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Ferček I, Ozretić P, Tambić-Andrašević A, Trajanoski S, Ćesić D, Jelić M, Geber G, Žaja O, Paić J, Lugović-Mihić L, Čivljak R. Comparison of the Skin Microbiota in the Periocular Region between Patients with Inflammatory Skin Diseases and Healthy Participants: A Preliminary Study. Life (Basel) 2024; 14:1091. [PMID: 39337875 PMCID: PMC11433335 DOI: 10.3390/life14091091] [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: 07/19/2024] [Revised: 08/22/2024] [Accepted: 08/29/2024] [Indexed: 09/17/2024] Open
Abstract
(1) Background: Periocular or periorbital dermatitis is a common term for all inflammatory skin diseases affecting the area of skin around the eyes. The clear etiopathogenesis of periocular dermatitis is still not fully understood. Advances in molecular techniques for studying microorganisms living in and on our bodies have highlighted the microbiome as a possible contributor to disease, as well as a promising diagnostic marker and target for innovative treatments. The aim of this study was to compare the composition and diversity of the skin microbiota in the periocular region between healthy individuals and individuals affected by the specific entity of periocular dermatitis. (2) Methods: A total of 35 patients with periocular dermatitis and 39 healthy controls were enrolled in the study. After a skin swab from the periocular region was taken from all participants, DNA extraction and 16S rRNA gene amplicon sequencing using Illumina NovaSeq technology were performed. (3) Results: Staphylococcus and Corynebacterium were the most abundant bacterial genera in the microbiota of healthy skin. Analysis of alpha diversity revealed a statistically significant change (p < 0.05) in biodiversity based on the Faith's PD index between patients and healthy individuals. We did not observe changes in beta diversity. The linear discriminant analysis effect size (LEfSe) revealed that Rothia, Corynebacterium, Bartonella, and Paracoccus were enriched in patients, and Anaerococcus, Bacteroides, Porphyromonas, and Enhydrobacter were enriched in healthy controls. (4) Conclusions: According to the results obtained, we assume that the observed changes in the bacterial microbiota on the skin, particularly Gram-positive anaerobic cocci and skin commensals of the genus Corynebacterium, could be one of the factors in the pathogenesis of the investigated inflammatory diseases. The identified differences in the microbiota between healthy individuals and patients with periocular dermatitis should be further investigated.
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Affiliation(s)
- Iva Ferček
- Department of Ophthalmology, Zabok General Hospital and Croatian Veterans' Hospital, 49210 Zabok, Croatia
| | - Petar Ozretić
- Laboratory for Hereditary Cancer, Division of Molecular Medicine, Ruđer Bošković Institute, 10000 Zagreb, Croatia
| | - Arjana Tambić-Andrašević
- School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Department of Clinical Microbiology, University Hospital for Infectious Diseases, 10000 Zagreb, Croatia
| | - Slave Trajanoski
- Core Facility Computational Bioanalytics, Center for Medical Research, Medical University Graz, 8010 Graz, Austria
| | - Diana Ćesić
- Department of Dermatology and Venereology, Medikol Clinic, 10000 Zagreb, Croatia
| | - Marko Jelić
- Department of Clinical Microbiology, University Hospital for Infectious Diseases, 10000 Zagreb, Croatia
| | - Goran Geber
- School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Department of Otorhinolaryngology and Head and Neck Surgery, Sestre Milosrdnice University Hospital Centre, 10000 Zagreb, Croatia
| | - Orjena Žaja
- School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Department of Pediatrics, Sestre Milosrdnice University Hospital Centre, 10000 Zagreb, Croatia
| | - Josipa Paić
- Department of Ophthalmology and Optometry, Šibenik General Hospital, 22000 Šibenik, Croatia
| | - Liborija Lugović-Mihić
- School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Department of Dermatology and Venereology, Sestre Milosrdnice University Hospital Centre, 10000 Zagreb, Croatia
| | - Rok Čivljak
- Department for Respiratory Infections, University Hospital for Infectious Diseases "Dr. Fran Mihaljević", 10000 Zagreb, Croatia
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
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Borzova E, Snarskaya E, Bratkovskaya A. Eyelid dermatitis in patch-tested adult patients: a systematic review with a meta-analysis. Sci Rep 2024; 14:18791. [PMID: 39138344 PMCID: PMC11322306 DOI: 10.1038/s41598-024-69612-z] [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: 11/24/2023] [Accepted: 08/07/2024] [Indexed: 08/15/2024] Open
Abstract
Eyelid dermatitis (ED) affects a cosmetically significant area and leads to patients' distress. Despite ongoing and recent research efforts, ED remains a multidisciplinary problem that needs further characterization. We aimed to evaluate the atopic eyelid dermatitis (AED) frequency in ED patients and to perform their clinical profiling. PubMed databases were searched from 01.01.1980 till 01.02.2024 to PRISMA guidelines using a search strategy: (eyelid OR periorbital OR periocular) AND (dermatitis or eczema). Studies with patch-tested ED patients were included. Proportional meta-analysis was performed using JBI SUMARI software. We included 65 studies across Europe, North America, Asia and Australia, with a total of 21,793 patch-tested ED patients. AED was reported in 27.5% (95% CI 0.177, 0.384) of patch-tested ED patients. Isolated ED was noted in 51.6% (95% CI 0.408, 0.623) of 8453 ED patients with reported lesion distribution, including 430 patients with isolated AED. Our meta-analysis demonstrated that the AED frequency in patch-tested ED patients exceeded the previous estimate of 10%. Isolated AED was noted in adult patients, attending contact allergy clinics. Future studies are needed to elucidate the global prevalence and natural history of isolated AED in adults.
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Affiliation(s)
- Elena Borzova
- Dermatology Division, Niigata University Graduate School of Medical and Dental Sciences (Medicine), 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan.
| | - Elena Snarskaya
- Department of Dermatology and Venereology, I.M. Sechenov First Moscow State Medical University, 4/1 Bolshaya Pirogovskaya Street, Moscow, Russian Federation, 119991
| | - Anna Bratkovskaya
- Department of Dermatology and Venereology, I.M. Sechenov First Moscow State Medical University, 4/1 Bolshaya Pirogovskaya Street, Moscow, Russian Federation, 119991
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Svendsen SV, Mortz CG, Mose KF. Contact allergy to topical ophthalmic medications: A retrospective single-centre study of three decades. Contact Dermatitis 2024; 91:119-125. [PMID: 38581258 DOI: 10.1111/cod.14552] [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: 12/14/2023] [Revised: 03/09/2024] [Accepted: 03/12/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND The prevalence of contact allergy to various ophthalmic medications appears to be rare; however, data on culprits, clinical relevance of sensitizations, and changes in frequency within recent decades are limited. OBJECTIVE This study aimed to investigate the clinical relevance, risk factors, and prevalence of contact allergy to topical ophthalmic medications in patients suspected of allergic contact dermatitis to ophthalmic medication. METHODS We retrospectively analysed patch test results and clinical data for 754 patients patch-tested with an ophthalmic medication series at our tertiary referral centre between January 1992 and December 2022. RESULTS In total, 37.5% (283/754) of patch-tested patients had a contact allergy to at least one ophthalmic allergen, with 87.3% (247) being clinically relevant sensitization. Phenylephrine (31.8%, 192/604), povidone-iodine (29%, 27/93), and tobramycin (23%, 46/200) were the most important sensitizers. The incidence of contact allergies increased significantly in a linear manner (p = 0.008) from 20% to 44.1% within the study period. Male sex and age above 40 were risk factors for contact allergy to ophthalmic medication. CONCLUSIONS One third of patch tested patients had allergic contact dermatitis to ophthalmic medication, particularly phenylephrine. Male sex and age above 40 years were independent risk factors and drove the linear increase in contact allergy to ophthalmic medications within the past 31 years.
