1
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Taliercio MJ, Alnabulsi RK, Uppal PA, Shaw IM, Semenza KM, Pasha MA. Metal implant allergy: A retrospective cohort analysis at a university allergy practice. Allergy Asthma Proc 2024; 45:186-194. [PMID: 38755777 DOI: 10.2500/aap.2024.45.240005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
Background: Concern of metal sensitization in pre- and postsurgical evaluation is growing, with the recent guidelines remaining the criterion standard for consideration of patch testing. Information remains scarce on surgical screening in the groups of patients who reported a history of metal sensitivity versus those with no reported history. Objective: The objective of this study was to assess the utility of patch testing in surgical candidates based on reported metal allergy history. The secondary objective was to evaluate the utility and outcomes in postsurgical patch testing. Methods: Nine hundred and thirty-one patient charts of patients with the diagnosis of "contact dermatitis" who underwent an evaluation at a single allergy clinic site between January 2013 and December 2022 were identified and reviewed as part of a retrospective chart review study. Patients were included in subgroups based on the time of patch testing and history of reported metal allergy. Results: In all, 67 patients underwent patch testing, 10 (14.9%) of whom were surgical candidates without a history of metal sensitivity, 31 (46.2%) of whom were surgical candidates with a history of metal sensitivity, and 26 (38.8%) of whom were postsurgical patients. Twenty-nine (43.3%) of patients had positive patch testing results, with only one (10%) in the presurgical group, 17 (54.8%) in the presurgical with a history of metal sensitivity, and 11 (42.3%) in the postsurgical group. Zero patients in our cohort without metal sensitivity who were undergoing the Nuss procedure had positive reactions on patch testing, whereas two of four (50%) with reported metal sensitivity who were undergoing the Nuss procedure had positive relevant metal reactions. Conclusion: Ambiguity in the utility of patch testing for surgical decision making remains, despite common utilization. Recent guidelines along with coordination of care among the surgeon, allergist, and patient remains the criterion standard of care.
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Affiliation(s)
- Mark J Taliercio
- From the Department of Internal Medicine, Albany Medical Center, Albany, New York
| | - Rawaa K Alnabulsi
- Division of Allergy and Immunology, Department of Internal Medicine, Albany Medical Center, Albany, New York
| | | | - Ian M Shaw
- Department of Pediatrics, Albany Medical Collage, Albany, New York, and
| | - Kristy M Semenza
- Department of Allergy and Immunology, Bassett Medical Center, Cooperstown, New York
| | - Muhammad A Pasha
- Division of Allergy and Immunology, Department of Internal Medicine, Albany Medical Center, Albany, New York
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2
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Paulsen E. The sesquiterpene lactone mix: A review of past, present and future aspects. Contact Dermatitis 2023; 89:434-441. [PMID: 37820718 DOI: 10.1111/cod.14419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/15/2023] [Accepted: 09/06/2023] [Indexed: 10/13/2023]
Abstract
The sesquiterpene lactones (SLs) are secondary plant metabolites, which are widespread in the Compositae/Asteraceae plant family. The first SLs were detected more than 100 years ago, and allergic contact dermatitis from Compositae has been reported since the beginning of the 1900s, but it was not until the late 1960s and early 1970s that a collaboration between dermatologists, chemists and botanists led to the detection of SLs as the main allergens of Compositae plants. In the 1980s, the SL mix, consisting of equimolar amounts of alantolactone, costunolide and dehydrocostus lactone, was developed as a screening agent for Compositae sensitisation. Today, after inclusion of SL mix in the baseline series, the mean prevalence of reactions in Europe is around 1%, and in North America 0.8%. In countries outside Europe and North America, the prevalence ranges between 0% and 10.7%. The detection rate of SL mix is lower than that of some plant extracts, and ideally, SL mix should be supplemented with a mix of SLs from locally prevalent allergenic plants. The prevalence of positive reactions to SL mix suggests continued baseline testing in most European countries, North America, New Zealand, Australia and probably some Chinese centres.
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Affiliation(s)
- Evy Paulsen
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense C, Denmark
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3
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Warshaw EM, Peterson MY, Atwater AR, DeKoven JG, Pratt MD, Taylor JS, Belsito DV, Silverberg JI, Reeder MJ, DeLeo VA, Houle MC, Dunnick CA, Yu J, Adler B, Mowad C, Botto NC. Patch Testing to Paraphenylenediamine: The North American Contact Dermatitis Group Experience (1994-2018). Dermatitis 2023; 34:536-546. [PMID: 37523239 DOI: 10.1089/derm.2023.0140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
Background/Objectives: Paraphenylenediamine (PPD) is an aromatic amine dye that may cause allergic contact dermatitis. This study examines the epidemiology of allergic patch test reactions to PPD. Methods: This retrospective analysis characterizes individuals tested to PPD (1% petrolatum) by the North American Contact Dermatitis Group (1994-2018). Demographics and dermatitis site(s) were compared between PPD-allergic and PPD-negative patients. PPD reactions were analyzed by reaction strength, clinical relevance, occupational relatedness, and source as well as coreactivity with structurally related compounds. Results: Of 54,917 patients tested to PPD, 3095 (5.6%) had an allergic patch test reaction. Compared with PPD-negative patients, PPD-allergic patients had significantly greater odds of age >40 years (odds ratio [OR] 1.55 [95% confidence interval; CI 1.43-1.69]) and female gender (OR 1.52 [95% CI 1.41-1.66]), but lower odds of being White (OR 0.66 [95% CI 0.60-0.71]). The most common primary anatomic sites of dermatitis were face (25.5%), hands (21.9%), and scattered/generalized pattern (15.5%). Over half (55.3%) of PPD reactions were ++ or +++ at the final reading and 60.9% were currently relevant. Common exposure sources included hair dye (73.5%) and clothing/shoes/apparel (3.9%). Occupationally related reactions occurred in 8.3%, most commonly in hairdressers/cosmetologists (72.8%). The most common coreactions were benzocaine (11.3%), N-isopropyl-N'-phenyl-p-phenylenediamine (6.7%), disperse dye mix (6.5%), and black rubber mix (5.1%). Conclusions: The 24-year percentage of allergic reactions to PPD was 5.6%. PPD allergy was associated with female gender and age >40 years. PPD allergic patients were less likely to be White. Allergic reactions were usually clinically relevant and hair dye was the most frequently identified source.
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Affiliation(s)
- Erin M Warshaw
- From the Department of Dermatology, Park Nicollet/Health Partners Health Services, Minneapolis, Minnesota, USA
- Department of Dermatology, University of Minnesota Medical School, Minneapolis, Minnesota, USA
- Department of Dermatology, Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota, USA
| | - Malina Yamashita Peterson
- From the Department of Dermatology, Park Nicollet/Health Partners Health Services, Minneapolis, Minnesota, USA
- University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Amber R Atwater
- Department of Dermatology, Duke University Medical Center, Durham, North Carolina, USA
| | - Joel G DeKoven
- Division of Dermatology, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada
| | - Melanie D Pratt
- Division of Dermatology, University of Ottawa, Ontario, Canada
| | - James S Taylor
- Department of Dermatology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Donald V Belsito
- Department of Dermatology, Columbia University Irving Medical School, New York, New York, USA
| | - Jonathan I Silverberg
- Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - Margo J Reeder
- Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Vincent A DeLeo
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Marie-Claude Houle
- Division of Dermatology, Centre Hospitalier Universitaire de Québec, Laval University, Québec, Canada
| | - Cory A Dunnick
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Jiade Yu
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Brandon Adler
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Christen Mowad
- Department of Dermatology, Geisinger Medical Center, Danville, Pennsylvania, USA
| | - Nina C Botto
- Department of Dermatology, University of California San Francisco, San Francisco, California, USA
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4
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Zawawi S, Yang YW, Cantwell HM, Drage LA, Youssef MJ, Yiannias JA, Davis MDP, Hall MR. Trends in Patch Testing With the Mayo Clinic Standard Series, 2017-2021. Dermatitis 2023; 34:405-412. [PMID: 37192467 DOI: 10.1089/derm.2023.0063] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Background: Patch testing to a standard series is used to identify culprit allergens in patients with contact dermatitis. The reaction rates evolve over time based on trends in cutaneous exposures by the general population. Objective: The aim of this study was to analyze the patch test results of the Mayo Clinic standard series in patients tested from 2017 to 2021. Methods: The patch test reactions of standard series allergens tested from 2017 to 2021 were retrospectively reviewed and compared with the results of our prior report from 2011 to 2015 as well as the North American Contact Dermatitis Group (NACDG) report from 2017 to 2018. Results: Of 2667 patients tested, 1683 (63.1%) had at least 1 positive reaction. The 15 allergens with the highest reaction rates were hydroperoxides of linalool 1%, nickel (II) sulfate hexahydrate, methylisothiazolinone, Myroxylon pereirae resin, hydroperoxides of linalool 0.5%, methyldibromo glutaronitrile, neomycin sulfate, cobalt (II) chloride hexahydrate, fragrance mix I, benzalkonium chloride, bacitracin, hydroperoxides of limonene, methylchloroisothiazolinone/methylisothiazolinone, p-phenylenediamine, and textile dye mix. Twelve (80%) of these allergens were also in the top 15 of the most recent NACDG report. Conclusions: Hydroperoxides of linalool and hydroperoxides of limonene are new allergens that have been added to our standard series. These are associated with high reaction rates.
