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Abstract
Eyelid dermatitis may present with a variety of clinical findings including erythema, pruritus, and edema, and it has a wide differential. Allergic contact dermatitis due to allergen sources in personal care products, cosmetics, and fragrances is a leading cause of eyelid dermatitis and may be challenging to diagnose by clinical examination alone. Expanded patch testing, in addition to careful inspection of the surrounding skin for additional areas of involvement and clinical clues, remains an important tool in differentiating allergic contact dermatitis from other relevant etiologies of eyelid dermatitis including irritant contact dermatitis, atopic dermatitis, seborrheic dermatitis, and rosacea. We present a practical approach to the management of eyelid dermatitis including the use of a topical anti-inflammatory for long-term control of eyelid findings. Further diagnostic workup may be warranted in patients with refractory eyelid dermatitis.
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Affiliation(s)
- Ashley M Hine
- University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Reid A Waldman
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Andrzej Grzybowski
- Department of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland; Foundation for Ophthalmology, Institute for Research in Ophthalmology, Poznan, Poland
| | - Jane M Grant-Kels
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, Connecticut, USA; Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida, USA.
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Roach K, Roberts J. A comprehensive summary of disease variants implicated in metal allergy. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2022; 25:279-341. [PMID: 35975293 PMCID: PMC9968405 DOI: 10.1080/10937404.2022.2104981] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Allergic disease represents one of the most prominent global public health crises of the 21st century. Although many different substances are known to produce hypersensitivity responses, metals constitute one of the major classes of allergens responsible for a disproportionately large segment of the total burden of disease associated with allergy. Some of the most prevalent forms of metal allergy - including allergic contact dermatitis - are well-recognized; however, to our knowledge, a comprehensive review of the many unique disease variants implicated in human cases of metal allergy is not available within the current scientific literature. Consequently, the main goal in composing this review was to (1) generate an up-to-date reference document containing this information to assist in the efforts of lab researchers, clinicians, regulatory toxicologists, industrial hygienists, and other scientists concerned with metal allergy and (2) identify knowledge gaps related to disease. Accordingly, an extensive review of the scientific literature was performed - from which, hundreds of publications describing cases of metal-specific allergic responses in human patients were identified, collected, and analyzed. The information obtained from these articles was then used to compile an exhaustive list of distinctive dermal/ocular, respiratory, gastrointestinal, and systemic hypersensitivity responses associated with metal allergy. Each of these disease variants is discussed briefly within this review, wherein specific metals implicated in each response type are identified, underlying immunological mechanisms are summarized, and major clinical presentations of each reaction are described.Abbreviations: ACD: allergic contact dermatitis, AHR: airway hyperreactivity, ASIA: autoimmune/ autoinflammatory syndrome induced by adjuvants, BAL: bronchoalveolar lavage, CBD: chronic beryllium disease, CTCL: cutaneous T-cell lymphoma, CTL: cytotoxic T-Lymphocyte, DRESS: drug reaction with eosinophilia and systemic symptoms, GERD: gastro-esophageal reflux disease, GI: gastrointestinal, GIP: giant cell interstitial pneumonia, GM-CSF: granulocyte macrophage-colony stimulating factor, HMLD: hard metal lung disease, HMW: high molecular weight, IBS: irritable bowel syndrome, Ig: immunoglobulin, IL: interleukin, LMW: low molecular weight, PAP: pulmonary alveolar proteinosis, PPE: personal protective equipment, PRR: pathogen recognition receptor, SLE: systemic lupus erythematosus, SNAS: systemic nickel allergy syndrome, Th: helper T-cell, UC: ulcerative colitis, UV: ultraviolet.
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Affiliation(s)
- Ka Roach
- Allergy and Clinical Immunology Branch (ACIB), National Institute of Occupational Safety and Health (NIOSH), Morgantown, WV, USA
| | - Jr Roberts
- Allergy and Clinical Immunology Branch (ACIB), National Institute of Occupational Safety and Health (NIOSH), Morgantown, WV, USA
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Damevska K, Simeonovski V, Darlenski R, Damevska S. How to prevent skin damage from air pollution part 2: Current treatment options. Dermatol Ther 2021; 34:e15132. [PMID: 34528361 DOI: 10.1111/dth.15132] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 09/01/2021] [Accepted: 09/13/2021] [Indexed: 12/26/2022]
Abstract
In the first part of this review, we have summarized the methods used to examine skin exposure to air pollution and the fundamental concept of skin-exposome interactions. Part 2 of this review focuses on dermatoses, whose aggravation or initiation by air pollution has been confirmed in evidence based medicine manner. Based on the model of photodermatology and photodermatoses, we propose a new concept of "polludermatoses." A key feature of this concept is identifying patients at risk, which will reveal the noxious effects of air pollutants on skin health. Identifying clinical signs of pollution-damaged skin could be beneficial in categorizing conditions caused or exacerbated by exposure to air pollution. Finally, we discuss the current treatment options and the pathogenetic processes targeted by these therapeutics or the development of novel treatment modalities.
