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Pires Pereira H, Silva E, Lopes JC, Carvalho JC, Todo-Bom A. Suture-Induced Allergic Contact Dermatitis to Polypropylene. Dermatitis 2024. [PMID: 38709136 DOI: 10.1089/derm.2024.0061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Affiliation(s)
- Helena Pires Pereira
- From the Allergy and Clinical Immunology Department, Coimbra University Hospital Center, Coimbra, Portugal
| | - Eduardo Silva
- Angiology and Vascular Surgery Department, Coimbra University Hospital Center, Coimbra, Portugal
| | - João Cardoso Lopes
- From the Allergy and Clinical Immunology Department, Coimbra University Hospital Center, Coimbra, Portugal
| | - Joni Costa Carvalho
- Allergy and Clinical Immunology Department, Baixo Vouga Hospital Center, Aveiro, Portugal
| | - Ana Todo-Bom
- From the Allergy and Clinical Immunology Department, Coimbra University Hospital Center, Coimbra, Portugal
- Faculty of Medicine, Coimbra University Hospital Center, Coimbra, Portugal
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Schroeder MJ, Kraft CT, Janis JE, Kraft MT. Diagnosis and Treatment of Perioperative Allergic Complications: A Practical Review. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2024; 12:e5734. [PMID: 38623441 PMCID: PMC11018239 DOI: 10.1097/gox.0000000000005734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 02/23/2024] [Indexed: 04/17/2024]
Abstract
Background Reported drug allergies are commonly encountered by surgeons and can lead to uncertainty in selecting an appropriate agent due to concerns of associated risks with related and cross-reactive drugs. This uncertainty can ultimately lead to increased infection rates. Methods A literature review was conducted in PubMed using a combination of the terms "allergy," "allergic reaction," "anaphylaxis," and "surgery," "surgical," or "operating room" for articles published within the last 10 years. Publications identified with these search terms were then filtered for review articles, sorted by "best match," and a maximum of 100 articles were manually reviewed for each combination of search terms. Results Search results yielded 46,484 articles, 676 of which were ultimately included for manual review, based on selection criteria. Specifically, articles selected for inclusion focused on surgical allergic reactions that were either related to mechanism of action, causative agent for the allergic reaction, timing of allergic reaction, or recommendations for appropriate management. Conclusions Allergic reactions can be a common occurrence in the operative room. Knowledge of likely causative agents, timing of a reaction to various agents, and appropriate management in the immediate and delayed setting can improve outcomes and safety for plastic surgery patients.
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Affiliation(s)
- Michael J. Schroeder
- From the Department of Plastic and Reconstructive Surgery, Ohio State University, Columbus, Ohio
| | | | - Jeffrey E. Janis
- From the Department of Plastic and Reconstructive Surgery, Ohio State University, Columbus, Ohio
| | - Monica T. Kraft
- Department of Otolaryngology, Division of Allergy and Immunology, Ohio State University, Columbus, Ohio
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Miller AC, Ratushny V, Cognetta AB. Rash and Poor Wound Healing After Mastectomy. JAMA 2023; 330:1092-1093. [PMID: 37642971 DOI: 10.1001/jama.2023.16367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
A patient who had recently undergone bilateral mastectomy had erythema, edema, pain, pruritus, serous fluid drainage at the incision sites, and an erythematous papulovesicular rash on the trunk and extremities. A skin swab bacterial culture result was negative, and the skin findings did not improve with antibiotics. What is the diagnosis and what would you do next?
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Affiliation(s)
- Austinn C Miller
- Dermatology Associates of Tallahassee, Tallahassee, Florida
- University of Central Florida/HCA Consortium, Tallahassee
| | - Vladimir Ratushny
- Dermatology Associates of Tallahassee, Tallahassee, Florida
- Mohs Micrographic Surgery Unit, Division of Dermatology, Florida State University College of Medicine, Tallahassee
| | - Armand B Cognetta
- Dermatology Associates of Tallahassee, Tallahassee, Florida
- University of Central Florida/HCA Consortium, Tallahassee
- Mohs Micrographic Surgery Unit, Division of Dermatology, Florida State University College of Medicine, Tallahassee
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Kahwash BM, Fonacier L. Contact Dermatitis of a Surgical Wound. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY: IN PRACTICE 2022; 10:3044-3045.e17. [DOI: 10.1016/j.jaip.2022.08.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/22/2022] [Accepted: 08/22/2022] [Indexed: 11/09/2022]
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Contact Dermatitis in the Inpatient Hospital Setting–an Updated Review of the Literature. CURRENT DERMATOLOGY REPORTS 2022. [DOI: 10.1007/s13671-022-00366-5] [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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Contact Dermatitis in the Surgical Patient: A Focus on Wound Closure Materials. Dermatitis 2022; 34:191-200. [PMID: 35481860 DOI: 10.1097/der.0000000000000860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ABSTRACT Irritant and allergic contact dermatitis from wound closure materials can occur in patients after surgical procedures. The resulting inflammation from contact dermatitis can compromise wound healing, mimic surgical site infections, and result in wound dehiscence. Components of wound closure material, such as antibiotic coatings, dyes, sterilizing compounds, or the material itself, have been implicated as contact allergens. This article provides the latest overview of the components of 3 major forms of wound closure materials-sutures, staples, and tissue adhesives-associated with contact dermatitis, discusses their cross-reactivity, and provides diagnostic and treatment guidelines.