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Affiliation(s)
- Suha Zawawi
- From the Department of Dermatology, Mayo Clinic Florida, Jacksonville, Florida, USA
| | - Yul W Yang
- Department of Dermatology, Mayo Clinic Arizona, Scottsdale, Florida, USA; and
| | - Hafsa M Cantwell
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Lisa A Drage
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Molly J Youssef
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota, USA
| | - James A Yiannias
- Department of Dermatology, Mayo Clinic Arizona, Scottsdale, Florida, USA; and
| | - Mark D P Davis
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Matthew R Hall
- From the Department of Dermatology, Mayo Clinic Florida, Jacksonville, Florida, USA
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5
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Multisanti CR, Riolo K, Impellitteri F, Chebbi I, Faggio C, Giannetto A. Short-term in vitro exposure of Pinctada imbricata's haemocytes to Quaternium-15: exploring physiological and cellular responses. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2023; 101:104198. [PMID: 37391050 DOI: 10.1016/j.etap.2023.104198] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 06/21/2023] [Accepted: 06/23/2023] [Indexed: 07/02/2023]
Abstract
Since the 2000s, the pearl oyster Pinctada imbricata (Röding, 1798) has become established along the transitional waterways of the "Capo Peloro Lagoon" natural reserve, where it is now abundant due to its adaptability to different hydrological, climatic, environmental, and pollution conditions. This study aims to evaluate haemocyte immune-mediated responses in vitro to quaternium-15, a common pollutant in aquatic ecosystems. Cell viability and phagocytosis activity decreased when exposed to 0.1 or 1mg/L of quaternium-15. Moreover, decreasing phagocytosis was confirmed by gene expression modulation of actin, involved in cytoskeleton rearrangement. Effects on oxidative stress-related genes were also assessed (Cat, MnSod, Zn/CuSod, GPx). The qPCR data revealed alterations in antioxidant responses through gene dose- and time-dependent modulation. This study presents insights into the physiological responses and cellular mechanisms of P. imbricata haemocytes to environmental stressors, indicating that this species is useful as a novel bioindicator for future toxicological studies.
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Affiliation(s)
- Cristiana Roberta Multisanti
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Viale Ferdinando Stagno D'Alcontres, 31, 98166 - Messina, Italy.
| | - Kristian Riolo
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Viale Ferdinando Stagno D'Alcontres, 31, 98166 - Messina, Italy.
| | - Federica Impellitteri
- Department of Veterinary Sciences, University of Messina, Viale Giovanni Palatucci snc, 98168, Messina, Italy.
| | - Imen Chebbi
- Laboratory of Biodiversity and Aquatic Ecosystems, Faculty of Science, University of Sfax, BP, 3038, Tunisia.
| | - Caterina Faggio
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Viale Ferdinando Stagno D'Alcontres, 31, 98166 - Messina, Italy.
| | - Alessia Giannetto
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Viale Ferdinando Stagno D'Alcontres, 31, 98166 - Messina, Italy.
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Diagnostic testing of eczematous dermatitis with incomplete response to dupilumab. J Am Acad Dermatol 2022; 87:692-695. [PMID: 35367296 DOI: 10.1016/j.jaad.2022.03.047] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 02/12/2022] [Accepted: 03/01/2022] [Indexed: 11/23/2022]
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DeKoven JG, DeKoven BM, Warshaw EM, Mathias CGT, Taylor JS, Sasseville D, Belsito DV, Fowler JF, Pratt MD, Zug KA, Maibach HI, DeLeo VA, Silverberg JI, Atwater AR, Reeder MJ, Holness DL. Occupational contact dermatitis: Retrospective analysis of North American Contact Dermatitis Group Data, 2001 to 2016. J Am Acad Dermatol 2021; 86:782-790. [PMID: 33753252 DOI: 10.1016/j.jaad.2021.03.042] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 03/02/2021] [Accepted: 03/06/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Patch testing is an important diagnostic tool for suspected allergic contact dermatitis (ACD) in occupational settings. OBJECTIVE Provide an overview of occupational skin disease (OSD) and an analysis of occupational ACD in North American patients undergoing patch testing between 2001and 2016. METHODS Patients with OSD were analyzed for frequency of allergic reactions to a screening series of allergens, occupational relevance, location of skin disease, and exposure sources. Demographic, occupation, and industry information were recorded. RESULTS Of 38,614 patients evaluated, 4471 (11.6%) had OSD, of whom 3150 (70.5%) had ACD. The most common occupationally related allergens included rubber accelerators, preservatives, and bisphenol A epoxy resin. Hands (75.8%), arms (30.0%), and face (15.9%) were common sites of dermatitis. The occupations most affected were service workers and machine operators. LIMITATIONS Our cohort may not reflect the general working population. CONCLUSION This study identified common occupational allergens, exposure sources, and occupations/industries at risk. This information may help the clinician evaluate and manage patients with occupational contact dermatitis.
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Affiliation(s)
- Joel G DeKoven
- Division of Occupational Medicine, Department of Medicine, St Michael's Hospital, Unity Health, University of Toronto, Toronto, Ontario, Canada.
| | - Benjamin M DeKoven
- Division of Occupational Medicine, Department of Medicine, St Michael's Hospital, Unity Health, University of Toronto, Toronto, Ontario, Canada
| | - Erin M Warshaw
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota
| | | | - James S Taylor
- Department of Dermatology, Cleveland Clinic, Cleveland, Ohio
| | - Denis Sasseville
- Division of Dermatology, Montreal General Hospital, McGill University, Montreal, Quebec, Canada
| | - Donald V Belsito
- Department of Dermatology, Columbia University Irving Medical School, New York, New York
| | - Joseph F Fowler
- Division of Dermatology, University of Louisville, Louisville, Kentucky
| | - Melanie D Pratt
- Division of Dermatology, University of Ottawa, Ottawa, Ontario, Canada
| | - Kathryn A Zug
- Department of Dermatology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | - Howard I Maibach
- Department of Dermatology, University of California San Francisco, San Francisco, California
| | - Vincent A DeLeo
- Department of Dermatology, Keck School of Medicine, Los Angeles, California
| | - Jonathan I Silverberg
- Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Amber R Atwater
- Department of Dermatology, Duke University Medical Center, Durham, North Carolina
| | - Margo J Reeder
- Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - D Linn Holness
- Division of Occupational Medicine, Department of Medicine, St Michael's Hospital, Unity Health, University of Toronto, Toronto, Ontario, Canada
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8
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Olusegun OA, Martincigh BS. Allergic contact dermatitis: a significant environmental and occupational skin disease. Int J Dermatol 2021; 60:1082-1091. [PMID: 33710640 DOI: 10.1111/ijd.15502] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 02/04/2021] [Accepted: 02/10/2021] [Indexed: 12/01/2022]
Abstract
This review article seeks to provide an overview of allergic contact dermatitis (ACD) as a significant environmental and occupational skin disease, the phases of ACD, its causes from the occupational and environmental perspectives, its detection, the effects of ACD with respect to the social, psychological, occupational, and financial perspectives, and its cure and/or prevention. Human skin is very sensitive and as the largest organ in the body, it is highly prone to direct and indirect contact with the substances from its environment. The skin reacts to these substances (xenobiotics) differently depending on the individual's tolerance level or threshold. Allergic contact dermatitis is a significant environmental and occupational skin disease that should not be ignored in our society because it can affect the quality of life of an affected individual. There are multiple causes of ACD, and these causes of ACD have been discussed from two perspectives: environmental and occupational. The effects of ACD can be psychological, social, financial, and occupational. There is need for more public enlightenment on the effects of ACD as well as a precise understanding that it is not a contagious disease so as to significantly reduce the psychological and social effects of ACD on these patients.