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Affiliation(s)
- Sebastian Vigand Svendsen
- Department of Dermatology and Allergy Centre, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Charlotte G Mortz
- Department of Dermatology and Allergy Centre, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Kristian Fredløv Mose
- Department of Dermatology and Allergy Centre, Odense University Hospital, University of Southern Denmark, Odense, Denmark
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Stingeni L, Foti C, Guarneri F, Corazza M, Cristaudo A, Ferrucci SM, Gallo R, Martina E, Musumeci ML, Napolitano M, Nettis E, Patruno C, Pigatto PD, Piras V, Schena D, Casciola G, Antonelli E, Hansel K. Contact allergy to SIDAPA baseline series allergens in patients with eyelid dermatitis: An Italian multicentre study. Contact Dermatitis 2024; 90:479-485. [PMID: 38268123 DOI: 10.1111/cod.14507] [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: 09/22/2023] [Revised: 01/03/2024] [Accepted: 01/12/2024] [Indexed: 01/26/2024]
Abstract
BACKGROUND Eyelid dermatitis is a frequent reason of dermatological consultation. Its aetiology is not univocal, being contact dermatitis, both allergic and irritant, the most frequent. The primary sources of allergen exposure include cosmetics, metals, and topical medications, from direct, indirect, or airborne contact. OBJECTIVES To define the frequency of positive patch test reactions to SIDAPA baseline series allergens, to document positive allergens, and to precise the final diagnosis in patients with eyelid involvement. METHODS A total of 8557 consecutive patients from 12 Italian Dermatology Clinics underwent patch testing with SIDAPA baseline series in 2018 and 2019. Patients were divided into two groups: (i) with eyelid involvement with or without other involved sites (E-Group) and (ii) without eyelid involvement (NE-Group). The final diagnosis and the frequency of positive relevant patch test reactions were evaluated. RESULTS E-Group consisted of 688 patients (females 78.6%, mean age 45.3 years), 8.0% of 8557 consecutively patch-tested patients. The final diagnosis in E-Group was ADC in 42.4%, ICD in 34.2%, and AD in 30.5%. The highest reaction rates were elicited by nickel sulphate and methylchloroisothiazolinone/methylisothiazolinone in both E-Group and NE-Group, even if these allergens were significantly more frequently positive in NE-Group patients than in E-Group ones. Positive patch test reactions to fragrance Mix II, dimethylaminopropylamine, and sorbitan sesquiolate were significantly more frequent in E-Group patients than in NE-Group ones. CONCLUSIONS Eyelid dermatitis is a frequent dermatological complaint. Allergic contact dermatitis is the most frequent diagnosis commonly caused by nickel sulphate, isothiazolinones, and fragrances. The surfactants dimethylaminopropylamine and sorbitan sesquioleate are emerging causes of eyelid allergic contact dermatitis.
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Affiliation(s)
- Luca Stingeni
- Section of Dermatology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Caterina Foti
- Section of Dermatology and Venereology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari "Aldo Moro", Italy
| | - Fabrizio Guarneri
- Section of Dermatology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Monica Corazza
- Section of Dermatology and Infectious Diseases, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Antonio Cristaudo
- Clinical Dermatology Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Silvia Mariel Ferrucci
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Rosella Gallo
- Section of Dermatology, Dipartimento di Scienze della Salute (DISSAL), University of Genoa and IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Emanuela Martina
- Dermatology Clinic, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | | | - Maddalena Napolitano
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Eustachio Nettis
- Department of Emergency and Organ Transplantation, School of Allergology and Clinical, Immunology, University of Bari "Aldo Moro", Bari, Italy
| | - Cataldo Patruno
- Section of Dermatology, Health Sciences Department, Magna Graecia University, Catanzaro, Italy
| | | | - Viviana Piras
- Dermatological Clinic, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Donatella Schena
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - Gabriele Casciola
- Section of Dermatology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Elettra Antonelli
- Section of Dermatology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Katharina Hansel
- Section of Dermatology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
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Yazdanparast T, Nassiri Kashani M, Shamsipour M, Izadi Heidari F, Amiri F, Firooz A. Contact allergens responsible for eyelid dermatitis in adults. J Dermatol 2024; 51:691-695. [PMID: 38351529 DOI: 10.1111/1346-8138.17140] [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: 08/07/2023] [Revised: 12/05/2023] [Accepted: 01/21/2024] [Indexed: 05/03/2024]
Abstract
Allergic contact dermatitis has been established as the most frequent cause of eyelid dermatitis, but it is often misdiagnosed. The purpose of this study was to evaluate the characteristics of patients with eyelid dermatitis who were referred for patch testing. The patients were divided into three subgroups in this retrospective study: patients with only eyelid involvement, patients with involvement of eyelids and other areas, and patients without eyelid involvement. Data was collected on diagnoses, medical history, personal care products and make-up use, occupational dermatitis, and positive allergens. An independent t-test, one-way ANOVA, and chi-squared test were used to analyze the data. A total of 427 patients who referred for patch tests were included in the study. Of these, 139 patients had eyelid dermatitis. Allergic contact dermatitis (ACD) was the most common diagnosis in all three groups referred for patch tests. Use of shaving cream and hair conditioner was significantly higher in patients with only eyelid involvement and nickel sulfate was the most common allergen among them. Patch testing is the gold standard tool in the evaluation of eyelid contact dermatitis, and it is a necessity in the treatment of eyelid dermatitis, for the accurate identification of responsible allergens.
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Affiliation(s)
- T Yazdanparast
- Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran
| | - M Nassiri Kashani
- Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran
| | - M Shamsipour
- Department of Research Methodology and Data Analysis, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | - F Izadi Heidari
- Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran
| | - F Amiri
- Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran
| | - A Firooz
- Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran
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Meer EA, Patel SB, Herskowitz WBA, Briceño CA. The treatment of refractory periorbital dermatitis. Indian J Ophthalmol 2023; 71:3386-3393. [PMID: 37787240 PMCID: PMC10683672 DOI: 10.4103/ijo.ijo_2944_22] [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: 11/04/2022] [Revised: 06/13/2023] [Accepted: 06/14/2023] [Indexed: 10/04/2023] Open
Abstract
Purpose Refractory periorbital dermatitis has a chronic course with exacerbations leading to discomfort and cosmetic issues, yet characterization of treatment options is limited. Aims The objective was to present comprehensive demographic data and medical management of a series of patients with refractory periorbital dermatitis. Settings and Design Retrospective review identified patients treated at a single institution from January 2010 to August 2020. Methods Descriptive analyses were performed. Demographic data and treatment history were reviewed and data including medication, use, date of use and discontinued use, reason for discontinuation (if applicable), refractory status, formulation, concentration, and dose frequency were extracted. Statistical Analysis Used Descriptive analyses. Results Forty-five patients were included. The average age at first diagnosis was 60.3 years (sd 14.9). 82.2% were women and 84.4% identified as Caucasian. Triamcinolone cream was most frequently used followed by tobramycin-dexamethasone, tacrolimus, and neomycin-polymyxin-dexamethasone. Less than 30% of patients on triamcinolone were refractory. 13.3% of patients used topical hydrocortisone, with over 80% of these patients experiencing refractory episodes of persistent irritation and erythema. Most patients were refractory during initial use or the first recurrence of periorbital dermatitis flare. Conclusions By better characterizing the diverse treatment regimens in a unique subset of refractory patients, we hope to better inform potential courses of medical management for periorbital dermatitis.
