive list of distinctive dermal/ocular, respiratory, gastrointestinal, and systemic hypersensitivity responses associated with metal allergy. Each of these disease variants is discussed briefly within this review, wherein specific metals implicated in each response type are identified, underlying immunological mechanisms are summarized, and major clinical presentations of each reaction are described.Abbreviations: ACD: allergic contact dermatitis, AHR: airway hyperreactivity, ASIA: autoimmune/ autoinflammatory syndrome induced by adjuvants, BAL: bronchoalveolar lavage, CBD: chronic beryllium disease, CTCL: cutaneous T-cell lymphoma, CTL: cytotoxic T-Lymphocyte, DRESS: drug reaction with eosinophilia and systemic symptoms, GERD: gastro-esophageal reflux disease, GI: gastrointestinal, GIP: giant cell interstitial pneumonia, GM-CSF: granulocyte macrophage-colony stimulating factor, HMLD: hard metal lung disease, HMW: high molecular weight, IBS: irritable bowel syndrome, Ig: immunoglobulin, IL: interleukin, LMW: low molecular weight, PAP: pulmonary alveolar proteinosis, PPE: personal protective equipment, PRR: pathogen recognition receptor, SLE: systemic lupus erythematosus, SNAS: systemic nickel allergy syndrome, Th: helper T-cell, UC: ulcerative colitis, UV: ultraviolet.
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Affiliation(s)
- Ka Roach
- Allergy and Clinical Immunology Branch (ACIB), National Institute of Occupational Safety and Health (NIOSH), Morgantown, WV, USA
| | - Jr Roberts
- Allergy and Clinical Immunology Branch (ACIB), National Institute of Occupational Safety and Health (NIOSH), Morgantown, WV, USA
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Subramanian M, Bera D, Theodore J, Kishore J, Srinivas A, Saggu D, Yalagudri S, Narasimhan C. Putative role of prosthetic dental implants in the development of cardiac sarcoidosis: A case-control study. SARCOIDOSIS VASCULITIS AND DIFFUSE LUNG DISEASES 2021; 38:e2021023. [PMID: 34744419 PMCID: PMC8552573 DOI: 10.36141/svdld.v38i3.110922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 05/14/2021] [Indexed: 11/30/2022]
Abstract
Background: Etiopathogenesis of cardiac sarcoidosis is poorly understood. The objective of this study is to examine a possible role of previous dental procedures on the development of cardiac sarcoidosis (CS). Methods: Clinical details of 73 patients with CS from the Granulomatous Myocarditis Registry were extracted. Data regarding clinical presentation, comorbidities, baseline electrocardiogram, echocardiogram, and 18fluorodeoxyglucose(FDG) PET-CT was extracted from the registry database. A comprehensive history of dental procedures for all patients was recorded. The two control groups comprised of 79 patients with idiopathic ventricular tachycardia and/or complete heart block (with similar clinical presentation) and 145 healthy age and sex matched patients, respectively. Results: Dental evaluation revealed that patients with CS had undergone a previous prosthetic dental implant(PI) (OR 12.4, 95% CI 4.0-38.1, p<0.001) or root canal treatment (RCT) (OR 2.43, 95% CI 1.12-5.26, p=0.025) more often than the healthy controls. The patients with CS and previous dental procedures had higher18FDG uptake in the LV myocardium (SUV max 8.6±3.3vs.5.5 ±1.8 (mean±SD), p<0.001) and mediastinal lymph nodes (9.3±4.6vs.5.4±1.7 (mean±SD), p<0.001) as compared to patients who did not undergo a dental procedure. The subset of CS patients with a previous PI or RCT had higher uptake levels in the myocardium (max SUV 9.4±3.1vs.6.7±2.0, p=0.011, number of abnormal LV Segments 10.3±3.1vs.6.5±2.8(mean±SD), p=0.008) and mediastinal lymph nodes(max SUV 10.5±4.8vs. 7.2±1.8,p=0.002) compared to those who underwent crowning or extraction. In addition, CS was diagnosed after a shorter latency period (47.3±21.0vs.81.6±25.3 months (mean±SD), p<0.001) following PI and RCT compared to other dental procedures. Conclusions: We observed a significant association between PI and RCT and the occurrence of CS. This group of patients also appear to have a more severe form of the disease.