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Affiliation(s)
- Olufunmilayo A Olusegun
- School of Chemistry and Physics, University of KwaZulu-Natal, Westville Campus, Private Bag X54001, Durban, 4000, South Africa
| | - Bice S Martincigh
- School of Chemistry and Physics, University of KwaZulu-Natal, Westville Campus, Private Bag X54001, Durban, 4000, South Africa
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9
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Sánchez-Pujol MJ, Docampo-Simón A, Mercader P, González-Pérez R, Hervella-Garcés M, Sanz-Sánchez T, Córdoba S, Sánchez-Pérez J, Heras-Mendaza F, Giménez-Arnau AM, Gatica-Ortega ME, Pastor-Nieto MA, Zaragoza V, Carrascosa JM, García-Bravo B, Ruiz-González I, Borrego L, Sánchez-Pedreño P, de Frutos JO, Armario-Hita JC, García-Gavín J, Fernández-Redondo V, Serra E, Silvestre JF. Frequency of sensitization to the individual fragrances of fragrance mix I and II according to the factors included in the MOAHLFA index. Contact Dermatitis 2021; 84:395-406. [PMID: 33534191 DOI: 10.1111/cod.13801] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 01/05/2021] [Accepted: 01/30/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Fragrances constitute the second most frequent cause of allergic contact dermatitis in Spain. OBJECTIVES To determine the rate of sensitization to the individual fragrances of fragrance mix (FM) I and FM II for each of the demographic and clinical factors included in the MOAHLFA (male, occupational dermatitis, atopic dermatitis, hand dermatitis, leg dermatitis, facial dermatitis, age) index. METHODS We conducted a 5-year retrospective study in 23 Spanish centres. We identified the patients who had undergone patch testing with a specific fragrance series after reacting positively to fragrance markers in a baseline series. We obtained the MOAHLFA index items in this population, then calculated for each demographic and clinical factor the frequencies of sensitization to the individual fragrances of FM I and FM II. RESULTS A specific fragrance series was patch tested in 1013 patients. The most frequent allergens in men, women, children, and retired people were Evernia prunastri (16%), geraniol (16.6%), isoeugenol (17.9%), and geraniol (22.4%), respectively. Citral (20.5%) and hydroxyisohexyl 3-cyclohexene carboxaldehyde (HICC) (14.5%) were the most common allergens in occupational eczemas and were also associated with a large proportion of hand and facial dermatitis. CONCLUSIONS Frequency of sensitization to the individual fragrances of FM I and FM II varies with age, sex, affected body region, and history of occupational or atopic dermatitis.
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Affiliation(s)
- María J Sánchez-Pujol
- Department of Dermatology, Hospital General Universitario de Alicante-ISABIAL, Alicante, Spain
| | - Alexandre Docampo-Simón
- Department of Dermatology, Hospital General Universitario de Alicante-ISABIAL, Alicante, Spain
| | - Pedro Mercader
- Department of Dermatology, Hospital General Universitario Jose M Morales Meseguer, Murcia, Spain
| | | | | | | | - Susana Córdoba
- Department of Dermatology, Hospital Universitario de Fuenlabrada, Fuenlabrada, Spain
| | | | | | - Ana M Giménez-Arnau
- Department of Dermatology, Hospital del Mar, Universitat Autònoma Barcelona, Barcelona, Spain
| | | | - María A Pastor-Nieto
- Department of Dermatology, Hospital Universitario de Guadalajara, Guadalajara, Spain
| | - Violeta Zaragoza
- Department of Dermatology, Consorci Hospital Universitari de Valencia, Valencia, Spain
| | - José M Carrascosa
- Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Begoña García-Bravo
- Department of Dermatology, Hospital Universitario Virgen de la Macarena, Sevilla, Spain
| | | | - Leopoldo Borrego
- Department of Dermatology, Hospital Universitario Insular de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas, Spain
| | | | - Javier O de Frutos
- Department of Dermatology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - José C Armario-Hita
- Department of Dermatology, Hospital Universitario de Puerto Real, Cádiz, Spain
| | - Juan García-Gavín
- Department of Dermatology, Complejo Hospitalario Universitario de Vigo, Vigo, Spain
| | - Virginia Fernández-Redondo
- Department of Dermatology, Hospital Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Esther Serra
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Juan F Silvestre
- Department of Dermatology, Hospital General Universitario de Alicante-ISABIAL, Alicante, Spain
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10
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Ashraf DC, Idowu OO, Wang Q, YeEun T, Copperman TS, Tanaboonyawat S, Arnold BF, Oldenburg CE, Vagefi MR, Kersten RC. The Role of Topical Antibiotic Prophylaxis in Oculofacial Plastic Surgery: A Randomized Controlled Study. Ophthalmology 2020; 127:1747-1754. [PMID: 32698033 PMCID: PMC7686086 DOI: 10.1016/j.ophtha.2020.07.032] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 07/08/2020] [Accepted: 07/14/2020] [Indexed: 02/05/2023] Open
Abstract
PURPOSE The usefulness of topical antibiotic prophylaxis for routine oculofacial plastic surgery is not well established. Given concerns such as contact dermatitis, antibiotic resistance, and healthcare costs in conjunction with a low baseline rate of surgical site infections, the investigators sought to determine the frequency of infection with and without the use of topical antibiotic prophylaxis. DESIGN Randomized, controlled, unmasked clinical trial. PARTICIPANTS Adult patients undergoing routine periocular surgery without prior history of periocular surgical site infection, need for perioperative oral or parenteral antibiotics, or allergy to all study medications. METHODS Participants were randomized before surgery to receive either antibiotic or placebo (mineral oil and petrolatum-based) ointment after surgery. Outcomes were measured at the first postoperative visit. The 2-tailed Fisher exact test was used to compare outcomes between groups. MAIN OUTCOME MEASURES The primary outcome was the incidence of surgical site infections. The secondary outcomes included stratification of infections by patient risk characteristics, incidence of allergic contact dermatitis, and incidence of wound complications. RESULTS Four hundred one participants were enrolled and randomized, and 13 participants did not proceed with surgery or were lost to follow-up. High-risk features for infection were identified in 24% of the placebo group and 21% of the antibiotic group. Surgical site infections were more common in the placebo group (2.7% vs. 0.0%; P = 0.025). The rate of contact dermatitis was similar (0.5% vs. 0.5%; P = 1.00), as was the rate of wound dehiscence (2.7% vs. 3.5%; P = 0.77). Among the placebo group, the incidence of infections in the low- and high-risk participants was 2.9% and 2.2%, respectively. Infections were treated with oral or topical antibiotics and resolved without complication, except in 1 patient who required 2 subsequent surgeries to address the sequelae. CONCLUSIONS After routine oculofacial plastic surgery, patients treated with a topical antibiotic ointment showed a lower risk of surgical site infection compared with patients treated with a nonantibiotic ointment.
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Affiliation(s)
- Davin C Ashraf
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California.
| | - Oluwatobi O Idowu
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California
| | - Qinyun Wang
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California
| | - Tak YeEun
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California
| | - Thomas S Copperman
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California
| | - Sombat Tanaboonyawat
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California; Department of Ophthalmology, Phramongkutklao College of Medicine, Bangkok, Thailand
| | - Benjamin F Arnold
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California; Francis I. Proctor Foundation, University of California, San Francisco, San Francisco, California
| | - Catherine E Oldenburg
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California; Francis I. Proctor Foundation, University of California, San Francisco, San Francisco, California
| | - M Reza Vagefi
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California
| | - Robert C Kersten
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California
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Torfs E, Brackman G. A perspective on the safety of parabens as preservatives in wound care products. Int Wound J 2020; 18:221-232. [PMID: 33236854 PMCID: PMC8243994 DOI: 10.1111/iwj.13521] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 10/23/2020] [Accepted: 10/27/2020] [Indexed: 01/19/2023] Open
Abstract
Antimicrobial and/or preservative ingredients incorporated in wound care products are subjected to certain safety restrictions. However, several of those agents, and paraben preservatives in particular, have been criticised. Conflicting reports on the potential of parabens to induce allergic contact dermatitis, and their assumed oestrogen‐like activity, raised public health concerns about their overall safety. Here, we seek to provide a balanced perspective on the most significant purported adverse health effects, and thereby allay the many misconceptions regarding the safety of parabens. Extensive and long‐term monitoring of paraben allergy frequencies illustrate that allergic reactions are quite uncommon, especially when compared with other antimicrobial and preservative agents. The estrogenic potential of parabens was illustrated to be far less potent than that of natural oestrogen receptor ligands, and the etiological significance of their presence in human tissue has not been established. The general consensus based on investigations by both the scientific community and regulatory agencies indicates that, with current safety regulations regarding their use in place, this effective and well‐documented group of preservatives should not warrant drastic measures to replace them. As such, despite the ongoing concern, it is indicated that, when used at typical concentrations, parabens are unlikely to affect human health.
