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Kwan Z, Han WH, Yong SS, Faheem NAA, Choong RKJ, Zainuddin SI, Lam CL, Tan MP, Capelle DP. Dermatological Issues Among Individuals Receiving Palliative Care - A Review. Am J Hosp Palliat Care 2024; 41:952-964. [PMID: 37625380 DOI: 10.1177/10499091231198752] [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] [Indexed: 08/27/2023] Open
Abstract
Skin disorders among individuals receiving palliative care may be associated with the primary condition or underlying comorbidities and patients may experience pruritus, discomfort or pain. Common conditions include xerosis, pressure ulcers, intertrigo, superficial fungal infections, telogen effluvium, pruritus, herpes zoster, eczematous disorders and edema. During end-of-life care, there is reduced skin perfusion and metabolism hence leading to susceptibility to infection, pressure and injury. Other factors affecting the skin include limited mobility, nutritional deficits and immunosuppression. Although treatment strategies for each skin condition are usually aligned with standard protocols, considerations among these patients include limited life-expectancies, potential treatment burden, drug-drug interactions as well as comfort-directed rather than cure-directed therapy. For patients with xerosis cutis, the regular use of moisturisers is recommended. The management and prevention of pressure ulcers include the strategies of skin assessment and care, pressure redistribution, nutrition and hydration and ulcer care. Superficial fungal infections require treatment with appropriate topical and/or systemic antifungals while antivirals and adjunctive treatment can be prescribed for herpes zoster. Treatment and symptom control of skin disorders in this population can improve quality of life and patients' comfort level.
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Affiliation(s)
- Zhenli Kwan
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Winn Hui Han
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Shin Shen Yong
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Nik Aimee Azizah Faheem
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Rebecca Kai Jan Choong
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Sheriza Izwa Zainuddin
- Division of Palliative Medicine, Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Chee Loong Lam
- Division of Palliative Medicine, Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Maw Pin Tan
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - David Paul Capelle
- Division of Palliative Medicine, Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
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van Zuuren EJ, Arents BWM, Vermeulen S, Schoones JW, Fedorowicz Z. Global Guidelines in Dermatology Mapping Project (GUIDEMAP)-A systematic review of the methodological quality of contact dermatitis clinical practice guidelines. Contact Dermatitis 2024; 90:543-555. [PMID: 38403277 DOI: 10.1111/cod.14530] [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: 12/11/2023] [Revised: 02/11/2024] [Accepted: 02/13/2024] [Indexed: 02/27/2024]
Abstract
The Global Guidelines in Dermatology Mapping Project (GUIDEMAP) assesses the methodological quality of clinical practice guidelines (CPGs) for high-burden skin diseases. This review focuses on contact dermatitis. We searched MEDLINE, Embase, PubMed, Web of Science, Cochrane Library, Emcare, Epistemonikos, PsycINFO and Academic Search Premier for CPGs published between 1 November 2018 and 1 November 2023. Prespecified guideline resources were hand searched. Two authors independently undertook screening, data extraction and quality assessments. Instruments used were the Appraisal of Guidelines for Research and Evaluation (AGREE) II Reporting Checklist, the U.S. Institute of Medicine's (IOM) criteria of trustworthiness, The Agency for Healthcare Research and Quality's National Guideline Clearinghouse Extent Adherence to Trustworthy Standards (NEATS) Instrument and Lenzer's Red Flags. Twenty five CPGs were included, exhibiting heterogeneity in both the topics they addressed and their methodological quality. Whereas the CPGs on management of hand eczema from Denmark, Europe and the Netherlands scored best, most CPGs fell short of being clear, unbiased, trustworthy and evidence-based. Disclosure of conflicts of interest scored well, and areas needing improvement include 'strength and wording of recommendations', 'applicability', 'updating' and 'external review'. Adhering to AGREE II and Grading of Recommendations, Assessment, Development and Evaluations (GRADE) enhances methodological quality.
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Affiliation(s)
- Esther J van Zuuren
- Dermatology Department, Leiden University Medical Centre, Leiden, The Netherlands
| | - Bernd W M Arents
- Dutch Association for People with Atopic Dermatitis, Nijkerk, The Netherlands
| | - Sofieke Vermeulen
- Department of Dermatology, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Jan W Schoones
- Directorate of Research Policy (formerly: Walaeus Library), Leiden University Medical Centre, Leiden, The Netherlands
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3
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Afsar B, Afsar RE. Hypersensitive Reactions During Hemodialysis Treatment: What Do We Need to Know? Semin Dial 2024; 37:189-199. [PMID: 38433728 DOI: 10.1111/sdi.13197] [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: 11/22/2023] [Accepted: 01/30/2024] [Indexed: 03/05/2024]
Abstract
Kidney replacement therapies (KRTs) including hemodialysis (HD) are one of the treatment options for most of the patients with end-stage kidney disease. Although HD is vital for these patients, it is not hundred percent physiological, and various adverse events including hypersensitivity reactions may occur. Fortunately, these reactions are rare in total and less when compared to previous decades, but it is still very important for at least two reasons: First, the number of patients receiving kidney replacement treatment is increasing globally; and the cumulative number of these reactions may be substantial. Second, although most of these reactions are mild, some of them may be very severe and even lead to mortality. Thus, it is very important to have basic knowledge and skills to diagnose and treat these reactions. Hypersensitivity reactions can occur at any component of dialysis machinery (access, extracorporeal circuit, medications, etc.). The most important preventive measure is to avoid the allergen. However, even with very specific test, sometimes the allergen cannot be found. In mild conditions, HD can be contained with non-specific treatment (topical creams, antihistaminics, corticosteroids). In more severe conditions, treatment must be stopped immediately, blood should not be returned to patient, drugs must be stopped, and rules of general emergency treatment must be followed.
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Affiliation(s)
- Baris Afsar
- Department of Nephrology, School of Medicine, Suleyman Demirel University, Isparta, Turkey
| | - Rengin Elsurer Afsar
- Department of Nephrology, School of Medicine, Suleyman Demirel University, Isparta, Turkey
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Ochoa B, Lai K, Eldredge RS, Viswanath V, Bae JO, Lee J, McMahon LE, Notrica DM, Padilla BE. Preoperative Metal Allergy Testing for Pectus Excavatum Repair Does Not Effectively Identify Patients Who Develop Metal bar Allergy. J Pediatr Surg 2024; 59:956-961. [PMID: 38016849 DOI: 10.1016/j.jpedsurg.2023.10.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 09/20/2023] [Accepted: 10/30/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND Metal allergy following placement of a metal pectus bar for minimally invasive repair of pectus excavatum (MIRPE) is a rare complication with potentially significant morbidity. There is no consensus regarding preoperative metal allergy testing (MAT). This study aims to assess incidence of metal allergy and titanium bar use in tested and untested patients and trends in MAT with different approaches to MAT. METHODS A retrospective chart review was performed on patients who underwent MIRPE from July 2009 to June 2022 at a single institution. During this time, MAT was performed routinely (RT; routine testing) and selectively (ST; selective testing). RESULTS The cohort included 741 patients for analysis. Metal bar allergy was documented in 1.3 % of all patients; the incidence was 1.3 % in patients with MAT and 1.4 % without MAT. The incidence of bar allergy was 1.1 % in the RT group and 1.6 % in the ST group. In the RT group, bar allergy occurred in 1.4 % (3/216) of patients with a negative MAT. In the ST group, bar allergy occurred in 1.2 % (2/164) of patients with a negative MAT and in 1.9 % (3/162) of untested patients with a stainless-steel bar. Titanium bar use was not significantly different between the RT and ST groups (18.3 % vs 16.3 %, p > 0.05). CONCLUSION The incidence of metal bar allergy after MIRPE was less than 2 %, and titanium bar use was not significantly different in routine and selective testing groups. MAT was not associated with a reduction in bar allergy, and its use remains unsupported. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Brielle Ochoa
- Division of Pediatric Surgery, Department of Surgery, Phoenix Children's, Phoenix, AZ, USA
| | - Krista Lai
- Division of Pediatric Surgery, Department of Surgery, Phoenix Children's, Phoenix, AZ, USA
| | - R Scott Eldredge
- Division of Pediatric Surgery, Department of Surgery, Phoenix Children's, Phoenix, AZ, USA
| | - Vijay Viswanath
- Division of Pediatric Surgery, Department of Surgery, Phoenix Children's, Phoenix, AZ, USA
| | - Jae-O Bae
- Division of Pediatric Surgery, Department of Surgery, Phoenix Children's, Phoenix, AZ, USA
| | - Justin Lee
- Division of Pediatric Surgery, Department of Surgery, Phoenix Children's, Phoenix, AZ, USA; Department of Child Health and Development, University of Arizona, School of Medicine, Phoenix, AZ, USA
| | - Lisa E McMahon
- Division of Pediatric Surgery, Department of Surgery, Phoenix Children's, Phoenix, AZ, USA; Department of Child Health and Development, University of Arizona, School of Medicine, Phoenix, AZ, USA
| | - David M Notrica
- Division of Pediatric Surgery, Department of Surgery, Phoenix Children's, Phoenix, AZ, USA; Department of Child Health and Development, University of Arizona, School of Medicine, Phoenix, AZ, USA; Department of Surgery, Mayo Clinic School of Medicine and Science, Phoenix, AZ, USA
| | - Benjamin E Padilla
- Division of Pediatric Surgery, Department of Surgery, Phoenix Children's, Phoenix, AZ, USA; Department of Child Health and Development, University of Arizona, School of Medicine, Phoenix, AZ, USA.