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Affiliation(s)
- Muthiah Subramanian
- Department of Cardiac Sciences and Research, AIG Hospitals, Gachibowli, Hyderabad, India
| | - Debabrata Bera
- Department of Cardiac Sciences and Research, AIG Hospitals, Gachibowli, Hyderabad, India
| | - Jospeh Theodore
- Department of Cardiac Sciences and Research, AIG Hospitals, Gachibowli, Hyderabad, India
| | - Jugal Kishore
- Department of Rheumatology, CARE Hospital, Banjara Hills, Hyderabad, India
| | - Akula Srinivas
- Department of Dentistry/Dental surgery, CARE Hospital, Banjara Hills, Hyderabad, India
| | - Daljeet Saggu
- Department of Cardiac Sciences and Research, AIG Hospitals, Gachibowli, Hyderabad, India
| | - Sachin Yalagudri
- Department of Cardiac Sciences and Research, AIG Hospitals, Gachibowli, Hyderabad, India
| | - Calambur Narasimhan
- Department of Cardiac Sciences and Research, AIG Hospitals, Gachibowli, Hyderabad, India
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Sanajou S, Şahin G, Baydar T. Aluminium in cosmetics and personal care products. J Appl Toxicol 2021; 41:1704-1718. [PMID: 34396567 DOI: 10.1002/jat.4228] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 07/27/2021] [Accepted: 07/29/2021] [Indexed: 11/08/2022]
Abstract
Usage of inorganic ingredients like aluminium salts in cosmetics and personal care products has been a concern for producers and consumers. Although aluminium is used to treat hyperhidrosis, some worries have been raised about aluminium's role in breast cancer, breast cyst and Alzheimer's disease. The human population is exposed to aluminium from vaccines, diet, and drinking water, but the frequent use of aluminium-based cosmetics might add additional local exposure. This paper reviews literature to determine if aluminium-based products may pose potential harm to the body. The dermal absorption of aluminium is not widely understood. It is not yet known whether aluminium can travel from the skin to brain to cause Alzheimer's disease. Aluminium may cause gene instability, alter gene expression or enhance oxidative stress, but the carcinogenicity of aluminium has not been proved yet. Until now, epidemiological researches were based on oral information, which lacks consistency, and the results are conflicting. Future studies should target real-life-based long-time exposure to antiperspirants and other aluminium-containing cosmetics and personal care products.
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Affiliation(s)
- Sonia Sanajou
- Faculty of Pharmacy, Eastern Mediterranean University, Famagusta, Turkey.,Department of Toxicology, Faculty of Pharmacy, Hacettepe University, Ankara, Turkey
| | - Gönül Şahin
- Faculty of Pharmacy, Eastern Mediterranean University, Famagusta, Turkey
| | - Terken Baydar
- Department of Toxicology, Faculty of Pharmacy, Hacettepe University, Ankara, Turkey
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Presence of Antibodies Binding to Negative Elongation Factor E in Sarcoidosis. J Clin Med 2020; 9:jcm9030715. [PMID: 32155774 PMCID: PMC7141344 DOI: 10.3390/jcm9030715] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 02/28/2020] [Accepted: 03/03/2020] [Indexed: 12/19/2022] Open
Abstract
Sarcoidosis is characterized by multiorgan involvement and granulomatous inflammation. Its origin is unknown and the potential role of autoimmunity has not been sufficiently determined. We investigated the presence of autoantibodies in sarcoidosis using protein array technology. The derivation cohort consisted of patients with sarcoidosis (n = 25) and controls including autoimmune disease and blood donors (n = 246). In addition, we tested a validation cohort including pulmonary sarcoidosis patients (n = 58) and healthy controls (n = 13). Initially, sera of three patients with sarcoidosis were screened using a protein array with 28.000 proteins against controls. Thereby we identified the Negative Elongation Factor E (NELF-E) as an autoantigen. With confirmatory Enzyme-linked Immunosorbent Assay (ELISA)testing, 29/82 patients (35%) with sarcoidosis had antibodies against NELF-E of the Immunoglobulin (Ig) G type, whereas 18/253 (7%) sera of the controls were positive for NELF-E. Clinically, there was an association of the frequency of NELF-E antibody detection with lung parenchymal involvement and corresponding x-ray types. NELF-E autoantibodies are associated with sarcoidosis and should be further investigated.
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Banoei MM, Iupe I, Bazaz RD, Campos M, Vogel HJ, Winston BW, Mirsaeidi M. Metabolomic and metallomic profile differences between Veterans and Civilians with Pulmonary Sarcoidosis. Sci Rep 2019; 9:19584. [PMID: 31863066 PMCID: PMC6925242 DOI: 10.1038/s41598-019-56174-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 12/03/2019] [Indexed: 12/18/2022] Open
Abstract
Sarcoidosis is a disorder characterized by granulomatous inflammation of unclear etiology. In this study we evaluated whether veterans with sarcoidosis exhibited different plasma metabolomic and metallomic profiles compared with civilians with sarcoidosis. A case control study was performed on veteran and civilian patients with confirmed sarcoidosis. Proton nuclear magnetic resonance spectroscopy (1H NMR), hydrophilic interaction liquid chromatography mass spectrometry (HILIC-MS) and inductively coupled plasma mass spectrometry (ICP-MS) were applied to quantify metabolites and metal elements in plasma samples. Our results revealed that the veterans with sarcoidosis significantly differed from civilians, according to metabolic and metallomics profiles. Moreover, the results showed that veterans with sarcoidosis and veterans with COPD were similar to each other in metabolomics and metallomics profiles. This study suggests the important role of environmental risk factors in the development of different molecular phenotypic responses of sarcoidosis. In addition, this study suggests that sarcoidosis in veterans may be an occupational disease.
