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Eczema
Kinds of Eczema Terms modified by Eczema Selected AbstractsP01 Contact dermatitis from textile colours in three Spanish townsCONTACT DERMATITIS, Issue 3 2004Begoña Garcia-Bravo Objective:, Prevalence of textile dye contact dermatitis (TD-CD) are lacking in many countries. Our aim is to know the frequency of TD-CD in three different areas of Spain. Methods:, 100 patients were tested with Spanish standard series and the five most frequent TD in each city. D. Orange 1, D. Orange 3, D. Blue 35, D. Blue 106, D. Blue 124 were included in Murcia and Seville, and the three last and D. Red 1, D. Red 17 in Santiago. Results:, 23/300 (15 women and 8 men) were positives to one or more TD. D. Blue 124 was the most frequent allergen (18/300), followed by D. Blue 106 (17/300). D. Red 1, D. Red 17 and D. Orange 1 were positives in 2/200. D. Orange 3 and D. Blue 35 were positives in 1/200. Eczema was located on hands in 13 cases. Clinical picture was variable. Origin of sensitization was clothing and occupational. Relevance was obtained in 20/23 cases. Conclusions:, The study confirm an high frequency of disperse dye allergy in Spain with a very different prevalence in the three areas: Seville 14%, Murcia 5% and Santiago 4%, that are probably due to social and cultural factors. We recommend the inclusion of D. Blue 106, D. Blue 124, D. Blue 35, D. Red 1, D. Red 17, D. Orange 1 and D. Orange 3 in standard series in order to detect sensitivity to textile colours that is most frequent than previously suspected. [source] Asthma and allergies in schoolchildren of MaputoALLERGY, Issue 3 2007S. Mavale-Manuel Aim:, The study aimed to determine prevalence and severity of asthma, rhinitis and eczema in Maputo, Mozambique. Methods:, The International Study of Asthma and Allergies (ISAAC) protocol was applied in 27 schools in urban, suburban and semi-rural areas. Results:, A total of 2630 completed questionnaires were obtained from students aged 13,14 years, and 2383 from schoolchildren aged 6,7 years. The prevalence of current asthma was 13.3% in the two groups, the prevalence of rhinoconjuctivitis and eczema was 23% and 10% in teenagers and 8.8% and 8.5% respectively in children 6,7 years old. Overall, 35% of the adolescents and 23.8% of children were found to have at least one atopic condition or asthma in the last year. In symptomatic adolescents, the conditions were: rhinoconjuctivitis (41.3%), asthma (20%) and eczema (12.4%). In symptomatic children, asthma was the principal condition (36.2%), followed by eczema (20.3%) and rhinoconjunctivitis (19.1%). In adolescents, asthma was more frequently associated with rhinoconjuctivitis (28%). About 4% of all surveyed children had three atopic conditions associated. In adolescents, past year rhinitis was more frequent and severe in the urban area. Hay fever was commoner in the semi-urban area. Eczema was significantly more recurrent in suburban and semi-rural area. Exercise-induced wheeze, nocturnal cough and ever asthma were more reported in children of suburban area. Conclusion:, Asthma and allergic diseases are important public health problems in Maputo and improvement in prevention and management plans are required. [source] Prevalence of allergy-related symptoms in Singaporean children in the second year of lifePEDIATRIC ALLERGY AND IMMUNOLOGY, Issue 2 2005Teng Nging Tan This study describes the cross-sectional prevalence of symptoms associated with eczema (chronic itchy rash), asthma (wheeze), and allergic rhinitis (rhinoconjunctivitis) in 1026 subjects between 18.5 and 23 months old (median age is 21 months) in Singapore. The first 2 yr cumulative prevalence of chronic itchy rash, wheeze, and rhinoconjunctivitis were 22.1% (n = 227), 22.9% (n = 235), and 8.4% (n = 86) respectively. In total, 42.2% (414 of 979) reported ever having any of these symptoms. Eczema, although prevalent, was diagnosed only in 34.4% (n = 78) of children with chronic itchy rash. Children with this eczematous rash were also more prone to wheeze (cOR = 2.0, 95% CI: 1.2,3.0) and rhinoconjunctivitis (cOR = 2.0, 95% CI: 1.4,2.8). Similarly, subjects who reported rhinoconjunctivitis and chronic itchy rash were 2.4 times (95% CI: 1.6,3.6) and 1.4 times (95% CI: 1.0,2.0) more at risk of wheezing respectively. Family history of allergy was a significant risk factor for chronic itchy rash (aOR = 1.8, 95% CI: 1.3,2.4) and wheeze (aOR = 1.7, 95% CI: 1.3,2.4). Thus, symptoms related to allergy were already prevalent during the second year of life. Significant proportions of these symptoms are likely to be due to true atopy as strong relationship with familial history and comorbidity with other potential allergic symptoms were observed. [source] The Prevalence, Characteristics of and Risk Factors for Eczema in Belgian SchoolchildrenPEDIATRIC DERMATOLOGY, Issue 2 2009Elke Govaere M.D. In this cross-sectional study we examined the prevalence and characteristics of eczema in an unbiased community population of 2,021 Belgian schoolchildren, aged 3.4 to 14.8 years with skin prick testing and parental questionnaires. Our study identified an eczema prevalence of 23.3% and a considerable allergic co-morbidity, mainly in sensitized children. The reported prevalence of eczema in infancy was 18.5% and for current eczema 11.6%. The overall sensitization rate (33.2%) as well as sensitization rates for the individual allergens were significantly higher in children with "eczema ever." Sensitization to Dermatophagoides pteronyssinus (19.6%), mixed grass pollen (15.1%), and cat (9.1%) were most common. Until the age of 6 years, boys with eczema were significantly more sensitized than girls (p = 