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Affiliation(s)
- Eveline Torfs
- Research and Development department, Flen Health NV, Kontich, Belgium
| | - Gilles Brackman
- Research and Development department, Flen Health NV, Kontich, Belgium
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Park J, Yang HS, Song MK, Kim DI, Lee K. Formaldehyde exposure induces regulatory T cell-mediated immunosuppression via calcineurin-NFAT signalling pathway. Sci Rep 2020; 10:17023. [PMID: 33046725 PMCID: PMC7550593 DOI: 10.1038/s41598-020-72502-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 04/15/2020] [Indexed: 11/08/2022] Open
Abstract
In this study, we investigated the effects of Formaldehyde (FA) exposure on splenic immune responses wherein helper T cells become activated and differentiate into effector T and regulatory T cells. BALB/c mice were exposed to two FA concentrations (1.38 mg/m3 and 5.36 mg/m3) for 4 h/day and 5 days/week for 2 weeks. FA-induced immune responses were examined by the production of cytokines, expression of mRNAs, and distributions of helper T cells and regulatory T cells. Moreover, expression of calcineurin and NFATs, regulatory T cell-related signalling proteins, were evaluated. FA exposure suppressed Th2-, Th1-, and Th17-related splenic cytokines in a dose-dependent manner. mRNA expression of splenic cytokines was also decreased by FA exposure, which correlated with decreased cytokine expression. In parallel, FA exposure promoted T cell differentiation into regulatory T cells in a dose-dependent manner supported by the expression of calcineurin and NFAT1. Taken together, our results indicated that FA exposure increases the number of regulatory T cells via calcineurin-NFAT signalling, thereby leading to effector T cell activity suppression with decreased T cell-related cytokine secretion and mRNA expression. These findings provide insight into the mechanisms underlying the adverse effects of FA and accordingly have general implications for human health, particularly in occupational settings.
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Affiliation(s)
- Jeongsik Park
- Jeonbuk Department of inhalation Research, National Center for Efficacy Evaluation of Respiratory Disease Products, Korea Institute of Toxicology, 30 Baehak 1-gil, Jeonguep, Jeollabuk-do, 56212, Republic of Korea
- Department of Human and Environmental Toxicology, University of Science and Technology, Daejeon, 34113, Republic of Korea
| | - Hyo-Seon Yang
- Jeonbuk Department of inhalation Research, National Center for Efficacy Evaluation of Respiratory Disease Products, Korea Institute of Toxicology, 30 Baehak 1-gil, Jeonguep, Jeollabuk-do, 56212, Republic of Korea
| | - Mi-Kyung Song
- Jeonbuk Department of inhalation Research, National Center for Efficacy Evaluation of Respiratory Disease Products, Korea Institute of Toxicology, 30 Baehak 1-gil, Jeonguep, Jeollabuk-do, 56212, Republic of Korea
- Department of Human and Environmental Toxicology, University of Science and Technology, Daejeon, 34113, Republic of Korea
| | - Dong Im Kim
- Jeonbuk Department of inhalation Research, National Center for Efficacy Evaluation of Respiratory Disease Products, Korea Institute of Toxicology, 30 Baehak 1-gil, Jeonguep, Jeollabuk-do, 56212, Republic of Korea
| | - Kyuhong Lee
- Jeonbuk Department of inhalation Research, National Center for Efficacy Evaluation of Respiratory Disease Products, Korea Institute of Toxicology, 30 Baehak 1-gil, Jeonguep, Jeollabuk-do, 56212, Republic of Korea.
- Department of Human and Environmental Toxicology, University of Science and Technology, Daejeon, 34113, Republic of Korea.
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Kurokawa R, Amemiya S, Akashi K, Abe O. Persistent collection of antibiotic ointment masquerading as a lipoma arising at a surgical site. Radiol Case Rep 2019; 14:1423-1426. [PMID: 31695830 PMCID: PMC6823761 DOI: 10.1016/j.radcr.2019.09.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 09/07/2019] [Indexed: 12/02/2022] Open
Abstract
Antibiotic ointments are often used to treat or prevent infections in surgical wounds. However, due to a dearth of reports on adverse effects, the complications of the use of such ointments, especially possible long-term effects, are largely unknown. We experienced a unique case of a cystic lesion that developed after surgical site infection treated with gentamicin ointment in a 62-year-old man who underwent subtotal glossectomy for tongue cancer. The antibiotic ointment that was applied following abscess drainage remained there, replacing the abscess cavity and forming an oval mass. The lesion was found incidentally on follow-up MR examination to monitor cancer recurrence. On both T1- and T2-weighted images, it showed high-intensity reflecting oily base material, constituting the ointment, which appeared to be a fat-containing tumor such as a lipoma that had arisen at the surgical site. Echo-guided drainage extracted the ointment, which was seemingly unaltered from the time it was applied 11 months before. We describe the clinical course and imaging findings to acknowledge this potential adverse effect associated with topical antibiotic treatment for surgical site infection.
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Affiliation(s)
- Ryo Kurokawa
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Shiori Amemiya
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Ken Akashi
- Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Osamu Abe
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
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Ozbagcivan O, Akarsu S, Dolas N, Fetil E. Contact sensitization to cosmetic series of allergens in patients with rosacea: A prospective controlled study. J Cosmet Dermatol 2019; 19:173-179. [DOI: 10.1111/jocd.12989] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 04/13/2019] [Accepted: 04/16/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Ozlem Ozbagcivan
- Faculty of Medicine, Department of Dermatology Dokuz Eylul University Izmir Turkey
| | - Sevgi Akarsu
- Faculty of Medicine, Department of Dermatology Dokuz Eylul University Izmir Turkey
| | - Necla Dolas
- Faculty of Medicine, Department of Dermatology Dokuz Eylul University Izmir Turkey
| | - Emel Fetil
- Faculty of Medicine, Department of Dermatology Dokuz Eylul University Izmir Turkey
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Rajabi‐Estarabadi A, Tsang DC, Nouri K, Tosti A. Evaluation of positive patch test reactions using optical coherence tomography: A pilot study. Skin Res Technol 2019; 25:625-630. [DOI: 10.1111/srt.12695] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 02/16/2019] [Indexed: 01/17/2023]
Affiliation(s)
- Ali Rajabi‐Estarabadi
- Dr.Phillip Frost Department of Dermatology and Cutaneous SurgeryUniversity of Miami Miller School of Medicine Miami Florida USA
| | - Darren C. Tsang
- Dr.Phillip Frost Department of Dermatology and Cutaneous SurgeryUniversity of Miami Miller School of Medicine Miami Florida USA
| | - Keyvan Nouri
- Dr.Phillip Frost Department of Dermatology and Cutaneous SurgeryUniversity of Miami Miller School of Medicine Miami Florida USA
| | - Antonella Tosti
- Dr.Phillip Frost Department of Dermatology and Cutaneous SurgeryUniversity of Miami Miller School of Medicine Miami Florida USA
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Characteristics of Decreased Pulmonary Function and Clinical Symptoms in Nickel Electroplating Workers. J Occup Environ Med 2018; 60:337-342. [PMID: 29065059 DOI: 10.1097/jom.0000000000001204] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
BACKGROUND Hexavalent chromium in cement is a common cause of occupational allergic contact dermatitis (OACD). METHODS Analysis of patch test data during 1999 to 2013 was done. Patients with cement-induced chromate OACD filled the Dermatology Life Quality Index, graded 1 to 5. RESULTS Of 4846 consecutive patients who were patch tested, 146 (3%) were chromate-sensitive. Of 46 (31.5%) who presented with chromate OACD, 27 (59%) had cement-induced chromate OACD. The proportion of chromate-sensitive patients with clinically relevant cement exposure increased from 7.7% in 2002 to 2004 to 28.7% in 2011 to 2013 (P = 0.04). The median age of presentation was younger than for other chromate-sensitive patients (32 vs 42 years). Hand eczema (88.9%) was the most frequent clinical presentation. Of the 27 with cement-induced chromate OACD, 21 (77.8%) had ongoing dermatitis at the time of the review. Although 14/27 (51.9%) changed their occupation to avoid exposure to cement, symptoms persisted in 9/14 (64.3%). Prolonged exposure to cement before development of symptoms was associated with chronicity. All the symptomatic patients experienced at least a moderate effect on their quality of life (grade 3 or higher on the Dermatology Life Quality Index). CONCLUSIONS We recommend the adoption of the European legislation in Israel, to reduce the prevalence of chromate OACD from cement.