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Affiliation(s)
| | - Isabella Iupe
- Department of Medicine, University of Miami, Miami, FL, USA
| | - Reza Dowlatabadi Bazaz
- Department of Biological Science, Bio-NMR-metabolomics Research center, University of Calgary, Calgary, Canada
- Departments of Critical Care Medicine, Medicine and Biochemistry and Molecular Biology, University of Calgary, Calgary, Alberta, Canada
| | - Michael Campos
- Section of Pulmonary, Miami VA Healthcare System, Miami, FL, USA
- Division of Pulmonary and Critical Care, University of Miami, Miami, FL, USA
| | - Hans J Vogel
- Department of Biological Science, Bio-NMR-metabolomics Research center, University of Calgary, Calgary, Canada
- Departments of Critical Care Medicine, Medicine and Biochemistry and Molecular Biology, University of Calgary, Calgary, Alberta, Canada
| | - Brent W Winston
- Department of Biological Science, Bio-NMR-metabolomics Research center, University of Calgary, Calgary, Canada
- Departments of Critical Care Medicine, Medicine and Biochemistry and Molecular Biology, University of Calgary, Calgary, Alberta, Canada
| | - Mehdi Mirsaeidi
- Section of Pulmonary, Miami VA Healthcare System, Miami, FL, USA.
- Division of Pulmonary and Critical Care, University of Miami, Miami, FL, USA.
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Seok J, Choi SY, Kwon TR, Kim JH, Park KY, Li K, Kim HS, Kim BJ. Tattoo Granuloma Restricted to Red Dyes. Ann Dermatol 2017; 29:824-826. [PMID: 29200786 PMCID: PMC5705379 DOI: 10.5021/ad.2017.29.6.824] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 11/09/2016] [Accepted: 11/30/2016] [Indexed: 11/08/2022] Open
Affiliation(s)
- Joon Seok
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Sun Young Choi
- Department of Dermatology, Inje University Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Tae-Rin Kwon
- Department of Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Jong Hwan Kim
- Department of Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Kui Young Park
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Kapsok Li
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Hee Sung Kim
- Department of Pathology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Beom Joon Kim
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
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Üzmezoğlu B, Şimşek C, Gülgösteren S, Gebeşoğlu B, Sarı G, Çelik D. Sarcoidosis in iron-steel industry: mini case series. SARCOIDOSIS VASCULITIS AND DIFFUSE LUNG DISEASES 2017; 34:365-372. [PMID: 32476870 DOI: 10.36141/svdld.v34i4.6185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 07/31/2017] [Indexed: 11/02/2022]
Abstract
Sarcoidosis is a disease of unknown etiology. Despite the proposed connection between the development of sarcoidosis and exposure to environmental and toxic substances, no definitive associations could be established. Also, the role of silica and silicates in the etiology of this condition is currently unknown. Heat-treatment of silica results in the generation of tridymite and cristobalite forms and iron-steel industry represents one branch of industry in which silicone element is exposed to temperatures around 2000°C. Studies reporting on the incidence of sarcoidosis in the workers of iron-steel industry are scarce in number, and workers of this industrial branch are known to be exposed to silica in the form of cristobalite, nano-particulate silicone, metal oxides, and silicates. These substances, which have respiratory toxic properties and have been reported to be associated with autoimmune conditions, may also play a role in the pathogenesis of sarcoidosis. In our clinic, sarcoidosis was diagnosed in a total of 4 individuals, who works in the iron-steel industry. Through this report involving a series of patients with sarcoidosis, we also wanted to discuss the role of crystalline silica forms and silicates in the etiology of sarcoidosis, which is also considered to be an auto-immune condition. (Sarcoidosis Vasc Diffuse Lung Dis 2017; 34: 365-372).
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Affiliation(s)
- Bilge Üzmezoğlu
- Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Occupational Diseases Clinic, Ankara, Turkey
| | - Cebrail Şimşek
- Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Occupational Diseases Clinic, Ankara, Turkey
| | - Sevtap Gülgösteren
- Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Occupational Diseases Clinic, Ankara, Turkey
| | - Berna Gebeşoğlu
- Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Occupational Diseases Clinic, Ankara, Turkey
| | - Gülden Sarı
- Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Occupational Diseases Clinic, Ankara, Turkey
| | - Deniz Çelik
- Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Occupational Diseases Clinic, Ankara, Turkey
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Razak A, Ebinesan AD, Charalambous CP. Metal Hypersensitivity in Patients with Conventional Orthopaedic Implants. JBJS Rev 2016; 2:01874474-201402000-00001. [PMID: 27490934 DOI: 10.2106/jbjs.rvw.m.00082] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Arif Razak
- Department of Orthopaedic Surgery, Blackpool Victoria Hospital, Whinney Heys Road, Blackpool, FY3 8NR, United Kingdom
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Abstract
A large list of foreign substances may penetrate the skin and induce a foreign body granulomatous reaction. These particles can enter the skin by voluntary reasons or be caused by accidental inclusion of external substances secondary to cutaneous trauma. In these cases, foreign body granulomas are formed around such disparate substances as starch, cactus bristles, wood splinters, suture material, pencil lead, artificial hair, or insect mouthparts. The purpose of this article is to update dermatologists, pathologists, and other physicians on the most recent etiopathogenesis, clinical presentations, systemic associations, evaluation, and evidence-based management concerning foreign body granulomatous reactions of skin.