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Affiliation(s)
- Elana A Meer
- Department of Ophthalmology, University of San Francisco, San Francisco, CA, USA
| | - Suraj B Patel
- Lincoln Memorial University - DeBusk College of Osteopathic Medicine, Knoxville, TN, USA
| | | | - César A Briceño
- Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA, USA
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Abstract
Eyelid dermatitis may present with a variety of clinical findings including erythema, pruritus, and edema, and it has a wide differential. Allergic contact dermatitis due to allergen sources in personal care products, cosmetics, and fragrances is a leading cause of eyelid dermatitis and may be challenging to diagnose by clinical examination alone. Expanded patch testing, in addition to careful inspection of the surrounding skin for additional areas of involvement and clinical clues, remains an important tool in differentiating allergic contact dermatitis from other relevant etiologies of eyelid dermatitis including irritant contact dermatitis, atopic dermatitis, seborrheic dermatitis, and rosacea. We present a practical approach to the management of eyelid dermatitis including the use of a topical anti-inflammatory for long-term control of eyelid findings. Further diagnostic workup may be warranted in patients with refractory eyelid dermatitis.
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Affiliation(s)
- Ashley M Hine
- University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Reid A Waldman
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Andrzej Grzybowski
- Department of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland; Foundation for Ophthalmology, Institute for Research in Ophthalmology, Poznan, Poland
| | - Jane M Grant-Kels
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, Connecticut, USA; Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida, USA.
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Tan J, Demessant A, Le Dantec G, Le Floc’h C, Kerob D. Tolerance and Efficacy of a Dermocosmetic Containing Neurosensine ® in Subjects with Eyelid Eczema. CLINICAL, COSMETIC AND INVESTIGATIONAL DERMATOLOGY 2023; 16:161-165. [PMID: 36711070 PMCID: PMC9880017 DOI: 10.2147/ccid.s391890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 01/10/2023] [Indexed: 01/21/2023]
Abstract
Background Eyelid eczema (EE) is frequently observed in patients with an allergic or atopic diathesis. As for atopic eczema, restoring the skin barrier of the periocular region together with relieving clinical signs and symptoms is important in the management of EE. This study assessed the benefit and tolerance of a dedicated dermocosmetic (DC) in subjects with EE. Materials and Methods Open-label study in adults with EE and sensitive skin. The DC was applied twice daily for 28 days. Dermatological signs (eczema, desquamation/dryness, erythema, swelling, roughness) and symptoms (itching, prickling, heat/burning sensation, tightness) on the periorbital region, as well as ophthalmological evaluation were assessed at Day 0, 14 and 28. Subjects assessed quality of life (QOL) using DLQI, the perceived benefit and cosmetic acceptability of the DC. Results Overall, 41 subjects were included; 59% were women. The mean age was 52.4±15.8 years; all subjects had periorbital sensitive skin. The DC immediately reduced the intensity of itching, prickling, heat/burning sensation and tightness. Clinical signs and symptoms had all significantly (p<0.001) improved by Day 14 and were sustained to Day 28. The DC significantly (p<0.001) improved the perception of irritation (73%) and swelling (66%) while soothing (59%) the periorbital skin regions at Day 28. QOL had improved at Day 28 (0.82±1.0) compared to Day 0 (4.17±2.23). No local adverse reactions were reported. Ophthalmological examinations paralleled the excellent dermatological tolerance of DC. Discussion The tested DC is highly efficacious in reducing clinical signs and symptoms of eyelid eczema and was well tolerated. ClinicalTrialsgov Identifier NCT05540496.
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Affiliation(s)
- Jerry Tan
- Department of Medicine and Windsor Clinical Research Inc, Western University, Windsor, ON, Canada,Correspondence: Jerry Tan, Western University, Department of Medicine and Windsor Clinical Research Inc, 300-2224 Walker Road, Windsor, ON, N8W 5L7, Canada, Tel +8615199719542, Email
| | - Ann’Laure Demessant
- International Scientific Affairs, La Roche-Posay Laboratoire Dermatologique, Levallois-Perret, France
| | - Guénaelle Le Dantec
- International Scientific Affairs, La Roche-Posay Laboratoire Dermatologique, Levallois-Perret, France
| | - Caroline Le Floc’h
- International Scientific Affairs, La Roche-Posay Laboratoire Dermatologique, Levallois-Perret, France
| | - Delphine Kerob
- International Scientific Affairs, La Roche-Posay Laboratoire Dermatologique, Levallois-Perret, France
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Demographic and clinical characteristics of patients with eyelid eczema attended at a referral service from 2004 to 2018. An Bras Dermatol 2023; 98:84-86. [PMID: 36335045 PMCID: PMC9837659 DOI: 10.1016/j.abd.2021.10.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 09/14/2021] [Accepted: 10/11/2021] [Indexed: 11/09/2022] Open
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Alves PB, Figueiredo AC, Codeço C, Regateiro FS, Gonçalo M. A closer look at allergic contact dermatitis caused by topical ophthalmic medications. Contact Dermatitis 2022; 87:331-335. [PMID: 35715881 DOI: 10.1111/cod.14174] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/14/2022] [Accepted: 06/06/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Allergic contact dermatitis caused by topical ophthalmic medications (OftACD) is frequently difficult to confirm with patch testing and, therefore, it is considered uncommon. METHODS We collected retrospective data from a cohort of 65 patients with suspected OftACD patch tested in our Dermatology Unit (2005-2021) according to ESCD guidelines, using a series of topical drugs and excipients (Chemotechnique Diagnostics), including betaxolol and timolol 5% pet. kindly supplied by the pharmaceutical industry. Also, frequently used ophthalmic medications as well as patient's own products were also patch tested 'as is' in most patients. RESULTS Positive patch tests to ophthalmic medications occurred in 44 patients (67.7%) (38F/6M; mean age 63.1 years), with 102 positive reactions. Most positive reactions were associated with active ingredients (n = 56), especially aminoglycoside antibiotics (n = 27), followed by excipients (n = 24) such as sodium metabisulfite (n = 7). There were also positive reactions to topical products tested 'as is' (n = 22), mostly containing beta-blockers, but only five of these reacted to the active ingredient. DISCUSSION This study reinforces previous findings in OftACD, such as older age of onset, and the importance of antibiotics, contrasting with the progressively lower prevalence of excipients. In addition, it helps raising awareness for the sensitization to beta-blockers, which is probably underestimated. Patch test preparations for the diagnosis of OftACD may require protocol optimization.
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Affiliation(s)
- Pedro Botelho Alves
- Allergy and Clinical Immunology Unit, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal
| | | | | | - Frederico S Regateiro
- Allergy and Clinical Immunology Unit, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal.,Institute of Immunology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Margarida Gonçalo
- Dermatology Unit, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.,Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Dermatology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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11
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Narla S, Silverberg JI, Simpson EL. Management of inadequate response and adverse effects to dupilumab in atopic dermatitis. J Am Acad Dermatol 2022; 86:628-636. [PMID: 34126094 DOI: 10.1016/j.jaad.2021.06.017] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 06/02/2021] [Accepted: 06/07/2021] [Indexed: 02/06/2023]
Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by pruritus, skin pain, and sleep disturbances. Currently, dupilumab is the only systemic therapy and biologic medication approved by the United States Food and Drug Administration for moderate-to-severe AD in adults and children. There is a sparsity of literature available on determining treatment failure with dupilumab and the next steps health care providers can take to treat AD. Individual goals and quality of life and not just body surface area should be considered when defining treatment failure. Possible confounding dermatoses also should be ruled out. Early identification of dupilumab-induced adverse events is important. For most patients, dupilumab can be continued while treatment for the adverse event is initiated. Adjusting the frequency of dupilumab dosing also may be considered in some circumstances. Adjuvant therapies, such as methotrexate, azathioprine, mycophenolate mofetil, cyclosporine, or phototherapy can be added but the safety and efficacy of these combination treatments are not known at this time.