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Heal CF, Banks JL, Lepper P, Kontopantelis E, van Driel ML. Meta-analysis of randomized and quasi-randomized clinical trials of topical antibiotics after primary closure for the prevention of surgical-site infection. Br J Surg 2017; 104:1123-1130. [PMID: 28656693 DOI: 10.1002/bjs.10588] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 02/23/2017] [Accepted: 04/06/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND Surgical-site infections (SSIs) increase patient morbidity and costs. The aim was to identify and synthesize all RCTs evaluating the effect of topical antibiotics on SSI in wounds healing by primary intention. METHODS The search included Ovid MEDLINE, Ovid Embase, the Cochrane Wounds Specialized Register, Central Register of Controlled Trials and EBSCO CINAHL from inception to May 2016. There was no restriction of language, date or setting. Two authors independently selected studies, extracted data and assessed risk of bias. When sufficient numbers of comparable trials were available, data were pooled in meta-analysis. RESULTS Fourteen RCTs with 6466 participants met the inclusion criteria. Pooling of eight trials (5427 participants) showed that topical antibiotics probably reduced the risk of SSI compared with no topical antibiotic (risk ratio (RR) 0·61, 95 per cent c.i. 0·42 to 0·87; moderate-quality evidence), equating to 20 fewer SSIs per 1000 patients treated. Pooling of three trials (3012 participants) for risk of allergic contact dermatitis found no clear difference between antibiotics and no antibiotic (RR 3·94, 0·46 to 34·00; very low-quality evidence). Pooling of five trials (1299 participants) indicated that topical antibiotics probably reduce the risk of SSI compared with topical antiseptics (RR 0·49, 0·30 to 0·80; moderate-quality evidence); 43 fewer SSIs per 1000 patients treated. Pooling of two trials (541 participants) showed no clear difference in the risk of allergic contact dermatitis with antibiotics or antiseptic agents (RR 0·97, 0·52 to 1·82; very low-quality evidence). CONCLUSION Topical antibiotics probably prevent SSI compared with no topical antibiotic or antiseptic. No conclusion can be drawn regarding whether they cause allergic contact dermatitis.
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Affiliation(s)
- C F Heal
- Department of General Practice and Rural Medicine, James Cook University, Mackay, Queensland, Australia
- College of Medicine and Dentistry, James Cook University, Mackay, Queensland, Australia
- Mackay Institute of Research and Innovation, James Cook University, Mackay, Queensland, Australia
| | - J L Banks
- College of Medicine and Dentistry, James Cook University, Mackay, Queensland, Australia
| | - P Lepper
- College of Medicine and Dentistry, James Cook University, Mackay, Queensland, Australia
| | - E Kontopantelis
- Centre for Health Informatics, Institute of Population Health, University of Manchester, Manchester, UK
| | - M L van Driel
- Discipline of General Practice, School of Medicine, University of Queensland, Brisbane, Queensland, Australia
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Patch Test Reactions to Corticosteroids: Retrospective Analysis From the North American Contact Dermatitis Group 2007–2014. Dermatitis 2017; 28:58-63. [DOI: 10.1097/der.0000000000000251] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Heal CF, Banks JL, Lepper PD, Kontopantelis E, van Driel ML. Topical antibiotics for preventing surgical site infection in wounds healing by primary intention. Cochrane Database Syst Rev 2016; 11:CD011426. [PMID: 27819748 PMCID: PMC6465080 DOI: 10.1002/14651858.cd011426.pub2] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND Surgical site infections (SSI) can delay wound healing, impair cosmetic outcome and increase healthcare costs. Topical antibiotics are sometimes used to reduce microbial contaminant exposure following surgical procedures, with the aim of reducing SSIs. OBJECTIVES The primary objective of this review was to determine whether the application of topical antibiotics to surgical wounds that are healing by primary intention reduces the incidence of SSI and whether it increases the incidence of adverse outcomes (allergic contact dermatitis, infections with patterns of antibiotic resistance and anaphylaxis). SEARCH METHODS In May 2015 we searched: the Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL; the Cochrane Library); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid Embase and EBSCO CINAHL. We also searched clinical trial registries for ongoing studies, and bibliographies of relevant publications to identify further eligible trials. There was no restriction of language, date of study or setting. The search was repeated in May 2016 to ensure currency of included studies. SELECTION CRITERIA All randomized controlled trials (RCTs) and quasi-randomised trials that assessed the effects of topical antibiotics (any formulation, including impregnated dressings) in people with surgical wounds healing by primary intention were eligible for inclusion. DATA COLLECTION AND ANALYSIS Two review authors independently selected studies and independently extracted data. Two authors then assessed the studies for risk of bias. Risk ratios were calculated for dichotomous variables, and when a sufficient number of comparable trials were available, trials were pooled in a meta-analysis. MAIN RESULTS A total of 10 RCTs and four quasi-randomised trials with 6466 participants met the inclusion criteria. Six studies involved minor procedures conducted in an outpatient or emergency department setting; eight studies involved major surgery conducted in theatre. Nine different topical antibiotics were included. We included two three-arm trials, two four-arm trials and 10 two-arm trials. The control groups comprised; an alternative topical antibiotic (two studies), topical antiseptic (six studies) and no topical antibiotic (10 studies), which comprised inert ointment (five studies) no treatment (four studies) and one study with one arm of each.The risk of bias of the 14 studies varied. Seven studies were at high risk of bias, five at unclear risk of bias and two at low risk of bias. Most risk of bias concerned risk of selection bias.Twelve of the studies (6259 participants) reported infection rates, although we could not extract the data for this outcome from one study. Four studies (3334 participants) measured allergic contact dermatitis as an outcome. Four studies measured positive wound swabs for patterns of antimicrobial resistance, for which there were no outcomes reported. No episodes of anaphylaxis were reported. Topical antibiotic versus no topical antibioticWe pooled the results of eight trials (5427 participants) for the outcome of SSI. Topical antibiotics probably reduce the risk of SSI in people with surgical wounds healing by primary intention compared with no topical antibiotic (RR 0.61, 95% CI 0.42 to 0.87; moderate-quality evidence downgraded once for risk of bias). This equates to 20 fewer SSIs per 1000 patients treated with topical antibiotics (95% CI 7 to 29) and a number needed to treat for one additional beneficial outcome (NNTB) (i.e. prevention of one SSI) of 50.We pooled the results of three trials (3012 participants) for the outcome of allergic contact dermatitis, however this comparison was underpowered, and it is unclear whether topical antibiotics affect the risk of allergic contact dermatitis (RR 3.94, 95% CI 0.46 to 34.00; very low-quality evidence, downgraded twice for risk of bias, once for imprecision). Topical antibiotic versus antiseptic We pooled the results of five trials (1299 participants) for the outcome of SSI. Topical antibiotics probably reduce the risk of SSI in people with surgical wounds healing by primary intention compared with using topical antiseptics (RR 0.49, 95% CI 0.30 to 0.80; moderate-quality evidence downgraded once for risk of bias). This equates to 43 fewer SSIs per 1000 patients treated with topical antibiotics instead of antiseptics (95% CI 17 to 59) and an NNTB of 24.We pooled the results of two trials (541 participants) for the outcome of allergic contact dermatitis; there was no clear difference in the risk of dermatitis between topical antibiotics and antiseptics, however this comparison was underpowered and a difference cannot be ruled out (RR 0.97, 95% CI 0.52 to 1.82; very low-quality evidence, downgraded twice for risk of bias and once for imprecision). Topical antibiotic versus topical antibioticOne study (99 participants) compared mupirocin ointment with a combination ointment of neomycin/polymyxin B/bacitracin zinc for the outcome of SSI. There was no clear difference in the risk of SSI, however this comparison was underpowered (very low-quality evidence downgraded twice for risk of bias, once for imprecision).A four-arm trial involved two antibiotic arms (neomycin sulfate/bacitracin zinc/polymyxin B sulphate combination ointment versus bacitracin zinc, 219 participants). There was no clear difference in risk of SSI between the combination ointment and the bacitracin zinc ointment. The quality of evidence for this outcome was low, downgraded once for risk of bias, and once for imprecision. AUTHORS' CONCLUSIONS Topical antibiotics applied to surgical wounds healing by primary intention probably reduce the risk of SSI relative to no antibiotic, and relative to topical antiseptics (moderate quality evidence). We are unable to draw conclusions regarding the effects of topical antibiotics on adverse outcomes such as allergic contact dermatitis due to lack of statistical power (small sample sizes). We are also unable to draw conclusions regarding the impact of increasing topical antibiotic use on antibiotic resistance. The relative effects of different topical antibiotics are unclear.