0.007). Children with both eczema in infancy and current eczema show a tendency to be more sensitized than children with eczema in infancy only or current eczema only, but significance was only noted for a few individual allergens. Analysis of factors associated with eczema revealed a predominantly atopic profile characterized by family or personal history of allergy. Breastfeeding and environmental factors seemed to assume little relevance except for a protective effect of prematurity and having a dog at birth. [source] ORIGINAL RESEARCH,PAIN: Sexual Dysfunction in Patients with Chronic Hand Eczema in the Turkish PopulationTHE JOURNAL OF SEXUAL MEDICINE, Issue 6 2007Mahizer Ergün MD ABSTRACT Introduction., Hand eczema can cause considerable psychosocial disorders, such as anxiety, depression, and difficulties at work, and it may also cause sexual dysfunction. Aim., The aim of this study was to investigate sexual function in patients with hand eczema and to find out whether concomitant depression has an additional negative effect on sexual function in these patients. Main Outcome Measures., Sexual functions were evaluated in hand eczema patients. Methods., Ninety-one female (43 patients vs. 48 controls) and 79 male (45 patients vs. 34 controls) subjects were enrolled in the study. Hand eczema severity index was used to determine severity of hand eczema. The Female Sexual Function Index (FSFI) and the International Index of Erectile Function (IIEF) were used to assess sexual function. Quality of life was assessed with the Dermatology Life Quality Index. Diagnosis of depression was made based on the Structured Clinical Interview for the DSM-IV, while the Hamilton Depression Rate Scale was used for grading depression. Results., Among 43 female subjects with hand eczema, 26 had depression (60.46%); of the 45 male patients, 11 had depression (24.44%). FSFI total score was found to be significantly decreased in female patients with both eczema and depression compared with controls (20.84 ± 9.19 vs. 24.04 ± 3.40, P < 0.05). FSFI total score was found to be significantly decreased in female patients with both eczema and depression compared with those without depression (20.84 ± 9.19 vs. 22.23 ± 5.82, P < 0.05). IIEF total score was also found to be significantly decreased in male patients with or without depression compared with controls (52.36 ± 14.83 vs. 59.88 ± 5.65 vs. 62.03 ± 11.04, P < 0.05). Conclusions., The results of the study demonstrated that patients with hand eczema had sexual dysfunction, and concomitant depression had an additional negative effect on sexual dysfunction. Patients with hand eczema should be evaluated with regard to sexual function and depression to provide a better quality of life. Ergün M, Türel Ermertcan A, Öztürkcan S, Temelta, G, Deveci A, and Dinç G. Sexual dysfunction in patients with chronic hand eczema in the Turkish population. J Sex Med 2007;4:1684,1690. [source] The temporal sequence of allergic sensitization and onset of infantile eczemaCLINICAL & EXPERIMENTAL ALLERGY, Issue 4 2007A. J. Lowe Summary Background Eczema is commonly associated with sensitization in infants, but the causative role of sensitization in the development of eczema has been questioned. Objective To determine if allergic sensitization increases the risk of developing eczema, or alternatively, if eczema increases the risk of developing allergic sensitization. Methods We used data from the Melbourne Atopy Cohort Study, a prospective birth cohort of 552 infants with a family history of atopic disease. The main outcomes were risk of developing eczema from 6 months to 7 years of age in asymptomatic infants; and risk of developing sensitization, as measured by skin prick tests to milk, egg white, peanut, house dust mite, rye grass pollen and cat extracts, in previously unsensitized infants. Results Sensitization to food extracts at 6 months was associated with an increased risk of developing eczema [hazard ratio (HR) 1.63, 95% confidence interval 1.13,2.35] up to 7 years of age, after excluding infants with eczema in the first 6 months. However, eczema in the first 6 months was also associated with increased risk of new sensitization at both 1 year (HR 2.34, 1.38,3.98) and 2 years (HR 3.47, 1.65,7.32). Conclusion In some infants, sensitization precedes and predicts the development of eczema, while in others eczema precedes and predicts the development of sensitization. This indicates that there are multiple pathways to atopic eczema. [source] Characterization of the polysensitized patient: a matched case,control studyCONTACT DERMATITIS, Issue 1 2009Berit Christina Carlsen Background: Polysensitization ( , 3 contact allergies) may be regarded as a special entity in patients with contact allergies. However, this group of polysensitized patients is poorly characterized. Filaggrin mutations are associated with atopic eczema and lead to impaired skin barrier which may predispose to contact allergy. Therefore, it is of interest to consider atopic eczema and contact allergies, especially in patients with multiple allergies. Objective: To characterize polysensitized patients regarding occurrence, duration and course of dermatitis, and examine potential risk factors for polysensitization, including atopic eczema. Methods: A questionnaire case,control study of 562 polysensitized and 1124 single/double-sensitized individuals was performed. Results: The results show that 45% of polysensitized and 31% of single/double-sensitized patients had or had had atopic eczema, and atopic eczema was identified as a risk factor for polysensitization. Patients with leg ulcer constituted only a minor part of the polysensitized group and leg ulcers were