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Opstrup MS, Bergmann K, Rossau AK. [Not Available]. Ugeskr Laeger 2022; 184:V71101. [PMID: 35593374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
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2
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Opstrup MS, Jemec GE, Kaae J. [Not Available]. Ugeskr Laeger 2022; 184:V71097. [PMID: 35485797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
| | | | - Jeanette Kaae
- Dermatologisk Afdeling, Sjøllands Universitetshospital, Roskilde
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Opstrup MS, Simmelsgaard L, Cvetkovski RS. [Hot foot syndrome]. Ugeskr Laeger 2021; 183:V71063. [PMID: 34704934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
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4
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Andersen S, Opstrup MS. [Pityriasis amiantacea]. Ugeskr Laeger 2021; 183:V71042. [PMID: 33491625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
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Bandier J, Opstrup MS. [Pakydermodaktyli - en sjælden årsag til hævede fingre]. Ugeskr Laeger 2020; 182:V71027. [PMID: 33046189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
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6
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Opstrup MS, Puchner M, Larsen HK. [Verrukøst karcinom udgående fra et kondylom]. Ugeskr Laeger 2020; 182:V71014. [PMID: 32829750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
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Sejersen TS, Opstrup MS, Adolfsson EL, Pörksen S, Saunte DM. [Not Available]. Ugeskr Laeger 2019; 181:V70442. [PMID: 31495357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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8
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Opstrup MS. [Airborne allergic contact dermatitis]. Ugeskr Laeger 2019; 181:V01190054. [PMID: 31036141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
In this case report, a 25-year-old woman presented with contact dermatitis caused by airborne exposure to isothiazolinones in paints. Allergic contact dermatitis is most frequently caused by direct contact with a product containing an allergen. However, in rare cases, allergic contact dermatitis can be caused by airborne exposure to an allergen. This report highlights the importance of considering airborne exposure in patients with unexplained dermatitis.
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Abstract
PURPOSE OF REVIEW In recent years, the risk of allergy to chlorhexidine is increasingly recognised. In this review, we discuss why the allergy is so easily overlooked and point out several preventative initiatives that can minimise the risk of both chlorhexidine sensitisation and allergy development and accidental re-exposure in patients with chlorhexidine allergy. Testing for chlorhexidine allergy is also discussed. RECENT FINDINGS Numerous reports have been published from many different specialties. Symptoms range from mild skin symptoms to life-threatening anaphylaxis. Testing for chlorhexidine allergy is based on skin testing and in vitro testing. Recently, it was found that both skin prick testing and specific IgE have high sensitivities and specificities. This review gives an overview of chlorhexidine allergy with a special focus on preventative initiatives and testing.
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Affiliation(s)
- Morten Schjørring Opstrup
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark. .,Danish Anaesthesia Allergy Centre, Allergy Clinic, Department of Dermatology and Allergy, Copenhagen University Hospital Gentofte, Kildegårdsvej 28, 2900, Hellerup, Denmark.
| | - Gregor Borut Ernst Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Lene Heise Garvey
- Danish Anaesthesia Allergy Centre, Allergy Clinic, Department of Dermatology and Allergy, Copenhagen University Hospital Gentofte, Kildegårdsvej 28, 2900, Hellerup, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Opstrup MS, Garvey LH. Chlorhexidine Allergy: Mild Allergic Reactions Can Precede Anaphylaxis in the Healthcare Setting. Turk J Anaesthesiol Reanim 2019; 47:342-344. [PMID: 31380516 DOI: 10.5152/tjar.2019.22058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 12/26/2018] [Indexed: 11/22/2022] Open
Abstract
Chlorhexidine can cause severe immediate-type allergic reactions such as urticaria, anaphylactic shock or, even, cardiac arrest. We report the case of a patient who developed perioperative anaphylactic shock caused by chlorhexidine 1 year after a postoperative urticarial reaction, which was assumed not to be significant at the time. This case highlights the importance of identifying mild allergy symptoms after exposure to chlorhexidine at the pre-anaesthetic assessment to prevent more severe allergic reactions in future.
