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Özkaya E, Turgut HD. Generalized allergic contact dermatitis from polysensitization to strong (nitrofurazone) and weak (ichthammol, polyethylene glycol) contact sensitizers in a patient with stasis dermatitis. Contact Dermatitis 2024; 90:192-195. [PMID: 37933637 DOI: 10.1111/cod.14459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 10/26/2023] [Accepted: 10/27/2023] [Indexed: 11/08/2023]
Affiliation(s)
- Esen Özkaya
- İstanbul Faculty of Medicine, Department of Dermatology and Venereology, İstanbul University, İstanbul, Turkey
| | - Hamit Doğuş Turgut
- İstanbul Faculty of Medicine, Department of Dermatology and Venereology, İstanbul University, İstanbul, Turkey
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Bonefeld CM, Geisler C, Gimenéz-Arnau E, Lepoittevin JP, Uter W, Johansen JD. Immunological, chemical and clinical aspects of exposure to mixtures of contact allergens. Contact Dermatitis 2017; 77:133-142. [DOI: 10.1111/cod.12847] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 05/18/2017] [Accepted: 05/20/2017] [Indexed: 01/06/2023]
Affiliation(s)
- Charlotte M. Bonefeld
- Faculty of Health and Medical Sciences, Department of Immunology and Microbiology; University of Copenhagen; 2200 Copenhagen Denmark
| | - Carsten Geisler
- Faculty of Health and Medical Sciences, Department of Immunology and Microbiology; University of Copenhagen; 2200 Copenhagen Denmark
| | - Elena Gimenéz-Arnau
- Laboratory of Dermatochemistry, Institute of Chemistry-CNRS UMR 7177; University of Strasbourg; 67081 Strasbourg France
| | - Jean-Pierre Lepoittevin
- Laboratory of Dermatochemistry, Institute of Chemistry-CNRS UMR 7177; University of Strasbourg; 67081 Strasbourg France
| | - Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology; University of Erlangen/Nürnberg; 91054 Erlangen Germany
| | - Jeanne D. Johansen
- Department of Dermatology-Allergy, National Allergy Research Centre; Copenhagen University Hospital Gentofte; 2900 Hellerup Denmark
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Kostner L, Anzengruber F, Guillod C, Recher M, Schmid-Grendelmeier P, Navarini AA. Allergic Contact Dermatitis. Immunol Allergy Clin North Am 2017; 37:141-152. [DOI: 10.1016/j.iac.2016.08.014] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Yu DS, Kim HJ, Park YG, Bae JM, Kim JW, Lee YB. Patch-test results using Korean standard series: a 5-year retrospective review. J DERMATOL TREAT 2016; 28:258-262. [DOI: 10.1080/09546634.2016.1219015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Pochhammer J, Weller MP, Schäffer M. Polihexanide for prevention of Wound Infection in Surgery. Is the contact time essential? POLIS-trial: A historic controlled, clinical pilot trial. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.wndm.2016.07.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Abstract
Background: In allergic contact dermatitis (ACD), polysensitization consists of positive patch test reactions to three or more unrelated allergens. Objective: The purpose of this case report is to document a 27-year-old female with recurrent lip dermatitis, polysensitization, and reactions to a number of clinically relevant exposures. Methods: Patch testing results revealed positive reactions to tixocortol-21-pivalate (3+), lanolin (3+), neomycin (3+), nickel (1+), hydroxyethyl methylacrylate (3+), bacitracin (3+), and abitol (3+). Results: The patient had seven positive reactions, meeting the criteria for polysensitization. Of known clinical relevance, the patient had applied lanolin-containing lip balms and hydrocortisone- and bacitracin-containing products to the lips, all of which she was strongly reactive to on patch testing. Conclusion: Polysensitization occurs when three or more unrelated allergens are positive on patch testing. This case highlights the importance of considering polysensitization in ACD as numerous allergens that were positive on patch testing were clinically relevant.
