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Objective: To analyse the clinical characteristics and sensitivity of an essential oil patch test series (EOS) in patients sensitized to their own essential oils (EOs). Method: We analysed the clinical data and patch test results obtained with the European baseline series (BSE) and an EOS, as well as the mode of use of EOs, through a questionnaire included in the patient file. Results: The study included 42 patients (79% women, average age 50 years) with allergic contact dermatitis (ACD), 8 patients required hospitalization. All patients were sensitized to the EO they used, primarily lavender (Lavandula augustifolia, 8000‐28‐0), tea tree (Melaleuca alternifolia leaf oil, 68647‐73‐4), ravintsara (Cinnamomum camphora oil, 92201‐50‐8), and 2 cases were attributed to helichrysum (helichrysum italicum flower absolute, 90045‐56‐0). 71% had positive patch tests to fragrance mix I or II, 9 only to the EOS and 4 only with their personal EO. Interestingly, 40% of patients did not spontaneously mention the use of EOs, and only 33% received advice on their use at the time of purchase. Conclusion: Patch tests with the BSE, limonene and linalool HP, and oxidized tea tree oil is sufficient to detect most EO‐sensitized patients. The most important is to test the patient's own used EOs. [ABSTRACT FROM AUTHOR]

Keywords: allergic contact dermatitis; CAS no. 78336-31-9; case report; copolymers; cosmetic products; PEG-22/dodecyl glycol copolymer; PEG-45/dodecyl glycol copolymer EN allergic contact dermatitis CAS no. 78336-31-9 case report copolymers cosmetic products PEG-22/dodecyl glycol copolymer PEG-45/dodecyl glycol copolymer 213 215 3 08/04/23 20230901 NES 230901 We report a case of allergic contact dermatitis (ACD) caused by PEG-22/dodecyl glycol copolymer and PEG-45/dodecyl glycol copolymer contained in two different "skin-repairing" creams. Allergic contact dermatitis, CAS no. 78336-31-9, case report, copolymers, cosmetic products, PEG-22/dodecyl glycol copolymer, PEG-45/dodecyl glycol copolymer Allergic contact dermatitis caused by PEG-22 and PEG-45 dodecyl glycol copolymers in two skin-repairing creams. [Extracted from the article]

Skin tests, including patch tests (PTs), prick tests, and intradermal tests (IDTs), are useful in identifying the culprits of cutaneous adverse drug reactions (CADRs), and determining safer, alternative drugs. PTs have a low sensitivity but are valuable in investigating maculopapular exanthema (MPE), as well as severe CADR, including toxic epidermal necrolysis (TEN), Stevens‐Johnson syndrome (SJS), and in particular, acute generalized exanthematous pustulosis (AGEP), and drug reaction with eosinophilia and systemic symptoms (DRESS). To ensure their specificity, at least 10 control tests should be performed. Prick tests are mainly used in the evaluation of immediate‐type hypersensitivity and can be performed with all drugs, except opiates. IDTs can be used to explore immediate and delayed‐type hypersensitivity, if an injectable form of the drug exists. Except for SJS/TEN, IDTs should be performed by injecting 0.02 mL of the drug. We here provide a practical, up‐to‐date review on the use of these skin tests in the work‐up of CADRs. Numerous negative controls for drug PTs, as well as criteria for the immediate and delayed positivity of prick tests and IDT, are included. It should be emphasized that a negative result never excludes the potential responsibility of a drug in a CADR. [ABSTRACT FROM AUTHOR]

Background and Objectives: The repeated open application test (ROAT) is an adjuvant investigation measure to patch testing in the diagnosis of allergic contact dermatitis. ESCD recommends a 15 days duration but its overall duration varies according to publications and patients hardly adhere to prolonged ROAT duration beyond 1 week. Materials and Methods: The Dermatology and Allergy Group of the French Society of Dermatology performed a prospective study with the aim of determining the best duration for the ROAT. Results: A total of 328 ROAT results were collected for topical products, including cosmetics (60%) and topical medications (31.1%). Fifty‐nine (18%) ROATs were positive, and 16 (5%) were doubtful. All the positive ROATs occurred within 10 days, with a median time to positivity of 3 days. Conclusion: According to our results, a minimum duration of 10 days is necessary to achieve a positive ROAT to a topical product. [ABSTRACT FROM AUTHOR]

