Autosensitization dermatitis: A case of rosacea-like id reaction

Autosensitization Triggered by Neosporin Use: A Unique Phenomenon

Interface dermatitis is a type of dermatological insult to the dermo-epidermal skin junction. When this reaction causes secondary dermatosis that occurs distally on the body, it is known as autosensitization or autoeczematization. Here, we present the case of a middle-aged gentleman, with a medical history including human immunodeficiency virus, non-adherent to highly active antiretroviral therapy, initially presenting due to chronic recurring cellulitis on the left lower leg that had become progressively erythematous and tender to palpation. A few days later, he developed an intensely pruritic, papular rash on his face and chest. Following further investigation, he reported using Neosporin ointment on the leg rash prior to admission which had then caused allergic contact dermatitis. Ultimately, the patient was diagnosed with acute interface dermatitis due to Neosporin use, which led to a secondary autosensitization reaction involving his head, neck, and arms. This case illustrates the importance of thorough history taking and clinical suspicion to appropriately diagnose this phenomenon, further demonstrating the temporal association between allergic contact dermatitis and autosensitization.

Chronic Non-Healing Ulcers Associated with Atopic Inflammation: A Case Report

Chronic non-healing ulcers are the undesirable outcome of delayed wound healing influenced by many factors. It can be seen in patients with diabetes, autoimmune conditions and multiple primary skin conditions. But chronic non-healing ulcers secondary to atopic inflammation are rarely reported in the literature. In this study, we reported a case with wounds caused by the wrong tattoo and surgery, activation of atopic inflammation caused delayed wound healing and the formation of chronic non-healing ulcers. The patient’s atopic inflammation was relieved and stabilized with oral cyclosporine and topical application of halometasone cream and subsequently 0.1% tacrolimus cream, and then the chronic non-healing ulcers healed well, without recurrence at a follow-up visit 3 months later.

Id reaction and allergic contact dermatitis post-picosecond laser tattoo removal: A case report

The novel picosecond lasers have emerged as a mainstay device in laser tattoo removal alongside Q-switch lasers, considered the gold standard in the field. Here, we present a 45-year-old female who developed a severe reaction to both her treated and untreated tattoos after two picosecond laser treatments and subsequent widespread eczematous eruption. Skin biopsies revealed findings consistent with hypersensitivity to exogenous red pigment. The clinicopathologic findings were consistent with an id reaction (autoeczematization) associated with allergic contact dermatitis to tattoo pigment. This case report highlights the potential for tattoo hypersensitivity following picosecond laser treatment and the dilemma associated with tattoo removal in sensitized patients. Additional therapeutic approaches are needed to provide patients with a safe means of tattoo removal while mitigating the risk of hypersensitivity reactions.