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Affiliation(s)
- Kathleen Fraser
- College of Medicine, University of Saskatchewan, Saskatoon, SK
- Division of Dermatology, University of Ottawa, Ottawa, ON
| | - Melanie Pratt
- College of Medicine, University of Saskatchewan, Saskatoon, SK
- Division of Dermatology, University of Ottawa, Ottawa, ON
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Abstract
A crucial role of the epidermal permeability barrier is obvious in contact dermatitis. An intact skin barrier prevents the penetration of harmful substances into the skin. Irritants and allergens that stay on the skin surface and come into contact with the stratum corneum only do not harm the skin. After disruption of the skin barrier, however, irritants may penetrate into the living epidermal layers, injure the keratinocyte membrane, and release cytokines, which leads to inflammation and to irritant contact dermatitis. The skin barrier is often disrupted by chronic exposure to water plus detergents, solvents, or other irritants. A disrupted barrier in irritant contact dermatitis also allows for the penetration of allergens. Allergens may come into contact with Langerhans and T cells, induce immunological reactions, and cause inflammation, which results in allergic contact dermatitis. Treatments in contact dermatitis should restore the skin barrier to prevent relapse of the disease. Topical corticosteroids, most often used in treating contact dermatitis, reduce immunological reactions and inflammation but do not lead to a complete barrier repair. Skin barrier repair is more complete after treatment with calcineurin inhibitors and bland lipid-based emollient; therefore, these preparations should be preferred for long-term treatment of contact dermatitis.
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Peiser M, Tralau T, Heidler J, Api AM, Arts JHE, Basketter DA, English J, Diepgen TL, Fuhlbrigge RC, Gaspari AA, Johansen JD, Karlberg AT, Kimber I, Lepoittevin JP, Liebsch M, Maibach HI, Martin SF, Merk HF, Platzek T, Rustemeyer T, Schnuch A, Vandebriel RJ, White IR, Luch A. Allergic contact dermatitis: epidemiology, molecular mechanisms, in vitro methods and regulatory aspects. Current knowledge assembled at an international workshop at BfR, Germany. Cell Mol Life Sci 2011; 69:763-81. [PMID: 21997384 PMCID: PMC3276771 DOI: 10.1007/s00018-011-0846-8] [Citation(s) in RCA: 224] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2011] [Revised: 08/29/2011] [Accepted: 09/20/2011] [Indexed: 12/13/2022]
Abstract
Contact allergies are complex diseases, and one of the important challenges for public health and immunology. The German ‘Federal Institute for Risk Assessment’ hosted an ‘International Workshop on Contact Dermatitis’. The scope of the workshop was to discuss new discoveries and developments in the field of contact dermatitis. This included the epidemiology and molecular biology of contact allergy, as well as the development of new in vitro methods. Furthermore, it considered regulatory aspects aiming to reduce exposure to contact sensitisers. An estimated 15–20% of the general population suffers from contact allergy. Workplace exposure, age, sex, use of consumer products and genetic predispositions were identified as the most important risk factors. Research highlights included: advances in understanding of immune responses to contact sensitisers, the importance of autoxidation or enzyme-mediated oxidation for the activation of chemicals, the mechanisms through which hapten-protein conjugates are formed and the development of novel in vitro strategies for the identification of skin-sensitising chemicals. Dendritic cell cultures and structure-activity relationships are being developed to identify potential contact allergens. However, the local lymph node assay (LLNA) presently remains the validated method of choice for hazard identification and characterisation. At the workshop the use of the LLNA for regulatory purposes and for quantitative risk assessment was also discussed.
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Affiliation(s)
- M. Peiser
- Department of Product Safety, German Federal Institute for Risk Assessment (BfR), Thielallee 88-92, 14195 Berlin, Germany
| | - T. Tralau
- Department of Product Safety, German Federal Institute for Risk Assessment (BfR), Thielallee 88-92, 14195 Berlin, Germany
| | - J. Heidler
- Department of Product Safety, German Federal Institute for Risk Assessment (BfR), Thielallee 88-92, 14195 Berlin, Germany
| | - A. M. Api
- Research Institute for Fragrance Materials, Hackensack, NJ USA
| | | | | | - J. English
- Nottingham University Hospitals, Nottingham, UK
| | - T. L. Diepgen
- Department of Social Medicine, Occupational and Environmental Dermatology, University of Heidelberg, Heidelberg, Germany
| | | | - A. A. Gaspari
- School of Medicine, University of Maryland, Baltimore, MD USA
| | - J. D. Johansen
- Department of Derma-allergology, Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - A. T. Karlberg
- Department of Chemistry, Dermatochemistry and Skin Allergy, University of Gothenburg, Gothenburg, Sweden
| | - I. Kimber
- Faculty of Life Sciences, University of Manchester, Manchester, UK
| | | | - M. Liebsch