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Michaels BS, Ayers T, Brooks-McLaughlin J, McLaughlin RJ, Sandoval-Warren K, Schlenker C, Ronaldson L, Ardagh S. Potential for Glove Risk Amplification via Direct Physical, Chemical, and Microbiological Contamination. J Food Prot 2024; 87:100283. [PMID: 38679200 DOI: 10.1016/j.jfp.2024.100283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 04/17/2024] [Accepted: 04/22/2024] [Indexed: 05/01/2024]
Abstract
This review focuses on the potential direct physical, chemical, and microbiological contamination from disposable gloves when utilized in food environments, inclusive of the risks posed to food products as well as worker safety. Unrecognized problems endemic to glove manufacturing were magnified during the COVID-19 pandemic due to high demand, increased focus on PPE performance, availability, supply chain instability, and labor shortages. Multiple evidence-based reports of contamination, toxicity, illness, deaths, and related regulatory action linked to contaminated gloves in food and healthcare have highlighted problems indicative of systemic glove industry shortcomings. The glove manufacturing process was diagramed with sources and pathways of contamination identified, indicating weak points with documented occurrences detailed. Numerous unsafe ingredients can introduce chemical contaminants, potentially posing risks to food and to glove users. Microbial hazards present significant challenges to overall glove safety as contaminants appear to be introduced via polluted water sources or flawed glove manufacturing processes, resulting in increased risks within food and healthcare environments. Frank and opportunistic pathogens along with food spoilage organisms can be introduced to foods and wearers. When the sources and pathways of glove-borne contamination were explored, it was found that physical failures play a pivotal role in the release of sweat build-up, liquefaction of chemical residues, and incubation of microbial contaminants from hands and gloves. Thus, with glove physical integrity issues, including punctures in new, unused gloves that can develop into significant rips and tears, not only can direct physical food contamination occur but also chemical and microbiological contamination can find their way into food. Enhanced regulatory requirements for Acceptable Quality Limits of food-grade gloves, and the establishment of appropriate bioburden standards would enhance safety in food applications. Based on the information provided, together with a false sense of security associated with glove use, the unconditional belief in glove chemical and microbiological purity may be unfounded.
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Affiliation(s)
- Barry S Michaels
- B. Michaels Group Inc., 487 West River Road, Palatka, FL 32177, USA.
| | - Troy Ayers
- Eurofins Microbiology Laboratories Inc., Des Moines, IA 50321, USA
| | | | | | | | | | - Lynda Ronaldson
- Eagle Protect PBC, South Lake Tahoe, CA 96150, USA; Eagle Protect Ltd. Christchurch 8011, New Zealand
| | - Steve Ardagh
- Eagle Protect PBC, South Lake Tahoe, CA 96150, USA; Eagle Protect Ltd. Christchurch 8011, New Zealand
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Reeder MJ, Nihal A, Aravamuthan SR, Warshaw EM, DeKoven JG, Atwater AR, Houle MC, Adler BL, Silverberg JI, Taylor JS, Pratt MD, Belsito DV, Yu J, Botto NB, Mowad CM, Dunnick CA, DeLeo VA. Allergic or Not: Final Interpretation of Doubtful Patch Test Reactions From the North American Contact Dermatitis Group, 2019-2020. Dermatitis 2024; 35:138-143. [PMID: 38320244 DOI: 10.1089/derm.2023.0285] [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: 02/08/2024]
Abstract
Background: Doubtful patch test reactions generally do not meet criterion for positivity in patch testing. However, the North American Contact Dermatitis Group (NACDG) allows for doubtful reactions to be coded with a final determination of "allergic/positive" based on the temporal pattern, appearance, known characteristics of the allergen, and/or other supportive patch test reactions. Objectives: To analyze NACDG data from the 2019-2020 patch test cycle to identify patterns in the interpretation and relevance of doubtful reactions. Methods: The frequency and proportions of doubtful reactions were tabulated and analyzed for patterns. Statistical analyses were limited to allergens with ≥30 doubtful reactions to ensure adequate sample size. Results: Of patch-tested patients, 31.9% (1315/4121) had ≥1 doubtful reaction. Of 2538 total doubtful reactions, 46% (n = 1167) had a final interpretation of "allergic/positive." The allergens with the highest proportion of doubtful reactions at the final visit were hydroperoxides of linalool 1% (4.5%), fragrance mix I 8.0% (3.9%), and cetrimonium chloride 0.5% (3.4%). Methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) 0.02% (P < 0.001), MI 0.2% (P < 0.001), nickel sulfate hexahydrate 2.5% (P = 0.001), and neomycin sulfate 20.0% (P = 0.003) doubtful reactions were more likely to be interpreted as allergic than nonallergic. Methyldibromoglutaronitrile/phenoxyethanol 0.2% (P < 0.001), oleamidopropyl dimethylamine 0.1% (P < 0.001), formaldehyde 2.0% (P < 0.001), cetrimonium chloride 0.5% (P < 0.001), benzophenone-4 (sulisobenzone) 10% (P < 0.001), iodopropynyl butylcarbamate 0.5% (P < 0.001), cocamidopropyl betaine 1.0% (P = 0.002), and benzisothiazolinone 0.1% (P = 0.012) doubtful reactions were less likely to be interpreted as allergic. Of the 1167 doubtful reactions interpreted as allergic, 84.9% had current relevance. Conclusions: Doubtful reactions were common and approximately one half were coded with a final interpretation of "allergic/positive." Of those, most were clinically relevant. MCI/MI, MI, nickel, and neomycin were more likely to be interpreted as allergic.