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Affiliation(s)
- Clare F Heal
- James Cook UniversityGeneral Practice and Rural MedicineMackay Base HospitalBridge RoadMackayQueenslandAustralia4740
- Anton Breinl Research Centre for Health Systems StrengtheningTownsvilleQueenslandAustralia
| | - Jennifer L Banks
- James Cook UniversitySchool of Medicine and DentistryMackayQueenslandAustralia4740
| | - Phoebe D Lepper
- James Cook UniversitySchool of Medicine and DentistryMackayQueenslandAustralia4740
| | - Evangelos Kontopantelis
- The University of ManchesterCentre for Health Informatics, Institute of Population HealthWilliamson Building, 5th FloorOxford RoadManchesterGreater ManchesterUKM13 9PL
| | - Mieke L van Driel
- The University of QueenslandDiscipline of General Practice, School of MedicineBrisbaneQueenslandAustralia4029
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Cressey BD, Belum VR, Scheinman P, Silvestri D, McEntee N, Livingston V, Lacouture ME, Zippin JH. Stoma care products represent a common and previously underreported source of peristomal contact dermatitis. Contact Dermatitis 2016; 76:27-33. [PMID: 27576564 DOI: 10.1111/cod.12678] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 07/26/2016] [Accepted: 07/27/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Peristomal dermatitis is a common complication for the >700 000 patients in the United States with an ostomy. The role of stoma skin care products in peristomal dermatitis is poorly understood. OBJECTIVE To evaluate stoma skin care products as a cause of peristomal dermatitis. METHODS A retrospective chart review of patients with peristomal dermatitis at four academic hospitals from January 2010 to March 2014 was performed. Patient demographics, clinical information and use test and patch test results were documented. RESULTS Eighteen patients identified as having peristomal dermatitis were tested. Twelve of these had peristomal contact dermatitis. We identified numerous stoma skin care products as triggers of irritant and/or allergic contact dermatitis. The most common stoma skin care product used and/or involved in dermatitis was Cavilon™ No Sting Barrier Film. CONCLUSIONS Our data support a paradigm shift whereby healthcare workers treating patients with peristomal dermatitis, which is currently considered to be a reaction mainly to bodily fluids, must consider those products used to protect the skin as potential triggers for this disease. Therefore, patients with peristomal dermatitis should be tested with their stoma skin care agents to determine the need for removal or change of these products. Additionally, full ingredient labelling by manufacturers would help identify new allergens and irritants.
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Affiliation(s)
- Brienne D Cressey
- Department of Dermatology, Weill Cornell Medical Center and New York-Presbyterian Hospital, New York, NY 10065, USA
| | - Viswanath R Belum
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10022, USA
| | - Pamela Scheinman
- Department of Dermatology, Tufts Medical Center, Boston, MA 02111, USA.,Department of Dermatology, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Dianne Silvestri
- Division of Dermatology, Department of Medicine, University of Massachusetts Medical School, Worcester, MA 01605, USA
| | - Nancy McEntee
- Sidney Kimmel Center for Prostate and Urologic Cancers, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA
| | - Vashti Livingston
- Sidney Kimmel Center for Prostate and Urologic Cancers, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA
| | - Mario E Lacouture
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10022, USA
| | - Jonathan H Zippin
- Department of Dermatology, Weill Cornell Medical Center and New York-Presbyterian Hospital, New York, NY 10065, USA
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Majid I. Contact Allergens Causing Hand Eczema in Ethnic Kashmiri Population: A Study of 7-years. Indian J Dermatol 2016; 61:119. [PMID: 26955125 PMCID: PMC4763635 DOI: 10.4103/0019-5154.174083] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Hand eczema is one of the commonest eczemas encountered in dermatology practice. Contact allergens responsible for causing hand eczema vary from one geographical area of the world to another. AIM The study tries to identify the commonest allergens causing hand eczema in ethnic Kashmiri population. MATERIAL AND METHODS A total of 800 patients were patch tested at a sole patch testing facility for the local population over a 7-year period out of which 278 were diagnosed with hand eczema. The morphological type of hand eczema was noted and the patch testing results were analyzed. Past or present relevance of the patch-test result to the clinical diagnosis was also analyzed. RESULTS Hand eczema was the most common type of eczema patch tested over the 7-year period, constituting 34.75% of the patch-tested population. A positive patch-test result was obtained in 135 patients (48.5%) out of which it was found to be clinically relevant in about 65% cases. Nickel and potassium dichromate were found to be the two commonest allergens causing hand eczema in our population with positive patch test reactions in 45 and 27 patients respectively. Females showed a much higher incidence of hand eczema as well as higher patch test positivity than males (54.1% vs. 38.1%). CONCLUSIONS Hand eczema with a positive patch-test report was found to be much more common in females than males and nickel and potassium dichromate were seen to be the commonest allergens causing hand eczema in ethnic Kashmiri population.
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Affiliation(s)
- Imran Majid
- Department of Dermatology, Government Medical College, Srinagar, Jammu and Kashmir, India; CUTIS Skin and Laser Institute, Srinagar, Jammu and Kashmir, India
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Tanno LK, Darlenski R, Sánchez-Garcia S, Bonini M, Vereda A, Kolkhir P, Antolin-Amerigo D, Dimov V, Gallego-Corella C, Becerra JCA, Diaz A, Linares VB, Villa L, Rosenwasser LJ, Sanchez-Borges M, Ansotegui I, Pawankar R, Bieber T. International survey on skin patch test procedures, attitudes and interpretation. World Allergy Organ J 2016; 9:8. [PMID: 26962386 PMCID: PMC4778281 DOI: 10.1186/s40413-016-0098-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 01/27/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Skin patch test is the gold standard method in diagnosing contact allergy. Although used for more than 100 years, the patch test procedure is performed with variability around the world. A number of factors can influence the test results, namely the quality of reagents used, the timing of the application, the patch test series (allergens/haptens) that have been used for testing, the appropriate interpretation of the skin reactions or the evaluation of the patient's benefit. METHODS We performed an Internet -based survey with 38 questions covering the educational background of respondents, patch test methods and interpretation. The questionnaire was distributed among all representatives of national member societies of the World Allergy Organization (WAO), and the WAO Junior Members Group. RESULTS One hundred sixty-nine completed surveys were received from 47 countries. The majority of participants had more than 5 years of clinical practice (61 %) and routinely carried out patch tests (70 %). Both allergists and dermatologists were responsible for carrying out the patch tests. We could observe the use of many different guidelines regardless the geographical distribution. The use of home-made preparations was indicated by 47 % of participants and 73 % of the respondents performed 2 or 3 readings. Most of the responders indicated having patients with adverse reactions, including erythroderma (12 %); however, only 30 % of members completed a consent form before conducting the patch test. DISCUSSION The heterogeneity of patch test practices may be influenced by the level of awareness of clinical guidelines, different training backgrounds, accessibility to various types of devices, the patch test series (allergens/haptens) used for testing, type of clinical practice (public or private practice, clinical or research-based institution), infrastructure availability, financial/commercial implications and regulations among others. CONCLUSION There is a lack of a worldwide homogeneity of patch test procedures, and this raises concerns about the need for standardization and harmonization of this important diagnostic procedure.