not identified as a risk factor for polysensitization in this study. The influence of contact allergies on duration and course of disease diverged between the group of patients with atopic eczema and the group without atopic eczema. Conclusion: Patients with atopic eczema were overrepresented in the group of polysensitized patients and polysensitized patients should be viewed in the light of occurrence or lack of atopic eczema. [source] Classification of atopic hand eczema and the filaggrin mutationsCONTACT DERMATITIS, Issue 5 2008Charlotte Giwercman Hand eczema is a common disease with various risk factors of which atopic dermatitis is known to be one of the most important. Recently, two mutations in the gene coding for filaggrin, a protein important for the skin barrier, have repeatedly been shown to be associated with atopic dermatitis. Moreover, one study point towards an association between the filaggrin null alleles and the subgroup of patients having both hand eczema and atopic dermatitis. For the remainder of hand eczema patients, still unknown genetic risk factors exist. We propose that in future, classification of atopic hand eczema should distinguish between patients with and without the filaggrin null alleles and to further differentiate between associations with type I allergy, type IV allergy and exposure to irritants, respectively. Furthermore, we suggest future studies of atopic hand eczema to analyse for the filaggrin mutations. We believe this will increase the possibility of subgrouping this otherwise heterogenic disease and thereby enable a better phenotype,genotype characterization of hand eczema. This could improve the preventive initiatives, secure better information of patients about the prognosis for their disease, and possibly enable targeted treatment. [source] Occurrence and prognosis of hand eczema in the car industry: results from the PACO follow-up study (PACO II)CONTACT DERMATITIS, Issue 6 2008Christian J. Apfelbacher Background:, Only a few epidemiological studies on hand eczema (HE) in the metalworking industry have been conducted, and no study has attempted a long-term follow-up. Objectives:, In the Prospective Audi Cohort (PACO) II follow-up study, we aimed to estimate burden and prognosis of HE in a car industry setting (follow-up > 10 years). Patients/Methods:, Eligible participants were individuals who had been examined in the original PACO study (1990,1998) and had been followed through until the end of their apprenticeship (n = 1909). Participants were interviewed and underwent dermatological examination. An exposure assessment was carried out according to a pre-defined algorithm. Results:, The follow-up rate was 78.3% (1494/1909). Mean follow-up time was 13.3 [standard deviation 1.3] years. The period prevalence of HE in the follow-up period was 21.0% [95% confidence interval (CI) 19.0,23.1%], yielding a cumulative incidence of 29.3% (95% CI 26.9,31.6%) in the entire study period. HE persisted after the end of apprenticeship in 40.0% (95% CI 33.3,46.7%) of subjects who had had HE during apprenticeship (n = 205). 18.0% (95% CI 15.9,20.1%) developed HE in the follow-up period (n = 1289). Conclusions:, Around 30% of subjects were affected by HE at least once during the study period. HE persisted in 40% of the participants affected during apprenticeship. [source] Hand eczema: causes, course, and prognosis ICONTACT DERMATITIS, Issue 6 2008Niels K. Veien Background:, Hand eczema is a common dermatosis. The course is often protracted. The prognosis is not well described. Objective:, To describe in detail a consecutive cohort of hand eczema patients with regard to aetiology and morphology as well as the dynamics of the hand eczema. Patients and Methods:, This prospective study included 522 consecutive patients (175 men and 347 women with hand eczema) seen in 1 year in a private practice of dermatology. 425 (81%) of the patients were patch tested in relation to the current study. Most of the remainder had been previously patch tested. Results:, 38% had mild dermatitis, 49% had dermatitis of moderate severity, and 11% had severe dermatitis. 23% had had dermatitis for more than 10 years. 33% had irritant contact dermatitis, 13% of the men and 20% of the women had allergic contact dermatitis, and 15% of the men and 16% of the women had atopic dermatitis. For 34% of the men and 29% of the women, the dermatitis was certainly or possibly occupational. There was no relationship to smoking. Conclusions:, The majority of this cohort of hand eczema patients had long-standing disease. Irritant contact dermatitis was the most common aetiological diagnosis. [source] The epidemiology of contact allergy in the general population , prevalence and main findingsCONTACT DERMATITIS, Issue 5 2007Jacob Pontoppidan Thyssen A substantial number of studies have investigated the prevalence of contact allergy in the general population and in unselected subgroups of the general population. The aim of this review was to determine a median prevalence and summarize the main findings from studies on contact allergy in the general population. Published research mainly originates from North America and Western Europe. The median prevalence of contact allergy to at least 1 allergen was 21.2% (range 12.5,40.6%), and the weighted average prevalence was 19.5%, based on data collected on all age groups and all countries between 1966 and 2007. The most prevalent contact allergens were nickel, thimerosal, and fragrance mix. The median nickel allergy prevalence was 8.6% (range 0.7,27.8%) and demonstrates that nickel was an important cause of contact allergy in the general population and that it was widespread in both men and