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Sobrino M, Moreno EM, Laffond E, Muñoz-Bellido FJ, Gracia-Bara MT, Martín C, Macías EM, de Arriba S, Gallardo A, Castillo R, Cabrera A, Dávila I. Contact Palpebral Dermatitis and Conjunctivitis Due to Delayed Hypersensitivity to Timolol. Dermatitis 2023; 34:470-471. [PMID: 35674513 DOI: 10.1097/der.0000000000000902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Miriam Sobrino
- Department of Allergy, University Hospital of Salamanca, Spain; Institute for Biomedical Research of Salamanca, IBSAL, Spain
| | - Esther M Moreno
- Department of Allergy, University Hospital of Salamanca, Spain ; Institute for Biomedical Research of Salamanca, IBSAL, Spain; Department of Biomedical and Diagnostic Sciences, University of Salamanca, Spain; Asthma, Allergic and Adverse Reactions (ARADyAL) Network for Cooperative Research in Health of Instituto de Salud Carlos III, Hospital Universitario de Salamanca, Spain
| | - Elena Laffond
- Department of Allergy, University Hospital of Salamanca, Spain; Institute for Biomedical Research of Salamanca, IBSAL, Spain; Department of Biomedical and Diagnostic Sciences, University of Salamanca, Spain
| | - Francisco J Muñoz-Bellido
- Department of Allergy, University Hospital of Salamanca, Spain; Institute for Biomedical Research of Salamanca, IBSAL, Spain; Department of Biomedical and Diagnostic Sciences, University of Salamanca, Spain
| | - Maria Teresa Gracia-Bara
- Department of Allergy, University Hospital of Salamanca, Spain; Institute for Biomedical Research of Salamanca, IBSAL, Spain
| | - Cristina Martín
- Department of Allergy, University Hospital of Salamanca, Spain
| | - Eva M Macías
- Department of Allergy, University Hospital of Salamanca, Spain; Institute for Biomedical Research of Salamanca, IBSAL, Spain; Department of Biomedical and Diagnostic Sciences, University of Salamanca, Spain
| | - Sonia de Arriba
- Department of Allergy, University Hospital of Salamanca, Spain; Institute for Biomedical Research of Salamanca, IBSAL, Spain; Department of Biomedical and Diagnostic Sciences, University of Salamanca, Spain
| | - Alicia Gallardo
- Department of Allergy, University Hospital of Salamanca, Spain
| | - Rosita Castillo
- Department of Allergy, University Hospital of Salamanca, Spain
| | | | - Ignacio Dávila
- Department of Allergy, University Hospital of Salamanca, Spain; Institute for Biomedical Research of Salamanca, IBSAL, Spain; Department of Biomedical and Diagnostic Sciences, University of Salamanca, Spain; Asthma, Allergic and Adverse Reactions (ARADyAL) Network for Cooperative Research in Health of Instituto de Salud Carlos III, Hospital Universitario de Salamanca, Spain
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Scherrer MAR, Abreu ÉP, Rocha VB. Neomycin: sources of contact and sensitization evaluation in 1162 patients treated at a tertiary service. An Bras Dermatol 2023:S0365-0596(23)00070-3. [PMID: 37003899 DOI: 10.1016/j.abd.2022.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/29/2022] [Accepted: 07/19/2022] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND Neomycin is used in several over-the-counter pharmaceutical formulations in Brazil. In Europe and Canada, where it is not freely available, its sensitization frequency is lower than in the United States, where this does not occur. OBJECTIVE To present the frequency of sensitization to neomycin observed in a tertiary hospital and the pharmaceutical formulations sold in Brazil containing neomycin. METHOD Retrospective analysis of positive results to neomycin, obtained through patch tests performed in a tertiary hospital, from 2009 to 2018 and investigation of topical drugs and vaccines containing neomycin in Brazilian databases available on the internet. RESULTS Among 1,162 patients, 71 (6%) had positive reactions to neomycin, 65% female and 35% male individuals, 46% were over 50 years old, and 24% had a personal history of atopy. The dermatitis lasted from four months to 20 years. Lesions were located in 69% of the patients on the upper limbs, in 55% they were on the lower limbs, and in 42% they were disseminated in more than 4 sites. Polysensitization was detected in 55% of cases. Of these, 28% were linked to sensitization to rubber allergens and 27% to potassium bichromate. A total of 158 topical presentations of neomycin were found: 79 ointments, 58 creams, 10 ophthalmic solutions, seven otological solutions, one oral solution, two nasal solutions, and one antiseptic powder, in addition to 11 types of vaccines. STUDY LIMITATIONS Retrospective study. CONCLUSION Sensitization to neomycin occurred in 6% of the studied population, affecting more females aged over 50 years, with skin lesions located mainly on the upper and lower limbs, in the context of chronic contact dermatitis. Neomycin was found in 135 formulations, most of them available over the counter, as well as in 11 miscellaneous vaccines.