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Affiliation(s)
- Ana M Molina-Ruiz
- Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Avda. Reyes Católicos 2, Madrid 28040, Spain.
| | - Luis Requena
- Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Avda. Reyes Católicos 2, Madrid 28040, Spain
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Abstract
Sarcoidosis is a chronic multisystem disorder without any defined etiology. Cardiac sarcoidosis (CS) is detected in 2-7% of patients with sarcoidosis and more than 20% of the cases of sarcoidosis are clinically silent. Cardiac involvement in systemic sarcoidosis (SS) and isolated cardiac sarcoidosis (iCS) are associated with arrhythmia and severe heart failure (HF) and have a poor prognosis. Early diagnosis of CS and prompt initiation of corticosteroid therapy with or without other immunosuppressants is crucial. Electrocardiography, Holter monitoring, and Doppler echocardiography with speckle tracking imaging can serve as the initial steps to diagnosis of CS. Cardiac magnetic resonance (CMR) imaging and positron emission tomography (PET) are promising techniques for both diagnosis and follow-up of CS. This review discusses the main aspects of cardiac involvement in sarcoidosis.
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Affiliation(s)
- Emrah Ipek
- Department of Cardiology, Erzurum Education and Research Hospital, Erzurum, Turkey
| | - Selami Demirelli
- Department of Cardiology, Erzurum Education and Research Hospital, Erzurum, Turkey
- Address correspondence to: Dr. Selami Demirelli, Department of Cardiology, Erzurum Education and Research Hospital, Erzurum, Turkey. E-mail:
| | - Emrah Ermis
- Department of Cardiology, Erzurum Education and Research Hospital, Erzurum, Turkey
| | - Sinan Inci
- Department of Cardiology, Aksaray State Hospital, Aksaray, Turkey
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Gowring LE, Kobayashi TT, Lewin-Smith MR. Localized chrysiasis, aluminum salt deposition and dystrophic calcification a decade after gold injections. J Cutan Pathol 2015; 42:568-73. [PMID: 25950356 DOI: 10.1111/cup.12506] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2014] [Revised: 03/04/2015] [Accepted: 03/22/2015] [Indexed: 11/28/2022]
Abstract
Localized chrysiasis is rare and can occur in two settings: after localized or traumatic implantation of elemental gold or gold salts or after localized laser or light therapy in someone who has been previously exposed to systemic gold therapy. We report a unique case of localized chrysiasis with associated aluminum salt deposition and sclerosing lipogranulomas because of previous injections of aurothioglucose (Solganal®). The unique histopathologic findings seen in this case have not been previously reported.
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Affiliation(s)
- Lena E Gowring
- Department of Dermatology, San Antonio Military Medical Center, San Antonio, TX, USA
| | - Todd T Kobayashi
- Department of Dermatology, San Antonio Military Medical Center, San Antonio, TX, USA
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Abstract
: The cutaneous deposition disorders are a group of unrelated conditions characterized by the accumulation of either endogenous or exogenous substances within the skin. These cutaneous deposits are substances that are not normal constituents of the skin and are laid down usually in the dermis, but also in the subcutis, in a variety of different circumstances. There are 5 broad categories of cutaneous deposits. The first group includes calcium salts, bone, and cartilage. The second category includes the hyaline deposits that may be seen in the dermis in several metabolic disorders, such as amyloidosis, gout, porphyria, and lipoid proteinosis. The third category includes various pigments, heavy metals, and complex drug pigments. The fourth category, cutaneous implants, includes substances that are inserted into the skin for cosmetic purposes. The fifth category includes miscellaneous substances, such as oxalate crystals and fiberglass. In this article, the authors review the clinicopathologic characteristics of cutaneous deposition diseases, classify the different types of cutaneous deposits, and identify all the histopathologic features that may assist in diagnosing the origin of a cutaneous deposit.
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Nagata K, Maruyama K, Sugita S, Fukuchi U, Terada Y, Ishizuka A, Nakazawa T, Mochizuki M, Kinoshita S. Age Differences in Sarcoidosis Patients with Posterior Ocular Lesions. Ocul Immunol Inflamm 2013; 22:257-62. [DOI: 10.3109/09273948.2013.855796] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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14
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Requena L, Cerroni L, Kutzner H. Histopathologic patterns associated with external agents. Dermatol Clin 2012; 30:731-48, vii. [PMID: 23021056 DOI: 10.1016/j.det.2012.06.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
A large number of foreign substances may penetrate the skin for both voluntary and involuntary reasons. The voluntary group includes the particulate materials used in tattoos and cosmetic fillers, whereas the involuntary group is almost always caused by accidental inclusion of external substances secondary to cutaneous trauma. This article focuses on the histopathologic findings seen in cutaneous reactions to exogenous agents, with special emphasis on the microscopic morphology of the external particles in recognizing specifically the involved substance (something that is becoming increasingly important in the event of litigation).
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Affiliation(s)
- Luis Requena
- Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Avenida Reyes Católicos 2, Madrid 28040, Spain.