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Affiliation(s)
- Morten Schjørring Opstrup
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark.,Danish Anaesthesia Allergy Centre, Allergy Clinic, Department of Dermatology and Allergy, Copenhagen University Hospital Gentofte, Gentofte, Denmark
| | - Lene Heise Garvey
- Danish Anaesthesia Allergy Centre, Allergy Clinic, Department of Dermatology and Allergy, Copenhagen University Hospital Gentofte, Gentofte, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Opstrup MS, Heidenheim M. [Not Available]. Ugeskr Laeger 2018; 180:V70115. [PMID: 30618358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Opstrup MS, Garvey LH. Intraoperative anaphylaxis: remember the hidden allergens. The Journal of Allergy and Clinical Immunology: In Practice 2018; 6:2175-2176. [DOI: 10.1016/j.jaip.2018.08.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 08/27/2018] [Indexed: 11/28/2022]
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Opstrup MS, Togsverd-Bo K, Bregnbak D. [Erythema multiforme with severe mucosal involvement]. Ugeskr Laeger 2017; 179:V68584. [PMID: 28074768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Foss-Skiftesvik MH, Winther L, Mosbech HF, Skov PS, Opstrup MS, Søsted H, Zachariae C, Johansen JD, Johnsen CR. Optimizing diagnostic tests for persulphate-induced respiratory diseases. Clin Transl Allergy 2016; 6:26. [PMID: 27446529 PMCID: PMC4955245 DOI: 10.1186/s13601-016-0118-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 06/21/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Persulphates from hair bleaching products are considered the major cause of occupational-rhinitis and asthma in hairdressers. The specific inhalation challenge (SIC) is considered 'reference standard' for diagnosing persulphate-induced asthma and rhinitis; however, the currently validated method of performing SIC with persulphate powder is time consuming with a duration of up to 4 days. The value of skin prick tests (SPTs) and histamine release tests (HRTs) with persulphates is unknown. The aim of this study was to establish a novel rapid SIC with persulphate powder to test for both rhinitis and asthma simultaneously in 1 day. In addition, we assessed the suitability of SPTs and HRTs for detecting persulphate-induced respiratory diseases. METHODS The study population included 19 hairdressers with a history of work-related rhinitis and/or asthma symptoms, 12 symptomatic controls (10 with concurrent allergic asthma and rhinitis and two with non-allergic asthma), and 40 healthy controls. A previous severe asthmatic reaction and/or anaphylactic reaction to persulphates was considered an exclusion criterion for hairdressers. The 19 hairdressers and 12 symptomatic controls had SIC performed with 3 × 5 min exposures to potassium persulphate powder in a provocation chamber. All participants, including the 40 healthy controls, were subjected also to SPTs and HRTs with three persulphate salts at concentrations of 2-20 % and 0.03-1 %, respectively. RESULTS None of the symptomatic controls had a nasal or bronchial response to SIC with potassium persulphate. Six hairdressers presented a nasal and two a bronchial response. No severe reactions occurred. No positive SPTs were recorded, neither among hairdressers, symptomatic controls, nor healthy controls. All three groups showed nonspecific non-IgE mediated histamine release to persulphates in HRT. CONCLUSIONS The proposed method for performing SIC showed a high specificity for detecting persulphate-induced asthma and rhinitis. The rapid SIC was able to produce positive nasal and bronchial responses in symptomatic hairdressers without any severe reactions occurring. SPTs and HRTs cannot predict asthma or rhinitis caused by persulphates.
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Affiliation(s)
- M H Foss-Skiftesvik
- Department of Dermato-Allergology, National Allergy Research Centre, Copenhagen University Hospital Gentofte, Kildegårdsvej 28, 2900 Hellerup, Denmark ; Department of Dermato-Allergology, Research Centre for Hairdressers and Beauticians, Copenhagen University Hospital Gentofte, Hellerup, Denmark
| | - L Winther
- Allergy Clinic, Department of Dermato-Allergology, Copenhagen University Hospital Gentofte, Hellerup, Denmark
| | - H F Mosbech
- Allergy Clinic, Department of Dermato-Allergology, Copenhagen University Hospital Gentofte, Hellerup, Denmark
| | | | - M S Opstrup
- Department of Dermato-Allergology, National Allergy Research Centre, Copenhagen University Hospital Gentofte, Kildegårdsvej 28, 2900 Hellerup, Denmark ; Allergy Clinic, Department of Dermato-Allergology, Copenhagen University Hospital Gentofte, Hellerup, Denmark
| | - H Søsted