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Affiliation(s)
| | - Érica Possa Abreu
- Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Vanessa Barreto Rocha
- Department of Internal Medicine, Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
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Rasul TF, Morgan O, Elkhadem A, Henderson A. Soft tissue infection and follow-up for an unsheltered patient: the role of Street Medicine providers in bridging gaps in care. BMJ Case Rep 2023; 16:e251082. [PMID: 36737066 PMCID: PMC9899995 DOI: 10.1136/bcr-2022-251082] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Street Medicine is a volunteer-run initiative for low-resource healthcare settings. Formed to bridge gaps in care for persons experiencing homelessness, these organisations work to provide preventative medicine through maintenance care and follow-up. However, there are limits to what Street Medicine can accomplish given the geographical radius covered, lack of available transportation options and vulnerable sleeping locations night to night for the patients served. The subject of this case report is a middle-aged Spanish-speaking unsheltered man who began his care with a Street Medicine team. He was unable to attend medical appointments due to relocation, complicating his disease course and resulting in hospital intervention for cellulitis. Post-discharge, he stayed within radius and was treated by the street team. Increased emphasis on the effects of housing insecurity and addressing social determinants of health could prevent deterioration of manageable diseases and should be an area of active interest for Street Medicine team expansion.
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Affiliation(s)
- Taha Faiz Rasul
- Medical Education, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Orly Morgan
- Medical Education, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Adam Elkhadem
- College of Arts and Sciences, Columbia University, New York City, New York, USA
| | - Armen Henderson
- Medical Education, University of Miami Miller School of Medicine, Miami, Florida, USA
- Internal Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA
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4
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He C, Yue Y, Li R, Huang Y, Shu L, Lv H, Wang J, Zhang Z. Sodium hyaluronates applied in the face affects the diversity of skin microbiota in healthy people. Int J Cosmet Sci 2023. [PMID: 36710533 DOI: 10.1111/ics.12845] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 12/15/2022] [Accepted: 01/27/2023] [Indexed: 01/31/2023]
Abstract
OBJECTIVE A healthy and stable microbiome has many beneficial effects on the host, while an unbalanced or disordered microbiome can lead to various skin diseases. Hyaluronic acid is widely used in the cosmetics and pharmaceutical industries; however, specific reports on its effect on the skin microflora of healthy people have not been published. This study aimed to determine the effect of sodium hyaluronate on the facial microflora of healthy individuals. METHODS Face of 20 healthy female volunteers between 18 and 24 years was smeared with sodium hyaluronate solution once per day. Cotton swabs were used to retrieve samples on days 0, 14, and 28, and high-throughput sequencing of 16 S rRNA was used to determine the changes in bacterial community composition. RESULTS Facial application of HA can reduce the abundance of pathogenic bacteria, such as Cutibacterium and S. aureus, and increase the colonization of beneficial bacteria. CONCLUSION This is the first intuitive report to demonstrate the effect of hyaluronic acid on facial microflora in healthy people. Accordingly, sodium hyaluronate was found to have a positive effect on facial skin health.
