[The disease under chronic urticaria: beyond itching]

BACKGROUND

Brief erythematous-papular skin rashes suggest the diagnosis of urticaria; However, it may be another type of dermatitis, and complementary examinations must be carried out to establish its diagnosis.

CASE REPORT

53-year-old female patient, diagnosed in 2016 with diffuse large B cell lymphoma, in complete remission. Since 2010, he has had episodes of erythematous-papular lesions lasting 24-36 hours. He received antihistamines, corticosteroids and omalizumab without clinical improvement. The ANA determination was positive (1/320), nuclear mitotic pattern. The skin biopsy was compatible with dermatitis herpetiformis. The study of celiac and locus antibodies showed positivity for HLA-DQ2 and DQ2.5 in heterozygosity. The diagnosis of dermatitis herpetiformis was established. Treatment consisted of a gluten-free diet and prescription of dapsone, with satisfactory results.

CONCLUSION

It is important to establish the differential diagnosis of patients with chronic urticaria who do not respond to the reference treatment, in addition to carrying out a thorough clinical examination and physical examination before starting treatment and relying on a multidisciplinary team to establish an accurate diagnosis and treatment. appropriate. Due to the side effects of dapsone, subsequent follow-up of patients is essential.

[A drink with an unexpected ending... Adverse reaction by tonic water: A case report]

BACKGROUND

Quinine is an alkaloid with antipyretic and anti-infective properties, and also an ingredient in tonic waters. Adverse reactions have been reported with this product, such as photosensitivity, vasculitis, and contact dermatitis.

CASE REPORT

A 31-year-old male patient who, after 3-4 hours of consuming "Schweppes®" gin with tonic water, manifested ulcers on the lips and oral cavity, and a fixed erythematous lesion on the second phalanx of the hand, 24 hours later. Skin tests with aeroallergens and food were negative, and 48-hour patch tests were positive (quinine [++] and "Schweppes®" [++]). Based on the test findings, the diagnosis of an adverse reaction to quinine, contained in the tonic water, will be established.

CONCLUSIONS

Quinine can be found in other types of foods or medications, so it is important to establish an accurate diagnosis and offer adequate recommendations to the patient with the consumption of this product.

[Contact dermatitis caused by diagnostic devices and surgical orthopedic treatment]

BACKGROUND

Acrylates are plastic materials that are formed by the polymerization of monomers that are derived from acrylic or methacrylic acid; they have a wide range of applications, and they are increasingly used in medicine.

CASE REPORT

We are reporting two clinical cases of contact dermatitis in the hospital environment; the first one is about a nurse (occupational exposure) and, the second one, about a patient who experienced contact dermatitis after a diagnostic procedure was performed.

CONCLUSION

New sources of acrylates are identified every year due to the multiple uses of these synthetic resins; these materials are included in medical devices, both for orthopedic diagnosis or follow-up (telemetry, electrodes of electroencephalographs) and treatment (bone cement), as well as for surgery.