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Kahwash BM, Schalock PC. In vivo evaluation of allergic contact dermatitis to nylon suture: A case report. Contact Dermatitis 2022; 87:116-118. [PMID: 35340057 DOI: 10.1111/cod.14116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 03/21/2022] [Accepted: 03/22/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Basil M Kahwash
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Peter C Schalock
- Department of Dermatology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
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Morss-Walton PC, Yi JZ, Gunning ME, McGee JS. Ostomy 101 for dermatologists: Managing peristomal skin diseases. Dermatol Ther 2021; 34:e15069. [PMID: 34309140 DOI: 10.1111/dth.15069] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 07/23/2021] [Indexed: 11/30/2022]
Abstract
An estimated 1 million North Americans live with ostomies, with up to 80% of ostomy patients developing stoma-related skin morbidities. While ostomy nurses are often the first line of management, dermatologists may be involved in the care of ostomy patients with complex or persistent peristomal skin complications. Therefore, an understanding of the ostomy apparatus and possible peristomal skin conditions that may arise allows dermatologists to identify skin complications early and work effectively with a multidisciplinary team. In this article, we aim to review the ostomy apparatus, discuss the differential diagnoses, and provide practical guidelines for the management of peristomal skin conditions. Pubmed, Ovid Medline, and Google Scholar were searched for relevant articles assessing peristomal skin complications and their management. Peristomal skin complications may be local (e.g., contact dermatitis, infection, fistula, and mechanical trauma) or secondary to systemic disease (e.g., inflammatory bowel disease, pyoderma gangrenosum, and psoriasis). Ensuring appropriate ostomy fit and proper use of ostomy accessory products helps to reduce effluent leakage and prevent damage to the peristomal skin. For persistent peristomal skin conditions, corticosteroid sprays, systemic therapies, and surgical interventions may be warranted.
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Affiliation(s)
| | - Julie Z Yi
- Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - Mary-Ellen Gunning
- Nursing Wound Ostomy, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Jean S McGee
- Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
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Lauriola MM, Corazza M. Allergic contact dermatitis due to a preoperative antiseptic solution. Contact Dermatitis 2021; 85:460-462. [PMID: 33942918 DOI: 10.1111/cod.13879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/29/2021] [Accepted: 04/30/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Maria Michela Lauriola
- Istituti Ospedalieri Bergamaschi, Policlinico San Marco, Dermatology Unit, Zingonia, Italy
| | - Monica Corazza
- Department of Medical Sciences, Section of Dermatology, University of Ferrara, Ferrara, Italy
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10
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Strickler AG, Shah P, Bajaj S, Mizuguchi R, Nijhawan RI, Odueyungbo M, Rossi A, Ratner D. Preventing complications in dermatologic surgery: Presurgical concerns. J Am Acad Dermatol 2021; 84:883-892. [PMID: 33497750 DOI: 10.1016/j.jaad.2020.10.099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 10/15/2020] [Accepted: 10/16/2020] [Indexed: 01/19/2023]
Abstract
Cutaneous surgery has become critical to comprehensive dermatologic care, and dermatologists must therefore be equipped to manage the risks associated with surgical procedures. Complications may occur at any point along the continuum of care, and therefore assessing, managing, and preventing risk from beginning to end becomes essential. This review focuses on preventing surgical complications pre- and postoperatively as well as during the surgical procedure.
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Affiliation(s)
- Allen G Strickler
- Department of Dermatology, Geisinger Medical Center of Geisinger Commonwealth School of Medicine, Danville, Pennsylvania; Department of Laboratory Medicine, Geisinger Medical Center of Geisinger Commonwealth School of Medicine, Danville, Pennsylvania.