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Affiliation(s)
- Shanthi Narla
- Department of Dermatology, St. Luke's University Health Network, Easton, Pennsylvania
| | - Jonathan I Silverberg
- Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Eric L Simpson
- Department of Dermatology, Oregon Health and Science University, Portland, Oregon.
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12
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Narla S, Silverberg JI. Dermatology for the internist: optimal diagnosis and management of atopic dermatitis. Ann Med 2021; 53:2165-2177. [PMID: 34787024 PMCID: PMC8604464 DOI: 10.1080/07853890.2021.2004322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 11/02/2021] [Indexed: 11/29/2022] Open
Abstract
Internists are front-line health care providers that commonly provide the first encounter to patients for dermatological conditions, especially atopic dermatitis (AD). Internists need to be comfortable with managing mild-moderate AD in their practices. Criteria and guidelines established in dermatology literature are available to help the general practitioner diagnose and treat AD. AD is a systemic disease associated with multiple cutaneous and extra-cutaneous comorbidities that warrant screening by internists, especially mental health conditions. Environmental factors may play a role in the development or worsening of AD; however, there is currently no strong evidence to guide specific population- or clinic-based interventions for their avoidance. While food allergies are common in AD patients, the role of food allergens as an exacerbating factor for AD is controversial. Before starting any dietary modifications, careful evaluation should be performed by an allergist. If the patient is not well-controlled despite adequate topical therapies or is experiencing severe/worsening disease, early referral to dermatology is warranted to rule out confounding diagnoses and/or escalation to systemic therapies. Finally, it is important to recognise the racial disparities present in AD and address these when formulating treatment plans.Key messages:Confounding dermatoses, either instead of or in addition to AD, should be considered in treatment-refractory AD, and the appropriate workup may be initiated while awaiting dermatology referral.AD patients have multiple cutaneous and extra-cutaneous comorbidities that warrant screening by internists, especially mental health conditions.
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Affiliation(s)
- Shanthi Narla
- Department of Dermatology, St. Luke’s University Health Network, Easton, PA, USA
| | - Jonathan I. Silverberg
- Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
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Features of the Skin Microbiota in Common Inflammatory Skin Diseases. Life (Basel) 2021; 11:life11090962. [PMID: 34575111 PMCID: PMC8468136 DOI: 10.3390/life11090962] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 08/29/2021] [Accepted: 09/10/2021] [Indexed: 12/12/2022] Open
Abstract
Many relatively common chronic inflammatory skin diseases manifest on the face (seborrheic dermatitis, rosacea, acne, perioral/periorificial dermatitis, periocular dermatitis, etc.), thereby significantly impairing patient appearance and quality of life. Given the yet unexplained pathogenesis and numerous factors involved, these diseases often present therapeutic challenges. The term “microbiome” comprises the totality of microorganisms (microbiota), their genomes, and environmental factors in a particular environment. Changes in human skin microbiota composition and/or functionality are believed to trigger immune dysregulation, and consequently an inflammatory response, thereby playing a potentially significant role in the clinical manifestations and treatment of these diseases. Although cultivation methods have traditionally been used in studies of bacterial microbiome species, a large number of bacterial strains cannot be grown in the laboratory. Since standard culture-dependent methods detect fewer than 1% of all bacterial species, a metagenomic approach could be used to detect bacteria that cannot be cultivated. The skin microbiome exhibits spatial distribution associated with the microenvironment (sebaceous, moist, and dry areas). However, although disturbance of the skin microbiome can lead to a number of pathological conditions and diseases, it is still not clear whether skin diseases result from change in the microbiome or cause such a change. Thus far, the skin microbiome has been studied in atopic dermatitis, seborrheic dermatitis, psoriasis, acne, and rosacea. Studies on the possible association between changes in the microbiome and their association with skin diseases have improved the understanding of disease development, diagnostics, and therapeutics. The identification of the bacterial markers associated with particular inflammatory skin diseases would significantly accelerate the diagnostics and reduce treatment costs. Microbiota research and determination could facilitate the identification of potential causes of skin diseases that cannot be detected by simpler methods, thereby contributing to the design and development of more effective therapies.
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Semaan S, Abel MK, Raffi J, Murase JE. A clinician's guide to cutaneous T-cell lymphoma presenting as recalcitrant eczematous dermatitis in adults. Int J Womens Dermatol 2021; 7:422-427. [PMID: 34621954 PMCID: PMC8484943 DOI: 10.1016/j.ijwd.2021.04.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 04/14/2021] [Accepted: 04/19/2021] [Indexed: 11/16/2022] Open
Abstract
Cutaneous T-cell lymphoma (CTCL) encompasses a group of low-grade, non-Hodgkin lymphoma, including mycosis fungoides and Sézary syndrome. Diagnosis of CTCL can be challenging given the prolonged, gradual onset and shared characteristics with many benign inflammatory skin diseases. In this case series, we describe four unique cases of patients with chronic, recalcitrant eczematous dermatitis who presented for a patch-test consultation and were ultimately diagnosed with CTCL. In particular, we highlight clinical pearls to aid in distinguishing CTCL from inflammatory dermatoses and describe the diagnostic strategy to help dermatologists arrive at the diagnosis of CTCL at earlier stages of the disease.
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Affiliation(s)
- Sarah Semaan
- Department of Dermatology, University of California, San Francisco, San Francisco, California
| | - Mary Kathryn Abel
- Department of Dermatology, University of California, San Francisco, San Francisco, California
| | - Jodie Raffi
- Department of Dermatology, University of California, San Francisco, San Francisco, California.,Department of Dermatology, University of California, Los Angeles, Los Angeles, California
| | - Jenny E Murase
- Department of Dermatology, University of California, San Francisco, San Francisco, California.,Department of Dermatology, Palo Alto Foundation Medical Group, Mountain View, California
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15
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Clinical Features of Contact Dermatitis. Contact Dermatitis 2021. [DOI: 10.1007/978-3-030-36335-2_15] [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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16
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17
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Warshaw EM, Voller LM, Maibach HI, Zug KA, DeKoven JG, Atwater AR, Reeder MJ, Sasseville D, Taylor JS, Fowler JF, Pratt MD, Silverberg JI, Fransway AF, Zirwas MJ, Belsito DV, Marks JG, DeLeo VA. Eyelid dermatitis in patients referred for patch testing: Retrospective analysis of North American Contact Dermatitis Group data, 1994-2016. J Am Acad Dermatol 2020; 84:953-964. [PMID: 32679276 DOI: 10.1016/j.jaad.2020.07.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 07/06/2020] [Accepted: 07/08/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Eyelid dermatitis is a common dermatologic complaint. OBJECTIVE To characterize patients with eyelid dermatitis. METHODS Retrospective analysis (1994-2016) of North American Contact Dermatitis Group data. RESULTS Of 50,795 patients, 2332 (4.6%) had eyelid dermatitis only, whereas 1623 (3.2%) also had dermatitis of the eyelids and head or neck. Compared with patients without eyelid involvement (n = 26,130), groups with eyelid dermatitis only and dermatitis of the eyelid and head or neck were significantly more likely to be female, white, and older than 40 years, and to have a history of hay fever, atopic dermatitis, or both (P < .01). Final primary diagnoses included allergic contact dermatitis (eyelid dermatitis only: 43.4%; dermatitis of the eyelid and head or neck: 53.5%), irritant contact dermatitis (eyelid dermatitis only: 17.0%; dermatitis of the eyelid and head or neck: 9.8%), and atopic dermatitis (eyelid dermatitis only: 13.1%; dermatitis of the eyelid and head or neck: 13.8%). Top 5 currently relevant allergens included nickel sulfate (eyelid dermatitis only: 18.6%; dermatitis of the eyelid and head or neck: 22.5%), fragrance mix I (eyelid dermatitis only: 16.5%; dermatitis of the eyelid and head or neck: 18.3%), methylisothiazolinone (eyelid dermatitis only: 16.5%; dermatitis of the eyelid and head or neck: 17.7%), gold sodium thiosulfate (eyelid dermatitis only: 14.7%; dermatitis of the eyelid and head or neck: 11.4%), and balsam of Peru (eyelid dermatitis only: 11.9%; dermatitis of the eyelid and head or neck: 12.6%). Both eyelid-involvement groups were significantly more likely to react to gold sodium thiosulfate, carmine, shellac, dimethylaminopropylamine, oleamidopropyl dimethylamine, and thimerosal (P < .05) compared with the no eyelid involvement group. LIMITATIONS Lack of specific distribution patterns of eyelid dermatitis and no long-term follow-up data. CONCLUSION Patch testing remains a critical tool in evaluating patients with eyelid dermatitis.