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Affiliation(s)
- Chen He
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - YingXue Yue
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Ruilong Li
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yiping Huang
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Luan Shu
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Huixia Lv
- Special Cosmetics R&D Joint laboratory of China Pharmaceutical University & Bloomage Biotechnology Corporation Limited, Nanjing, China
| | - Jing Wang
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Zhenhai Zhang
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
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Patch Test Reactions Associated With Topical Medications: A Retrospective Analysis of the North American Contact Dermatitis Group Data (2001-2018). Dermatitis 2021; 33:144-154. [PMID: 34405832 DOI: 10.1097/der.0000000000000777] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND/OBJECTIVES Topical medications may lead to allergic contact dermatitis. This study characterized positive patch test reactions associated with medications in patients evaluated by the North American Contact Dermatitis Group (NACDG). METHODS This study is a retrospective analysis of the NACDG data (2001-2018). Patients with at least 1 positive patch test reaction associated with a medication source were included. Allergens, reaction characteristics, clinical relevance, and source details were tabulated. RESULTS Of 43,722 patients, 6374 (14.6%) had positive allergic patch test reactions associated with 1 or more topical medication sources. Patients with versus without allergic reactions to medications were more likely to be older than 40 years (P < 0.0001) and/or have primary sites of dermatitis on the legs, anal/genital region, or trunk (P < 0.0001). There were 8787 reactions to NACDG allergens; the most common were neomycin (29.4%), bacitracin (29.1%), propylene glycol 100% (10.6%), tixocortol-17-pivalate (10.0%), lidocaine (7.9%), budesonide (4.9%), and dibucaine (4.4%). Propylene glycol 100% was the most common inactive ingredient (10.6%). Current relevance was present in 61.0%. A total of 6.5% of the individuals with medication allergy would have had 1 or more positive patch test reactions missed if only tested to the NACDG screening series. CONCLUSIONS Positive patch test reactions associated with topical medications were common (14.6%), and most were clinically relevant. Patients with topical medication allergy were twice as likely to have anal/genital involvement. Active ingredients, especially neomycin, bacitracin, and tixocortol-17-pivalate, were frequent culprits.
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Contact Allergy to Topical Drugs. Contact Dermatitis 2021. [DOI: 10.1007/978-3-030-36335-2_38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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7
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Mizutani H, Nixon RL. The Australian Baseline Series. Contact Dermatitis 2021. [DOI: 10.1007/978-3-030-36335-2_68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Weyandt G, Breitkopf C, Werner RN, Zidane M, Furtwängler A, Jongen J, Rothhaar A, Schaefer D, Lenhard B. S1‐Leitlinie Diagnostik und Therapie des Analekzems. J Dtsch Dermatol Ges 2020; 18:648-657. [PMID: 32519493 DOI: 10.1111/ddg.14125_g] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 09/14/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Gerhard Weyandt
- Klinik für Dermatologie und Allergologie, Klinikum Bayreuth, Bayreuth
| | | | - Ricardo Niklas Werner
- Klinik für Dermatologie, Venerologie und Allergologie, Division of Evidence-based Medicine (dEBM), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin
| | - Miriam Zidane
- Klinik für Dermatologie, Venerologie und Allergologie, Division of Evidence-based Medicine (dEBM), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin
| | - Alex Furtwängler
- Praxisklinik 2000, Proktologische Praxis Freiburg, Freiburg im Breisgau
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Weyandt G, Breitkopf C, Werner RN, Zidane M, Furtwängler A, Jongen J, Rothhaar A, Schaefer D, Lenhard B. German S1 guidelines for the diagnosis and treatment of perianal dermatitis (anal eczema). J Dtsch Dermatol Ges 2020; 18:648-657. [PMID: 32469472 DOI: 10.1111/ddg.14125] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 09/14/2019] [Indexed: 11/30/2022]
Abstract
Perianal dermatitis (anal eczema, perianal eczema) is one of the most common proctological conditions. It may occur as a sequela or a presenting symptom of various proctological, dermatological, allergic or pathogen-induced disorders. The three main types of anal eczema are irritant-toxic, atopic and allergic contact dermatitis. Adequate and successful treatment requires a comprehensive diagnostic workup to determine disease etiology and includes treatment/elimination of causative factors as well as nonpharmacological interventions (avoidance of aggravating factors). In addition, adjuvant topical anti-inflammatory and/or specific symptomatic treatment may be required. The present guidelines contain recommendations for the diagnostic and therapeutic management of perianal dermatitis. Target users of these guidelines are clinicians in the fields of dermatology and proctology, as well as all other specialties involved in the management of patients with perianal dermatitis, both in hospital and office-based settings.