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Affiliation(s)
- Luciana K. Tanno
- />Hospital Sírio Libanês and Post-graduation Program in Health Sciences of IAMSPE, Rua Prof Arthur Ramos, 183, cj 21 01454-011, São Paulo, SP Brazil
| | - Razvigor Darlenski
- />Department of Dermatolgy and Venereology, Tokuda Hospital Sofia, Sofia, Bulgaria
| | | | - Matteo Bonini
- />Department of Public Health and Infectious Diseases, “Sapienza” University of Rome, Rome, Italy
| | | | - Pavel Kolkhir
- />Department of Dermatology and Venereology, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Dario Antolin-Amerigo
- />Immune System Diseases and Oncology Service-Allergy Unit. Hospital Universitario Príncipe de Asturias, Medicine and Medical Specialities Department, Universidad de Alcalá. Alcalá de Henares, Madrid, Spain
| | - Vesselin Dimov
- />Department of Allergy and Immunology, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd Weston, Florida, FL 33331 USA
| | | | | | - Alexander Diaz
- />Department of Allergy, Medical Center, Guira de Melena, Havana, Cuba
| | | | - Leonor Villa
- />Sanatorio Privado San Roque, Marcos Juárez, Córdoba Argentina
| | - Lanny J. Rosenwasser
- />Department of Pediatrics, Division of Immunology Research, Children’s Mercy Hospitals & Clinics, Kansas City, MO 64108 USA
| | - Mario Sanchez-Borges
- />Allergy and Clinical Immunology Department, Centro Medico Docente La Trinidad, Caracas, Venezuela
| | - Ignacio Ansotegui
- />Department of Allergy and Immunology, Hospital Quirón Bizkaia, Bizkaia, Spain
| | - Ruby Pawankar
- />Division of Allergy, Department of Pediatrics, Nippon Medical School, Tokyo, Japan
| | - Thomas Bieber
- />Department of Dermatology and Allergy, Rheinische Friedrich-Wilhelms-University Bonn, Bonn, Germany
| | - on behalf of the WAO Junior Members Group
- />Hospital Sírio Libanês and Post-graduation Program in Health Sciences of IAMSPE, Rua Prof Arthur Ramos, 183, cj 21 01454-011, São Paulo, SP Brazil
- />Department of Dermatolgy and Venereology, Tokuda Hospital Sofia, Sofia, Bulgaria
- />Allergy Department. Hospital Infantil Universitario Niño Jesús, Madrid, Spain
- />Department of Public Health and Infectious Diseases, “Sapienza” University of Rome, Rome, Italy
- />Allergy Clinic, Paris, 75015 France
- />Department of Dermatology and Venereology, Sechenov First Moscow State Medical University, Moscow, Russia
- />Immune System Diseases and Oncology Service-Allergy Unit. Hospital Universitario Príncipe de Asturias, Medicine and Medical Specialities Department, Universidad de Alcalá. Alcalá de Henares, Madrid, Spain
- />Department of Allergy and Immunology, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd Weston, Florida, FL 33331 USA
- />Medicine Faculty, Xochicalco University, Tijuana, Mexico
- />Allergy and Immunology Division, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru
- />Department of Allergy, Medical Center, Guira de Melena, Havana, Cuba
- />Intercenter Allergy Unit, Virgen Macarena University Hospital, Seville, Spain
- />Sanatorio Privado San Roque, Marcos Juárez, Córdoba Argentina
- />Department of Pediatrics, Division of Immunology Research, Children’s Mercy Hospitals & Clinics, Kansas City, MO 64108 USA
- />Allergy and Clinical Immunology Department, Centro Medico Docente La Trinidad, Caracas, Venezuela
- />Department of Allergy and Immunology, Hospital Quirón Bizkaia, Bizkaia, Spain
- />Division of Allergy, Department of Pediatrics, Nippon Medical School, Tokyo, Japan
- />Department of Dermatology and Allergy, Rheinische Friedrich-Wilhelms-University Bonn, Bonn, Germany
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Fonacier L, Bernstein DI, Pacheco K, Holness DL, Blessing-Moore J, Khan D, Lang D, Nicklas R, Oppenheimer J, Portnoy J, Randolph C, Schuller D, Spector S, Tilles S, Wallace D. Contact dermatitis: a practice parameter-update 2015. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2016; 3:S1-39. [PMID: 25965350 DOI: 10.1016/j.jaip.2015.02.009] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 02/26/2015] [Indexed: 01/08/2023]
Abstract
This parameter was developed by the Joint Task Force on Practice Parameters, which represents the American Academy of Allergy, Asthma & Immunology (AAAAI); the American College of Allergy, Asthma & Immunology (ACAAI); and the Joint Council of Allergy, Asthma & Immunology. The AAAAI and the ACAAI have jointly accepted responsibility for establishing "Contact Dermatitis: A Practice Parameter-Update 2015." This is a complete and comprehensive document at the current time. The medical environment is changing and not all recommendations will be appropriate or applicable to all patients. Because this document incorporated the efforts of many participants, no single individual, including members serving on the Joint Task Force, are authorized to provide an official AAAAI or ACAAI interpretation of these practice parameters. Any request for information or interpretation of this practice parameter by the AAAAI or ACAAI should be directed to the Executive Offices of the AAAAI, the ACAAI, and the Joint Council of Allergy, Asthma & Immunology. These parameters are not designed for use by the pharmaceutical industry in drug development or promotion. Previously published practice parameters of the Joint Task Force on Practice Parameters for Allergy & Immunology are available at http://www.JCAAI.org or http://www.allergyparameters.org.
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Evaluation of Functionality and Biological Responses of Mytilus galloprovincialis after Exposure to Quaternium-15 (Methenamine 3-Chloroallylochloride). Molecules 2016; 21:144. [PMID: 26821003 PMCID: PMC6273939 DOI: 10.3390/molecules21020144] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Revised: 01/11/2016] [Accepted: 01/20/2016] [Indexed: 11/19/2022] Open
Abstract
Although the irritant effects of quaternium-15 have been established, little is known about the toxicological consequences induced by this xenobiotic on aquatic invertebrates. The present article reports toxicological, histological and physiological effects of quaternium-15 following the exposure of Mytilus galloprovincialis for 18 days at three different concentrations (0.1, 1.0 and 2.0 mg/L). The results demonstrate that at higher concentrations histological damages to M. galloprovincialis gills occur, like melanosis, light exfoliations, increase of mucus production and infiltrative inflammation. In addition digestive gland cells of M. galloprovincialis, were not able to perform the regulation volume decrease (RVD) owing to osmotic stress following the exposure to the preservative. Overall, this first study on quaternium-15 highlights that it can jeopardize both the morphology and vital physiological processes in marine invertebrates, depending on the duration of exposure and the concentration of the preservative, indicating that further studies are necessary to increase our knowledge about the effects of this substance, commonly added to our products of daily use.
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Bommarito L, Mietta S, Cadario G. Anaphylaxis after application of topical bacitracin-neomycin powder. Ann Allergy Asthma Immunol 2015; 115:74-5. [PMID: 25935430 DOI: 10.1016/j.anai.2015.03.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 03/27/2015] [Accepted: 03/31/2015] [Indexed: 11/16/2022]
Affiliation(s)
- Luisa Bommarito
- SC Allergy and Clinical Immunology, AOU Città della Salute e della Scienza di Torino, Molinette Hospital, Turin, Italy.
| | - Sabrina Mietta
- SC Allergy and Clinical Immunology, AOU Città della Salute e della Scienza di Torino, Molinette Hospital, Turin, Italy
| | - Gianni Cadario
- SC Allergy and Clinical Immunology, AOU Città della Salute e della Scienza di Torino, Molinette Hospital, Turin, Italy
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Correa da Rosa J, Malajian D, Shemer A, Rozenblit M, Dhingra N, Czarnowicki T, Khattri S, Ungar B, Finney R, Xu H, Zheng X, Estrada YD, Peng X, Suárez-Fariñas M, Krueger JG, Guttman-Yassky E. Patients with atopic dermatitis have attenuated and distinct contact hypersensitivity responses to common allergens in skin. J Allergy Clin Immunol 2015; 135:712-20. [DOI: 10.1016/j.jaci.2014.11.017] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Revised: 11/13/2014] [Accepted: 11/17/2014] [Indexed: 01/09/2023]
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Wong CC, Gamboni SE, Palmer AM, Nixon RL. Occupational allergic contact dermatitis to chromium from cement: Estimating the size of the problem in Australia. Australas J Dermatol 2014; 56:290-3. [DOI: 10.1111/ajd.12238] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 06/30/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Celestine C Wong
- Occupational Dermatology Research and Education Centre; Skin and Cancer Foundation; Melbourne Victoria Australia
| | - Sarah E Gamboni
- Occupational Dermatology Research and Education Centre; Skin and Cancer Foundation; Melbourne Victoria Australia
| | - Amanda M Palmer
- Occupational Dermatology Research and Education Centre; Skin and Cancer Foundation; Melbourne Victoria Australia
| | - Rosemary L Nixon
- Occupational Dermatology Research and Education Centre; Skin and Cancer Foundation; Melbourne Victoria Australia
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Effects of formaldehyde on lymphocyte subsets and cytokines in the peripheral blood of exposed workers. PLoS One 2014; 9:e104069. [PMID: 25157974 PMCID: PMC4144836 DOI: 10.1371/journal.pone.0104069] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 07/06/2014] [Indexed: 11/19/2022] Open
Abstract
Formaldehyde (FA) is a well-known irritant, and it is suggested to increase the risk of immune diseases and cancer. The present study aimed to evaluate the distribution of major lymphocyte subsets and cytokine expression profiles in the peripheral blood of FA-exposed workers. A total of 118 FA-exposed workers and 79 controls were enrolled in the study. High performance liquid chromatography, flow cytometry, and cytometric bead array were used to analyze FA in air sample and formic acid in urine, blood lymphocyte subpopulations, and serum cytokines, respectively. The FA-exposed workers were divided into low and high exposure groups according to their exposure levels. The results showed that both the low and high FA-exposed groups had a significant increase of formic acid in urine when compared to the controls. Both the low and high exposure groups had a significant increase in the percentage of B cells (CD19+) compared to the control group (p<0.01). A significant increase in the percentage of the natural killer (NK) cells (CD56+) was observed in the low exposure group compared to the control (p = 0.013). Moreover, the FA-exposed workers in both exposure groups showed a significant higher level of IL-10 but lower level of IL-8 than the control (p<0.01). Subjects in the high exposure group had a higher level of IL-4 but a lower level of IFN-γ than the control (p<0.05). Finally, there is a significant correlation between the levels of IL-10, IL-4, and IL-8 and formic acid (p<0.05). The findings from the present study may explain, at least in part, the association between FA exposure and immune diseases and cancer.