women. Numerous studies demonstrated that pierced ears were a significant risk factor for nickel allergy. Nickel was a risk factor for hand eczema in women. Finally, heavy smoking was associated with contact allergy, mostly in women. Population-based epidemiological studies are considered a prerequisite in the surveillance of national and international contact allergy epidemics. [source] Management of chronic hand eczemaCONTACT DERMATITIS, Issue 4 2007Thomas L. Diepgen Hand eczema (HE) is one of the most frequent skin diseases and has often a chronically relapsing course with a poor prognosis resulting in a high social and economic impact for the individual and the society. In this article, we highlight the results of an expert workshop on the ,management of severe chronic hand eczema' with the focus on the epidemiology, the burden of severe HE, its classification and diagnostic procedures, and the current status of treatment options according to an evidence-based approach (randomized controlled clinical trials, RCTs). We conclude that despite the abundance of topical and systemic treatment options, disease management in patients with severe chronic HE is frequently inadequate. There is a strong need for RCTs of existing and new treatment options based on clearly diagnosed subtypes of HE and its severity. [source] Hypersensitivity to titanium osteosynthesis with impaired fracture healing, eczema, and T-cell hyperresponsiveness in vitro: case report and review of the literatureCONTACT DERMATITIS, Issue 4 2006Peter Thomas There are very few reports on hypersensitivity reactions in association with titanium-based materials so that the existence of allergy to titanium is still put in question. We report on a patient in whom impaired fracture healing and eczema localized to the perioperative area developed upon titanium-based osteosynthesis. Patch testing gave no reactions to titanium nor to nickel, chromium, or cobalt. However, in the lymphocyte transformation test, the patient's lymphocytes showed markedly enhanced proliferation in vitro to titanium. After removal of the titanium material, fracture healing was achieved and the eczema cleared. Parallel to this, in vitro hyperreactivity to titanium disappeared. Although contact allergic reactions to titanium have been very rarely reported, these findings support a diagnosis of titanium allergy in our patient. [source] Cr(III) reactivity and foot dermatitis in Cr(VI) positive patientsCONTACT DERMATITIS, Issue 3 2006Malene Barré Hansen Chromium allergy has become synonymous with Cr(VI) allergy. However, real exposure to chromium from leather products may include both Cr(III) and Cr(VI). In this study, we investigate the reactivity to both Cr(VI) and Cr(III) in consecutive patients to analyse the relation between foot eczema/leather exposure and reactivity to Cr(III). From March 2002 to December 2004, 2211 consecutive patients with suspected allergic contact dermatitis were patch tested with 0.5% potassium dichromate (Cr(VI)) and 13% chromium trichloride (Cr(III)). A total of 71 (3.2%) patients had a positive reaction to Cr(VI), of which 31 also had a positive Cr(III) reaction. No Cr(VI) negative patients had a positive reaction to Cr(III). An increased risk of foot dermatitis was found in Cr(VI) positive patients with a concomitant positive or doubtful reaction to Cr(III) compared with Cr(VI) positive patients with no reactions to Cr(III). The increased risk was not due to a higher degree of sensitivity to Cr(VI). Leather was reported most frequently as the suspected cause of chromium dermatitis (54%). However, Cr(VI) allergics having foot eczema and positive or doubtful Cr(III) reactions often had positive reactions to other shoe allergens. Thus, Cr(III) allergy is part of a multiple shoe allergy pattern. [source] FS02.5 Nickel allergy and hand eczema , a twenty-year follow-upCONTACT DERMATITIS, Issue 3 2004Anna Josefson Aim:, To investigate the occurrence of hand eczema after 20 years in schoolgirls previously patch-tested to nickel. Methods:, In 1982,83, 960 schoolgirls, aged 8, 11 and 15 years, were investigated for the occurrence of nickel allergy (Larson-Stymne B and Widström L, Contact Dermatitis 1985:13:289,293). The girls were patch-tested and the prevalence of nickel allergy was 9%. Twenty years later, the same individuals have received a questionnaire regarding hand eczema and factors of importance for the development of hand eczema. After two reminders, the response rate was 81%. Results:, In total 17.5% of the girls reported hand eczema after the age of 15. The 1-year prevalence of hand eczema was 12.6%. Of the previously patch-tested schoolgirls who answered the questionnaire, 63 were sensitive to nickel. In this study, the prevalence of hand eczema among those 63 was 16%, compared to 17% in the non-sensitive group (NS). Excluding persons with atopic dermatitis, the prevalence of hand eczema was 12.5% in the nickel-sensitive group, and 10% among the others (NS). 