Background: An aqueous antiseptic containing "chlorhexidine digluconate/benzalkonium chloride/benzyl alcohol" (CBB) is widely used in France. The only previous documented study dealing with allergic contact dermatitis (ACD) to this antiseptic is one small case series in children. The French Vigilance Network for Dermatology and Allergy (REVIDAL‐GERDA) has collected many cases in the last few years. Objectives: To evaluate the clinical and sensitization profiles of patients diagnosed with ACD to CBB. Methods: We performed a retrospective study of patients with contact dermatitis to CBB and positive tests to CBB and/or at least one of its components. All patients had to be tested with all components of CBB. Results: A total of 102 patients (71 adults and 31 children) were included. The lesions were extensive in 63% of patients and 55% had delayed time to diagnosis. CBB patch tests were positive in 93.8% of cases. The allergen was identified in 97% of patients, mainly benzyl alcohol in adults (81.7%) and chlorhexidine digluconate in children (54.8%). About 32.4% of the patients were sensitized to several components. Conclusion: CBB is a cause of ACD at all ages. The components of the antiseptic should be tested. The sensitization profile seems to be different between adults and children. [ABSTRACT FROM AUTHOR]

(C) Positive prick test with undiluted Desomedine on delayed reading at day 2 (same prick test as in B) gl Prick tests were performed with undiluted Desomedine (hexamidine 0.1%), and these confirmed both immediate and delayed type hypersensitivity on immediate (Figure 1B) and delayed readings on day (D)2 (Figure 1C). Although allergic contact dermatitis in response to antiseptics is common, we should be aware that occasionally this may co-exist with immediate-type hypersensitivity, and also with molecules frequently sold over the counter. Keywords: case report; delayed hypersensitivity; hexamidine; immediate hypersensitivity EN case report delayed hypersensitivity hexamidine immediate hypersensitivity 580 582 3 10/22/21 20211101 NES 211101 CASE REPORT A 66-year-old man with a history of arterial hypertension (treated by dietary approaches only), allergic rhinitis, asthma, and atopic dermatitis, developed a grade II anaphylactic reaction 5 minutes after the first intranasal application of hexamidine (Desomedine, Chauvin Bausch & Lomb laboratory, Montpellier, France) for a cold. [Extracted from the article]

Keywords: allergic contact dermatitis; alternative medicine; black cumin; essential oil; Nigella sativa oil; t-butylhydroquinone; thymoquinone EN allergic contact dermatitis alternative medicine black cumin essential oil Nigella sativa oil t-butylhydroquinone thymoquinone 132 134 3 07/27/20 20200801 NES 200801 Thymoquinone (TQ), the main constituent of I Nigella sativa i L. oil (NSO), was investigated for therapeutic use in different diseases for its antioxidant, anti-inflammatory, antiproliferative, and proapoptotic properties.1 Several cases of allergic contact dermatitis (ACD) and bullous eruption from NSO have been published, and the hypothesis of TQ being the causative substance was suggested but not confirmed.2,3 We report a case of ACD caused by NSO with a positive patch test to TQ. Strong or extreme-positive patch-test reactions were observed to NSO (++/++), I t i ert-butylhydroquinone (TBHQ) (++/++) (in the cosmetic series), carvone (++/++), amyl cinnamal (-/++), and TQ (+++/+++) (Figure 1). Allergic contact dermatitis, alternative medicine, black cumin, essential oil, Nigella sativa oil, t-butylhydroquinone, thymoquinone. [Extracted from the article]

Thereby, the similar patch test profile results in our five patients support the hypothesis that TBHQ is a good marker for NSO allergy through a TQ sensitization. Keywords: allergic contact dermatitis; Cas number 1948-33-0; patch test; Nigella sativa oil; tert-butylhydroquinone; thymoquinone EN allergic contact dermatitis Cas number 1948-33-0 patch test Nigella sativa oil tert-butylhydroquinone thymoquinone 447 449 3 05/06/21 20210601 NES 210601 Use of complementary and alternative medicine has increased in industrialized countries.1,2 I Nigella sativa i oil (NSO), used as an herbal medicine for thousands of years, has drawn interest for its immunoregulatory, antimicrobial, cardiovascular, and antitumoral properties.3 Although patients expect alternative medicine to be safe,4 allergic contact dermatitis (ACD) and bullous dermatitis with NSO have been reported.5,6 The hypothesis that thymoquinone (TQ), its major component, is the causative substance of allergic reaction to NSO was proposed,7 but thymoquinone is not yet available in France for patch tests. These five cases and the previously published one support the hypothesis that due to chemical similarities with TQ, which is supposed to be the responsible for NSO sensitization, TBHQ would be a good marker for NSO allergy. [Extracted from the article]