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Affiliation(s)
- Gerhard Weyandt
- Department of Dermatology and Allergology, Klinikum Bayreuth, Bayreuth, Germany
| | | | - Ricardo Niklas Werner
- Department of Dermatology, Venereology und Allergology, Division of Evidence-based Medicine (dEBM), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt University of Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Miriam Zidane
- Department of Dermatology, Venereology und Allergology, Division of Evidence-based Medicine (dEBM), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt University of Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Alex Furtwängler
- Praxisklinik 2000, Proktologische Praxis Freiburg, Freiburg im Breisgau, Germany
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10
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Allergic Contact Dermatitis to Pramoxine (Pramocaine). Dermatitis 2020; 32:32-37. [PMID: 32404620 DOI: 10.1097/der.0000000000000606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Prescription and over-the-counter topical anesthetics are commonly used. Although allergy to amide and ester anesthetics is known, little has been reported on the nonamide, nonester pramoxine (pramocaine). This article briefly reviews allergy to topical anesthetics, provides detailed information on pramoxine, and describes characteristics of multiple patients with positive, relevant reactions to pramoxine.
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11
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The Australian Baseline Series. Contact Dermatitis 2020. [DOI: 10.1007/978-3-319-72451-5_68-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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12
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Topical Drugs. Contact Dermatitis 2020. [DOI: 10.1007/978-3-319-72451-5_38-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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13
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Goossens A, Gonçalo M. Contact Allergy to Topical Drugs. Contact Dermatitis 2020. [DOI: 10.1007/978-3-319-72451-5_38-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Cutaneous reactions caused by nitrofurazone. Postepy Dermatol Alergol 2019; 36:398-402. [PMID: 31616212 PMCID: PMC6791145 DOI: 10.5114/ada.2019.87444] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 04/09/2018] [Indexed: 11/17/2022] Open
Abstract
Introduction Allergic contact dermatitis (ACD) is a form of dermatitis due to type 4 hypersensitivity reaction that occurs when the skin comes into contacts with the topical product. Topical nitrofurazone is a widely used antimicrobial drug in our country which is well known to cause ACD. Aim In this study, ACD cases with different clinical features attributed to the use of nitrofurazone were evaluated. Material and methods Patients hospitalized in our clinic between 2013 and 2017 with ACD diagnosis due to nitrofurazone were evaluated. The patient age, gender, atopy histories, clinical features, dissemination of the lesions, treatment given were reviewed. Results In a 5-year period, 58 cases were identified and their data were analysed. Twelve patients were female (21%), 46 patients were male (79%). Clinical presentations were dyshidrosiform (45%), excoriated papules and plaques (33%), combined (21%), and erythroderma in one patient. The dissemination was generalized in 34 patients, localized in 14 patients, and local spread in 10 patients. The mean hospitalization time was 7 ±3 days, and ranged from 3 to 18 days. Conclusions There may be widespread and severe ACD due to the use of nitrofurazone. Topical nitrofurazone should not be applied on damaged skin as sensitization may develop. Patients and physicians should be aware of the ACD risk associated with topical nitrofurazone, which is also commonly used as self-medication, physicians should take a detailed history of the drug use and products containing nitrofurazone should not be used in conditions where skin integrity is not intact, whenever possible.
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Kumar BV, Ashwini PK, Kanthraj GR, Jayadev BB. Patch Testing in Allergic Contact Dermatitis over the Lower Extremities. Indian J Dermatol 2019; 64:164. [PMID: 30983622 PMCID: PMC6440194 DOI: 10.4103/ijd.ijd_759_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background: There is an increased incidence of allergic contact dermatitis (ACD) over the lower extremities due to over-the-counter topical preparations, occupational risk, and usage of several chemicals in the manufacture of designer footwear. Aims and Objectives: The aim of the study was to identify the common allergens and polysensitization pattern involved in ACD over the lower extremities. Materials and Methods: It is a cross-sectional study, wherein a total of 80 patients were recruited over a period of 18 months. Demographic and clinical characteristics were noted. Patch test was done with the Indian standard series. Interpretation of patch test readings was read according to the International Contact Dermatitis Research Group criteria at 48 and 96 h. Results: There were 45 males and 35 females (M:F= 1.3:1). Mean age was 41.65 years. Most of the patients belonged to 21–40 years age group. Farmers, homemakers, and students were commonly affected. Most common presentation was itching, hyperpigmentation, and scaly plaques over the feet. Patch test was performed in 75% of the patients. One or more positive results were observed in 57% of the patients. Common allergens noted were potassium dichromate (35%), followed by nickel sulfate (23.5%), mercapto mix, and mercaptobenzothiazole. Potassium dichromate and nickel were the common allergens reported in males and females, respectively. Neomycin was the common medication responsible for dermatitis medicamentosa. Polysensitization was seen with mercapto mix, mercaptobenzothiazole, potassium dichromate, and fragrance mix. Conclusion: Potassium dichromate and nickel were the common allergens responsible for ACD over the lower extremities. Polysensitization was seen commonly with mercapto mix, mercaptobenzothiazole, and fragrance mix. Recommendation: Screening for usage of topical preparations and late patch test readings (96 h or more) is recommended.