32% of the persons who had had atopic dermatitis reported hand eczema after 15 years of age, compared to 10% of those with no history of atopic dermatitis (p < 0.001). Conclusion:, Contact allergy to nickel in early childhood (8,15 years) did not seem to increase the prevalence of hand eczema later in life. The prevalence of hand eczema was increased by a factor of three among those with a history of atopic dermatitis, which is in accordance with earlier reports. [source] FS04.5 Iodopropynylbutyl carbamate (IPBC) 0.2% is suggested for patch testing of patients with eczema possibly related to preservativesCONTACT DERMATITIS, Issue 3 2004Jochen Brasch Iodopropynylbutyl carbamate (IPBC)is a preservative that has been increasingly used for skin care products and cosmetics within the last years and the first cases of contact sensitization have meanwhile been reported. Therefore, a surveillance for IPBC contact allergy is now necessary. Our study was aimed to find out a suitable test concentration of IPBC for this purpose. The data 8106 patients tested by 23 centres of the German Contact Dermatitis Research Group (DKG) and the Information Network of Departments of Dermatology (IVDK)in the time from May 2001 to July 2003 with IPBC in concentrations of 0.1%, 0.2%, 0.3%, and 0.5% were retrospectively evaluated. Criteria considered to determine the optimal test concentration of IPBC were the reaction index, the positivity ratio, the rate of crescendo reactions, and the relation of IPBC-reactions with MOAHLFA-indices, with irritant reactions to sodium lauryl sulfate, and with positive reactions to the most common standard contact allergens and 4 other preservatives. For statistical evaluations the exact McNemar test was applied and odds ratios were calculated according to the profile likelihood method, as derived from logistic regression analyses. The rate of positive reactions to IPBC increased from 0.5% with IPBC 0.1% to 1.7% with IPBC 0.5%, but there was a problem with sensitivity or specificity with both of these 2 concentrations. Therefore, we focused on IPBC 0.2%(0.8% positive reactions) and IPBC 0.3%(1.3% positive reactions) for further detailed analyses. An evaluation of the related parameters revealed that with IPBC 0.2% as compared to IPBC 0.3% a higher percentage of crescendo reactions, a higher reaction index, a lower number of doubtful reactions, a plausible association of positive reactions with reactions to other preservatives, nd no association with a pronounced skin irritability was found. In conclusion, we recommend to start with IPBC 0.2% for patch testing of all persons with contact dermatitis that may be related to preservatives. [source] FS05.1 Treatment of hand eczemaCONTACT DERMATITIS, Issue 3 2004Niels K Veien Hand eczema is a common skin disease that often becomes chronic, and treatment of the disease is often challenging. Skin protection is of great importance for the prevention of hand eczema and is a fundamental aspect of the treatment of hand eczema. Emollients have been shown to be successful in the primary prevention of hand eczema as well as in reducing eczema activity. Topical corticosteroids are still the mainstay of treatment, but randomised controlled trials of their efficacy are needed. A combination of tacrolimus and topical corticosteroids may reduce the risk of steroid-associated side-effects. UV-therapy and Grenz rays can also suppress hand eczema. Systemic treatment with immunosuppressants such as cyclosporine and methotrexate show promising results, and acitretin may suppress keratotic hand eczema. Treatment possibilities for hand eczema, indications and side effects will be discussed. [source] FS07.1 A survey of occupational hand eczema in DenmarkCONTACT DERMATITIS, Issue 3 2004Rikke Skoet Background:, The need for prevention to reduce the number of occupational hand eczema is high. Occupational hand eczema is the most frequently recognised work-related disease in Denmark. Previous findings have shown that almost half of all cases develop a chronic condition with persistent dermatitis, and the annual cost to society is immense. Aims:, The aim of this study was to survey the trends and development of occupational hand eczema in Denmark and thereby help to ensure future successful prevention of chronic disabling occupational hand eczema. Methods:, 758 patients with recognised occupational hand eczema were included prospectively in the period October 2001- November 2002. Data on diagnoses, disease duration, severity, absence from work and occupation was obtained from The Danish National Board of Industrial Injuries and an additional questionnaire was administered by mail. Results:, 621 patients answered the questionnaire (response rate 82%). Irritant contact dermatitis was the most frequent diagnosis and the female/male ratio was 2:1. High prevalence was found in particularly wet occupations. 19 per cent had sick leave more than 5 weeks per year and the mean disease duration was 4.8 years (median 2.1 years). 68.2% had chronic changes. Conclusion:, The results showed a marked gender difference in the pattern of diagnosis and occupation. The impact of occupational hand eczema is still high with prolonged absence from work and a high percentage of chronic disease. The results of the study give important suggestions for future preventive strategies for health authorities. [source] FS09.1 Diacetylmorphine (heroin) allergyCONTACT DERMATITIS, Issue 3 2004Aliet J Hogen Esch Since heroin is delivered to a selected group of drug addicts under supervision of nurses in the Netherlands, we reported about several nurses who presented with work-related eczema and positive patch tests to heroin. To investigate the prevalence of heroin contact allergy among all workers in this heroin delivery project, a study was started using questionnaires. Altogether 31 nurses reported work-related complaints out of 100 who returned questionnaires. Besides reports of eczema, mainly of eyelids (probably airborne) and hands, there were mucosal and respiratory complaints. Patch tests were performed in 25 nurses with complaints; in 9 of them a heroin contact allergy could be confirmed. In 6 out of these 9 nurses this was combined with mucosal or respiratory complaints. There were also 6 nurses with mucosal or respiratory complaints without a contact allergy. Contact dermatitis from opioids, such as morphine and codeine, has been documented