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Affiliation(s)
- Erin M Warshaw
- Department of Dermatology, Park Nicollet Health Services, Minneapolis, Minnesota; Department of Dermatology, University of Minnesota, Minneapolis, Minnesota; Department of Dermatology, Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota
| | - Lindsey M Voller
- Department of Dermatology, Park Nicollet Health Services, Minneapolis, Minnesota; Department of Dermatology, Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota; University of Minnesota Medical School, Minneapolis, Minnesota.
| | - Howard I Maibach
- Department of Dermatology, University of California-San Francisco, San Francisco, California
| | - Kathryn A Zug
- Department of Dermatology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | - Joel G DeKoven
- Division of Dermatology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Amber R Atwater
- Department of Dermatology, Duke University Medical Center, Durham, North Carolina
| | - Margo J Reeder
- Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Denis Sasseville
- Division of Dermatology, Royal Victoria Hospital, McGill University, Montreal, Quebec, Canada
| | - James S Taylor
- Department of Dermatology, Cleveland Clinic, Cleveland, Ohio
| | - Joseph F Fowler
- Division of Dermatology University of Louisville, Louisville, Kentucky
| | - Melanie D Pratt
- Division of Dermatology, University of Ottawa, Ottawa, Ontario, Canada
| | - Jonathan I Silverberg
- Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
| | | | - Matthew J Zirwas
- Department of Dermatology, Ohio State University, Columbus, Ohio
| | - Donald V Belsito
- Department of Dermatology, Columbia University, New York, New York
| | - James G Marks
- Department of Dermatology, Pennsylvania State University, Hershey, Pennsylvania
| | - Vincent A DeLeo
- Department of Dermatology, Keck School of Medicine, Los Angeles, California
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Luna‐Bastante L, Gatica‐Ortega M, Pastor‐Nieto M, Vergara‐de‐la‐Campa L, Gómez‐Dorado BA, Alonso‐Naranjo L, Pérez‐Hortet C. Allergic contact dermatitis to Tinosorb S,
Scutellaria baicalensis
, and other emerging allergens in cosmetics. Contact Dermatitis 2020; 82:307-309. [DOI: 10.1111/cod.13460] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 12/25/2019] [Indexed: 11/27/2022]
Affiliation(s)
| | | | - María‐Antonia Pastor‐Nieto
- Dermatology DepartmentUniversity Hospital of Guadalajara Guadalajara Spain
- Medicine and Medical Specialties Department, Alcalá de Henares University Alcalá de Henares, Madrid Spain
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Borghi A, Corazza M, Maietti E, Patruno C, Napolitano M, Schena D, Musumeci ML, Micali G, Magrone T, Romita P, Foti C. Eyelid Dermatitis and Contact Sensitization to Nickel: Results from an Italian Multi-Centric Observational Study. Endocr Metab Immune Disord Drug Targets 2019; 19:38-45. [PMID: 30062976 DOI: 10.2174/1871530318666180731114418] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 06/20/2018] [Accepted: 06/21/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND Due to the sensitizing constituents of eye cosmetics, allergic contact dermatitis is considered a frequent cause of eyelid dermatitis. An association between eyelid dermatitis and nickel contained in make-ups remains controversial. OBJECTIVE The study aimed to assess the association between nickel allergy, the use of pigmented makeup products and self-reported eyelid dermatitis. METHOD This multi-centric, cross-sectional study enrolled 165 women sensitized to nickel (patients) and 103 women without intolerance to metals (controls). We recorded: demographics, atopy, use of pigmented eye cosmetics (mascara, eyeshadow, eyeliner, eyebrow pencil), and previous eyelid dermatitis. Among the patients, any co-sensitization to cosmetics or metals was recorded. RESULTS 87.3% of the patients and 91.3% of the controls reported their use of eye make-up; 44.9% and 52.4%, respectively, reported previous episodes of eyelid dermatitis, without significant differences. The occurrence of eyelid dermatitis was significantly associated with the use of eye make-up products, both in general and considering each product separately. Age, atopy, or co-sensitization to other metals or cosmetics did not affect the occurrence of eyelid dermatitis. CONCLUSION Nickel allergy should not be considered the main risk factor for eyelid dermatitis. The use of pigmented eye make-up may be a triggering factor for eyelid dermatitis, probably due to an irritant action.
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Affiliation(s)
- Alessandro Borghi
- Department of Medical Sciences, Section of Dermatology and Infectious Diseases, University of Ferrara, Ferrara, Italy
| | - Monica Corazza
- Department of Medical Sciences, Section of Dermatology and Infectious Diseases, University of Ferrara, Ferrara, Italy
| | - Elisa Maietti
- Department of Medical Sciences, University of Ferrara, Center for Clinical Epidemiology, Ferrara, Italy
| | - Cataldo Patruno
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy
| | - Maddalena Napolitano
- Section of Dermatology, Department of Medicine and Heath Science Vincenzo Tiberio, University of Molise, Campobasso, Italy
| | - Donatella Schena
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - Maria Letizia Musumeci
- Dermatology Clinic, University of Catania, A.O.U. Policlinico-Vittorio Emanuele, Catania, Italy
| | - Giuseppe Micali
- Dermatology Clinic, University of Catania, A.O.U. Policlinico-Vittorio Emanuele, Catania, Italy
| | - Thea Magrone
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University of Bari, School of Medicine, Bari, Italy
| | - Paolo Romita
- Department of Biomedical Science and Human Oncology, Dermatological Clinic, University of Bari, Bari, Italy
| | - Caterina Foti
- Department of Biomedical Science and Human Oncology, Dermatological Clinic, University of Bari, Bari, Italy
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de Groot AC. Myroxylon pereirae
resin (balsam of Peru) – A critical review of the literature and assessment of the significance of positive patch test reactions and the usefulness of restrictive diets. Contact Dermatitis 2019; 80:335-353. [DOI: 10.1111/cod.13263] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 03/02/2019] [Accepted: 03/04/2019] [Indexed: 11/30/2022]
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21
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Pandit SA, Glass LRD. Non-glaucoma periocular allergic, atopic, and irritant dermatitis at an academic institution: A retrospective review. Orbit 2019; 38:112-118. [PMID: 29985741 DOI: 10.1080/01676830.2018.1490442] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Accepted: 06/13/2018] [Indexed: 06/08/2023]
Abstract
PURPOSE To better understand the nature of periocular dermatitis (PD) patient presentation, treatment, time-to-cure, and referral pattern for allergy testing in an ophthalmic academic center. METHODS A retrospective chart review of 344 patients diagnosed with PD between January 1, 2000 and November 30, 2016 at the Edward S. Harkness Eye Institute was performed. Eighty patients were eligible for the study. The primary endpoint was the time-to-cure. Cox proportional hazards regression was performed to assess if there was a significant difference between time-to-cure in patients treated with: 1) combination topical steroid/antibiotic (n = 6) vs. topical steroid alone (n = 40) and 2) combination topical steroid and oral antihistamine (n = 5) vs. topical steroid alone (n = 40). RESULTS The median age of eligible patients was 57.69 years old, 66.25% of patients were female, and 41.25% had a history of atopy. Seven patients in total were referred for allergy testing. A significant difference was found in likelihood of cure when comparing combination topical steroid and oral antihistamine versus topical steroid alone, adjusting for age and gender (aHR = 3.97, 95% CI: 1.40-11.25). No significance was found when comparing combination topical steroid/antibiotic versus topical steroid alone (aHR = 1.96, 95% CI: 0.72-5.27). CONCLUSION Patients treated with topical steroid and oral antihistamine were approximately 4 times more likely to experience cure in comparison to patients treated with topical steroids alone. While the majority of patients were not referred for formal allergy testing, this would likely be of benefit.