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Affiliation(s)
- Katerina Damevska
- Ss. Cyril and Methodius University, University Clinic for Dermatology, Skopje, Republic of Macedonia
| | - Viktor Simeonovski
- Ss. Cyril and Methodius University, University Clinic for Dermatology, Skopje, Republic of Macedonia
| | - Razvigor Darlenski
- Department of Dermatology and Venereology, Trakia University, Stara Zagora, Bulgaria.,Acibadem City Clinic Tokuda Hospital, Sofia, Bulgaria
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Hayakawa M, Suzuki C, Zhu Y, Anzai H. Airborne allergic contact dermatitis caused by coffee beans in a coffee roaster. Contact Dermatitis 2021; 86:46-48. [PMID: 34469027 DOI: 10.1111/cod.13964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 08/24/2021] [Accepted: 08/27/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Michitaro Hayakawa
- Department of Dermatology, Kawasaki municipal Ida hospital, Kawasaki, Japan
| | - Chihiro Suzuki
- Department of Dermatology, Kawasaki municipal Ida hospital, Kawasaki, Japan
| | - Yingyao Zhu
- Department of Dermatology, Kawasaki municipal Ida hospital, Kawasaki, Japan
| | - Hidemi Anzai
- Department of Dermatology, Kawasaki municipal Ida hospital, Kawasaki, Japan
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Li Y, Li L. Contact Dermatitis: Classifications and Management. Clin Rev Allergy Immunol 2021; 61:245-281. [PMID: 34264448 DOI: 10.1007/s12016-021-08875-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2021] [Indexed: 01/04/2023]
Abstract
Contact dermatitis (CD) is a common inflammatory skin disease caused by exposure to contact allergens and irritants. It is also the most common reason of occupational dermatitis and contributes greatly to hand dermatitis and facial dermatitis. Besides the two major forms of contact dermatitis: allergic contact dermatitis and irritant contact dermatitis, other subtypes of CD have been recognized including immediate skin reactions, photoinduced contact dermatitis, systemic contact dermatitis, and non-eczematous contact dermatitis. CD is a great imitator which can mimic many kinds of skin diseases, such as atopic dermatitis, lichen planus, and angioedema. For the diagnosis of CD, a complete medical history, including occupational history, is very important. It can give a clue of CD and provide a list of suspected substances. Besides the well-known diagnostic test, patch testing, there are many other diagnostic tests can be used to help diagnosis of CD and identify the causative allergens, including photopatch test, skin tests for detecting of immediate contact reactions, serum allergen-specific IgE test, and qualitative and quantitative testing of allergen in the suspected materials patients exposed to and challenge test. Before the treatment, the suspected irritants or allergens should be avoided completely. This includes both the removal of the patient from the environment that contains those substances and the promotion of the metabolism and expulsion of the allergens that have been absorbed by the body. In addition, it is also important to restore the skin barrier and reduce skin inflammation through multiple treatments, such as emollients, topical corticosteroids, and antihistamines, as well as systemic corticosteroids and immunosuppressants. Early and appropriate treatments are important to prevent further deterioration and persistence of the skin condition.
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Affiliation(s)
- Yan Li
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Linfeng Li
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China.
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Abstract
BACKGROUND Aerosolized liquid (e-liquid) of electronic cigarettes can be toxic. Beyond the solvent (propylene glycol, vegetable glycerin) and nicotine, little is known about the liquid composition. Formaldehyde, a carcinogen and source of contact dermatitis, has been reported in the vaporized e-liquid, but no studies have assessed the actual e-liquid. OBJECTIVE The aim of the study was to evaluate e-liquid products for the presence of formaldehyde. METHODS Sixteen e-liquid products were purchased and analyzed for the release of formaldehyde using the chromotropic acid method of detection. RESULTS Of the 16 e-liquids purchased, 4 (25%) were positive for the presence of formaldehyde; 2 were flavored and 2 were nonflavored. All positive e-liquids were in pods or disposable electronic cigarette devices, and 2 were purchased from local vape shops. The average nicotine content in the positive e-liquids was 3.85% versus 4.03% in the negative e-liquids. CONCLUSIONS The e-liquid products contain toxic chemicals not declared on product labels, as shown in this study with 25.0% of e-liquids containing formaldehyde. All positive e-liquids were within pods or disposable devices. Continued analysis of e-liquids and increased product regulation are needed.