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Mannello F, Tonti GA, Darbre PD. Concentration of aluminium in breast cyst fluids collected from women affected by gross cystic breast disease. J Appl Toxicol 2009; 29:1-6. [DOI: 10.1002/jat.1384] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Krewski D, Yokel RA, Nieboer E, Borchelt D, Cohen J, Harry J, Kacew S, Lindsay J, Mahfouz AM, Rondeau V. Human health risk assessment for aluminium, aluminium oxide, and aluminium hydroxide. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2007; 10 Suppl 1:1-269. [PMID: 18085482 PMCID: PMC2782734 DOI: 10.1080/10937400701597766] [Citation(s) in RCA: 509] [Impact Index Per Article: 29.9] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Affiliation(s)
- Daniel Krewski
- Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
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Lamirel C, Badelon I, Gout O, Berthet K, Héran F, Laloum L, Cochereau I, Gaudric A, Bousser MG, Vignal-Clermont C. Manifestations neuro-ophtalmologiques révélatrices d’une neuro-sarcoïdose. J Fr Ophtalmol 2006; 29:241-9. [PMID: 16557167 DOI: 10.1016/s0181-5512(06)73779-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PURPOSE To describe different forms of neuro-ophthalmologic onset of sarcoidosis: clinical signs, means of diagnosis, treatment, and progression. PATIENTS AND METHODS Retrospective study of 13 patients with neuro-ophthalmologic initial onset of sarcoidosis diagnosed in three departments between 1997 and 2003. RESULTS There were ten women and three men, with a mean age of 36 years. Six patients suffered from diplopia. In three cases, the cavernous sinus was involved; the three other patients with diplopia had meningoradiculitis. Nine patients had infiltration of the anterior visual pathway: the optic nerve was involved in five cases, the chiasm in two cases, and two patients had papilledema. Two patients also had both symptoms. The dosage of the angiotensin-converting enzyme level was evaluated in 11 patients and was elevated in six cases. Nine patients underwent a lumbar puncture; the cerebrospinal fluid protein was high in seven cases. Chest radiography and CT were abnormal in nine cases of 11. Ten patients had histological proof of sarcoidosis; the three others had enough evidence to support this diagnosis. All of them were treated with systemic corticosteroids. The diplopia improved for the six patients. Among the seven patients with optic nerve or chiasmal infiltration, one recovered completely, two were partially improved, and four remained stable. CONCLUSIONS Diplopia and anterior visual pathway abnormalities can be the manifestation of initial onset of sarcoidosis; therefore this diagnosis must be kept in mind when these frequent neuro-ophthalmologic signs are encountered. Complementary exams, mainly biopsy of the involved areas with histological analysis, are needed to confirm this diagnosis. Corticosteroid treatment is generally followed by improvement, but relapses may occur.
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Affiliation(s)
- C Lamirel
- Service d'Ophtalmologie, CHU, Angers.
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Darbre PD. Aluminium, antiperspirants and breast cancer. J Inorg Biochem 2006; 99:1912-9. [PMID: 16045991 DOI: 10.1016/j.jinorgbio.2005.06.001] [Citation(s) in RCA: 141] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2005] [Revised: 05/17/2005] [Accepted: 06/01/2005] [Indexed: 12/30/2022]
Abstract
Aluminium salts are used as the active antiperspirant agent in underarm cosmetics, but the effects of widespread, long term and increasing use remain unknown, especially in relation to the breast, which is a local area of application. Clinical studies showing a disproportionately high incidence of breast cancer in the upper outer quadrant of the breast together with reports of genomic instability in outer quadrants of the breast provide supporting evidence for a role for locally applied cosmetic chemicals in the development of breast cancer. Aluminium is known to have a genotoxic profile, capable of causing both DNA alterations and epigenetic effects, and this would be consistent with a potential role in breast cancer if such effects occurred in breast cells. Oestrogen is a well established influence in breast cancer and its action, dependent on intracellular receptors which function as ligand-activated zinc finger transcription factors, suggests one possible point of interference from aluminium. Results reported here demonstrate that aluminium in the form of aluminium chloride or aluminium chlorhydrate can interfere with the function of oestrogen receptors of MCF7 human breast cancer cells both in terms of ligand binding and in terms of oestrogen-regulated reporter gene expression. This adds aluminium to the increasing list of metals capable of interfering with oestrogen action and termed metalloestrogens. Further studies are now needed to identify the molecular basis of this action, the longer term effects of aluminium exposure and whether aluminium can cause aberrations to other signalling pathways in breast cells. Given the wide exposure of the human population to antiperspirants, it will be important to establish dermal absorption in the local area of the breast and whether long term low level absorption could play a role in the increasing incidence of breast cancer.
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Affiliation(s)
- P D Darbre
- Division of Cell and Molecular Biology, School of Animal and Microbial Sciences, The University of Reading, P.O. Box 228, Whiteknights, Reading, RG6 6AJ, UK.
