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Sugimoto N, Kuribayashi K, Yamamoto Y, Nagayasu S, Suga O, Fujimoto Y. Contact Dermatitis after Prescription of an Ophthalmic Ointment Containing Fradiomycin Sulfate: A Retrospective Database Study Using Japanese Health Insurance Claims Data. Drugs Real World Outcomes 2018; 5:45-54. [PMID: 29188591 PMCID: PMC5825390 DOI: 10.1007/s40801-017-0127-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Topical ointments containing fradiomycin sulfate, such as fradiomycin sulfate/methylprednisolone (F/M) and fradiomycin sulfate/betamethasone sodium phosphate (F/B), are known to cause allergic contact dermatitis (CD) in some patients, especially when used for the periocular region. F/M is commonly prescribed to patients for various conditions; however, there are no reports with respect to the incidence of CD caused by F/M in actual practice. OBJECTIVE The aim was to investigate the incidence of CD using a data-based retrospective cohort study. METHODS Using a Japanese health insurance claims database [MinaCare Co. Ltd. healthcare database (MinaCare HDB)], a comparative assessment was conducted of F/M and another combination drug (F/B) and two single-drug treatments (ophthalmic ointments with either an antibiotic or a steroid). The total data set consisted of 1,176,082 individuals in the MinaCare HDB, with 54,016 having received prescriptions for one of the four investigational drug regimens. RESULTS Overall, the incidences of CD were similar in three of the four groups in this study (F/M 0.091; F/B 0.092; steroids 0.102), while being lower in the fourth group (antibiotics 0.060). Even after confirmation of a diagnosis of CD, prescriptions for the investigational drugs were repeatedly filled for some patients. CONCLUSION This study demonstrated that there was no clear difference in the incidence of CD after filling prescriptions for F/M, F/B, and ophthalmic ointment containing a steroid, while the incidence with antibiotics was lower by 0.03-0.04 compared with the other groups. Considering the observation that the investigational drugs were repeatedly prescribed even after the diagnosis of CD, it is critical that the risk of CD with these prescribed topical ointments is better understood by primary care physicians in order to take appropriate countermeasures.
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Affiliation(s)
- Naomi Sugimoto
- Pfizer Japan Inc., 3-22-7 Yoyogi, Shibuya-ku, Tokyo, 151-8589, Japan
| | | | - Yuji Yamamoto
- MinaCare Co. Ltd., 2-3-11 Nihonbashihoncho, Chuo-ku, Tokyo, 103-0023, Japan
| | - Satoshi Nagayasu
- MinaCare Co. Ltd., 2-3-11 Nihonbashihoncho, Chuo-ku, Tokyo, 103-0023, Japan
| | - Osamu Suga
- Pfizer Japan Inc., 3-22-7 Yoyogi, Shibuya-ku, Tokyo, 151-8589, Japan
| | - Yoko Fujimoto
- Pfizer Japan Inc., 3-22-7 Yoyogi, Shibuya-ku, Tokyo, 151-8589, Japan.
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Moore NA, Czyz CN, Carter TD, Foster JA, Cahill KV. Neomycin, polymyxin B, and dexamethasone allergic reactions following periocular surgery. J Ophthalmic Inflamm Infect 2017; 7:15. [PMID: 28608297 PMCID: PMC5468176 DOI: 10.1186/s12348-017-0133-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 05/26/2017] [Indexed: 11/16/2022] Open
Abstract
Background The aim of this study was to evaluate the rate of periocular allergic skin reactions to topical neomycin, polymyxin B, and dexamethasone (NPD) ophthalmic ointment. Methods A consecutive patient prospective study was performed. A total of 522 patients who had a procedure involving incision of the periocular skin with subsequent postoperative application of NPD ophthalmic ointment were included. Patients were evaluated for signs of allergy at 1 week postoperatively or prior if the patient had complaints. A periocular allergic reaction was defined as any periocular skin pruritus, erythema, edematous papules, vesicles, or plaques at the site of ointment application beyond that of the typical postprocedure presentation. The patients continued to be monitored for 30 days postoperatively. Results Of the 522 patients who completed the study, eight (1.5%) had a definitive periocular allergic contact dermatitis to the NPD ophthalmic ointment. Allergic presentation ranged from postoperative day 3 to 14. Conclusions The rate of periocular allergic reactions to NPD ophthalmic ointment is significantly lower than reported in the literature for other topical preparations of neomycin and polymyxin B. The low rate of allergy in this study suggests that NPD ophthalmic ointment can safely be applied to the periocular skin with a very minimal risk of inciting an allergic reaction.
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Affiliation(s)
- Nicholas A Moore
- Department of Ophthalmology, Indiana University School of Medicine, 2022 Ruckle St., Indianapolis, IN, 46202, USA.
| | - Craig N Czyz
- Division of Ophthalmology, Oculofacial Plastic and Reconstructive Surgery, Doctors Hospital, Columbus, OH, USA.,Department of Ophthalmology, Oral and Maxillofacial Surgery, Grant Medical Center, Columbus, OH, USA
| | - Tracy D Carter
- Division of Ophthalmology, Oculofacial Plastic and Reconstructive Surgery, Doctors Hospital, Columbus, OH, USA
| | - Jill A Foster
- Ophthalmic Surgeons and Consultants of Ohio, Columbus, OH, USA
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Antonov D, Schliemann S, Elsner P. Hand dermatitis: a review of clinical features, prevention and treatment. Am J Clin Dermatol 2015; 16:257-270. [PMID: 25920436 DOI: 10.1007/s40257-015-0130-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Hand dermatitis is a socially significant health problem. This review provides a discussion on the clinical features and patterns as well as the differential diagnosis of hand dermatitis, because these are essential for proper diagnosis in clinical practice. The morphology, however, is poorly related to the etiology in chronic cases. In all cases of chronic hand dermatitis, a full diagnostic examination should be undertaken and the etiology should be clarified and addressed in the treatment concept, instead of just moving directly from a morphological diagnosis to therapy. Preventive measures should be included in the treatment concept according to etiology. A stepwise approach for escalating therapy is advised, including basic topical therapy, topical corticosteroids, calcineurin inhibitors, as well as phototherapy and systemic therapy with corticosteroids, alitretinoin, cyclosporine, methotrexate, azathioprine, and others.