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Dhingra N, Shemer A, Correa da Rosa J, Rozenblit M, Fuentes-Duculan J, Gittler JK, Finney R, Czarnowicki T, Zheng X, Xu H, Estrada YD, Cardinale I, Suárez-Fariñas M, Krueger JG, Guttman-Yassky E. Molecular profiling of contact dermatitis skin identifies allergen-dependent differences in immune response. J Allergy Clin Immunol 2014; 134:362-72. [DOI: 10.1016/j.jaci.2014.03.009] [Citation(s) in RCA: 181] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 03/14/2014] [Accepted: 03/18/2014] [Indexed: 01/08/2023]
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Saco M, Howe N, Nathoo R, Cherpelis B. Topical antibiotic prophylaxis for prevention of surgical wound infections from dermatologic procedures: a systematic review and meta-analysis. J DERMATOL TREAT 2014; 26:151-8. [DOI: 10.3109/09546634.2014.906547] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Wentworth AB, Yiannias JA, Keeling JH, Hall MR, Camilleri MJ, Drage LA, Torgerson RR, Fett DD, Prakash AV, Scalf LA, Allen EM, Johnson JS, Singh N, Nordberg Linehan DL, Killian JM, Davis MD. Trends in patch-test results and allergen changes in the standard series: A Mayo Clinic 5-year retrospective review (January 1, 2006, to December 31, 2010). J Am Acad Dermatol 2014; 70:269-75.e4. [DOI: 10.1016/j.jaad.2013.09.047] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Revised: 09/17/2013] [Accepted: 09/19/2013] [Indexed: 10/26/2022]
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Güner E, Kalkan G, Meral E, Baykır M. The triggering role of allergic contact dermatitis in discoid lupus erythematosus. Cutan Ocul Toxicol 2013; 32:194-9. [DOI: 10.3109/15569527.2012.751390] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Karpuzoglu E, Holladay SD, Gogal RM. Parabens: potential impact of low-affinity estrogen receptor binding chemicals on human health. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2013; 16:321-35. [PMID: 23909435 DOI: 10.1080/10937404.2013.809252] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Parabens, alkyl esters of p-hydroxybenzoic acid, are widely used in cosmetics, pharmaceuticals, personal care products and as food additives to inhibit microbial growth and extend product shelf life. Consumers of these compounds are frequently exposed via the skin, lips, eyes, oral mucosa, nails, and hair. Parabens are estrogenic molecules but exert weaker activity than natural estrogens, which would imply a low risk. Consistent with this idea, a number of recent commission reports from different countries suggested that parabens pose a negligible endocrine-disrupting risk at the recommended doses. However, individuals are not routinely exposed to a single paraben, and most of the available paraben toxicity data, reviewed in these reports, are from single-exposure studies. Further, assessing the additive and cumulative risk of multiple paraben exposure from daily use of multiple cosmetic and/or personal care products is presently not possible based on current studies. In this review, current and recent studies of paraben exposure and public health policies as well as critical gaps in the knowledge are discussed and new research directions regarding multiple exposures and novel target cohorts are recommended.
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Affiliation(s)
- Ebru Karpuzoglu
- Department of Veterinary Biosciences and Diagnostic Imaging, College of Veterinary Medicine, University of Georgia, Athens, Georgia 30602-7382, USA
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Waterbrook AL, Hiller K, Hays DP, Berkman M. Do topical antibiotics help prevent infection in minor traumatic uncomplicated soft tissue wounds? Ann Emerg Med 2012; 61:86-8. [PMID: 22964473 DOI: 10.1016/j.annemergmed.2012.08.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2012] [Revised: 08/01/2012] [Accepted: 08/01/2012] [Indexed: 11/28/2022]
Affiliation(s)
- Anna L Waterbrook
- Department of Emergency Medicine, University of Arizona, Tucson, AZ, USA.
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Scognamiglio J, Jones L, Letizia C, Api A. Fragrance material review on 2-phenoxyethanol. Food Chem Toxicol 2012; 50 Suppl 2:S244-55. [DOI: 10.1016/j.fct.2011.10.030] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2011] [Revised: 08/30/2011] [Accepted: 10/05/2011] [Indexed: 11/30/2022]
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Belsito D, Bickers D, Bruze M, Calow P, Dagli ML, Fryer AD, Greim H, Miyachi Y, Saurat JH, Sipes IG. A toxicological and dermatological assessment of aryl alkyl alcohols when used as fragrance ingredients. Food Chem Toxicol 2012; 50 Suppl 2:S52-99. [PMID: 22051184 DOI: 10.1016/j.fct.2011.10.042] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2011] [Revised: 08/30/2011] [Accepted: 10/05/2011] [Indexed: 11/18/2022]
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Pomerantz RG, Lee DA, Siegel DM. Risk assessment in surgical patients: balancing iatrogenic risks and benefits. Clin Dermatol 2011; 29:669-77. [DOI: 10.1016/j.clindermatol.2011.08.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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A multi-center, retrospective review of patch testing for contact dermatitis in allergy practices. Ann Allergy Asthma Immunol 2011; 107:487-92. [PMID: 22123377 DOI: 10.1016/j.anai.2011.09.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2011] [Revised: 08/26/2011] [Accepted: 09/12/2011] [Indexed: 11/21/2022]
Abstract
BACKGROUND Studies assessing patch testing (PT) in allergy practices are limited. OBJECTIVES To determine whether PT results using a limited panel of allergens such as in the Thin-Layer Rapid-Use Epicutaneous Test (TT) as compared with an expanded panel, such as the addition of supplemental allergens (North American Contact Dermatitis [NACD] Panel, Dormer Cosmetics, hairdressing series, corticosteroid series, and personal products) will miss a significant number of positive PTs. To compare our PT results with published data from dermatology practices. METHODS This is a 5-year multicenter retrospective chart review of PT at 3 separate allergy practices. RESULTS Four hundred twenty-seven patients (mean age, 49.8 years) were patch tested. Eighty-two percent were female; 54% reported an atopic history. Of the standardized allergens, the 5 most common positives were nickel sulfate, fragrance mix I, p-phenylenediamine (PPD), thimerosal, and cobalt chloride. Two hundred eighteen (56.9%; 95% CI = 51.9-61.8%) patients were positive to at least 1 TT allergen. Ninety-eight (25.6%; 95% CI = 21.5-30.2%) patients were positive to both a TT and a supplemental allergen. Forty-eight (12.5%; 95% CI = 9.6-16.2%) patients were negative to a TT allergen but positive to a supplemental allergen. CONCLUSION Positive allergens would have been missed in 12.5% of patients when evaluating with TT allergens alone, whereas 25.6% would be partially evaluated. Patch test performance characteristics for these allergy practices appear to parallel that seen for dermatology. The TT remains an adequate screening tool in an allergy practice, but a more comprehensive panel may be needed to fully evaluate contact dermatitis.
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Aakhus AE, Warshaw EM. Allergy to Methyldibromoglutaronitrile/Phenoxyethanol (Euxyl K 400): Regulatory Issues, Epidemiology, Clinical Characteristics, and Management. Dermatitis 2011. [DOI: 10.2310/6620.2011.10081] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Fernández-Vozmediano J, Padilla-Moreno M, Armario-Hita J, Carranza-Romero C. Patrón de sensibilización por contacto a parafenilendiamina y su detección en tintes capilares. ACTAS DERMO-SIFILIOGRAFICAS 2011; 102:206-11. [DOI: 10.1016/j.ad.2010.03.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2010] [Accepted: 03/31/2010] [Indexed: 10/18/2022] Open
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Nardelli A, Drieghe J, Claes L, Boey L, Goossens A. Fragrance allergens in ‘specific’ cosmetic products. Contact Dermatitis 2011; 64:212-9. [DOI: 10.1111/j.1600-0536.2011.01877.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Verallo-Rowell VM. The Validated Hypoallergenic Cosmetics Rating System: Its 30-Year Evolution and Effect on the Prevalence of Cosmetic Reactions. Dermatitis 2011. [DOI: 10.2310/6620.2011.10046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Fernández-Vozmediano J, Padilla-Moreno M, Armario-Hita J, Carranza-Romero C. Pattern of Contact Sensitization to Paraphenylenediamine and Its Detection in Hair Dyes. ACTAS DERMO-SIFILIOGRAFICAS 2011. [DOI: 10.1016/s1578-2190(11)70786-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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