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Affiliation(s)
- Margo J Reeder
- From the Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Aman Nihal
- University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Srikanth R Aravamuthan
- From the Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Erin M Warshaw
- Department of Dermatology, Park Nicollet Health Services, Minneapolis, Minnesota, USA
- Department of Dermatology, Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota, USA
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Joel G DeKoven
- Division of Dermatology, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada
| | - Amber R Atwater
- Department of Dermatology, Duke University Medical Center, Durham, North Carolina, USA
| | - Marie-Claude Houle
- Division of Dermatology, CHU de Quebec, Laval University, Quebec City, Quebec, Canada
| | - Brandon L Adler
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Jonathan I Silverberg
- Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - James S Taylor
- Department of Dermatology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Melanie D Pratt
- Division of Dermatology, University of Ottawa, Ontario, Canada
| | - Donald V Belsito
- Department of Dermatology, Columbia University Irving Medical School, New York, New York, USA
| | - Jiade Yu
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Nina B Botto
- Department of Dermatology, University of California, San Francisco, California, USA
| | - Chris M Mowad
- Department of Dermatology, Geisinger Medical Center, Danville, Pennsylvania, USA
| | - Cory A Dunnick
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA; and
- Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado, USA
| | - Vincent A DeLeo
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
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Ashton SJ, Mughal AA. Contact Dermatitis to Ophthalmic Solutions: An Update. Dermatitis 2023; 34:480-483. [PMID: 37327018 DOI: 10.1089/derm.2023.0033] [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: 06/17/2023]
Abstract
Eyelid and periorbital dermatitis remains a distressing and recalcitrant disease. Contact dermatitis remains the most common cause of eyelid and periorbital dermatitis. Ophthalmic solutions used in the treatment of ophthalmic conditions can often be the cause. This article is an update of our previous study, summarizing the contact allergens involved and the new test concentrations reported to investigate through patch testing. New insights found during the review are also documented.
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Affiliation(s)
| | - Avad A Mughal
- Department of Dermatology, Neath and Port Talbot Hospital, Port Talbot, United Kingdom
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Passanisi S, Berg AK, Chobot A, Dos Santos TJ, Piona CA, Messer L, Lombardo F. First International Survey on Diabetes Providers' Assessment of Skin Reactions in Youth With Type 1 Diabetes Using Technological Devices. J Diabetes Sci Technol 2023:19322968231206155. [PMID: 37846755 DOI: 10.1177/19322968231206155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
BACKGROUND Advances in diabetes technological devices led to optimization of diabetes care; however, long-lasting skin exposure to devices may be accompanied by an increasing occurrence of cutaneous reactions. METHODS We used an open-link web-based survey to evaluate diabetes-care providers' viewpoint on prevalence, management practices, and knowledge related to skin reactions with the use of diabetes technological devices. A post hoc analysis was applied to investigate differences in the level of awareness on this topic in relation to the experience in diabetes technology. RESULTS One hundred twenty-five responses from 39 different countries were collected. Most respondents (69%) routinely examine patients' skin at each visit. All the preventive measures are not clear and, mainly, homogenously put into clinical practice. Contact dermatitis was the most frequently reported cutaneous complication due to diabetes devices, and its most common provocative causes are not yet fully known by diabetes-care providers. Almost half of the respondents (42%) had discussed the presence of harmful allergens contained in adhesives with device manufacturers. There is general agreement on the need to strengthen knowledge on dermatological complications. CONCLUSIONS Although diabetes-care providers are quite aware of the chance to develop skin reactions in people with diabetes using technological devices, there are still some unmet needs. Large follow-up studies and further dissemination tools are awaited to address the gaps revealed by our survey.
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Affiliation(s)
- Stefano Passanisi
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi," University of Messina, Messina, Italy
| | - Anna Korsgaard Berg
- Copenhagen University Hospital, Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Agata Chobot
- Department of Pediatrics, Institute of Medical Sciences, University of Opole, Opole, Poland
| | | | - Claudia Anita Piona
- Pediatric Diabetes and Metabolic Disorders Unit, Regional Center for Pediatric Diabetes, University City Hospital of Verona, Verona, Italy
| | - Laurel Messer
- Barbara Davis Center for Diabetes, University of Colorado Anschutz, Aurora, CO, USA
| | - Fortunato Lombardo
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi," University of Messina, Messina, Italy
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Spiewak R. Diseases from the Spectrum of Dermatitis and Eczema: Can "Omics" Sciences Help with Better Systematics and More Accurate Differential Diagnosis? Int J Mol Sci 2023; 24:10468. [PMID: 37445645 DOI: 10.3390/ijms241310468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/16/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023] Open
Abstract
Researchers active in the field of inflammatory skin diseases from the spectrum of dermatitis and eczema are well aware of a considerable overlap in the clinical pictures and proposed sets of diagnostic criteria for these diseases, which can hardly be overcome through the clinical or epidemiological research. In effect, patients are included in studies based on vague and overlapping criteria, while heterogeneous study populations may, in turn, lead to non-representative outcomes and continued confusion. In this narrative review, a systematics of diseases from the spectrum of dermatitis and eczema is proposed based on the origins of causative factors and the pathomechanisms involved. Difficulties in differentiating between these diseases are discussed, and the extent to which advances in the "omics" sciences might help to overcome them is considered. Of all the "omics" research in this field, more than 90% of the published papers were devoted to atopic dermatitis, with a striking underrepresentation of other diseases from the spectrum of dermatitis and eczema, conditions which collectively exceed the rates of atopic dermatitis by far. A greater "omics" research effort is urgently needed to tackle other dermatitides, like allergic, irritant and protein contact dermatitis, as well as radiation, seborrheic, stasis or autoimmune dermatitis. Atopic dermatitis findings should be validated not only against healthy donors but also other dermatitides. A clinic-oriented approach is proposed for future "omics" studies in the field of dermatitis and eczema.
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Affiliation(s)
- Radoslaw Spiewak
- Department of Experimental Dermatology and Cosmetology, Faculty of Pharmacy, Jagiellonian University Medical College, ul. Medyczna 9, 30-688 Krakow, Poland
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Tran HG, Shuayprom A, Kueanjinda P, Leelahavanichkul A, Wongsinkongman P, Chaisomboonpan S, Tawatsin A, Ruchusatsawat K, Wongpiyabovorn J. Oxyresveratrol Attenuates Inflammation in Human Keratinocyte via Regulating NF-kB Signaling and Ameliorates Eczematous Lesion in DNCB-Induced Dermatitis Mice. Pharmaceutics 2023; 15:1709. [PMID: 37376157 DOI: 10.3390/pharmaceutics15061709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/06/2023] [Accepted: 06/10/2023] [Indexed: 06/29/2023] Open
Abstract
Oxyresveratrol (ORV) is one of the novel antioxidants having been extensively studied in recent years. One of the main sources of ORV is Artocarpus lakoocha, which has been used in traditional medicine in Thailand for decades. However, the role of ORV in skin inflammation has not been clearly demonstrated. Therefore, we investigated the anti-inflammatory effects of ORV on dermatitis model. The effect of ORV was examined on human immortalized and primary skin cells exposed to bacterial components including peptidoglycan (PGN) and lipopolysaccharide (LPS) and 2,4-Dinitrochlorobenzene (DNCB)-induced dermatitis mouse model. PGN and LPS were used to induce inflammation on immortalized keratinocytes (HaCaT) and human epidermal keratinocytes (HEKa). We then performed MTT assay, Annexin V and PI assay, cell cycle analysis, real-time PCR, ELISA and Western blot in these in vitro models. H&E staining, immunohistochemistry (IHC) staining with CD3, CD4 and CD8 markers were used to evaluate the effects of ORV in in vivo model of skin inflammation using BALB/c mice. Pretreatment of HaCaT and HEKa cells with ORV inhibited pro-inflammatory cytokine production through inhibition of NF-κB pathway. In DNCB-induced dermatitis mouse model, ORV treatment reduced lesion severity, and skin thickness and numbers of CD3, CD4 and CD8 T cells in the sensitized skin of mice. In conclusion, it has been demonstrated that ORV treatment can ameliorate inflammation in the in vitro models of skin inflammation and in vivo models of dermatitis, suggesting a therapeutic potential of ORV for treatment of skin diseases particularly eczema.
