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Häberle M, Geier J, Mahler V. Kontaktallergie auf Sulfite und Sulfitunverträglichkeit: klinische und berufliche Relevanz. ALLERGO JOURNAL 2017. [DOI: 10.1007/s15007-017-1298-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Contact allergy and intolerance to sulphite compounds: clinical and occupational relevance. ACTA ACUST UNITED AC 2017. [DOI: 10.1007/s40629-016-0003-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Cressey BD, Scheinman PL. Systemic allergic dermatitis of the lips resulting from allergy to an antimicrobial agent in a contact lens disinfecting solution. Contact Dermatitis 2012; 67:239-40. [DOI: 10.1111/j.1600-0536.2012.02088.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Benjamin B, Chris F, Salvador G, Melissa G, Susan N. Visual and confocal microscopic interpretation of patch tests to benzethonium chloride and benzalkonium chloride. Skin Res Technol 2011; 18:272-7. [DOI: 10.1111/j.1600-0846.2011.00577.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2011] [Indexed: 11/27/2022]
Affiliation(s)
| | | | - González Salvador
- Memorial Sloan-Kettering Cancer Center; Department of Dermatology; New York; NY; USA
| | - Gill Melissa
- Skin Medical Research and Diagnostics; P.L.L.C.; Dobbs Ferry; NY; USA
| | - Nedorost Susan
- University Hospitals Case Medical Center; Department of Dermatology; Cleveland; OH; USA
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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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Collet E, Castelain M, Milpied B. Œil, paupières et allergènes de contact. REVUE FRANCAISE D ALLERGOLOGIE 2011. [DOI: 10.1016/j.reval.2011.01.045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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MIYAZATO H, YAMAGUCHI S, TAIRA K, ASATO Y, YAMAMOTO YI, HAGIWARA K, UEZATO H. Allergic contact dermatitis due to diclofenac sodium in eye drops. J Dermatol 2010; 38:276-9. [DOI: 10.1111/j.1346-8138.2010.00934.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Malik A, Fletcher EC, Chong V, Dasan J. Local anesthesia for cataract surgery. J Cataract Refract Surg 2010; 36:133-52. [PMID: 20117717 DOI: 10.1016/j.jcrs.2009.10.025] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2008] [Revised: 09/29/2009] [Accepted: 10/01/2009] [Indexed: 11/17/2022]
Abstract
Various aspects of local anesthesia for cataract surgery, such as the anesthetic agents and their interaction with ocular nerve supply, anesthesia requirements, available clinical techniques and their inherent complications are reviewed. A comparative evaluation of clinical techniques in terms of efficacy, akinesia, and patient-perceived pain during both anesthesia administration and intraoperative cataract surgery is presented, along with the prevailing practice patterns of anesthesia techniques among refractive surgeons in the United Kingdom and United States. More randomized clinical trials are needed to facilitate statistical methods of metaanalysis to establish convincingly the overall benefits and efficacy of the various local anesthesia procedures in cataract surgery. The wide scope of the present review is of relevance in structuring ophthalmology and anesthesia specialist training programs for junior staff.
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Affiliation(s)
- Adeela Malik
- Department of Ophthalmology, Epsom & St. Helier University Hospitals, Carshalton, United Kingdom.
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Dickel H, Kamphowe J, Geier J, Altmeyer P, Kuss O. Strip patch test vs. conventional patch test: investigation of dose-dependent test sensitivities in nickel- and chromium-sensitive subjects. J Eur Acad Dermatol Venereol 2009; 23:1018-25. [DOI: 10.1111/j.1468-3083.2009.03237.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
We previously reviewed allergic contact dermatitis due to ophthalmic drugs and contact lens solutions. Since 1997, an additional 15 allergens have been reported. Here, we provide a review and discussion of these allergens.
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Affiliation(s)
- Paru R Chaudhari
- Department of Dermatology, Mount Sinai School of Medicine, New York, NY, USA
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Hashimoto Y, Aragane Y, Kawada A. Allergic contact dermatitis due to levobunolol in an ophthalmic preparation. J Dermatol 2006; 33:507-9. [PMID: 16848829 DOI: 10.1111/j.1346-8138.2006.00121.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Corazza M, Virgili A. Allergic contact dermatitis from ophthalmic products: can pre-treatment with sodium lauryl sulfate increase patch test sensitivity? Contact Dermatitis 2005; 52:239-41. [PMID: 15898995 DOI: 10.1111/j.0105-1873.2005.00606.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In patients suspected of allergic contact dermatitis because of topical ophthalmic medicaments, patch tests performed with patients' own products are often negative. The irritant anionic surfactant sodium lauryl sulfate (SLS) may alter the stratum corneum and increase antigen penetration. Pre-treatment of the skin with SLS 0.5% for 24 h was performed in the sites of patch tests with patients' own products in 15 selected patients. In patients previously negative to their own products tested with conventional patch tests, SLS pre-treatment showed 6 new relevant positive reactions and induced a stronger positive reaction in 1 patient. SLS pre-treatment could be proposed as an alternative promising method, which may increase sensitivity of patch tests with patients' own products.