- Department of Dermato-Allergology, Research Centre for Hairdressers and Beauticians, Copenhagen University Hospital Gentofte, Hellerup, Denmark
| | - C Zachariae
- Department of Dermato-Allergology, Copenhagen University Hospital Gentofte, Hellerup, Denmark
| | - J D Johansen
- Department of Dermato-Allergology, Research Centre for Hairdressers and Beauticians, Copenhagen University Hospital Gentofte, Hellerup, Denmark
| | - C R Johnsen
- Allergy Clinic, Department of Dermato-Allergology, Copenhagen University Hospital Gentofte, Hellerup, Denmark
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Opstrup MS, Poulsen LK, Malling HJ, Jensen BM, Garvey LH. Dynamics of plasma levels of specific IgE in chlorhexidine allergic patients with and without accidental re-exposure. Clin Exp Allergy 2016; 46:1090-8. [PMID: 27079633 DOI: 10.1111/cea.12743] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 02/25/2016] [Accepted: 04/08/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Chlorhexidine is an effective disinfectant, which may cause severe allergic reactions. Plasma level of specific IgE to chlorhexidine (ImmunoCAP(®) ) has high estimated sensitivity and specificity when measured within 6 months of allergic reaction, but knowledge of the dynamics over longer time periods is lacking and it is unknown whether levels fall below <0.35 kUA/L in patients with previously elevated levels. It is also unclear whether re-exposure influences levels of specific IgE. OBJECTIVE To investigate the dynamics of specific IgE in chlorhexidine allergic patients with and without re-exposure. METHODS All patients diagnosed with chlorhexidine allergy in the Danish Anaesthesia Allergy Centre January 1999 to March 2015 were invited to participate. The study included blood samples from the time of reaction and time of investigation and blood samples drawn prospectively over several years. RESULTS Overall, 23 patients were included. Specific IgE within hours of reaction was available in eight patients and was >0.35 kUA/L in six of these. During allergy investigations, usually 2-4 months later, specific IgE was >0.35 kUA/L in 22 of 23 patients. In the following months/years specific IgE declined <0.35 kUA/L in 17 of 23 patients (most rapidly within 4 months). Nine re-exposures in the healthcare setting were reported by seven patients (35%). Most re-exposures caused symptoms and were followed by an increase in specific IgE. Two patients with specific IgE <0.35 kUA/L reacted upon re-exposure. CONCLUSIONS & CLINICAL RELEVANCE Time from reaction should be considered when interpreting specific IgE results. Specific IgE is >0.35 kUA/L in most patients at time of reaction but should be repeated after a few weeks/months if negative. The optimal sampling time seems to be >1 month and <4 months. A value <0.35 kUA/L neither excludes allergy nor implies loss of reactivity in previously sensitized patients. Re-exposures are common, often iatrogenic, and can cause a rebound in specific IgE.
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Affiliation(s)
- M S Opstrup
- Danish Anaesthesia Allergy Centre, Allergy Clinic, Department of Dermato-Allergology, Copenhagen University Hospital Gentofte, Hellerup, Denmark.,National Allergy Research Centre, Department of Dermato-Allergology, Copenhagen University Hospital Gentofte, Hellerup, Denmark
| | - L K Poulsen
- Danish Anaesthesia Allergy Centre, Allergy Clinic, Department of Dermato-Allergology, Copenhagen University Hospital Gentofte, Hellerup, Denmark
| | - H J Malling
- Danish Anaesthesia Allergy Centre, Allergy Clinic, Department of Dermato-Allergology, Copenhagen University Hospital Gentofte, Hellerup, Denmark
| | - B M Jensen
- Danish Anaesthesia Allergy Centre, Allergy Clinic, Department of Dermato-Allergology, Copenhagen University Hospital Gentofte, Hellerup, Denmark
| | - L H Garvey
- Danish Anaesthesia Allergy Centre, Allergy Clinic, Department of Dermato-Allergology, Copenhagen University Hospital Gentofte, Hellerup, Denmark
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Affiliation(s)
| | | | - Rossana Bossi
- Aarhus UniversityInstitut for Bioscience ‐ Arctic Research CentreDenmark
| | | | - Lene Heise Garvey
- Copenhagen University Hospital Gentofte, Danish Anaesthesia Allergy CentreAllergy ClinicDenmark
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Opstrup MS, Mosbech H, Garvey LH. Allergic sensitization to ethylene oxide in patients with suspected allergic reactions during surgery and anesthesia. J Investig Allergol Clin Immunol 2010; 20:269-270. [PMID: 20635797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Affiliation(s)
- M S Opstrup
- Danish Anaesthesia Allergy Centre, Allergy Unit, Copenhagen University Hospital, Gentofte Hospital, Denmark.
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