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Affiliation(s)
- Hung Gia Tran
- Graduate Program in Clinical Sciences, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Aussavashai Shuayprom
- Department of Medical Sciences, Ministry of Public Health, Nonthaburi 11000, Thailand
| | - Patipark Kueanjinda
- Center of Excellence in Immune-Mediated Diseases, Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Asada Leelahavanichkul
- Center of Excellence on Translational Research in Inflammation and Immunology (CETRII), Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Prapai Wongsinkongman
- Department of Medical Sciences, Ministry of Public Health, Nonthaburi 11000, Thailand
| | | | - Apiwat Tawatsin
- Department of Medical Sciences, Ministry of Public Health, Nonthaburi 11000, Thailand
| | | | - Jongkonnee Wongpiyabovorn
- Center of Excellence in Immune-Mediated Diseases, Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
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11
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De Caux D, Mariappa G, Perera G, Girling J. Prescribing for pregnancy: chronic skin diseases. Drug Ther Bull 2023; 61:55-60. [PMID: 36990470 DOI: 10.1136/dtb.2022.000036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
Chronic skin disease is common in women of reproductive age. Although skin can improve or remain stable during pregnancy, it is also common for existing conditions to flare and for new conditions to develop. A small number of medications used to control chronic skin disease can potentially have adverse effects on the outcome of the pregnancy. This article forms part of a series on prescribing for pregnancy and highlights the importance of achieving good control of the skin disease prior to conception and during pregnancy. It emphasises the need for patient-centred, open and informed discussions around medication options to achieve good control. During pregnancy and breastfeeding each patient should be treated as an individual in accordance with the medications that are appropriate for them, their preferences, and the severity of their skin disease. This should be done through collaborative working across primary care, dermatology and obstetric services.
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Affiliation(s)
- Deborah De Caux
- Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | | | - Gayathri Perera
- Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - Joanna Girling
- Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
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12
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Loi AST, Aribou ZM, Fong YT. Improving Recovery of Irritant Hand Dermatitis in Healthcare Workers With Workplace Interventions During the COVID-19 Pandemic. Front Public Health 2022; 10:844269. [PMID: 35923967 PMCID: PMC9340064 DOI: 10.3389/fpubh.2022.844269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 06/20/2022] [Indexed: 11/28/2022] Open
Abstract
Introduction: Occupational hand dermatitis is common among healthcare workers, with increased incidence during the COVID-19 pandemic. Irritant contact dermatitis accounts for the majority of occupational hand dermatitis and is largely due to frequent contact with hand hygiene products. Long-term prognosis of occupational contact dermatitis is often very poor. This study aims to identify and implement suitable workplace interventions to aid in the recovery of occupational irritant hand dermatitis among healthcare workers during the COVID-19 pandemic. Methods A quality improvement (QI) project was performed in a tertiary hospital using the Plan-Do-Study-Act model. Healthcare workers seen at the Occupational Dermatology Clinic from March 2020 to May 2021 for the first time for likely occupational irritant dermatitis were targeted for the project. Four workplace interventions were implemented: (a) substitute current alcohol-based hand rub (ABHR) with a different, gentler ABHR, (b) alternate ABHR with gentle hand wash products, (c) temporary job modification with less clinical work (d) switch latex gloves to nitrile gloves. The improvement was assessed after 2 months of workplace intervention using a visual analogue scale, based on changes seen on photographs taken at the baseline and monthly review. The target improvement was set at 70% after 2 months of workplace interventions. Results A total of 21 participants were included in the QI project. All participants were found to have significant improvement in their hand condition. The estimated mean reduction of signs and symptoms was 80% in comparison to their baseline hand condition before intervention. Conclusion Workplace interventions such as substituting irritant hand hygiene products with gentler alternatives and temporary reduction in clinical duties may be useful in improving the recovery rate of irritant hand dermatitis among healthcare workers. Areas with high hand hygiene workload or high incidences of hand dermatitis may opt to implement systemic workplace changes.
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Affiliation(s)
- Alicia S. T. Loi
- Department of Occupational and Environmental Medicine, Singapore General Hospital, Singapore, Singapore
- Preventive Medicine, National University Health System, Singapore, Singapore
- *Correspondence: Alicia S. T. Loi
| | - Zeenathnisa M. Aribou
- Department of Occupational and Environmental Medicine, Singapore General Hospital, Singapore, Singapore
- Preventive Medicine, National University Health System, Singapore, Singapore
| | - Yuke Tien Fong
- Department of Occupational and Environmental Medicine, Singapore General Hospital, Singapore, Singapore
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13
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Lin Y, Zhou HC, Chen N, Ren Y, Gao R, Li Q, Deng Y, Han X, Zhang X, Xiang AP, Guo B, Liu C, Ren J. Unveiling the improved targeting migration of mesenchymal stem cells with CXC chemokine receptor 3-modification using intravital NIR-II photoacoustic imaging. J Nanobiotechnology 2022; 20:307. [PMID: 35764961 PMCID: PMC9238014 DOI: 10.1186/s12951-022-01513-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 06/14/2022] [Indexed: 12/13/2022] Open
Abstract
Background Therapy with genetically modified mesenchymal stem cells (MSCs) has clinical translation promise. Optimizing the targeting migratory ability of MSCs relies on accurate imaging of the distribution and extravasation kinetics of MSCs, and the corresponding imaging results could be used to predict therapeutic outcomes and guide the optimization of the treatment program. Among the different imaging modalities, second near-infrared (NIR-II) optical-resolution photoacoustic microscopy (OR-PAM) has merits, including a fine resolution, a deep penetration, a high sensitivity, and a large signal-to-background ratio. It would be an ideal candidate for precise monitoring of MSCs, although it has not been tested for this purpose so far. Results Penetrating peptide-decorated conjugated polymer nanoparticles (TAT-CPNPs) with strong NIR-II absorbance were used to label chemokine-receptor genetically modified MSCs, which were subsequently evaluated under intravital NIR-II OR-PAM regarding their targeting migratory ability. Based on the upregulation of chemokine (C-X-C motif) ligand 10 in the inflamed ears of contact hypersensitivity mice, MSCs with overexpression of corresponding receptor, chemokine (C-X-C motif) receptor 3 (Cxcr3) were successfully generated (MSCCxcr3). TAT-CPNPs labeling enabled NIR-II photoacoustic imaging to discern MSCCxcr3 covered by 1.2 cm of chicken breast tissue. Longitudinal OR-PAM imaging revealed enhanced inflammation-targeting migration of MSCCxcr3 over time attributed to Cxcr3 gene modification, which was further validated by histological analysis. Conclusions TAT-CPNPs-assisted NIR-II PA imaging is promising for monitoring distribution and extravasation kinetics of MSCs, which would greatly facilitate optimizing MSC-based therapy. Graphical Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s12951-022-01513-7.
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Affiliation(s)
- Yuejun Lin
- Department of Ultrasound, Laboratory of Novel Optoacoustic/Ultrasonic Imaging, Key Laboratory of Liver Disease of Guangdong Province, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510630, China
| | - Hui-Chao Zhou
- Department of Ultrasound, Laboratory of Novel Optoacoustic/Ultrasonic Imaging, Key Laboratory of Liver Disease of Guangdong Province, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510630, China
| | - Ningbo Chen
- Research Laboratory for Biomedical Optics and Molecular Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Yaguang Ren
- Research Laboratory for Biomedical Optics and Molecular Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Rongkang Gao
- Research Laboratory for Biomedical Optics and Molecular Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Qiaojia Li
- Department of Ultrasound, Laboratory of Novel Optoacoustic/Ultrasonic Imaging, Key Laboratory of Liver Disease of Guangdong Province, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510630, China
| | - Yiwen Deng
- Center for Stem Cell Biology and Tissue Engineering, Key Laboratory for Stem Cells and Tissue Engineering, Ministry of Education, Sun Yat-Sen University, Guangzhou, 510630, China
| | - Xuejiao Han
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, 150081, China
| | - Xiaoran Zhang
- Center for Stem Cell Biology and Tissue Engineering, Key Laboratory for Stem Cells and Tissue Engineering, Ministry of Education, Sun Yat-Sen University, Guangzhou, 510630, China
| | - Andy Peng Xiang
- Center for Stem Cell Biology and Tissue Engineering, Key Laboratory for Stem Cells and Tissue Engineering, Ministry of Education, Sun Yat-Sen University, Guangzhou, 510630, China
| | - Bing Guo
- School of Science and Shenzhen Key Laboratory of Flexible Printed Electronics Technology, Harbin Institute of Technology, Shenzhen, 518055, China.
| | - Chengbo Liu
- Research Laboratory for Biomedical Optics and Molecular Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China.
| | - Jie Ren
- Department of Ultrasound, Laboratory of Novel Optoacoustic/Ultrasonic Imaging, Key Laboratory of Liver Disease of Guangdong Province, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510630, China.