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Affiliation(s)
- Monica Corazza
- Dipartimento di Medicina Clinica e Sperimentale, Sezione di Dermatologia, Università di Ferrara, Italy.
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González-Mendiola MR, Balda AG, Delgado MC, Montaño PP, De Olano DG, Sánchez-Cano M. Contact allergy from tobramycin eyedrops. Allergy 2005; 60:527-8. [PMID: 15727588 DOI: 10.1111/j.1398-9995.2005.00588.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We report a patient with allergic conjunctivitis and blepharitis as a result of tobramycin eyedrops.
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Linares Mata T, Pardo Sánchez J, de la Cuadra Oyanguren J. Contact dermatitis caused by allergy to dorzolamide. Contact Dermatitis 2005; 52:111-2. [PMID: 15725294 DOI: 10.1111/j.0105-1873.2005.00498f.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Herbst RA, Uter W, Pirker C, Geier J, Frosch PJ. Allergic and non-allergic periorbital dermatitis: patch test results of the Information Network of the Departments of Dermatology during a 5-year period. Contact Dermatitis 2004; 51:13-9. [PMID: 15291826 DOI: 10.1111/j.0105-1873.2004.00334.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Periorbital dermatitis is common and can be due to the external use of ophthalmic drugs. We evaluated patch test results of the Information Network of the Departments of Dermatology. During a 5-year period (1995-99), of a total 49,256 patch-tested patients, 1053 (2.1%) were eventually diagnosed as allergic periorbital contact dermatitis (APD) and 588 (1.2%) as non-allergic periorbital dermatitis (NAPD). Patient characteristics between APD, NAPD and other cases (OCs) differed with respect to sex (19.7% male in both periorbital groups versus 36.3% in OCs), atopic dermatitis (10.4% in APD versus 60.2% in NAPD versus 16.9% in OCs) and age, APD being substantially more often (68.2%) aged 40 and above than NAPD (52.6%). Several of the top allergens in OCs [such as fragrance mix, Myroxylon pereirae resin (balsam of Peru), lanolin alcohol and potassium dichromate] caused significantly fewer positive test reactions in both periorbital groups. In contrast, thimerosal, phenylmercuric acetate, sodium disulfite, gentamicin sulfate, phenylephrine hydrochloride and benzalkonium chloride tested positively significantly more often in APD but not in NAPD, verifying them as true ophthalmic allergens. Finally, in 42 cases (4%) of APD patients, additional allergens were identified by testing of the patients' own substances (mostly beta-blockers, oxybuprocaine and dexpanthenol), supporting the necessity of testing with ophthalmic drugs as is where individual substances are not readily available.
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Affiliation(s)
- R A Herbst
- Departments of Dermatology, Klinikum Dortmund gGmbH and University of Witten/Herdecke, D-44137 D 44137 Dortmund, Germany.
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Basketter DA, Marriott M, Gilmour NJ, White IR. Strong irritants masquerading as skin allergens: the case of benzalkonium chloride. Contact Dermatitis 2004; 50:213-7. [PMID: 15186375 DOI: 10.1111/j.0105-1873.2004.00331.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Chemicals may possess a number of hazards to human health including the ability to cause skin irritation and contact allergy. Identification and characterization of these properties should fall within predictive toxicology, but information derived from human exposure, including clinical experience, is also of importance. In this context, it is of interest to review the case of benzalkonium chloride, a cationic surfactant. This chemical is a well-known skin irritant, but on occasions it has also been reported to have allergenic properties, typically on the basis of positive diagnostic patch test data. Because the accumulated knowledge concerning the properties of a chemical is employed as the basis for its regulatory classification (e.g. in Europe), as well as for informing the clinical community with respect to the diagnosis of irritant versus allergic contact dermatitis (ACD), it is important to distinguish properly which chemicals are simply irritants from those which are both irritant and allergenic on skin. A review of the information on benzalkonium chloride confirms that it is a significant skin irritant. However, both predictive test results and clinical data lead to the conclusion that benzalkonium chloride is, at most, an extremely rare allergen, except perhaps in the eye, but with many supposed cases of ACD being likely to arise from the misinterpretation of patch test data. As a consequence, this substance should not normally be regarded as, or classified as, a significant skin sensitizer.