| | - Payal Shah
- School of Medicine, New York University Langone Health, New York, New York
| | - Shirin Bajaj
- Department of Dermatology, New York University Langone Health, New York, New York
| | - Richard Mizuguchi
- Department of Dermatology, Mount Sinai Medical School, New York, New York
| | - Rajiv I Nijhawan
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas
| | | | - Anthony Rossi
- Weill Cornell Medical College, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Désirée Ratner
- Department of Dermatology, New York University Langone Health, New York, New York
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Abstract
BACKGROUND Both surgical personnel and patients undergoing procedures are exposed regularly to different antiseptic chemicals in various forms. Little is known about the ingredients in these antiseptics and the risk these products may provoke allergic contact dermatitis. OBJECTIVE The aim of the study was to identify and characterize common allergens in surgical scrubs and patient surgical cleansers that health care workers and surgical patients may encounter in the perioperative period. METHODS DailyMed website was searched using numerous terms for surgical disinfectants. Products used for health care worker handwashing/scrubbing or patient surgical cleansing/disinfecting were included. Each product's ingredients were recorded; those found on the 2017 American Contact Dermatitis Society (ACDS) Core Allergen Series were noted from each product. CONCLUSIONS A total of 1940 products were identified, of which 267 were included in the analysis. A total of 66.3% contained iodine, 25.8% contained chlorhexidine digluconate, and 2.6% contained chloroxylenol. Within the group analyzed, 1586 ingredients were identified. Of these, 241 were ACDS Core Series allergens. Most products contained a single ACDS allergen. There were significant differences in allergens based on product type and active ingredient, with iodine-containing products having the fewest number of allergens. The most common ACDS allergens found were cocamide diethanolamide (22.5%), fragrance (21.7%), lanolin (19.5%), propylene glycol (6.7%), alkyl glucosides (6.0%), and sorbic acid derivatives (5.6%).
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Affiliation(s)
- Jamie P Schlarbaum
- From the Park Nicollet Contact Dermatitis Clinic
- University of Minnesota Medical School
| | - Sara A Hylwa
- From the Park Nicollet Contact Dermatitis Clinic
- Department of Dermatology, University of Minnesota, Minneapolis
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Jithpratuck W, Kays D, Sriaroon P. A mysterious rash around surgical wounds. Ann Allergy Asthma Immunol 2019; 124:106-107. [PMID: 31520773 DOI: 10.1016/j.anai.2019.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 09/02/2019] [Accepted: 09/05/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Warit Jithpratuck
- Division of Allergy and Immunology, Department of Pediatrics, University of South Florida, St Petersburg, Florida
| | - David Kays
- Department of Surgery, Johns Hopkins All Children's Hospital, St Petersburg, Florida
| | - Panida Sriaroon
- Division of Allergy and Immunology, Department of Pediatrics, University of South Florida, St Petersburg, Florida.
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Dickison P, Smith SD. Biting down on the truth: A case of a delayed hypersensitivity reaction to lidocaine. Australas J Dermatol 2019; 60:66-67. [DOI: 10.1111/ajd.12864] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Philippa Dickison
- Northern Clinical School; University of Sydney; Sydney New South Wales Australia
- Department of Dermatology; Royal North Shore Hospital; St Leonards New South Wales Australia
| | - Saxon D. Smith
- Northern Clinical School; University of Sydney; Sydney New South Wales Australia
- Department of Dermatology; Royal North Shore Hospital; St Leonards New South Wales Australia
- The Dermatology and Skin Cancer Centre; Gosford New South Wales Australia
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Watts TJ, Thursfield D, Haque R. Allergic contact dermatitis caused by VenaSeal tissue adhesive. Contact Dermatitis 2019; 80:393-395. [DOI: 10.1111/cod.13206] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 12/20/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Timothy J. Watts
- Department of Adult AllergyGuy's and St Thomas’ NHS Foundation Trust London UK
| | - David Thursfield
- Department of Adult AllergyGuy's and St Thomas’ NHS Foundation Trust London UK
| | - Rubaiyat Haque
- Department of Adult AllergyGuy's and St Thomas’ NHS Foundation Trust London UK
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Schatz M, Sicherer SH, Zeiger RS. The Journal of Allergy and Clinical Immunology: In Practice 2017 Year in Review. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2018; 6:328-352. [PMID: 29397373 DOI: 10.1016/j.jaip.2017.12.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 12/19/2017] [Indexed: 12/29/2022]
Abstract
An impressive number of clinically impactful studies and reviews were published in The Journal of Allergy and Clinical Immunology: In Practice in 2017. As a service to our readers, the editors provide this Year in Review article to highlight and contextualize the advances published over the past year. We include information from articles on asthma, allergic rhinitis, rhinosinusitis, immunotherapy, atopic dermatitis, contact dermatitis, food allergy, anaphylaxis, drug hypersensitivity, urticarial/angioedema, eosinophilic disorders, and immunodeficiency. Within each topic, epidemiologic findings are presented, relevant aspects of prevention are described, and diagnostic and therapeutic advances are enumerated. Treatments discussed include behavioral therapy, allergen avoidance therapy, positive and negative effects of pharmacologic therapy, and various forms of immunologic and desensitization management. We hope this review will help readers consolidate and use this extensive and practical knowledge for the benefit of patients.
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Affiliation(s)
- Michael Schatz
- Department of Allergy, Kaiser Permanente Southern California, San Diego, Calif.
| | - Scott H Sicherer
- Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Robert S Zeiger
- Department of Allergy, Kaiser Permanente Southern California, San Diego, Calif
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