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Kelly DM, Greene CM, Meachery G, O'Mahony M, Gallagher PM, Taggart CC, O'Neill SJ, McElvaney NG. Endotoxin Up-regulates Interleukin-18. Am J Respir Crit Care Med 2005; 172:1299-307. [PMID: 16100009 DOI: 10.1164/rccm.200411-1594oc] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE AND OBJECTIVES Sarcoidosis is a granulomatous disease of unknown etiology characterized by a helper T-cell type 1-mediated process. Previously we demonstrated a role for interleukin-18 in sarcoidosis. Here we examine the regulation of interleukin-18 in this condition. METHODS Cytokine levels in sarcoid epithelial lining fluid were measured by ELISA. We examined interleukin-18 promoter activity and mRNA and protein levels in the epithelial lining fluid of individuals with active sarcoidosis, and of individuals recovered from sarcoidosis, in response to purified protein derivative of Mycobacterium tuberculosis, beryllium sulfate, zirconium sulfate, aluminum sulfate, and lipopolysaccharide. Endotoxin levels in the epithelial lining fluid of individuals with sarcoidosis, individuals recovered from sarcoidosis, and control subjects were assessed by Limulus amebocyte lysate analysis. Allele-specific polymerase chain reaction was used to genotype 94 patients with sarcoidosis and 97 control subjects for the interleukin-18 -607(A/C) polymorphism. Species-specific polymerase chain reaction identified bacterial DNA in fluid samples. RESULTS Epithelial lining fluid from active sarcoids contained elevated levels of interleukin-18, interferon-gamma, and interleukin-12 compared with recovered patients and also contained significantly higher levels of endotoxin. Depletion of endotoxin from this epithelial lining fluid reduced its effect on the human interleukin-18 promoter in vitro. There was a higher frequency of the -607C allele and -607(C/C) genotype in the sarcoidosis population compared with control subjects; however, this was not associated with a functional response to endotoxin treatment. Finally, bacterial 16S rRNA from Haemophilus influenzae and Moraxella catarrhalis was detected in sarcoid fluid samples. CONCLUSIONS The pathogenesis of sarcoidosis is propagated through the actions of a helper T-cell type 1-driven response. This study shows that gram-negative bacteria may contribute to this effect by upregulating interleukin-18 expression.
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Affiliation(s)
- Deirdre M Kelly
- Respiratory Research Division, Department of Medicine, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin 9, Ireland
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Del Rosario RN, Barr RJ, Graham BS, Kaneshiro S. Exogenous and Endogenous Cutaneous Anomalies and Curiosities. Am J Dermatopathol 2005; 27:259-67. [PMID: 15900135 DOI: 10.1097/01.dad.0000158295.17792.dc] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Exogenous and endogenous substances can produce some interesting cutaneous abnormalities. Exogenous lesions are externally introduced materials or foreign bodies. Endogenous lesions are substances that result from tissue host response to an injury or physical insult. There may be an overlap of these endogenous and exogenous lesions such that externally introduced materials can lead to peculiar tissue reactions. Pathologists should be aware of these anomalies as many of them can simulate neoplasms (ie, Monsel's reaction, polyvinylpyrrolidone disease, silica reaction) and inflammatory (ie, paraffinoma) and infectious processes (ie, Drysol(R) reaction and Lycopodium granuloma). The most interesting and important entities within each of these categories are presented with essential clinical and pathologic descriptions.
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Affiliation(s)
- Raul N Del Rosario
- Dermatopathology Laboratory, University of California Irvine, Irvine, California, USA
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22
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Abstract
As body piercing is increasingly en vogue, complications are on the rise as well. Biopsies of such lesions can impose special problems to the reviewing dermatopathologist. We present two patients who developed papulonodular lesions at the sites of ear piercings. Unexpectedly, the findings included prominent sarcoidal granuloma formation with confluent areas of fibrinoid necrosis. An infectious etiology was excluded. However, patch testing revealed contact allergy to palladium, platinum, and nickel. Interestingly, histopathologic examination of the patch test sites also demonstrated granuloma formation. These findings suggest that the lesions represent allergic contact granulomas. When confronted with this special type of tissue reaction in skin biopsies of piercing sites, the reviewing dermatopathologist should consider the possibility of an allergic reaction. Careful history and thorough diagnostic procedures, including biopsy of the patch test site can establish the diagnosis of contact allergic granuloma.
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Affiliation(s)
- Claus Casper
- Department of Dermatology, University of Cologne, Germany
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23
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Abdallah A, Sato H, Grutters JC, Veeraraghavan S, Lympany PA, Ruven HJT, van den Bosch JMM, Wells AU, du Bois RM, Welsh KI. Inhibitor kappa B-alpha (IkappaB-alpha) promoter polymorphisms in UK and Dutch sarcoidosis. Genes Immun 2003; 4:450-4. [PMID: 12944982 DOI: 10.1038/sj.gene.6364001] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The aetiology of sarcoidosis is uncertain; current thinking implicates exposure of genetically susceptible hosts to environmental factors. The nuclear factor kappa B (NF-kappaB) family of transcription factors are critical regulators of immediate transcriptional responses in inflammatory situations and immune responses. Inhibitor kappa B-alpha (IkappaB-alpha) inhibits NF-kappaB and plays a major role in controlling its activity. We investigated IkappaB-alpha promoter polymorphisms using sequence-specific primer-polymerase chain reaction, at positions -881 (A/G), -826 (C/T), and -297 (C/T) in Caucasian sarcoidosis patients (UK and Dutch [NL]), each with their own controls. Disease severity at presentation was assigned using chest radiography and pulmonary function indices. In the combined populations, the -297T allele carriage was more prevalent in patients than in controls (P=0.008). Three common haplotypes were found, of which haplotype 2 (GTT) was significantly associated with sarcoidosis in comparison with control subjects (P=0.01). Subgroup analysis revealed that the -826T allelic carriage was most prevalent in stage II disease, and more prevalent in stage III than in stage IV (P=0.01). The -826T allelic carriage did not show any association with lung function. These results indicate that the NF-kappaB activation pathway might be associated with the inflammation of sarcoidosis.