among opioid industry workers, nurses, doctors, pharmacists, and in patients. In conclusion heroin appears to be a potent contact allergen, causing contact dermatitis. Mucosal and respiratory complaints however, cannot be explained by this contact allergy; they might be caused by a type-1-allergy to heroin, or by a direct histamine liberating effect. Opioids are known histamine liberators causing urticaria, rhinitis and anaphylactoid reactions; therefore intracutaneous tests with heroin are unreliable. In an ongoing research project it will be attempted to detect specific IgE to heroin in the 12 workers with mucosal or respiratory complaints; within the next few months results will be available. [source] FS09.3 Can Flutivate® cream be safely used in formaldehyde-allergic patients?CONTACT DERMATITIS, Issue 3 2004Marléne Isaksson Objectives:, To study the healing time of an experimental eczema treated with Flutivate® cream, a potent corticosteroid containing a formaldehyde releasing preservative, in patients allergic to formaldehyde and controls not allergic to formaldehyde. Methods:, 24 individuals allergic to nickel, 7 of whom were also allergic to formaldehyde, had a nickel-allergic contact dermatitis experimentally induced on both upper arms. The dermatitis was treated twice daily for a maximum of 3 weeks or until healing with either Flutivate® cream or Betnovate® cream, a corticosteroid with the same potency but containing another preservative, which was tolerated by all 24 study persons. The study was double-blind and randomized. Results:, In 12/17 controls (71%) the nickel-allergic contact dermatitis healed completely when treated with Flutivate® cream compared to 2/7 formaldehyde-allergic patients (29%)(p < 0.05). Conclusion:, Flutivate® cream should not be used by individuals allergic to formaldehyde. [source] FC03.1 Experience from joint occupational health/dermatology clinicsCONTACT DERMATITIS, Issue 3 2004Yat Wing Wong Background:, A monthly consultant led occupational health/dermatology clinic was started in 1999 providing rapid access to staff with suspected occupational skin disease including natural rubber latex (NRL) allergy and teaching for the occupational health staff. Objectives:, To evaluate the characteristics and outcome of staff attending this clinic and to assess patient satisfaction. Methods:, A retrospective case note survey was performed from staff attending the clinic from 1999 to 2002. A questionnaire was sent to them >3 months following consultation. Results:, A total of 116 patients were identified (12 male, 104 female), and 85 (73%) were nurses. 77 (66%) patients were referred with hand eczema (HE). Of the 45 patients referred with adverse reactions or exacerbation of hand dermatitis following the use of latex gloves, only 4 had positive prick tests and were considered to have NRL allergy. Patients with significant HE or occupational exacerbation of HE were referred for patch testing (n = 36). Of the remainder, most could be discharged after a single visit. 49/95 (52%) questionnaires were returned, 34/45 (76%) patients found the consultation useful. As a separate study, the data recorded within the patch test clinic looking at health care workers (HCW) referred both from this clinic and from other sources was analysed. This showed relevant positive patch tests in 16/49 (33%) patients. In 55/99 (56%), an occupational cause was likely. Conclusion:, Occupational skin disease in HCW is common, attendance at the clinic was beneficial and a single visit was sufficient in most cases. [source] FC03.3 Identification of subjects with atopic dermatitis in questionnaire studiesCONTACT DERMATITIS, Issue 3 2004Karen Frydendall Jepsen The performances of three different questions from The Nordic Occupational Skin Questionnaire (NOSQ-2002) were compared with respect to their ability to identify subjects with atopic dermatitis. NOSQ-2002 was used in an intervention study on the prevention of work related skin diseases among gut cleaners. The questions were: "Have you ever had an itchy rash that has been coming and going for at least 6 months, and at sometime has affected skin creases?"(A1), "Have you ever had eczema on the fronts of the elbow or behind the knees?"(S5a), and "Have you ever had "childhood" eczema?"(S5b). Question A1 is the single UK-working party question on atopic dermatitis; questions S5a & S5b are national atopic dermatitis questions previously used in different Nordic studies. A total of 255 of 622 (41%) gut cleaners answered "yes" to question A1. Questions S5a and S5b gave rise to 14% and 5% positive answers, respectively. The high frequency of positive answers to question A1 could be due to the occupational exposure of gut cleaners. Their working environment is wet and often involves both forearms and hands, hence often leading to eczema of elbow creases. In conclusion, compared to other Danish studies the UK question seems to lead to over-reporting. Question S5a seems to give a reliable frequency of atopic dermatitis in adult populations at risk for work-related skin diseases. [source] FS13.2 Intervention on work-related skin problems among gut cleanersCONTACT DERMATITIS, Issue 3 2004Mari-Ann Flyvholm Work-related skin problems are frequent in the food processing industry. A randomised intervention study with a one-year follow up was carried out among gut cleaners in order to prevent work-related skin problems due to wet work. The effects of the intervention were primarily measured by telephone interviews using questionnaires based on a standardized questionnaire for work-related skin diseases and exposure (NOSQ-2002).