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Scheinman PL, Vocanson M, Thyssen JP, Johansen JD, Nixon RL, Dear K, Botto NC, Morot J, Goldminz AM. Contact dermatitis. Nat Rev Dis Primers 2021; 7:38. [PMID: 34045488 DOI: 10.1038/s41572-021-00271-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/23/2021] [Indexed: 02/04/2023]
Abstract
Contact dermatitis (CD) is among the most common inflammatory dermatological conditions and includes allergic CD, photoallergic CD, irritant CD, photoirritant CD (also called phototoxic CD) and protein CD. Occupational CD can be of any type and is the most prevalent occupational skin disease. Each CD type is characterized by different immunological mechanisms and/or requisite exposures. Clinical manifestations of CD vary widely and multiple subtypes may occur simultaneously. The diagnosis relies on clinical presentation, thorough exposure assessment and evaluation with techniques such as patch testing and skin-prick testing. Management is based on patient education, avoidance strategies of specific substances, and topical treatments; in severe or recalcitrant cases, which can negatively affect the quality of life of patients, systemic medications may be needed.
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Affiliation(s)
- Pamela L Scheinman
- Department of Dermatology, Brigham and Women's Hospital, Boston, MA, USA
| | - Marc Vocanson
- CIRI - Centre International de Recherche en Infectiologie, INSERM, U1111; Univ Lyon; Université Claude Bernard Lyon 1; Ecole Normale Supérieure de Lyon; CNRS, UMR, 5308, Lyon, France
| | - Jacob P Thyssen
- National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Jeanne Duus Johansen
- National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Rosemary L Nixon
- Skin Health Institute - Occupational Dermatology Research and Education Centre, Carlton, VIC, Australia
| | - Kate Dear
- Skin Health Institute - Occupational Dermatology Research and Education Centre, Carlton, VIC, Australia
| | - Nina C Botto
- Department of Dermatology, University of California, San Francisco, San Francisco, CA, USA
| | - Johanna Morot
- CIRI - Centre International de Recherche en Infectiologie, INSERM, U1111; Univ Lyon; Université Claude Bernard Lyon 1; Ecole Normale Supérieure de Lyon; CNRS, UMR, 5308, Lyon, France
| | - Ari M Goldminz
- Department of Dermatology, Brigham and Women's Hospital, Boston, MA, USA.
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Bishop S, Roberts H. Methacrylate perspective in current dental practice. J ESTHET RESTOR DENT 2020; 32:673-680. [PMID: 32744420 DOI: 10.1111/jerd.12633] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 07/10/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To provide a current perspective concerning dental personnel sensitivity to methacrylate materials. OVERVIEW Methacrylate related sensitivity and allergies are currently beyond traditional thoughts concerning denture base resins and methyl methacrylate provisional materials. Methacrylates are now ubiquitous in current dental practice and dental personnel should be aware that dental adhesives contain potent sensitizers that may also cross-sensitize individuals to other methacrylates not experienced. The growing sensitivity to 2-hydroxyethyl methacrylate (HEMA) has been described to be epidemic in nature due to the artificial nail industry with dental patients and dental personnel may be more susceptible to dental methacrylate sensitization. While contact dermatitis remains the most prevalent methacrylate-related clinical presentation, respiratory complications and asthma are increasing associated with methacrylate exposure. While additional personal protective equipment (PPE) is thought to be first protective choice, the National Institute for Occupational Safety and Health (NIOSH) considers PPE overall largely ineffective and should be considered only as a last resort. CONCLUSION Dental personnel need to be more aware of methacrylate sources and use workplace control measures to limit methacrylate exposures to both dental personnel and patients. CLINICAL SIGNIFICANCE Sensitivity to methacrylate materials is a growing dental workplace major concern and dental personnel should be aware of both the methacrylate content of current materials and the products that contain ingredients with the most sensitization potential.