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14
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Abstract
Purpose of Review Recent Findings Summary
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Affiliation(s)
- Kajal Patel
- Occupational Dermatology Research and Education Centre, Skin Health Institute, Level 1/80 Drummond Street, Carlton, 3053 Australia
| | - Rosemary Nixon
- Occupational Dermatology Research and Education Centre, Skin Health Institute, Level 1/80 Drummond Street, Carlton, 3053 Australia
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15
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Passanisi S, Salzano G, Galletta F, Aramnejad S, Caminiti L, Pajno GB, Lombardo F. Technologies for Type 1 Diabetes and Contact Dermatitis: Therapeutic Tools and Clinical Outcomes in a Cohort of Pediatric Patients. Front Endocrinol (Lausanne) 2022; 13:846137. [PMID: 35370980 PMCID: PMC8965381 DOI: 10.3389/fendo.2022.846137] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 02/21/2022] [Indexed: 11/13/2022] Open
Abstract
The increasing use of technological devices for the management of diabetes is related to the prolonged exposure of patients' skin to chemical and mechanical agents and, consequently, to the increased risk of developing dermatological complications. Among these, contact dermatitis is the most insidious skin disorder. Despite the magnitude of the issue, no universally accepted recommendations on the management of this common complication are currently available. Our observational study aimed to describe all the solutions adopted by patients and their caregivers to treat and prevent the appearance of contact dermatitis and to describe the clinical impact of this cutaneous complication. Twenty-one pediatric patients (mean age 12.1 ± 3.7 years) with type 1 diabetes were recruited in the study. The most common treatment used to treat acute skin lesions was the application of topical corticosteroids, sometimes associated with topical antibiotics (9.5%). In order to prevent the further appearance of dermatitis, the most frequently adopted measure was the use of hydrocolloid and/or silicone-based adhesives, followed by the application of protective barrier films. One patient reported benefit from the off-label use of fluticasone propionate nasal spray. However, only 52.4% of the study participants achieved a definitive resolution of the skin issue, and 38.1% of patients were forced to discontinue insulin pump therapy and/or continuous glucose monitoring. No differences were observed in glycated hemoglobin values between the period before and after the onset of contact dermatitis. Our study confirms the severity of this dermatological complication that may hinder the spread of new technologies for the management of diabetes. Finally, our findings highlight the importance of establishing close collaboration both with pediatric allergy specialists to prescribe the most suitable treatment and with manufacturing companies to ensure that adhesives of technological devices are free of harmful well-known sensitizers.
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Affiliation(s)
- Stefano Passanisi
- Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, University of Messina, Messina, Italy
- *Correspondence: Stefano Passanisi,
| | - Giuseppina Salzano
- Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, University of Messina, Messina, Italy
| | - Francesca Galletta
- Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, Allergy Unit, University of Messina, Messina, Italy
| | - Sara Aramnejad
- Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, University of Messina, Messina, Italy
| | - Lucia Caminiti
- Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, Allergy Unit, University of Messina, Messina, Italy
| | - Giovanni B. Pajno
- Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, Allergy Unit, University of Messina, Messina, Italy
| | - Fortunato Lombardo
- Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, University of Messina, Messina, Italy
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16
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Levian B, Chan J, DeLeo VA, Adler BL. Patch Testing and Immunosuppression: a Comprehensive Review. CURRENT DERMATOLOGY REPORTS 2021. [DOI: 10.1007/s13671-021-00346-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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17
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Mughal AA, Lowe A, Hadjieconomou S, Bhoyrul B, Chu A, Cooper SM, Divekar P, Hill G, Holden CR, Johnston GA, Sabroe RA, Scharrer K, Stone N, Usmani N, Wilkinson SM. Ideal proportion of the population to be patch tested: How many should we be doing? Contact Dermatitis 2021; 85:693-697. [PMID: 34418105 DOI: 10.1111/cod.13957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 07/05/2021] [Accepted: 07/23/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND How many patients should we be patch testing? A previous study suggested that the minimum proportion of a population to be patch tested for allergic contact dermatitis was 1:700 annually. OBJECTIVES To evaluate if the current minimum rate for patch testing has changed over the 20 years since the previous study in order to maximize the value. METHODS In cooperation with the British Society for Cutaneous Allergy, a proforma for collation of retrospective data between January 2015 and December 2017 was sent to patch-test centers in the United Kingdom (UK) and the Republic of Ireland (ROI). The number of positive tests was analyzed against the proportion of population tested to see what proportion of the population would yield the greatest number of positive results. RESULTS Responses from 11 centers showed that the minimum number needed to patch test had increased to 1:550 per head of population per year using the current criteria. CONCLUSIONS In agreement with previous studies, we should be patch testing more people than we are. We could reduce the threshold for referral of patients we patch test to derive the most benefit from this investigation.
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Affiliation(s)
- Avad A Mughal
- Dermatology Department, Neath and Port Talbot Hospital, Port Talbot, UK
| | - Ashima Lowe
- Dermatology Department, University Hospital of Wales, Cardiff, UK
| | | | - Bevin Bhoyrul
- Dermatology, Sinclair Dermatology, Melbourne, Victoria, Australia
| | - Anthony Chu
- Dermatology, Hammersmith Hospital, London, UK
| | - Sue M Cooper
- Dermatology, Oxford University NHS Trust, Oxford, UK
| | | | - Glenda Hill
- Dermatology, Wrexham Maelor Hospital, Wrexham, UK
| | - Catherine R Holden
- Dermatology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | | | - Ruth A Sabroe
- Dermatology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | | | | | - Naila Usmani
- Dermatology, Mid Yorkshire NHS Trust, Wakefield, UK
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18
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Muthupalaniappen L, Jamil A. Prick, patch or blood test? A simple guide to allergy testing. MALAYSIAN FAMILY PHYSICIAN : THE OFFICIAL JOURNAL OF THE ACADEMY OF FAMILY PHYSICIANS OF MALAYSIA 2021; 16:19-26. [PMID: 34386160 PMCID: PMC8346756 DOI: 10.51866/rv1141] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This article provides information on allergy testing and serves as a simple guide for physicians who are considering using allergy testing as a step in patient management. Basic principles of allergy testing, indications for testing, and how and when to choose a suitable allergy test are discussed. Allergy testing in general refers to evaluation of either type I or type IV hypersensitivity reactions. The type I (immediate) reaction is evaluated using the skin prick test (in vivo) or serum IgE (in vitro) test methods, while the type IV (delayed) reaction is determined via the skin patch test method. The allergens responsible for a specific reaction can be identified from allergy testing, and this information is useful in administering avoidance measures. Appropriate treatment of allergic reactions along with allergen avoidance ensure a successful treatment outcome and prevent future reactions.
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Affiliation(s)
| | - Adawiyah Jamil
- AdvMDerm, Department of Medicine, University Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia,
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19
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Holness DL. Occupational Dermatitis and Urticaria. Immunol Allergy Clin North Am 2021; 41:439-453. [PMID: 34225899 DOI: 10.1016/j.iac.2021.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Occupational contact dermatitis is the most common occupational skin disease (OSD), and most of them are irritant in nature. There is less information available about contact urticaria than contact dermatitis. There are several strategies to prevent OSD, although workplace studies suggest there are gaps in their use in the workplace. Because early detection leads to improved outcomes, screening for dermatitis in industries such as health care would be useful. Both diagnosis and management involve 2 components: the actual disease diagnosis and medical treatment and the work-relatedness and management of the workplace to reduce exposures.
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Affiliation(s)
- Dorothy Linn Holness
- Department of Medicine and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Division of Occupational Medicine, Department of Medicine, St Michael's Hospital, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada; MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada.