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Affiliation(s)
- Saagar A Pandit
- a Department of Epidemiology , Columbia University Mailman School of Public Health New York , NY , USA
| | - Lora R Dagi Glass
- b Department of Ophthalmology , Columbia University Medical Center, Edward S. Harkness Eye Institute , New York , NY , USA
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Gilissen L, De Decker L, Hulshagen T, Goossens A. Allergic contact dermatitis caused by topical ophthalmic medications: Keep an eye on it! Contact Dermatitis 2019; 80:291-297. [DOI: 10.1111/cod.13209] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 12/26/2018] [Accepted: 01/04/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Liesbeth Gilissen
- Department of Microbiology and Immunology, Laboratory of Dermato‐ImmunologyKU Leuven Leuven Belgium
- Contact Allergy Unit, Department of DermatologyUniversity Hospitals Leuven Leuven Belgium
| | - Lana De Decker
- Faculty of Pharmaceutical SciencesKU Leuven Leuven Belgium
| | - Toon Hulshagen
- Faculty of Pharmaceutical SciencesKU Leuven Leuven Belgium
| | - An Goossens
- Department of Microbiology and Immunology, Laboratory of Dermato‐ImmunologyKU Leuven Leuven Belgium
- Contact Allergy Unit, Department of DermatologyUniversity Hospitals Leuven Leuven Belgium
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Veien NK. Clinical Features of Contact Dermatitis. Contact Dermatitis 2019. [DOI: 10.1007/978-3-319-72451-5_15-1] [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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24
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Yew YW, Thyssen JP, Silverberg JI. A systematic review and meta-analysis of the regional and age-related differences in atopic dermatitis clinical characteristics. J Am Acad Dermatol 2018; 80:390-401. [PMID: 30287309 DOI: 10.1016/j.jaad.2018.09.035] [Citation(s) in RCA: 137] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Revised: 09/18/2018] [Accepted: 09/20/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Previous studies found conflicting results about the commonality of different atopic dermatitis (AD) signs and symptoms. OBJECTIVE To determine the prevalences of AD characteristics and differences by region and age. METHODS A systematic review was performed of all published studies in MEDLINE, EMBASE, SCOPUS, LILACS, Cochrane, China National Knowledge Infrastructure, Taiwan Electronic Periodical Services, and CiNii that analyzed the proportion of AD characteristics. Two reviewers performed a review study titles and/or abstracts and data abstraction. RESULTS In all, 101 studies reported proportion of AD features with sufficient data for meta-analysis. The most prevalent AD features were pruritus, lichenification, and xerosis. There were differences in AD characteristics by study region. Flexural involvement was less commonly reported in India, the Americas, and Iran. Studies from East Asian reported more erythroderma and truncal, extensor, scalp, and auricular involvement. Studies from Southeast Asia reported more exudative eczema, truncal involvement, lichenification, and prurigo nodularis. Studies from Iran reported more head, face, and neck involvement; pityriasis alba; and xerosis. Studies from Africa reported more papular lichenoid lesions, palmar hyperlinearity, ichthyosis, and orbital darkening. LIMITATIONS Heterogeneity between studies and limited reporting of certain AD clinical characteristics. CONCLUSIONS AD characteristics are heterogeneous and vary by region and age.
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Affiliation(s)
- Yik Weng Yew
- Institute of Dermatology, National Skin Centre, Singapore
| | - Jacob P Thyssen
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Jonathan I Silverberg
- Department of Dermatology, Preventive Medicine and Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Northwestern Medicine Multidisciplinary Eczema Center, Chicago, Illinois.
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26
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Rozas-Muñoz E, Gamé D, Serra-Baldrich E. Allergic Contact Dermatitis by Anatomical Regions: Diagnostic Clues. ACTAS DERMO-SIFILIOGRAFICAS 2018. [DOI: 10.1016/j.adengl.2018.05.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Dermatitis de contacto alérgica por regiones anatómicas. Claves diagnósticas. ACTAS DERMO-SIFILIOGRAFICAS 2018; 109:485-507. [DOI: 10.1016/j.ad.2017.05.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 05/18/2017] [Accepted: 05/30/2017] [Indexed: 12/26/2022] Open
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Assier H, Tetart F, Avenel-Audran M, Barbaud A, Ferrier-le Bouëdec MC, Giordano-Labadie F, Milpied B, Amsler E, Collet E, Girardin P, Soria A, Waton J, Truchetet F, Bourrain JL, Gener G, Bernier C, Raison-Peyron N. Is a specific eyelid patch test series useful? Results of a French prospective study. Contact Dermatitis 2018; 79:157-161. [PMID: 29882592 DOI: 10.1111/cod.13040] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 04/27/2018] [Accepted: 04/29/2018] [Indexed: 10/14/2022]
Abstract
BACKGROUND Eyelids are frequent sites of contact dermatitis. No prospective study focused on eyelid allergic contact dermatitis (EACD) has yet been published, and this topic has never been studied in French patients. OBJECTIVES To prospectively evaluate the usefulness of an eyelid series in French patients patch tested because of EACD, and to describe these patients. METHODS We prospectively analysed standardized data for all patients referred to our departments between September 2014 and August 2016 for patch testing for suspected EACD as the main reason. All patients were patch tested with an eyelid series, the European baseline series (EBS), the French additional series, and their personal products. Patch testing with additional series and repeated open application tests (ROATs) or open tests were performed if necessary. A standardized assessment of the relevance was used, and the analysis of the results was focused on patients having positive test results with a current certain relevance. RESULTS Two-hundred and sixty-four patients (238 women and 26 men) were included. Three-hundred and twenty-two tests gave positive results in 167 patients, 84 of whom had currently relevant reactions: 56 had currently relevant positive test reactions to the EBS, 16 had currently relevant positive test reactions to their personal products, 8 had currently relevant positive test reactions to the French additional series, and 4 had currently relevant positive test reactions to the eyelid series. Sixty-seven per cent of all relevant cases were related to cosmetic products. The most frequent allergens with current relevance were methylisothiazolinone (10.2%), fragrance mix I (3%), nickel (2.7%), hydroxyperoxides of linalool (2.7%) and limonene (2.3%), and Myroxylon pereirae (2.3%). Current atopic dermatitis was found in 9.5% of patients. The duration of dermatitis was shorter (23.2 vs 34.2 months; P = .035) in patients with currently relevant test reactions. The percentage of currently relevant tests remained the same when atopic patients or dermatitis localized only on the eyelids were taken into account. CONCLUSION In French patients, testing for EACD with the extended baseline series and personal products, also including ROATs and use tests, appears to be adequate, considering the currently relevant positive test reactions. The regular addition of an eyelid series does not seem to be necessary.