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Affiliation(s)
- David A Basketter
- Safety and Environmental Assurance Centre, Unilever Colworth Laboratory, Sharnbrook, Bedford, UK.
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Yamamoto A, Harada S, Nakada T, Iijima M. Contact dermatitis to phenylephrine hydrochloride eyedrops. Clin Exp Dermatol 2004; 29:200-1. [PMID: 14987285 DOI: 10.1111/j.1365-2230.2004.01483.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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de Misa RF, Suárez J, Feliciano L, López B. Allergic periocular contact dermatitis due to atropine. Clin Exp Dermatol 2003; 28:97-8. [PMID: 12558645 DOI: 10.1046/j.1365-2230.2003.01156_5.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Affiliation(s)
- S C Davison
- Department of Dermatology, St. Mary's Hospital, London, UK
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Abstract
Eye drops are multiple dosage forms protected against microbial contamination by means of preservatives. However, the ocular tolerance of these chemicals can vary and this may result in adverse toxic or allergic reactions. This overview presents the pharmacopoeial requirements for the preservation of eye drops, the factors affecting ocular tolerance as well as the adverse external ocular effects induced by preservatives. The alternatives to the use of preservatives are also discussed, including the recent progress in eye drops packaging.
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Affiliation(s)
- Pascal Furrer
- School of Pharmacy, Institute of Medical Chemistry, University of Lausanne, Switzerland
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Corazza M, Levratti A, Zampino MR, Virgili A. Conventional patch tests are poor detectors of contact allergy from ophthalmic products. Contact Dermatitis 2002; 46:298-9. [PMID: 12084085 DOI: 10.1034/j.1600-0536.2002.460510.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Monica Corazza
- Department of Clinical and Experimental Medicine-Section of Dermatology, University of Ferrara, Ferrara, Italy.
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Crabbe A, Thompson P. Clinical trial of a patient-operated microwave care system for hydrogel contact lenses. Optom Vis Sci 2001; 78:605-9. [PMID: 11525552 DOI: 10.1097/00006324-200108000-00013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The clinical effects of a patient-operated system of microwave disinfection for soft contact lenses were assessed in a prospective pilot trial involving 103 patients who were drawn from five optometric practices. Fifty-six subjects used the test system for 1 month, and 13 subjects continued use for a total of 3 months. Both test and control subjects were examined for clinical signs using slitlamp tests. After 1 month, the incidence of all signs reported in the microwave group was not significantly greater than in the control group (p = 0.267), and the same was true after 3 months (p = 0.214). There was a significantly greater incidence of edema in the 1-month test group and of staining in the control group. UV spectroscopic examination of worn lenses from test subjects exhibiting significant signs did not show a higher level of deposition than on lenses worn by control subjects (p = 0.397).
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Affiliation(s)
- A Crabbe
- Department of Design, Nottingham Trent University, United Kingdom.
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Almeida L, Ortega N, Dumpierrez AG, Castillo R, Blanco C, Navarro L, Carrillo T. Conjunctival allergic contact hypersensitivity. Allergy 2001; 56:785. [PMID: 11488675 DOI: 10.1034/j.1398-9995.2001.056008785.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- L Almeida
- Lourdes Almeida Quintana, Avda Mesa y López 41-A 5A, 35010 Las Palmas de Gran Canaria, Spain
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Nino M, Suppa F, Ayala F, Balato N. Allergic contact dermatitis due to the β-blocker befunolol in eyedrops, with cross-sensitivity to carteolol. Contact Dermatitis 2001. [DOI: 10.1034/j.1600-0536.2001.044006366-4.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Affiliation(s)
- V Blaschke
- Department of Dermatology, Georg August University, Göttingen, Germany
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Riddell CE, Reed J, Shaw S, Duvall-Young J. Allergic contact fingertip dermatitis secondary to proxymetacaine in an ophthalmologist. Eye (Lond) 2000; 14:907-8. [PMID: 11584855 DOI: 10.1038/eye.2000.249] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Affiliation(s)
- M P Boukhman
- Department of Dermatology, University of California, San Francisco 94143-0316, USA
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Affiliation(s)
- S Erdmann
- Department of Dermatology, University Hospitals RWTH Aachen, Germany
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Abstract
PURPOSE To report the late diagnosis of allergic response to proparacaine hydrochloride in an ophthalmologist. METHOD Case report. In a 49-year-old practicing ophthalmologist, the history, clinical findings of fingertip dermatitis, skin pathology, and skin patch testing are described. RESULTS Proparacaine, as the initiating agent, took almost 3 years to identify because of the unusual pattern of allergy. We explored numerous treatment options before identifying and removing the offending agent. CONCLUSIONS Ophthalmologists may be exposed to proparacaine on a daily basis. This unique report heightens the awareness of this rare work-related complication.