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Affiliation(s)
- Bommireddy Vinay Kumar
- Department of Dermatology, Venereology and Leprology, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
| | - P Kombettu Ashwini
- Department of Dermatology, Venereology and Leprology, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
| | - Garehatty Rudrappa Kanthraj
- Department of Dermatology, Venereology and Leprology, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
| | - B Betkerur Jayadev
- Department of Dermatology, Venereology and Leprology, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
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Napolitano M, Cappello M, Festa B, Patruno C. Clotrimazole-related allergic contact dermatitis. GIORN ITAL DERMAT V 2018; 155:355-357. [PMID: 30350555 DOI: 10.23736/s0392-0488.18.05943-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Maddalena Napolitano
- Vincenzo Tiberio Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy -
| | - Milena Cappello
- Section of Dermatology, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Bianca Festa
- Section of Dermatology, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Cataldo Patruno
- Section of Dermatology, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
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Lam PL, Lee KKH, Wong RSM, Cheng GYM, Bian ZX, Chui CH, Gambari R. Recent advances on topical antimicrobials for skin and soft tissue infections and their safety concerns. Crit Rev Microbiol 2018; 44:40-78. [PMID: 28423970 DOI: 10.1080/1040841x.2017.1313811] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Antimicrobial resistance of disease-related microorganisms is considered a worldwide prevalent and serious issue which increases the failure of treatment outcomes and leads to high mortality. Considering that the increased resistance to systemic antimicrobial therapy often needs of the use of more toxic agents, topical antimicrobial therapy emerges as an attractive route for the treatment of infectious diseases. The topical antimicrobial therapy is based on the absorption of high drug doses in a readily accessible skin surface, resulting in a reduction of microbial proliferation at infected skin sites. Topical antimicrobials retain the following features: (a) they are able to escape the enzymatic degradation and rapid clearance in the gastrointestinal tract or the first-pass metabolism during oral administration; (b) alleviate the physical discomfort related to intravenous injection; (c) reduce possible adverse effects and drug interactions of systemic administrations; (d) increase patient compliance and convenience; and (e) reduce the treatment costs. Novel antimicrobials for topical application have been widely exploited to control the emergence of drug-resistant microorganisms. This review provides a description of antimicrobial resistance, common microorganisms causing skin and soft tissue infections, topical delivery route of antimicrobials, safety concerns of topical antimicrobials, recent advances, challenges and future prospective in topical antimicrobial development.