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20
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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: 31] [Impact Index Per Article: 10.3] [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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21
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Hand Dermatitis in the Time of COVID-19: A Review of Occupational Irritant Contact Dermatitis. Dermatitis 2021; 32:86-93. [PMID: 33606414 DOI: 10.1097/der.0000000000000721] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Occupational contact dermatitis accounts for 95% of all cases of occupational skin disease with irritant contact dermatitis (ICD) constituting 80% to 90% of these cases. Health care workers, hairdressers, and food service workers are typically most affected by occupational ICD of the hands as these occupations require frequent hand hygiene and/or prolonged exposure to water, also known as "wet work." In the context of the current COVID-19 pandemic, frequent hand hygiene has become a global recommendation for all individuals, and new workplace guidelines for hand sanitization and surface sterilization are affecting occupations not previously considered at risk of excessive wet work including grocery or retail workers, postal workers, sanitization workers, and others. In this review, we discuss the etiology and pathogenesis of occupational ICD with additional focus on treatment and interventions that can be made at an institutional and even national level for education and prevention of ICD resulting from frequent hand hygiene.
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22
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Flynn A, Malik M, McCarthy S, Shanahan F, Bourke J. The effect of immunosuppression on patch testing: A cross-sectional study in patients with inflammatory bowel disease. Contact Dermatitis 2021; 85:86-88. [PMID: 33438232 DOI: 10.1111/cod.13783] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 11/30/2020] [Accepted: 12/21/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Aoibheann Flynn
- Dermatology Department, South Infirmary Victoria University Hospital, Cork, Ireland
| | - Mohsin Malik
- Dermatology Department, South Infirmary Victoria University Hospital, Cork, Ireland
| | - Siobhan McCarthy
- Dermatology Department, South Infirmary Victoria University Hospital, Cork, Ireland
| | - Fergus Shanahan
- Gastroenterology Department, Cork University Hospital, Cork, Ireland
| | - John Bourke
- Dermatology Department, South Infirmary Victoria University Hospital, Cork, Ireland
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23
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Aerts O, Rustemeyer T, Wilkinson M. Comments on Various Baseline Series for Patch Testing. Contact Dermatitis 2021. [DOI: 10.1007/978-3-030-36335-2_95] [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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Ruini C, Rahimi F, Fiocco Z, French LE, Hartmann D, Oppel E, Sattler E. Optical coherence tomography for patch test grading: A prospective study on its use for noninvasive diagnosis of allergic contact dermatitis. Contact Dermatitis 2020; 84:183-191. [PMID: 33012002 DOI: 10.1111/cod.13714] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 09/27/2020] [Accepted: 10/01/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND The diagnosis of allergic contact dermatitis should be confirmed by skin patch tests. Distinguishing between irritant and allergic reactions is sometimes difficult. OBJECTIVES To analyse the in vivo morphological changes in patch test reactions compared to healthy skin, and to detect subclinical changes in doubtful reactions using optical coherence tomography (OCT). To develop an OCT-based algorithm to support patch-test grading. METHODS One hundred twenty-nine skin patch-test areas were scanned with OCT to evaluate the following features: architectural and vascular morphology, epidermal thickness, optical attenuation coefficient (AC), and blood flow at 0.1, 0.2, and 0.35 mm depth. RESULTS Most common OCT features of acute contact allergic reactions in patch tests were spongiosis with microvesicles (94.8%), macrovesicles (60.3%), and coalescing vesicles (46.6%), the latter useful in differentiating acute allergic from irritant dermatitis (P-value < .05). Objective quantitative parameters correlated well with the severity grade: epidermal thickness due to spongiosis, AC (P-value < .05) and blood flow at 0.2 and 0.35 mm (P-value < .01). CONCLUSIONS OCT as a noninvasive diagnostic tool, established for skin cancer diagnosis, is useful for evaluating contact allergic patch-test reactions. Not only morphological but also objective features such as blood flow and AC correlate with the reaction severity. Further studies are needed to explore the differences in irritant and allergic contact dermatitis.
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Affiliation(s)
- Cristel Ruini
- Department of Dermatology and Allergy, University Hospital, Ludwig Maximilian University, Munich, Germany.,Department of Dermatology and PhD Program in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Farnaz Rahimi
- Department of Dermatology and Allergy, University Hospital, Ludwig Maximilian University, Munich, Germany
| | - Zeno Fiocco
- Department of Dermatology and Allergy, University Hospital, Ludwig Maximilian University, Munich, Germany
| | - Lars E French
- Department of Dermatology and Allergy, University Hospital, Ludwig Maximilian University, Munich, Germany.,Dr. Phillip Frost Department of Dermatology & Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, Florida, USA
| | - Daniela Hartmann
- Department of Dermatology and Allergy, University Hospital, Ludwig Maximilian University, Munich, Germany
| | - Eva Oppel
- Department of Dermatology and Allergy, University Hospital, Ludwig Maximilian University, Munich, Germany
| | - Elke Sattler
- Department of Dermatology and Allergy, University Hospital, Ludwig Maximilian University, Munich, Germany
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25
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Ambarsari CG, Hidayati EL, Mushahar L, Kadaristiana A. Dressing <em>versus</em> non-dressing technique for long-term exit-site care in children on continuous ambulatory peritoneal dialysis: a single-center retrospective cohort study. MEDICAL JOURNAL OF INDONESIA 2020. [DOI: 10.13181/mji.oa.204171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND There is no consensus on the optimal long-term exit-site care strategy in children on long-term peritoneal dialysis (PD) worldwide. Thus, this study aimed to compared the dressing versus non-dressing technique for long-term exit-site care to prevent PD-related infection.
METHODS This retrospective cohort study involved patients aged <18 years with end-stage kidney disease who were on continuous ambulatory PD at the Cipto Mangunkusumo Hospital between March 2014 and March 2019. Long-term exit-site care was initiated within 3 months after the insertion of Tenckhoff catheter. The patients and caregivers can choose to either maintain the dressing method or change to the non-dressing method for the subsequent long-term exit-site care. The follow-up was performed until the following 6 months.
RESULTS Out of 34 patients, 18 were treated without dressing and 16 with dressing technique. The peritonitis rates were 0.17 and 0.06 episodes per year at risk in the non-dressing and dressing groups; the adjusted incidence rate ratio was 0.4 (95% confidence interval = 0.043.25; p = 0.4). Allergic contact dermatitis occurred in 15/18 (83%) patients in the non-dressing group and 11/16 (69%) in the dressing group before long-term exit-site care was applied. Ultimately, no patient in the non-dressing group developed allergic contact dermatitis, whereas 11 (69%) had allergic contact dermatitis in the dressing group at the end of follow-up.
CONCLUSIONS Non-dressing technique may increase the risk of peritonitis in children on long-term PD; however, it is beneficial for children vulnerable to allergic contact dermatitis.
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NLRP3 Inflammasome and Allergic Contact Dermatitis: A Connection to Demystify. Pharmaceutics 2020; 12:pharmaceutics12090867. [PMID: 32933004 PMCID: PMC7560080 DOI: 10.3390/pharmaceutics12090867] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 09/08/2020] [Accepted: 09/09/2020] [Indexed: 12/21/2022] Open
Abstract
Allergic contact dermatitis is a common occupational disease that manifests as a cell-mediated hypersensitivity reaction following skin exposure to small reactive chemicals termed haptens. Haptens penetrate the stratum corneum and covalently modify proteins in the epidermis, inducing intracellular stress, which further leads to the release of damage-associated molecular patterns (DAMPs), such as uric acid, reactive oxygen species, hyaluronic acid fragments and extracellular adenosine triphosphate (ATP). These DAMPs are recognized by pattern recognition receptors (PRRs) in innate immune cells, namely dendritic cells (DCs), leading to their maturation and migration to the draining lymph nodes where they activate naïve T lymphocytes. Among all PRRs, several studies emphasize the role of NOD-, LRR- and pyrin domain-containing protein 3 (NLRP3) inflammasome on the allergic contact dermatitis (ACD) sensitization phase. However, skin allergens—danger signals—NLRP3 inflammasome axis is yet to be completely elucidated. Therefore, in this review, we sought to discuss the molecular mechanisms underlying DAMPs release and NLRP3 inflammasome activation triggered by skin allergens. The elucidation of these key events might help to identify novel therapeutic strategies for ACD, as well as the development of nonanimal alternative methods for the identification and potency categorization of skin sensitizers.