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Affiliation(s)
- T J Liesegang
- Department of Ophthalmology, Mayo Clinic Jacksonville, Florida 32224, USA
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The Eye. Toxicology 1999. [DOI: 10.1016/b978-012473270-4/50078-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
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Parra A, Casas L, Tombo MJ, Ya nez M, Vila L. Contact dermatitis from dipivefrine with possible cross-reaction to epinephrine. Contact Dermatitis 1998; 39:325-6. [PMID: 9874037 DOI: 10.1111/j.1600-0536.1998.tb05961.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- A Parra
- Unidad de Alergología, Hospital da Costa, Burela, Lugo, Spain
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Thomas P, Rueff F, Przybilla B. Severe allergic contact blepharoconjunctivitis from phenylephrine in eyedrops, with corresponding T-cell hyper-responsiveness in vitro. Contact Dermatitis 1998; 38:41-3. [PMID: 9504246 DOI: 10.1111/j.1600-0536.1998.tb05636.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- P Thomas
- Department of Dermatology, Ludwig-Maximilians-University, Munich, Germany
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Affiliation(s)
- R A Herbst
- Department of Dermatology, Hannover Medical School, Germany
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Nagayama H, Hatamochi A, Shinkai H. A case of contact dermatitis due to sodium bisulfite in an ophthalmic solution. J Dermatol 1997; 24:675-7. [PMID: 9375469 DOI: 10.1111/j.1346-8138.1997.tb02315.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
We report a case of contact dermatitis due to sodium bisulfite in Tathion eye drops. A 72-year-old woman was treated daily with two solutions including Tathion eye drops for senile cataract for two years and three months. She developed edema, swelling, erythema, and vesicles on her eyelids. Because contact dermatitis due to a topical medication was suspected, patch testing was performed after disappearance of her eruption. A positive reaction to sodium bisulfite in Tathion eye drops was confirmed. Therefore, we diagnosed her eruption as contact dermatitis due to sodium bisulfite. The reaction to sodium sulfite in the next patch testing was negative. To the best of our knowledge, this is the first report from Japan about contact dermatitis caused by this medication.
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Affiliation(s)
- H Nagayama
- Department of Dermatology, Chiba University School of Medicine, Japan
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41
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Marcos ML, Garcés MM, Alonso L, Juste S, Carretero P, Blanco J, Garcia F, Perez R, Herrero D. Occupational allergic contact dermatitis from homatropine and phenylephrine eyedrops. Contact Dermatitis 1997; 37:189. [PMID: 9385525 DOI: 10.1111/j.1600-0536.1997.tb00204.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- M L Marcos
- Sección de Alergología, Hospital General Yagüe, Burgos, Spain
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Moreno-Ancillo A, Munoz-Robles ML, Cabañas R, Barranco P, Lopez-Serrano MC. Allergic contact reactions due to phenylephrine hydrochloride in eyedrops. Ann Allergy Asthma Immunol 1997; 78:569-72. [PMID: 9207720 DOI: 10.1016/s1081-1206(10)63217-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Dermatitis of and around the eye is common. Allergic contact reactions from phenylephrine are rare despite extensive use by ophthalmologists. Previous reports do not indicate crossreactivity between phenylephrine and other sympathomimetic drugs in patch testing. METHODS We report three cases of allergic contact reactions (dermato-conjunctivitis) after eyedrops. Skin prick tests, epicutaneous testing with the implicated drugs, additives, and a complete patch test battery, TRUE test (Upjohn-Pharmacia, Sweden), were performed in each patient. RESULTS All skin prick tests were negative. The three patients showed positive patch tests to phenylephrine and one of them also to ephedrine. Tolerance of the other eyedrops without phenylephrine was verified by challenge. CONCLUSION Phenylephrine was the responsible agent for the reactions in our patients as confirmed by clinical findings and positive patch tests. Our findings suggest the central structure as the sensitizing part of drug in the second patient. Patch testing is essential for diagnosis of allergic contact reactions of and around the eye.