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Affiliation(s)
- P L Lam
- a Department of Applied Biology and Chemical Technology, State Key Laboratory of Chirosciences , The Hong Kong Polytechnic University , Hong Kong , P.R. China
| | - K K H Lee
- b Department of Medicine and Therapeutics, School of Biomedical Sciences, MOE Key Laboratory for Regenerative Medicine , The Chinese University of Hong Kong , Hong Kong , P.R. China
| | - R S M Wong
- b Department of Medicine and Therapeutics, School of Biomedical Sciences, MOE Key Laboratory for Regenerative Medicine , The Chinese University of Hong Kong , Hong Kong , P.R. China
| | - G Y M Cheng
- c Faculty of Health Sciences , University of Macau , Macau , P.R. China
| | - Z X Bian
- d Clinical Division, School of Chinese Medicine , Hong Kong Baptist University , Hong Kong , P.R. China
| | - C H Chui
- a Department of Applied Biology and Chemical Technology, State Key Laboratory of Chirosciences , The Hong Kong Polytechnic University , Hong Kong , P.R. China
- d Clinical Division, School of Chinese Medicine , Hong Kong Baptist University , Hong Kong , P.R. China
| | - R Gambari
- e Department of Life Sciences and Biotechnology, Centre of Biotechnology , University of Ferrara , Ferrara , Italy
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Patel A, Burns E, Burkemper NM. Methotrexate use in allergic contact dermatitis: a retrospective study. Contact Dermatitis 2017; 78:194-198. [DOI: 10.1111/cod.12925] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 10/09/2017] [Accepted: 10/16/2017] [Indexed: 01/19/2023]
Affiliation(s)
- Ashaki Patel
- Departments of Dermatology and Pathology; Saint Louis University; St Louis MO 63104 USA
| | - Erin Burns
- Departments of Dermatology and Pathology; Saint Louis University; St Louis MO 63104 USA
| | - Nicole M. Burkemper
- Departments of Dermatology and Pathology; Saint Louis University; St Louis MO 63104 USA
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19
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Wilkinson M, Gallo R, Goossens A, Johansen JD, Rustemeyer T, Sánchez-Pérez J, Schuttelaar ML, Uter W. A proposal to create an extension to the European baseline series. Contact Dermatitis 2017; 78:101-108. [PMID: 29194657 DOI: 10.1111/cod.12918] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Revised: 09/04/2017] [Accepted: 09/29/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND The current European baseline series consists of 30 allergens, and was last updated in 2015. OBJECTIVES To use data from the European Surveillance System on Contact Allergies (ESSCA) to propose an extension to the European baseline series in response to changes in environmental exposures. METHODS Data from departmental and national extensions to the baseline series, together with some temporary additions from departments contributing to the ESSCA, were collated during 2013-2014. RESULTS In total, 31689 patients were patch tested in 46 European departments. Many departments and national groups already consider the current European baseline series to be a suboptimal screen, and use their own extensions to it. The haptens tested are heterogeneous, although there are some consistent themes. Potential haptens to include in an extension to the European baseline series comprise sodium metabisulfite, formaldehyde-releasing preservatives, additional markers of fragrance allergy, propolis, Compositae mix, and 2-hydroxyethyl methacrylate. CONCLUSION In combination with other published work from the ESSCA, changes to the current European baseline series are proposed for discussion. As well as addition of the allergens listed above, it is suggested that primin and clioquinol should be deleted from the series, owing to reduced environmental exposure.
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Affiliation(s)
- Mark Wilkinson
- Department of Dermatology, Leeds Teaching Hospitals NHS Trust, Leeds, LS7 4SA, UK
| | - Rosella Gallo
- Clinica Dermatologica, Department of Health Sciences (DiSSAL), Università di Genova, Ospedale Policlinico San Martino, 16132, Genoa, Italy
| | - An Goossens
- Contact Allergy Unit, Department of Dermatology, University Hospital KU Leuven, 3000, Leuven, Belgium
| | - Jeanne D Johansen
- Department of Dermato-Allergology, National Allergy Research Centre, Gentofte Hospital, University of Copenhagen, 2900, Hellerup, Denmark
| | - Thomas Rustemeyer
- Department of Dermatology, Free University of Amsterdam, 1081 HV, Amsterdam, The Netherlands
| | | | - Marie L Schuttelaar
- Department of Dermatology, University Medical Centre Groningen, University of Groningen, 9713 GZ, Groningen, The Netherlands
| | - Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, 91054, Erlangen, Germany
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Elliott JF, Abbas M, Hull P, de Gannes G, Toussi R, Milani A. Decreasing Rates of Neomycin Sensitization in Western Canada. J Cutan Med Surg 2016; 20:446-52. [DOI: 10.1177/1203475415623512] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Neomycin contact sensitization rates in North America range from 7% to 13%, whereas in Europe they average approximately 1.9%. Objectives: Given that topical neomycin products are no longer readily available in Canada, the aim of this study was to examine what influence this may have had on neomycin sensitization rates in the 3 western provinces. Methods: On the basis of an observation originally communicated by L. M. Parsons and C. Zhang of the University of Calgary, which suggested significantly reduced rates of neomycin sensitization in Calgary, Alberta, Canada, a multicenter study of patch test results from 5690 patient charts was undertaken. Data from 3 other western Canadian Universities (the University of Saskatchewan, the University of Alberta, and the University of British Colombia) were analyzed. Data were available from 2001 to 2013 for the University of Saskatchewan (except 2006), whereas the University of Alberta and the University of British Columbia had data from 2009 to 2013. Descriptive statistics, trend analysis, and risk estimates were determined using SPSS version 20. Results: Sensitization rates for neomycin have decreased in western Canada and are now similar to those of Europe. Conclusions: This trend is likely influenced by the reduced availability of over-the-counter and prescription neomycin products in Canada.