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Affiliation(s)
- A Abdallah
- Clinical Genomics Group, Royal Brompton Hospital, Imperial College, London, UK
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24
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Abstract
Although risk factors are known to include the loss of function of the susceptibility genes BRCA1/BRCA2 and lifetime exposure to oestrogen, the main causative agents in breast cancer remain unaccounted for. It has been suggested recently that underarm cosmetics might be a cause of breast cancer, because these cosmetics contain a variety of chemicals that are applied frequently to an area directly adjacent to the breast. The strongest supporting evidence comes from unexplained clinical observations showing a disproportionately high incidence of breast cancer in the upper outer quadrant of the breast, just the local area to which these cosmetics are applied. A biological basis for breast carcinogenesis could result from the ability of the various constituent chemicals to bind to DNA and to promote growth of the damaged cells. Multidisciplinary research is now needed to study the effect of long-term use of the constituent chemicals of underarm cosmetics, because if there proves to be any link between these cosmetics and breast cancer then there might be options for the prevention of breast cancer.
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Affiliation(s)
- P D Darbre
- Division of Cell and Molecular Biology, School of Animal and Microbial Sciences, University of Reading, PO Box 228, Whiteknights, Reading RG6 6AJ, UK.
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25
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Vannemreddy PSSV, Nanda A, Reddy PK, Gonzalez E. Primary cerebral sarcoid granuloma: the importance of definitive diagnosis in the high-risk patient population. Clin Neurol Neurosurg 2002; 104:289-92. [PMID: 12140090 DOI: 10.1016/s0303-8467(02)00012-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Sarcoidosis of the central nervous system has been variously reported in 5-15% of all sarcoid patients. However, presentation of sarcoidosis as an isolated 'intracranial tumor' is rare. A 35-year-old African-American woman presented with intractable headaches. Neuroimaging revealed a tumor that was suggestive of a glioma or meningioma or metastasis. The symptoms did not respond to steroids, and an open biopsy of the lesion revealed non-caseating granuloma. A thorough work-up for systemic sarcoidosis was negative. The patient remains symptom-free at a 2-year follow-up. Primary sarcoid granuloma of the brain is rare. Once systemic disease has been excluded, early tissue diagnosis is crucial. This is particularly relevant for patients in the high-risk population before considering empirical radiosurgery.
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Affiliation(s)
- Prasad S S V Vannemreddy
- Department of Neurosurgery, Louisiana State University Health Sciences Center in Shreveport, 1501 Kings Highway, PO Box 33932, Shreveport, LA 71130-3932, USA
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Greene CM, Meachery G, Taggart CC, Rooney CP, Coakley R, O'Neill SJ, McElvaney NG. Role of IL-18 in CD4+ T lymphocyte activation in sarcoidosis. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2000; 165:4718-24. [PMID: 11035116 DOI: 10.4049/jimmunol.165.8.4718] [Citation(s) in RCA: 79] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Sarcoidosis is a granulomatous disease of unknown etiology associated with the expansion of IL-2-producing activated CD4(+) T lymphocytes. A number of factors including the recently described IL-18 have been implicated in IL-2 expression in vitro. We investigated the role of IL-18 in IL-2 expression in sarcoidosis. Eighteen individuals with sarcoidosis and 15 normal controls were studied. IL-18R expression and epithelial lining fluid (ELF) concentrations of IL-18 were significantly elevated in the sarcoid group (p = 0.0143 and 0.0024, respectively). Both AP1 and NF-kappaB, transcription factors that regulate IL-2 gene expression, were activated in vivo in sarcoid pulmonary CD4(+) T lymphocytes. Transcription factor activity was not detected in pulmonary CD4(+) T lymphocytes from normal controls or from peripheral blood CD4(+) T lymphocytes from individuals with sarcoidosis, further evidence of compartmentalization of the lymphoproliferative process in this condition. We examined the effects of IL-18 on AP1 and NF-kappaB in Jurkat T cells in vitro. These effects were both time and dose dependent. Examination of transcription factor activation and IL-2 gene expression in Jurkat T cells revealed that sarcoid but not normal ELF activated AP1 and NF-kappaB, induced IL-2 gene transcription, and up-regulated IL-2 protein production. Addition of IL-18 to normal ELF also induced IL-2 mRNA accumulation, whereas correspondent depletion of IL-18 from sarcoid ELF using neutralizing Abs abrogated all of the effects. These data strongly implicate IL-18 in the pathogenesis of sarcoidosis via activation of AP1 and NF-kappaB, leading to enhanced IL-2 gene expression and IL-2 protein production and concomitant T cell activation.