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Affiliation(s)
- Haudrey Assier
- Department of Dermatology, CHU Henri-Mondor, Créteil, France
| | | | | | - Annick Barbaud
- Department of Dermatology and Allergy, Hôpital Tenon, Sorbonne Université, AP-HP, Paris, France
| | | | | | | | - Emmanuelle Amsler
- Department of Dermatology and Allergy, Hôpital Tenon, Sorbonne Université, AP-HP, Paris, France
| | - Evelyne Collet
- Department of Dermatology, Hôpital le Bocage, Dijon, France
| | | | - Angèle Soria
- Department of Dermatology and Allergy, Hôpital Tenon, Sorbonne Université, AP-HP, Paris, France
| | - Julie Waton
- Department of Dermatology, CHRU Nancy, Nancy, France
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Lee HJ, Byun JY, Choi YW, Choi HY. Two cases of eyelid dermatitis caused by cobalt in colour cosmetics. Contact Dermatitis 2016; 75:390-392. [PMID: 27870100 DOI: 10.1111/cod.12669] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Revised: 06/16/2016] [Accepted: 07/10/2016] [Indexed: 10/20/2022]
Affiliation(s)
- Hye Jin Lee
- Department of Dermatology, Ewha Womans University School of Medicine, Seoul, 07985, South Korea
| | - Ji Yeon Byun
- Department of Dermatology, Ewha Womans University School of Medicine, Seoul, 07985, South Korea
| | - You Won Choi
- Department of Dermatology, Ewha Womans University School of Medicine, Seoul, 07985, South Korea
| | - Hae Young Choi
- Department of Dermatology, Ewha Womans University School of Medicine, Seoul, 07985, South Korea
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Contact Dermatitis for the Practicing Allergist. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2016; 3:652-8; quiz 659-60. [PMID: 26362548 DOI: 10.1016/j.jaip.2015.06.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 05/18/2015] [Accepted: 06/04/2015] [Indexed: 12/22/2022]
Abstract
This article provides an overview of important practice recommendations from the recently updated Contact Dermatitis Practice Parameter. This updated parameter provides essential recommendations pertaining to clinical history, physical examination, and patch testing evaluation of patients suspected of allergic contact dermatitis. In addition to providing guidance for performing and interpreting closed patch testing, the updated parameter provides concrete recommendations for assessing metal hypersensitivity in patients receiving prosthetic devices, for evaluating workers with occupational contact dermatitis, and also for addressing allergic contact dermatitis in children. Finally, the document provides practical recommendations useful for educating patients regarding avoidance of exposure to known contact sensitizers in the home and at work. The Contact Dermatitis Parameter is designed as a practical, evidence-based clinical tool to be used by allergists and dermatologists who routinely are called upon to evaluate patients with skin disorders.
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Oh JE, Lee HJ, Choi YW, Choi HY, Byun JY. Metal allergy in eyelid dermatitis and the evaluation of metal contents in eye shadows. J Eur Acad Dermatol Venereol 2016; 30:1518-21. [PMID: 27004926 DOI: 10.1111/jdv.13646] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 02/04/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Allergic contact dermatitis is a common diagnosis in eyelid dermatitis. Sensitization to metals is prevalent in eyelid dermatitis and colour cosmetic products are frequently suspected as the source of metal exposure. OBJECTIVE To investigate the contact allergens for eyelid dermatitis and to assess metal contents in eye shadow products. METHODS Data were collected in the department of dermatology of Ewha Womans University hospital from December 1998 to February 2014. A total of 983 patients were patch tested during the period and 67 patients had eyelid dermatitis among them. To examine metal elements in colour cosmetic products for eyes, randomly selected 10 eye shadows were analysed. RESULTS Frequent allergens were metals, thiomersal and phenylenediamine in patients with eyelid dermatitis. The sensitization rates of individual allergens were not significantly different between patients with eyelid dermatitis and without eyelid dermatitis. All 10 eye shadow products contained more than 5 ppm of at least one element, nickel, cobalt or chromium. CONCLUSION Metals were top-rank allergens in patients with eyelid dermatitis as in the remaining patients patch tested. The eye shadow products contained significant amount of nickel, cobalt or chromium to elicit allergic reactions.
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Affiliation(s)
- J E Oh
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Korea
| | - H J Lee
- Department of Dermatology, Ewha Womans University School of Medicine, Seoul, Korea
| | - Y W Choi
- Department of Dermatology, Ewha Womans University School of Medicine, Seoul, Korea
| | - H Y Choi
- Department of Dermatology, Ewha Womans University School of Medicine, Seoul, Korea
| | - J Y Byun
- Department of Dermatology, Ewha Womans University School of Medicine, Seoul, Korea
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Fonacier L, Bernstein DI, Pacheco K, Holness DL, Blessing-Moore J, Khan D, Lang D, Nicklas R, Oppenheimer J, Portnoy J, Randolph C, Schuller D, Spector S, Tilles S, Wallace D. Contact dermatitis: a practice parameter-update 2015. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2016; 3:S1-39. [PMID: 25965350 DOI: 10.1016/j.jaip.2015.02.009] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 02/26/2015] [Indexed: 01/08/2023]
Abstract
This parameter was developed by the Joint Task Force on Practice Parameters, which represents the American Academy of Allergy, Asthma & Immunology (AAAAI); the American College of Allergy, Asthma & Immunology (ACAAI); and the Joint Council of Allergy, Asthma & Immunology. The AAAAI and the ACAAI have jointly accepted responsibility for establishing "Contact Dermatitis: A Practice Parameter-Update 2015." This is a complete and comprehensive document at the current time. The medical environment is changing and not all recommendations will be appropriate or applicable to all patients. Because this document incorporated the efforts of many participants, no single individual, including members serving on the Joint Task Force, are authorized to provide an official AAAAI or ACAAI interpretation of these practice parameters. Any request for information or interpretation of this practice parameter by the AAAAI or ACAAI should be directed to the Executive Offices of the AAAAI, the ACAAI, and the Joint Council of Allergy, Asthma & Immunology. These parameters are not designed for use by the pharmaceutical industry in drug development or promotion. Previously published practice parameters of the Joint Task Force on Practice Parameters for Allergy & Immunology are available at http://www.JCAAI.org or http://www.allergyparameters.org.