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27
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Sapsford S, Cheng H, Judd L. Patch testing in New Zealand: Barriers to evidence‐based care. Australas J Dermatol 2020; 62:47-50. [DOI: 10.1111/ajd.13449] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 08/03/2020] [Indexed: 11/30/2022]
Affiliation(s)
| | - Harriet Cheng
- University of Auckland AucklandNew Zealand
- Department of Dermatology Auckland District Health Board AucklandNew Zealand
| | - Lissa Judd
- Anywl Specialist Medical Centre Wellington New Zealand
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Silva FALS, Brites G, Ferreira I, Silva A, Miguel Neves B, Costa Pereira JLGFS, Cruz MT. Evaluating Skin Sensitization Via Soft and Hard Multivariate Modeling. Int J Toxicol 2020; 39:547-559. [PMID: 32757797 DOI: 10.1177/1091581820944395] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Allergic contact dermatitis is the most frequent manifestation of immunotoxicity in humans with a prevalence rate of 15% to 20% over general population. Skin sensitization is a complex end point that was for a long time being evaluated using animal testing. Great efforts have been made to completely substitute the use of animals and replace them by integrating data from in vitro and in chemico assays with in silico calculated parameters. However, it remains undefined how to make the best use of the cumulative data in such a way that information gain is maximized and accomplished with the fewest number of tests possible. In this work, 3 skin sensitization prediction models were considered: one to discriminate sensitizers from non-sensitizers, considering a 2-level scale; one according to the GHS, considering a 3-level scale; and the other to categorize potency in a 6-level scale, according to available human data. We used a data set of known human skin allergens for which in vitro, in chemico, and in silico descriptors where available to build classifiers based on soft and hard multivariate modeling. Model building, optimization, and refinement resulted in 100% accuracy in distinguishing between sensitizers and non-sensitizers. The same model was able to perform the characterization, in 3 and 6 levels, respectively, with 98.8 and 97.5% accuracy. Combining data from in vitro and in chemico tests with in silico descriptors is relatively simple to implement and some predictors are fitting the adverse outcome pathway for skin sensitization.
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Affiliation(s)
- Filipa A L S Silva
- Department of Chemistry, Faculty of Sciences and Technology, Coimbra Chemistry Centre, 56069University of Coimbra, Coimbra, Portugal
| | - Gonçalo Brites
- 530237Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal.,Faculty of Pharmacy, 530237University of Coimbra, Health Sciences Campus, Coimbra, Portugal
| | - Isabel Ferreira
- 530237Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal.,Faculty of Pharmacy, 530237University of Coimbra, Health Sciences Campus, Coimbra, Portugal
| | - Ana Silva
- 530237Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal
| | - Bruno Miguel Neves
- Department of Medical Sciences and Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal
| | - Jorge L G F S Costa Pereira
- Department of Chemistry, Faculty of Sciences and Technology, Coimbra Chemistry Centre, 56069University of Coimbra, Coimbra, Portugal
| | - Maria T Cruz
- 530237Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal.,Faculty of Pharmacy, 530237University of Coimbra, Health Sciences Campus, Coimbra, Portugal
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Skin Barrier Dysfunction in Contact Dermatitis and Atopic Dermatitis-Treatment Implications. CURRENT TREATMENT OPTIONS IN ALLERGY 2020. [DOI: 10.1007/s40521-020-00264-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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31
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Ophaug S, Schwarzenberger K. Pitfalls in Patch Testing: Minimizing the Risk of Avoidable False-Negative Reactions. Dermatol Clin 2020; 38:293-300. [PMID: 32475507 DOI: 10.1016/j.det.2020.02.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Patch testing is the gold-standard diagnostic tool for the diagnosis of allergic contact dermatitis; unfortunately, it is a procedure with potential for errors, including false-negative reactions. Some of the factors responsible for this are likely unavoidable; however, others may potentially lie within the control of the user. Knowledge and management of these controllable factors may improve the outcome of patch testing and minimize the incidence of false-negative patch test results.
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Affiliation(s)
- Solveig Ophaug
- Department of Dermatology, Oregon Health and Science University, 3303 SW Bond Avenue, CH16D, Portland, OR 97239, USA
| | - Kathryn Schwarzenberger
- Department of Dermatology, Oregon Health and Science University, 3303 SW Bond Avenue, CH16D, Portland, OR 97239, USA.
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Wootton CI, Sodaly MK, Billamay SX, English JSC, Mayfong M. Patch test results in paediatric patients with atopic dermatitis in Laos. PLoS One 2020; 15:e0231455. [PMID: 32287282 PMCID: PMC7156065 DOI: 10.1371/journal.pone.0231455] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 03/24/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Dermatological services in Laos, South East Asia are limited mainly to the capital and patch testing is currently not available, so no data exists regarding the common cutaneous allergens in this population. OBJECTIVES The aim of this study was to document common allergens in paediatric patients with atopic dermatitis attending the allergy clinic in the capital, Vientiane. PATIENTS/MATERIALS/METHODS Fifty paediatric patients with atopic dermatitis were patch tested using TRUE Test® panels 1 to 3 (35 allergens). Readings were taken at Days 2 and 4. RESULTS Twenty-six positive patch tests were recorded on Day 4 in 15 children (30%). The most common allergens were: gold (18%), nickel (10%), formaldehyde (6%) and p-Phenylenediamine (6%). Other positive allergens were potassium dichromate (2%), cobalt dichloride (2%), Bronopol (2%), paraben mix (2%), fragrance mix 1 (2%) and neomycin (2%). The majority of the patients with positive reactions were female. CONCLUSIONS This study represents the first documented patch test results in the Lao population. It is hoped that these findings will help clinicians to advise the families of children with atopic dermatitis on common allergens to avoid and inform future work on contact dermatitis in this population.
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Affiliation(s)
- Catriona I. Wootton
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Vientiane, Laos
- Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
- * E-mail:
| | - Mong K. Sodaly
- Allergy Clinic, Lao-Korea Childrens’ Hospital, Vientiane, Laos
| | | | | | - Mayxay Mayfong
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Vientiane, Laos
- Institute of Research and Education Development (IRED), University of Health Sciences, Ministry of Health, Vientiane, Laos
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, Churchill Hospital, Oxford, United Kingdom
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Wootton CI, Soukavong M, Kidoikhammouan S, Samountry B, English JSC, Mayfong M. Patch testing in Lao medical students. PLoS One 2020; 15:e0217192. [PMID: 31945067 PMCID: PMC6964850 DOI: 10.1371/journal.pone.0217192] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 12/30/2019] [Indexed: 11/30/2022] Open
Abstract
Background Dermatological services in Laos, South East Asia are limited to the capital and patch testing is currently not available, so no data exists regarding the common cutaneous allergens in this population. Objectives The aim of this study was to document positive patch tests in medical students without evidence of contact dermatitis in Laos. Patients/Materials/Methods One hundred and fifty medical students were patch tested using TRUE Test® panels 1 to 3 (35 allergens). Readings were taken at Days 2 and 4. Results Thirty-eight students (25.3%) had a positive reaction to at least one allergen, accounting for 52 reactions in total. The proportion of the students with positive patch test reading was significantly higher in the female [33/96 (34%)] than in the male [5/54 (9%)], p<0.001. The most common allergens were: nickel (10%), gold (6.6%), thiomersal (6.6%), cobalt dichloride (2%) and p-tert-Butylphenol formaldehyde resin (2%). Balsam of Peru (0.66%), black rubber mix (0.66%), Cl+Me-Isothiazolinone (0.66%), fragrance mix 1 (0.66%), quinolone mix (0.66%), methyldibromo glutaronitrile (0.66%), mercapto mix (0.66%), epoxy resin (0.66%), paraben mix (0.66%), thiuram (0.66%) and wool alcohols (0.66%) accounted for all of the other positive reactions. Conclusion This study represents the first documented patch test results in Lao medical students and in the adult Lao population. The results of this study will inform any future research into contact allergy in Laos and give an insight into the background level of contact sensitivity in this population.