* The intervention activities included an evidence-based prevention program and an evidence-based method for implementation. Six of the 18 participating departments were randomly assigned to the intervention group and the remaining 12 departments to the comparison group. A total of 644 employees responded in the baseline interview and 622 in the follow-up interview carried out a year later. The participation rates were 87,5% and 71,6% respectively. Among the 495 participants answering in both interviews the frequency of eczema on hands or forearms within the past 3 months was reduced significantly by more than 25% in the intervention departments. A minor increase was observed in the comparison departments. This study has shown that even in jobs without the possibility to reduce high exposure to wet work work-related skin problems can be reduced by proper preventive measures. *) Susitaival P, Flyvholm M-A, Meding B, Kanerva L, Lindberg M, Svensson Å, Ólafsson JH. Contact Dermatitis 2003;49:70,76. [source] P43 Acute urticaria to infliximabCONTACT DERMATITIS, Issue 3 2004Ana Giménez-Arnau Infliximab is a chimeric antitumor necrosis factor-alpha monoclonal antibody used to treat Crohn's disease and rheumatoid arthritis. Acute infusion reactions, headache, fever, chills, urticaria and chest pain were seen in 17% of patients with infliximab compared with 7% of those receiving placebo. Other adverse cutaneous reactions are fungal dermatitis, eczema, seborrhoea, hordeolum, bullous eruption, furunculosis, periorbital oedema, hyperkeratosis, rosacea, verruca, skin pigmentation, alopecia, leukocytoclastic vasculitis, lichenoid drug eruption, erythema multiforme, perniosis-like eruption, granuloma annulare and acute folliculitis. Any pathogenic mechanism has been suggested. Patch test with infliximab can induce flare-up of lesions, nausea and malaise and suggest a percutaneous absortion. A sixty years-old man with atopy background and rheumatoid arthritis treated with Remicare®, infliximab who developed a severe acute urticaria with angioedema is presented. The lesions appearance after previous endovenous administrations and the worsening spreading wheals days after the injection clinically suggested an hypersensitivity mechanism. The protocolized study drug hypersensitivity performed showed only the Prick Test positivity with infliximab at 30/60 minutes. Patch test with infliximab was negative and any adverse event was reported. Actually the patient is treated with etanercept and this drug is well tolerated. This result suggested a type I hypersensitivity mediated reaction. Urticaria could be induced as immunologic reaction of the host against the murine part of infliximab, just as it hapens with other antichimeric antibodies. [source] Nordic Occupational Skin Questionnaire (NOSQ-2002): a new tool for surveying occupational skin diseases and exposureCONTACT DERMATITIS, Issue 2 2003P Susitaival Occupational skin diseases are among the most frequent work-related diseases in industrialized countries. Good occupational skin disease statistics exist in few countries. Questionnaire studies are needed to get more data on the epidemiology of occupational skin diseases. The Nordic Occupational Skin Questionnaire Group has developed a new questionnaire tool , Nordic Occupational Skin Questionnaire (NOSQ-2002) , for surveys on work-related skin disease and exposures to environmental factors. The 2 NOSQ-2002 questionnaires have been compiled by using existing questionnaires and experience. NOSQ-2002/SHORT is a ready-to-use 4-page questionnaire for screening and monitoring occupational skin diseases, e.g. in a population or workplace. All the questions in the short questionnaire (NOSQ-2002/SHORT) are included in the long version, NOSQ-2002/LONG, which contains a pool of questions to be chosen according to research needs and tailored to specific populations. The NOSQ-2002 report includes, in addition to the questionnaires, a comprehensive manual for researchers on planning and conducting a questionnaire survey on hand eczema and relevant exposures. NOSQ-2002 questionnaires have been compiled in English and translated into Danish, Swedish, Finnish and Icelandic. The use of NOSQ-2002 will benefit research on occupational skin diseases by providing more standardized data, which can be compared between studies and countries. [source] Career counsellors and occupational contact dermatitisCONTACT DERMATITIS, Issue 4 2003Helen Saunders Career counsellors are in a unique position to provide timely preventive advice to young people at risk of developing occupational contact dermatitis. Career counsellors need to be aware of risk factors for this condition, including atopic eczema, and of high-risk occupations, such as hairdressing. A cross-sectional survey of 82 career counsellors was conducted at an Australian career counsellors' conference. 24 (29%, 95% confidence interval (95% CI) 19,40%) correctly identified eczema as a risk factor. 25 (30%, 95% CI 21,41%) indicated consideration of past skin problems during career counselling. 