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Higgins CL, Nixon RL. Periorbital Allergic Contact Dermatitis Caused by Lanolin in a Lubricating Eye Ointment. Australas J Dermatol 2016; 57:68-9. [DOI: 10.1111/ajd.12426] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Claire L Higgins
- Occupational Dermatology Research and Education Centre; Skin and Cancer Foundation; Melbourne Victoria Australia
| | - Rosemary L Nixon
- Occupational Dermatology Research and Education Centre; Skin and Cancer Foundation; Melbourne Victoria Australia
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Dinkloh A, Worm M, Geier J, Schnuch A, Wollenberg A. Contact sensitization in patients with suspected cosmetic intolerance: results of the IVDK 2006-2011. J Eur Acad Dermatol Venereol 2014; 29:1071-81. [DOI: 10.1111/jdv.12750] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 08/13/2014] [Indexed: 02/02/2023]
Affiliation(s)
- A. Dinkloh
- Department of Dermatology, Venereology and Allergy; Charité Universitätsmedizin; Berlin Germany
| | - M. Worm
- Department of Dermatology, Venereology and Allergy; Charité Universitätsmedizin; Berlin Germany
| | - J. Geier
- Information Network of Departments of Dermatology; Georg-August University; Göttingen Germany
| | - A. Schnuch
- Information Network of Departments of Dermatology; Georg-August University; Göttingen Germany
| | - A. Wollenberg
- Department of Dermatology, Venereology and Allergy; Ludwig-Maximilians-Universität; Munich Germany
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Byrom L, Zappala T, Muir J. Dermatological reactions to ophthalmic preparations: More than meets the eye. Australas J Dermatol 2014; 55:95-8. [DOI: 10.1111/ajd.12152] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2013] [Accepted: 01/12/2014] [Indexed: 12/01/2022]
Affiliation(s)
- Lisa Byrom
- Department of Dermatology; Mater Hospital; Brisbane Australia
| | - Tania Zappala
- Department of Dermatology; Mater Childrens Hospital; Brisbane Australia
| | - Jim Muir
- Department of Dermatology; Mater Hospital and Belmont Specialist Centre; Brisbane Australia
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Abstract
PURPOSE OF REVIEW Periorbital edema is a common problem that deserves scrutiny. Although a variety of healthcare providers may see this clinical entity, ophthalmologists are often consulted along the way toward diagnosis. It can challenge even the most astute clinicians. A diagnosis may reveal merely a bothersome issue or potentially a sight-threatening or life-threatening problem. RECENT FINDINGS Comprehensive reviews on this topic are scarce. Textbooks are brief. There are, however, many studies in the scientific literature of notable cases of periorbital edema. The causes generally fall into the categories of infectious, inflammatory or tumors, medication related, and postsurgical or trauma. SUMMARY This article synthesizes the current literature on the topic with a case series from our institution. It aims to provide a thorough resource for all practitioners to make the prospect of triaging, diagnosing, and treating periorbital edema less daunting.
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Current dilemmas and controversies in allergic contact dermatitis to ophthalmic medications. Clin Dermatol 2011; 29:295-9. [DOI: 10.1016/j.clindermatol.2010.11.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Cutaneous Lupus Erythematosus of the Eyelid as a Mimic of Squamous Epithelial Malignancies: A Clinicopathologic Study of 9 Cases. Ophthalmic Plast Reconstr Surg 2011; 27:168-72. [DOI: 10.1097/iop.0b013e3181f29d4d] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Shi M, Zhang H, Chen X, Guo Y, Tao J, Qi H, Gan J, Jiang A, Yu H, Liang J, Chen J, Yang L, Zhuang Y, Yan M, Gu Y, Yu X, Feng X, Yao Z. Clinical features of atopic dermatitis in a hospital-based setting in China. J Eur Acad Dermatol Venereol 2011; 25:1206-12. [PMID: 21214635 DOI: 10.1111/j.1468-3083.2010.03953.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Atopic dermatitis (AD) is a chronic relapsing inflammatory skin disease. There have been few detailed reports of the clinical evaluation of Chinese patients with AD. OBJECTIVES To give a profile of the clinical features of Chinese AD patients in a university hospital setting. METHODS A total of 1008 cases met Hanifin and Rajka diagnostic criteria of AD were recruited at Xinhua Hospital, Shanghai Jiaotong University School of Medicine, China. RESULTS In our survey, 22.7% patients were mild, 66.6% were moderate and 10.7% were severe according to the SCORAD index. Both the frequency and severity of the male patients were slightly higher. The frequency of asthma among the AD patients was 16.7% and it was increased with the age (χ2 = 205.20, P = 0.000). The frequencies of objective minor signs were demonstrated with age-related changes. Besides, three localized variants including eyelid eczema (49.8%), scalp dermatitis (49.7%), infra-auricular and retroauricular fissuring (44.8%) were commonly observed, especially in the infantile phase (P < 0.01). It was showed significant differences in serum total immunoglobulin E (IgE) and eosinophil cationic protein (ECP) levels of different age groups. The positive rate of Phadiatop was raised after 3 years old and that of the common food allergens were decreased after 6 years old. CONCLUSIONS More males than females had ongoing AD in our survey. Most AD debuted in the first year of the cases. High incidence of the three clinical signs: eyelid eczema, scalp dermatitis and infra-auricular and retroauricular fissuring among the patients suggests it can be a potential valuable diagnostic clue to AD.
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Affiliation(s)
- M Shi
- Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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Clinical Features. Contact Dermatitis 2011. [DOI: 10.1007/978-3-642-03827-3_15] [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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Current World Literature. Curr Opin Allergy Clin Immunol 2009; 9:574-8. [DOI: 10.1097/aci.0b013e328333c13c] [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]
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Thyssen JP, Linneberg A, Menné T, Nielsen NH, Johansen JD. No association between nickel allergy and reporting cosmetic dermatitis from mascara or eye shadow: a cross-sectional general population study. J Eur Acad Dermatol Venereol 2009; 24:722-5. [DOI: 10.1111/j.1468-3083.2009.03506.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Periorbital dermatitis is common and frequently difficult to treat. Patients with periorbital dermatitis often suffer severely because their disease is in such a visible location. Because of the variety of clinical appearance, the differential diagnostic considerations are often difficult. We examined the causes of periorbital dermatitis and compared the data of 88 patients from the Department of Dermatology, University Hospital Erlangen to those of the German IVDK (Information Network of the Departments of Dermatology). Between 1999 and 2004, predominant causes of periorbital dermatitis were allergic contact dermatitis (Erlangen 44%, IVDK 32%), atopic eczema (Erlangen 25%, IVDK 14%), airborne contact dermatitis (Erlangen 10%, IVDK 2%) and irritant contact dermatitis (Erlangen 9%, IVDK 8%). Less frequent causes for secondary eczematous periocular skin lesions were periorbital rosacea, allergic conjunctivitis or psoriasis vulgaris. Female gender, atopic skin diathesis and age of 40 years and older were identified as risk factors for periocular dermatitis. Common elicitors of periorbital allergic contact dermatitis were leave-on cosmetic products (face cream, eye shadow) and eye drops with the usual allergens being fragrances, preservatives and drugs. Exact identification of relevant contact allergens and allergen elimination are essential for successful treatment. Calcineurin inhibitors are the first-line therapy for facial atopic eczema. They may be also effective in periocular eczematous lesions of other origins although they are not approved for such use.
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Affiliation(s)
- Alexandra Feser
- Department of Dermatology, University Hospital of Erlangen, Friedrich-Alexander University, Erlangen-Nürnberg, Germany
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Abstract
The face is exposed to many foreign substances and may thus be a site of allergic contact dermatitis. Our aim is to elucidate the spectrum of factors associated with facial dermatitis by analyzing data of patients patch tested in the Information Network of Departments of Dermatology (IVDK) between 1995 and 2007. In 18,572 patients the main anatomical site of dermatitis was the face. Among these, the proportion of females and of patients with past or present atopic eczema was increased, while probable occupational causation was less common than in the overall group. Cosmetic allergens, as well as nickel, were significantly more common in women than men, including fragrance mix (10.8% vs. 8.3%), p-phenylenediamine (4.0% vs. 2.8%), lanolin alcohols (3.0% vs. 2.2%), Lyral(TM) (3.1% vs. 2.0%) and bufexamac (1.8% vs. 1.1%). In comparison, only epoxy resin contact allergy was diagnosed significantly more often in men than women: In patients with airborne contact dermatitis, over-represented allergens included sesquiterpene lactone mix, compositae mix, epoxy resin, (chloro-) methylisothiazolinone and oil of turpentine. In the clinical approach to patients with facial dermatitis, occupational airborne causation should be considered in addition to non-occupational (e.g., cosmetic) allergen exposure.
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