- Department of Experimental Toxicology and ZEBET, Center for Alternatives to Animal Testing, German Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - H. I. Maibach
- Department of Dermatology, University of California San Francisco, San Francisco, CA USA
| | - S. F. Martin
- Allergy Research Group, Department of Dermatology, University Medical Center Freiburg, Freiburg, Germany
| | - H. F. Merk
- Department of Dermatology and Allergology, University Hospitals Aachen, Aachen, Germany
| | - T. Platzek
- Department of Product Safety, German Federal Institute for Risk Assessment (BfR), Thielallee 88-92, 14195 Berlin, Germany
| | - T. Rustemeyer
- VU University Medical Center, Amsterdam, The Netherlands
| | - A. Schnuch
- Department of Dermatology, University of Göttingen, Göttingen, Germany
| | - R. J. Vandebriel
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - I. R. White
- St. John’s Institute of Dermatology, St. Thomas’ Hospital, London, UK
| | - A. Luch
- Department of Product Safety, German Federal Institute for Risk Assessment (BfR), Thielallee 88-92, 14195 Berlin, Germany
- Department of Experimental Toxicology and ZEBET, Center for Alternatives to Animal Testing, German Federal Institute for Risk Assessment (BfR), Berlin, Germany
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Kezic S, Visser MJ, Verberk MM. Individual susceptibility to occupational contact dermatitis. INDUSTRIAL HEALTH 2009; 47:469-478. [PMID: 19834255 DOI: 10.2486/indhealth.47.469] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Occupational Contact Dermatitis (OCD) is one of the most common work-related diseases. High risk occupations are in health care, hairdressing, food sector and metal industry. OCD tends to become chronic; persistent OCD often results in impaired quality of life and loss of work ability. The purpose of this article is to review the present knowledge on the factors which determine individual susceptibility to acquire OCD. Recent discoveries regarding genes involved in the skin barrier, inflammatory response and biotransformation of xenobiotics provide more insight in the individual susceptibility for OCD. Knowledge of the factors which predispose to OCD is useful in occupational health practice for the application of preventive measures and for career guidance for apprentices and workers in high risk occupations.
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Affiliation(s)
- Sanja Kezic
- Institute of Occupational Health, Academic Medical Center, University of Amsterdam, P.O. Box 22700, 1100 DE Amsterdam, The Netherlands.
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Lessmann H, Uter W, Schnuch A, Geier J. Skin sensitizing properties of the ethanolamines mono-, di-, and triethanolamine. Data analysis of a multicentre surveillance network (IVDK*) and review of the literature. Contact Dermatitis 2009; 60:243-55. [DOI: 10.1111/j.1600-0536.2009.01506.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Bibliography. Current world literature. Genetics and epidemiology. Curr Opin Allergy Clin Immunol 2008; 8:489-93. [PMID: 18769207 DOI: 10.1097/aci.0b013e32830f1c83] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Schnuch A, Aberer W, Agathos M, Becker D, Brasch J, Elsner P, Frosch PJ, Fuchs T, Geier J, Hillen U, Löffler H, Mahler V, Richter G, Szliska C. Patch testing with contact allergens. J Dtsch Dermatol Ges 2008. [DOI: 10.1111/j.1610-0387.2009.06787.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Carlsen BC, Menné T, Johansen JD. Associations between baseline allergens and polysensitization. Contact Dermatitis 2008; 59:96-102. [DOI: 10.1111/j.1600-0536.2008.01400.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Abstract
Genetic factors presumably play a role in contact allergy (CA). There is, however, a lack of conclusive evidence from clinical studies. This may be on account of the strongly competing or modifying impact of exogenous factors, namely the potency of allergens and the intensity of exposure, and the fact that - in principle - everybody can be sensitized. Regarding phenotype, in contrast, polysensitization (PS) seems to indicate a subset of individuals at greater risk. In human sensitization experiments with dinitrochlorobenzene, induction was facilitated in PS, and elicitation enhanced. Recent clinical epidemiological data, taking confounders for PS, such as age, sex, and other skin diseases into account, demonstrated the following: (i) PS was the greatest risk factor to be sensitized to a number of (even weak) index allergens, indicating higher susceptibility on the level of induction; (ii) patch test reactions in PS patients were generally stronger indicating higher susceptibility on the level of elicitation. These findings are complemented by reports on polymorphisms of TNF-alpha and IL-16 in PS patients. Future studies on the genetics of CA should be performed in subgroups with PS, focussing on polymorphisms relevant for CA-specific and nonspecific (inflammatory) processes.
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Affiliation(s)
- A Schnuch
- Center of the Information Network of Department of Dermatology, Institute at University of Göttingen, Göttingen, Germany
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