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Affiliation(s)
- Catriona I. Wootton
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Vientiane, Laos
- Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingodm
- * E-mail:
| | - Mick Soukavong
- Faculty of Basic Sciences, University of Health Sciences, Vientiane, Laos
| | | | | | | | - Mayxay Mayfong
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Vientiane, Laos
- Institute of Research and Education Development (IRED), University of Health Sciences, Ministry of Health, Vientiane, Laos
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Churchill Hospital, Oxford, United Kingodm
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Veverka KK, Davis MDP. Dubiously Doubtful: An Exploration of the Literature Concerning Doubtful, Macular Erythema, “?+,” and “+/−” Patch Test Reactions. Dermatitis 2020; 31:36-41. [DOI: 10.1097/der.0000000000000533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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35
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Comments on Various Baseline Series. Contact Dermatitis 2020. [DOI: 10.1007/978-3-319-72451-5_95-1] [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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36
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Comments on Various Baseline Series for Patch Testing. Contact Dermatitis 2020. [DOI: 10.1007/978-3-319-72451-5_95-2] [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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Daunton A, Williams J. The impact of ultraviolet exposure on patch testing in clinical practice: a case–control study. Clin Exp Dermatol 2019; 45:25-29. [DOI: 10.1111/ced.13987] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2019] [Indexed: 11/27/2022]
Affiliation(s)
- A. Daunton
- Dermatology Department Salford Royal Hospital NHS Foundation Trust Salford Manchester UK
| | - J. Williams
- Dermatology Department Salford Royal Hospital NHS Foundation Trust Salford Manchester UK
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38
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Carr JM, Bardhan A, Finch TM. Big trouble with temporary tattoos. Eur J Intern Med 2019; 63:e3-e4. [PMID: 30639192 DOI: 10.1016/j.ejim.2018.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Accepted: 12/19/2018] [Indexed: 11/22/2022]
Affiliation(s)
- James M Carr
- Dermatology Department, University Hospitals Birmingham NHS Foundation Trust, Solihull Hospital, Lode Lane, Solihull B91 2JL, United Kingdom.
| | - Ajoy Bardhan
- Dermatology Department, University Hospitals Birmingham NHS Foundation Trust, Solihull Hospital, Lode Lane, Solihull B91 2JL, United Kingdom.
| | - Tracey M Finch
- Dermatology Department, University Hospitals Birmingham NHS Foundation Trust, Solihull Hospital, Lode Lane, Solihull B91 2JL, United Kingdom.
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Leskur D, Bukić J, Petrić A, Zekan L, Rušić D, Šešelja Perišin A, Petrić I, Stipić M, Puizina‐Ivić N, Modun D. Anatomical site differences of sodium lauryl sulfate‐induced irritation: randomized controlled trial. Br J Dermatol 2019; 181:175-185. [DOI: 10.1111/bjd.17633] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2019] [Indexed: 01/03/2023]
Affiliation(s)
- D. Leskur
- Department of Pharmacy University of Split School of Medicine Šoltanska 2 21000 Split Croatia
| | - J. Bukić
- Department of Pharmacy University of Split School of Medicine Šoltanska 2 21000 Split Croatia
| | - A. Petrić
- Department of Pharmacy University of Split School of Medicine Šoltanska 2 21000 Split Croatia
- Split‐Dalmatia County Pharmacy Kneza Ljudevita Posavskog 12 b 21000 Split Croatia
| | - L. Zekan
- Department of Pharmacy University of Split School of Medicine Šoltanska 2 21000 Split Croatia
- Split‐Dalmatia County Pharmacy Kneza Ljudevita Posavskog 12 b 21000 Split Croatia
| | - D. Rušić
- Department of Pharmacy University of Split School of Medicine Šoltanska 2 21000 Split Croatia
| | - A. Šešelja Perišin
- Department of Pharmacy University of Split School of Medicine Šoltanska 2 21000 Split Croatia
| | - I. Petrić
- Department of Pharmacy University of Split School of Medicine Šoltanska 2 21000 Split Croatia
- Split‐Dalmatia County Pharmacy Kneza Ljudevita Posavskog 12 b 21000 Split Croatia
| | - M. Stipić
- Department of Pharmacy University of Split School of Medicine Šoltanska 2 21000 Split Croatia
| | - N. Puizina‐Ivić
- Department of Dermatovenerology University of Split School of Medicine Šoltanska 2 21000 Split Croatia
| | - D. Modun
- Department of Pharmacy University of Split School of Medicine Šoltanska 2 21000 Split Croatia
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40
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Arrandale VH, Holness DL. Using health insurance administrative data to explore patch testing utilization in Ontario, Canada-An untapped resource. Contact Dermatitis 2019; 80:386-390. [PMID: 30677151 DOI: 10.1111/cod.13229] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 01/13/2019] [Accepted: 01/21/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Patch testing is the key diagnostic test for diagnosing allergic contact dermatitis, but there is limited information on the use of patch testing at the population level. OBJECTIVES To utilize Ontario Health Insurance Plan (OHIP) data to analyse trends in the rate of patch testing in Ontario. METHODS Patch testing billing data submitted to the OHIP between 1992 and 2014 were analysed. Two patch test billing codes were investigated: one for work-related testing (G198), and one for non-work-related testing (G206). Rates of patch testing overall were calculated, and trends over time were described. RESULTS There were 51 576 patch test billings: 48 416 non-work-related and 3160 work-related. The annual rate of non-work-related patch testing (G206) ranged from 11.9 per 100 000 people to 25.9 per 100 000 people, increasing over time. The rate of work-related patch testing (G198) ranged from 0.17 to 2.32 per 1 000 000 people, and was relatively stable. The overall distribution of billing by specialty was 70% dermatology, 19% other medical subspecialties, and 10% paediatrics and family medicine. CONCLUSIONS Administrative health data can contribute to a more complete understanding of patch test utilization at the population level and, over time, can be used to track patch testing practices.
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Affiliation(s)
- Victoria H Arrandale
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Occupational Cancer Research Centre, Toronto, Ontario, Canada
| | - Dorothy L Holness
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Division of Occupational Medicine, Department of Medicine, St Michael's Hospital, Toronto, Ontario, Canada.,Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
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A Patch Testing Initiative for the Investigation of Allergic Contact Dermatitis in a UK Allergy Practice: A Retrospective Study. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019; 7:89-95. [DOI: 10.1016/j.jaip.2018.08.030] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 08/01/2018] [Accepted: 08/27/2018] [Indexed: 11/20/2022]
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Abstract
Hand dermatitis is a common condition with a lifetime prevalence of 20%. Glove allergic contact dermatitis (ACD) is a very important dermatitis affecting health care workers, hairdressers, cleaning personnel, kitchen workers, craftsmen, construction workers, laboratory workers, and homemakers. Occupationally related cases may be severe and can result in significant disability. Glove ACD is most commonly due to exposure to rubber accelerators, which are compounds that are added to rubber during production to increase strength and durability. Given the known allergic potential of these compounds, glove manufacturing companies have reformulated gloves leading to the introduction of new rubber allergens. In this review, we will discuss risk factors for glove ACD, both common and uncommon allergens in gloves, common contact allergens that permeate gloves, and patch testing to help uncover the inciting allergen(s).
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43
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Poveda-Montoyo I, Álvarez-Chinchilla PJ, Silvestre JF. Allergic Contact Dermatitis: Therapeutic Management. CURRENT TREATMENT OPTIONS IN ALLERGY 2018. [DOI: 10.1007/s40521-018-0156-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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