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Affiliation(s)
- John F. Elliott
- Division of Dermatology, Departments of Medicine & Medical Microbiology and Immunology, University of Alberta, Edmonton, AB, Canada
| | - Mariam Abbas
- Division of Dermatology, Departments of Medicine & Medical Microbiology and Immunology, University of Alberta, Edmonton, AB, Canada
| | - Peter Hull
- Division of Clinical Dermatology & Cutaneous Science, Department of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Gillian de Gannes
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
| | - Reza Toussi
- Division of Dermatology, Departments of Medicine & Medical Microbiology and Immunology, University of Alberta, Edmonton, AB, Canada
| | - Azita Milani
- Division of Dermatology, Departments of Medicine & Medical Microbiology and Immunology, University of Alberta, Edmonton, AB, Canada
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21
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Contact dermatitis to topical medicaments: A retrospective study from a medical center in Taiwan. DERMATOL SIN 2015. [DOI: 10.1016/j.dsi.2015.02.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Havlickova B, Weyandt GH. Therapeutic management of anal eczema: an evidence-based review. Int J Clin Pract 2014; 68:1388-99. [PMID: 24898365 PMCID: PMC4282279 DOI: 10.1111/ijcp.12457] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Accepted: 04/14/2014] [Indexed: 11/30/2022] Open
Abstract
AIM To conduct a systematic review of treatments for anal eczema (AE). METHODS We conducted a Medline search for clinical trial data for the treatment of perianal diseases including AE, including papers not published in the English language. We assessed the study reports using the system recommended by the Oxford Centre for Evidence-based Medicine. No meta-analysis was attempted. RESULTS The evidence base for topical treatments used to treat AE is very poor: there are very few studies and many of those that exist are of poor quality. The best evidence was found for medications that are yet to be licensed for AE. Among products with existing licences for the treatment of eczema, our assessment found some evidence to support the continued use of mild-to-moderate corticosteroids first line in most patients. DISCUSSION Features of the perianal region, and the fact that it is almost always occluded, mean that not all medications recommended in the general treatment guidelines for eczema are appropriate for AE. However, there are no specific treatment guidelines for these patients. This may in part be because of the lack of high-quality evidence-based medicine in this therapy area. Many frequently prescribed medications were developed and licensed many years ago, in an era when clinical trial design was not expected to be as rigorous as it is today. CONCLUSION This review highlights the need to conduct more high-quality clinical trials in patients with AE in order that specific guidelines for the management of this difficult proctological condition can be prepared.
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Affiliation(s)
- B Havlickova
- Global Clinical Development Dermatology, Bayer HealthCare, Berlin, Germany
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Abstract
Evidence for the effectiveness of patch testing and the need for an expanded series that provides experience and evidence-based suggestions for an extended patch testing series are examined in this review. Many of those testing with shorter allergen series are interested in expanding the spectrum of patch testing. The American Contact Dermatitis Society (ACDS) Core Allergen Series Group has arranged a group of suggested allergen groups that can be logically scaled up or down depending on the needs of the patch tester and the community being tested. This is not an "ACDS 80 Standard." We suggest a core group of allergens similar to the TRUE Test (SmartPractice, Phoenix, Ariz) with subsequent trays providing a greater breadth of coverage in a logical fashion, with more likely allergens being higher in the tray. For more extensive testing, specialty trays (ie, cosmetics, metals, plant, etc) are recommended.
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