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Valsecchi R, Pansera B, Leghissa P, Reseghetti A. Allergic contact dermatitis of the eyelids and conjunctivitis from diclofenac. Contact Dermatitis 1996; 34:150-1. [PMID: 8681554 DOI: 10.1111/j.1600-0536.1996.tb02157.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- R Valsecchi
- Department of Dermatology, Bergamo General Hospital, Italy
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Abstract
Distinguishing the cause of itching, red eyelids is often difficult. Pruritic, inflamed eyelids can reflect various etiologies and are a common clinical presentation to the office of a dermatologist or ophthalmologist. In this article, five of the more common causes of eyelid dermatitis (atopic dermatitis, contact dermatitis, contact urticaria, rosacea, seborrhea, and psoriasis) are reviewed in detail, with particular emphasis on the ocular and periocular features. Clinical clues, historical features, and patch testing in cases of eczematous eyelid dermatitis aid in differential diagnosis. In addition, pathogenesis and treatment are reviewed.
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Affiliation(s)
- K A Zug
- Section of Dermatology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
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Estlander T, Kanerva L, Kari O, Jolanki R, Mölsä K. Occupational conjunctivitis associated with type IV allergy to methacrylates. Allergy 1996; 51:56-9. [PMID: 8721530 DOI: 10.1111/j.1398-9995.1996.tb04551.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
On rare occasions, exposure to methacrylates (MAs) may induce mucosal symptoms. Three patients, two dental laboratory workers and one hearing aid laboratory worker, are presented. All three had allergic contact dermatitis from MAs which disappeared after avoidance of contact with uncured MA compounds. Two of the patients, the dental laboratory assistant and the hearing aid worker, had also developed symptoms of conjunctivitis. Both were exposed to chemically curable and light-curable MAs. The association between their conjunctivitis and type IV allergy to MAs was supported by the following observations: 1) sensitization to several MAs including methylMA, 2-hydroxyethylMA, ethyleneglycol diMA, triethyleneglycoldiMA, tetrahydrofurfuryldiMA, and 1,4-butanedioldiMA, as well as to pentaerythritol triacrylate; 2) simultaneous appearance of their eye symptoms and allergic contact dermatitis; 3) high exposure to MAs because of disturbances of ventilation; 4) disappearance of the eye symptoms during holidays; and 5) opthalmologist's findings of follicular conjunctivitis with some papillae, eosinophilia, and lymphocytosis in conjunctival scrapings corresponding to allergic contact conjunctivitis. In addition, the activation of eosinophils in the conjunctival scrapings was demonstrated with the monoclonal antibody technique, and an elevated level of eosinophilic cationic protein was found in the tear fluid. Our cases suggest that conjunctivitis may be caused by type IV allergy to MAs, although type I allergy (even though prick tests were negative), other hypersensitivity mechanisms, or irritation cannot be excluded. 4H-Gloves seem to give adequate hand protection even to allergic patients. More attention should be paid to ventilation systems if MA exposure occurs. In some cases, patients with eye symptoms need to be patch tested.
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Affiliation(s)
- T Estlander
- Finnish Institute of Occupational Health, Helsinki, Finland
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46
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Rudzki E, Kecik T, Rebandel P, Portacha L, Pauk M. Frequency of contact sensitivity to drugs and preservatives in patients with conjunctivitis. Contact Dermatitis 1995; 33:270. [PMID: 8654082 DOI: 10.1111/j.1600-0536.1995.tb00482.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- E Rudzki
- Department of Dermatology, Warsaw School of Medicine, Poland
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Koch P. Allergic contact dermatitis due to timolol and levobunolol in eyedrops, with no cross-sensitivity to other ophthalmic beta-blockers. Contact Dermatitis 1995; 33:140-1. [PMID: 8549145 DOI: 10.1111/j.1600-0536.1995.tb00530.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- P Koch
- Hautklinik der Universität des Saarlandes, Homburg/Saar, Germany
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48
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Thomas P, Rueff F, Przybilla B. Allergic contact dermatitis from phenylephrine in a phlebological ointment. Contact Dermatitis 1995; 32:249-50. [PMID: 7600791 DOI: 10.1111/j.1600-0536.1995.tb00686.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- P Thomas
- Department of Dermatology, Ludwig Maximilians University, Munich, Germany
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Caraffini S, Assalve D, Stingeni L, Lisi P. Allergic contact conjunctivitis and blepharitis from tobramycin. Contact Dermatitis 1995; 32:186-7. [PMID: 7774207 DOI: 10.1111/j.1600-0536.1995.tb00826.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- S Caraffini
- Department of Medical and Surgical Specialities, University of Perugia, Policlinico Monteluce, Italy
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50
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O'Donnell BF, Foulds IS. Contact allergic dermatitis and contact urticaria due to topical ophthalmic preparations. Br J Ophthalmol 1993; 77:740-1. [PMID: 7904178 PMCID: PMC504637 DOI: 10.1136/bjo.77.11.740] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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