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Affiliation(s)
- Susan Bishop
- Division of Restorative Dentistry, University of Kentucky College of Dentistry, Lexin1gton, Kentucky, USA
| | - Howard Roberts
- Director of Graduate Studies, University of Kentucky College of Dentistry, Lexington, Kentucky, USA.,USAF Postgraduate Dental College, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
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Warshaw EM, Voller LM, Maibach HI, Zug KA, DeKoven JG, Atwater AR, Reeder MJ, Sasseville D, Taylor JS, Fowler JF, Pratt MD, Silverberg JI, Fransway AF, Zirwas MJ, Belsito DV, Marks JG, DeLeo VA. Eyelid dermatitis in patients referred for patch testing: Retrospective analysis of North American Contact Dermatitis Group data, 1994-2016. J Am Acad Dermatol 2020; 84:953-964. [PMID: 32679276 DOI: 10.1016/j.jaad.2020.07.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 07/06/2020] [Accepted: 07/08/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Eyelid dermatitis is a common dermatologic complaint. OBJECTIVE To characterize patients with eyelid dermatitis. METHODS Retrospective analysis (1994-2016) of North American Contact Dermatitis Group data. RESULTS Of 50,795 patients, 2332 (4.6%) had eyelid dermatitis only, whereas 1623 (3.2%) also had dermatitis of the eyelids and head or neck. Compared with patients without eyelid involvement (n = 26,130), groups with eyelid dermatitis only and dermatitis of the eyelid and head or neck were significantly more likely to be female, white, and older than 40 years, and to have a history of hay fever, atopic dermatitis, or both (P < .01). Final primary diagnoses included allergic contact dermatitis (eyelid dermatitis only: 43.4%; dermatitis of the eyelid and head or neck: 53.5%), irritant contact dermatitis (eyelid dermatitis only: 17.0%; dermatitis of the eyelid and head or neck: 9.8%), and atopic dermatitis (eyelid dermatitis only: 13.1%; dermatitis of the eyelid and head or neck: 13.8%). Top 5 currently relevant allergens included nickel sulfate (eyelid dermatitis only: 18.6%; dermatitis of the eyelid and head or neck: 22.5%), fragrance mix I (eyelid dermatitis only: 16.5%; dermatitis of the eyelid and head or neck: 18.3%), methylisothiazolinone (eyelid dermatitis only: 16.5%; dermatitis of the eyelid and head or neck: 17.7%), gold sodium thiosulfate (eyelid dermatitis only: 14.7%; dermatitis of the eyelid and head or neck: 11.4%), and balsam of Peru (eyelid dermatitis only: 11.9%; dermatitis of the eyelid and head or neck: 12.6%). Both eyelid-involvement groups were significantly more likely to react to gold sodium thiosulfate, carmine, shellac, dimethylaminopropylamine, oleamidopropyl dimethylamine, and thimerosal (P < .05) compared with the no eyelid involvement group. LIMITATIONS Lack of specific distribution patterns of eyelid dermatitis and no long-term follow-up data. CONCLUSION Patch testing remains a critical tool in evaluating patients with eyelid dermatitis.
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Affiliation(s)
- Erin M Warshaw
- Department of Dermatology, Park Nicollet Health Services, Minneapolis, Minnesota; Department of Dermatology, University of Minnesota, Minneapolis, Minnesota; Department of Dermatology, Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota
| | - Lindsey M Voller
- Department of Dermatology, Park Nicollet Health Services, Minneapolis, Minnesota; Department of Dermatology, Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota; University of Minnesota Medical School, Minneapolis, Minnesota.
| | - Howard I Maibach
- Department of Dermatology, University of California-San Francisco, San Francisco, California
| | - Kathryn A Zug
- Department of Dermatology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | - Joel G DeKoven
- Division of Dermatology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - 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
| | - Denis Sasseville
- Division of Dermatology, Royal Victoria Hospital, McGill University, Montreal, Quebec, Canada
| | - James S Taylor
- Department of Dermatology, Cleveland Clinic, Cleveland, Ohio
| | - Joseph F Fowler
- Division of Dermatology University of Louisville, Louisville, Kentucky
| | - Melanie D Pratt
- Division of Dermatology, University of Ottawa, Ottawa, Ontario, Canada
| | - Jonathan I Silverberg
- Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
| | | | - Matthew J Zirwas
- Department of Dermatology, Ohio State University, Columbus, Ohio
| | - Donald V Belsito
- Department of Dermatology, Columbia University, New York, New York
| | - James G Marks
- Department of Dermatology, Pennsylvania State University, Hershey, Pennsylvania
| | - Vincent A DeLeo
- Department of Dermatology, Keck School of Medicine, Los Angeles, California
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Rozas-Muñoz E, Game D. Allergic Contact Dermatitis of the Face: a Review of the Common Agents Involved and Differential Diagnosis. CURRENT TREATMENT OPTIONS IN ALLERGY 2020. [DOI: 10.1007/s40521-020-00262-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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