30 (36%, 95% CI 25,47%) correctly reported at least 1 high-risk occupation, with hairdressing being most frequently identified. Only 3 of the 82 (4%, 95% CI 0,7%) correctly answered all 3 questions. [source] Quantitative aspects of contact allergy to chromium and exposure to chrome-tanned leatherCONTACT DERMATITIS, Issue 3 2002Malene Barré Hansen The potential of trivalent and hexavalent chromium to induce and elicit allergic contact dermatitis and the degree of chromium exposure from leather products are reviewed. Chromium dermatitis is often due to exposure in the occupational environment, with cement being one of the most common chromium sources. However, consumer products such as chromium(III)-tanned leather products are also an important source of chromium exposure. Apart from Cr(III), which is used for tanning, leather often also contains trace amounts of Cr(VI), which is formed by oxidation of Cr(III) during the tanning process. In a recent study of the Cr(VI) content of leather products bought on the Danish market, 35% of such articles had a Cr(VI) content above the detection limit of 3 p.p.m., ranging from 3.6 p.p.m. to 14.7 p.p.m. Leachable Cr(III) was detected at levels of 430,980 p.p.m. An examination of available dose,response studies showed that exposure to occluded patch test concentrations of 7,45 p.p.m. Cr(VI) elicits a reaction in 10% of the chromium-sensitive patients. When reviewing repeated open exposure studies, it is seen that either exposure to 5 p.p.m. Cr(VI) in the presence of 1% sodium lauryl sulfate (SLS) or exposure to 10 p.p.m. Cr(VI) alone both elicit eczema in chromium-sensitive patients. The eliciting capacity of Cr(III) has not been systematically investigated but, compared to Cr(VI), much higher concentrations are needed to elicit eczema. [source] Multicentre study of fragrance allergy in HungaryCONTACT DERMATITIS, Issue 6 2002Immediate, late type reactions The authors followed the frequency of fragrance contact sensitization in Hungary in a multicentre study in the years 1998 and 1999. A total of 3604 patients were tested with fragrance mix (FM), and positive reactions were observed in 294 (8.2%). In 160 FM hypersensitive patients, the study was continued with patch testing of the mix constituents (cinnamic alcohol, cinnamic aldehyde, eugenol, amyl cinnamic aldehyde, hydroxycitronellal, geraniol, isoeugenol, oak moss absolute). Of the patients tested, 70.6% produced positive reactions to the constituents. FM contact sensitization was mainly observed in female patients (74.4%). The incidence of contact urticaria in FM hypersensitive patients was 6.1%. Simultaneous patch test trials of other environmental contact allergens, in both early and late evaluations, mainly confirmed hypersensitivity reactions to balsams. Female dominance of hypersensitivity reactions observed during testing the individual components of the mix was striking (82.4%). In positive skin reactions, cinnamic alcohol, isoeugenol and oak moss provoked skin symptoms most frequently. We also tested the 104 patients who produced negative reactions to FM with the constituent individual allergens, with 11.9% positive incidence. The clinical symptoms of the patients were above all manifest in the form of contact eczema, located on the hands, face, eyelids and axillae. With this study, the authors, members of the Hungarian Contact Dermatitis Research Group, call attention to one of the most frequent allergens in the environment. [source] Differences between the sexes with regard towork-related skin disease ,CONTACT DERMATITIS, Issue 2 2000Birgitta Meding Work-related skin disease is common and usually presents as hand eczema. From the Occupational Injury Information System in Sweden, as well as from registers of industrial injuries in other countries, it is evident that females report skin disease more often than males. Epidemiological studies of hand eczema also show that women are more often affected than men, in particular young women. The most common type of hand eczema is irritant contact dermatitis, which is often caused by wet work. Many female-dominated occupations involve extensive wet work, e.g., hairdressing, catering, cleaning and health-care work. These occupations are also high-risk occupations for hand eczema. Experimental studies of skin irritation have not confirmed differences between the sexes; thus, the higher prevalence of irritant contact dermatitis among females is most likely due to exposure, occupational and non-occupational. Nickel allergy is the most common contact allergy, which is most frequent in young females, and in 30,40% results over time in hand eczema. Hand eczema has an impact on quality of life and females seem to report a higher degree of discomfort than males. To achieve the optimal effect of preventive efforts regarding occupational skin disease, the focus for prevention should aim at reducing wet exposure. [source] The use of protective gloves and the prevalence of hand eczema, skin complaints and allergy to natural rubber latex among dental personnel in the county of Uppsala, SwedenCONTACT DERMATITIS, Issue 1 2000Magnus Lindberg During the past decade, there has been an increasing problem with acrylate allergy and natural rubber latex (NRL) allergy among dental personnel. The aim of the present study was to evaluate the prevalence of these problems among dentists, dental nurses and dental hygienists in Uppsala county, Sweden. The study was based on a self-administered questionnaire sent to 690 persons with 527 responders (76%). The most common skin problem was dry skin, fissures and/or itching on the hands. Of the 72 persons (13.6%) reporting to have suffered from hand eczema during the past 12 months, 41 were patch tested with the TRUE Test standard series and the Swedish dental screening series. In the patch tested group, 9.8% reacted to 1 or more of the acrylates. In addition, 389 persons were tested for NRL allergy with the Pharmacia Upjohn CAP-RAST test, and of these, we found 7.2% to be positive. The prevalence of self-reported hand eczema and the number of positive CAP-RAST tests differed between the 3 occupations, with higher figures for the dentists. There was also a correlation between atopic eczema and hand eczema. Of those reporting skin symptoms, 67.7% connected them to the place of work and 28.8% related them to the use of gloves. [source] | ||||||||||||||||||||||||||||