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Affiliation(s)
- C M Greene
- Department of Respiratory Research, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland
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Affiliation(s)
- A K Shetty
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California, USA
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Abstract
Sarcoidosis is a chronic granulomatous disorder of unknown cause, characterized by activation of T-lymphocytes and macrophages. A Case Control Etiologic Study of Sarcoidosis (ACCESS) is a multicenter study designed to determine the etiology of sarcoidosis. The study organization includes 10 Clinical Centers, a Clinical Coordinating Center, specialized Core Laboratories, a Central Specimen Repository, and a Project Office at the National Heart, Lung, and Blood Institute. In addition to etiology, ACCESS will examine the socioeconomic status and clinical course of patients with sarcoidosis. We propose to enroll 720 newly diagnosed cases of sarcoidosis and compare them to 720 age, sex, and race matched controls and follow the first 240 cases for two years. Leads to the etiology of sarcoidosis have come from diverse sources: in clinical laboratory investigations, alveolitis has been found to precede granulomatous inflammation; in case control studies, familial aggregation has been identified; and in case reports, recurrence of granulomatous inflammation has been observed after lung transplantation. We describe the rationale for the study design based on genetic, environmental, infectious, and immune dysregulation hypotheses and the methods used for selecting controls. The cause may not prove to be a single, known exposure. Interactions of exposures with genetic predispositions would have important implications for our understanding of immune responses as well as the pathogenesis of sarcoidosis.
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Statement on sarcoidosis. Joint Statement of the American Thoracic Society (ATS), the European Respiratory Society (ERS) and the World Association of Sarcoidosis and Other Granulomatous Disorders (WASOG) adopted by the ATS Board of Directors and by the ERS Executive Committee, February 1999. Am J Respir Crit Care Med 1999; 160:736-55. [PMID: 10430755 DOI: 10.1164/ajrccm.160.2.ats4-99] [Citation(s) in RCA: 1370] [Impact Index Per Article: 54.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
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30
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Jappe U, Bonnekoh B, Gollnick H. Persistent granulomatous contact dermatitis due to palladium body-piercing ornaments. Contact Dermatitis 1999; 40:111-2. [PMID: 10048659 DOI: 10.1111/j.1600-0536.1999.tb06003.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- U Jappe
- Department of Dermatology and Venereology, Otto-von-Guericke-University of Magdeburg, Germany
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Abstract
Acne agminata is a papulo-pustular eruption typically affecting the face of young adults and characterized histologically by the presence of caseating granulomata in the dermis. We now describe two adults who developed the condition in the axillae.
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Affiliation(s)
- A J Bedlow
- Department of Dermatology, St. George's Hospital, London, UK
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Montemarano AD, Sau P, Johnson FB, James WD. Cutaneous granulomas caused by an aluminum-zirconium complex: an ingredient of antiperspirants. J Am Acad Dermatol 1997; 37:496-8. [PMID: 9308573 DOI: 10.1016/s0190-9622(97)70159-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- A D Montemarano
- Division of Communicable Diseases and Immunology, Walter Reed Army Institute of Research, Washington, D.C., USA
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Montemarano AD, Sau P, Johnson FB, James WD. Cutaneous granulomas caused by an aluminum-zirconium complex: An ingredient of antiperspirants. J Am Acad Dermatol 1997. [DOI: 10.1016/s0190-9622(18)30761-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Burch SE, Parker SA, Vann AM, Arazie JC. Measurement of 6-MV X-ray surface dose when topical agents are applied prior to external beam irradiation. Int J Radiat Oncol Biol Phys 1997; 38:447-51. [PMID: 9226334 DOI: 10.1016/s0360-3016(97)00095-3] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE Radiation therapy patients are typically warned not to apply lotions, deodorants, or powders to the skin within the treatment area because of the possible increase in surface dose due primarily to a bolus effect. This study investigates the effect of 15 products, with and without high atomic number components, on surface dose. METHODS AND MATERIALS A Markus-type parallel plate ionization chamber in a polystyrene phantom was used to measure surface doses for normal applications of the products for a small (5 x 5-cm2) and a large (25 x 25-cm2) field size. RESULTS The greatest surface dose increase for any product was 5.4% (21.8-27.2%) of the d(max) dose for the small field and 1.0% (43.6-44.6%) for the large field. Products with high-atomic-number components did not increase the surface dose relative to radiation therapy specialty products. CONCLUSION No large increase in surface dose was detected with a normal application of the products. However, the possibility exists that an increase in skin reaction may occur owing to chemical irritants in the applied product.
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Affiliation(s)
- S E Burch
- Department of Radiology, The Medical College of Georgia, Augusta 30912, USA
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35
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Affiliation(s)
- L S Newman
- Department of Medicine, National Jewish Medical and Research Center, Denver, CO 80206, USA
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