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de Waard-van der Spek FB, Andersen KE, Darsow U, Mortz CG, Orton D, Worm M, Muraro A, Schmid-Grendelmeier P, Grimalt R, Spiewak R, Rudzeviciene O, Flohr C, Halken S, Fiocchi A, Borrego LM, Oranje AP. Allergic contact dermatitis in children: which factors are relevant? (review of the literature). Pediatr Allergy Immunol 2013; 24:321-9. [PMID: 23373713 DOI: 10.1111/pai.12043] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/03/2013] [Indexed: 11/30/2022]
Abstract
Allergic contact dermatitis (ACD) in children is increasing. Sensitization to contact allergens can start in early infancy. The epidermal barrier is crucial for the development of sensitization and elicitation of ACD. Factors that may influence the onset of sensitization in children are atopic dermatitis, skin barrier defects and intense or repetitive contact with allergens. Topical treatment of ACD is associated with cutaneous sensitization, although the prevalence is not high. ACD because of haptens in shoes or shin guards should be considered in cases of persistent foot eruptions or sharply defined dermatitis on the lower legs. Clinical polymorphism of contact dermatitis to clothing may cause difficulties in diagnosing textile dermatitis. Toys are another potentially source of hapten exposure in children, especially from toy-cosmetic products such as perfumes, lipstick and eye shadow. The most frequent contact allergens in children are metals, fragrances, preservatives, neomycin, rubber chemicals and more recently also colourings. It is very important to remember that ACD in young children is not rare, and should always be considered when children with recalcitrant eczema are encountered. Children should be patch-tested with a selection of allergens having the highest proportion of positive, relevant patch test reactions. The allergen exposure pattern differs between age groups and adolescents may also be exposed to occupational allergens. The purpose of this review is to alert the paediatrician and dermatologist of the frequency of ACD in young children and of the importance of performing patch tests in every case of chronic recurrent or therapy-resistant eczema in children.
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Affiliation(s)
- Flora B de Waard-van der Spek
- Department of Dermatology, Erasmus MC University Medical Center Rotterdam and KinderHaven Havenziekenhuis, Rotterdam, The Netherlands.
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Sharma NS, Jindal R, Mitra B, Lee S, Li L, Maguire TJ, Schloss R, Yarmush ML. Perspectives on Non-Animal Alternatives for Assessing Sensitization Potential in Allergic Contact Dermatitis. Cell Mol Bioeng 2011; 5:52-72. [PMID: 24741377 DOI: 10.1007/s12195-011-0189-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Skin sensitization remains a major environmental and occupational health hazard. Animal models have been used as the gold standard method of choice for estimating chemical sensitization potential. However, a growing international drive and consensus for minimizing animal usage have prompted the development of in vitro methods to assess chemical sensitivity. In this paper, we examine existing approaches including in silico models, cell and tissue based assays for distinguishing between sensitizers and irritants. The in silico approaches that have been discussed include Quantitative Structure Activity Relationships (QSAR) and QSAR based expert models that correlate chemical molecular structure with biological activity and mechanism based read-across models that incorporate compound electrophilicity. The cell and tissue based assays rely on an assortment of mono and co-culture cell systems in conjunction with 3D skin models. Given the complexity of allergen induced immune responses, and the limited ability of existing systems to capture the entire gamut of cellular and molecular events associated with these responses, we also introduce a microfabricated platform that can capture all the key steps involved in allergic contact sensitivity. Finally, we describe the development of an integrated testing strategy comprised of two or three tier systems for evaluating sensitization potential of chemicals.
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Affiliation(s)
- Nripen S Sharma
- Department of Biomedical Engineering, Rutgers University, 599 Taylor Road, 231, Piscataway, NJ 08854, USA
| | - Rohit Jindal
- Department of Biomedical Engineering, Rutgers University, 599 Taylor Road, 231, Piscataway, NJ 08854, USA
| | - Bhaskar Mitra
- Department of Biomedical Engineering, Rutgers University, 599 Taylor Road, 231, Piscataway, NJ 08854, USA
| | - Serom Lee
- Department of Biomedical Engineering, Rutgers University, 599 Taylor Road, 231, Piscataway, NJ 08854, USA
| | - Lulu Li
- Department of Biomedical Engineering, Rutgers University, 599 Taylor Road, 231, Piscataway, NJ 08854, USA
| | - Tim J Maguire
- Department of Biomedical Engineering, Rutgers University, 599 Taylor Road, 231, Piscataway, NJ 08854, USA
| | - Rene Schloss
- Department of Biomedical Engineering, Rutgers University, 599 Taylor Road, 231, Piscataway, NJ 08854, USA
| | - Martin L Yarmush
- Department of Biomedical Engineering, Rutgers University, 599 Taylor Road, 231, Piscataway, NJ 08854, USA ; Center for Engineering in Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
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