Background: Eyelids are frequent sites of contact dermatitis. No prospective study focused on eyelid allergic contact dermatitis (EACD) has yet been published, and this topic has never been studied in French patients. Objectives: To prospectively evaluate the usefulness of an eyelid series in French patients patch tested because of EACD, and to describe these patients. Methods: We prospectively analysed standardized data for all patients referred to our departments between September 2014 and August 2016 for patch testing for suspected EACD as the main reason. All patients were patch tested with an eyelid series, the European baseline series (EBS), the French additional series, and their personal products. Patch testing with additional series and repeated open application tests (ROATs) or open tests were performed if necessary. A standardized assessment of the relevance was used, and the analysis of the results was focused on patients having positive test results with a current certain relevance. Results: Two‐hundred and sixty‐four patients (238 women and 26 men) were included. Three‐hundred and twenty‐two tests gave positive results in 167 patients, 84 of whom had currently relevant reactions: 56 had currently relevant positive test reactions to the EBS, 16 had currently relevant positive test reactions to their personal products, 8 had currently relevant positive test reactions to the French additional series, and 4 had currently relevant positive test reactions to the eyelid series. Sixty‐seven per cent of all relevant cases were related to cosmetic products. The most frequent allergens with current relevance were methylisothiazolinone (10.2%), fragrance mix I (3%), nickel (2.7%), hydroxyperoxides of linalool (2.7%) and limonene (2.3%), and Myroxylon pereirae (2.3%). Current atopic dermatitis was found in 9.5% of patients. The duration of dermatitis was shorter (23.2 vs 34.2 months; P = .035) in patients with currently relevant test reactions. The percentage of currently relevant tests remained the same when atopic patients or dermatitis localized only on the eyelids were taken into account. Conclusion: In French patients, testing for EACD with the extended baseline series and personal products, also including ROATs and use tests, appears to be adequate, considering the currently relevant positive test reactions. The regular addition of an eyelid series does not seem to be necessary. [ABSTRACT FROM AUTHOR]

The article presents a case study of several cases involving patients who experienced adverse drug reactions due to delayed sensitization to carboxymethylcellulose. Among the cases discussed include a 24-year-old man who had a drug reaction caused by Tegretol® and a 48-year-old man with rheumatism who developed rash after taking pills with piroxicam and carboxymethylcellulose. It discusses the contribution of carbomethylcellulose to these reactions and hypersensitivity among the patients.

Skin testing with a suspected drug has been reported to be helpful in determining the cause of cutaneous adverse drug reactions (CADR). Many isolated reports of positive drug skin tests are published, but without detailed information concerning the clinical features of the CADR and the method used in performing drug skin tests, such data are not very informative. A working party of the European Society of Contact Dermatitis (ESCD) for the study of skin testing in investigating cutaneous adverse drug reactions, has proposed the herein-reported guidelines for performing skin testing in CADR in order to standardize these procedures. In each reported case, the imputability of each drug taken at the onset of the CADR and a highly detailed description and characterization of the dermatitis need to be given. Drug skin tests are performed 6 weeks to 6 months after complete healing of the CADR. Drug patch tests are performed according to the methods used in patch testing in studying contact dermatitis. The commercialized form of the drug used by the patient is tested diluted at 30% pet. (pet.) and/or water (aq.). The pure drug is tested diluted at 10% in pet. or aq. In severe CADR, drug patch tests are performed at lower concentrations. It is also of value to test on the most affected site of the initial CADR. Drug prick tests are performed on the volar forearm skin with the commercialized form of the drug, but with sequential dilutions in cases of urticaria. Intradermal tests (IDT) are performed with sterile sequential dilutions (10–4, 10–3, 10–2, 10–1) of a pure sterile or an injectable form of the suspected drug with a small volume of 0.04 ml. Drug skin tests need to be read at 20 min and also later at D2 and D4 for patch tests, at D1 for prick tests and IDT. All these tests also need to be read at 1 week. The success of skin tests varies with the drug tested, with a high % of positive results, for example, with betalactam antibiotics,... [ABSTRACT FROM AUTHOR]

Allergic contact dermatitis, case report, cosmetics, patch tests A 53-year-old woman experienced a widespread eczema after application of two Tamanu oils on insect bites, with positive patch test results to the two Tamanu oils at 1% in olive oil. Keywords: allergic contact dermatitis; case report; cosmetics; patch tests EN allergic contact dermatitis case report cosmetics patch tests 99 100 2 06/14/22 20220701 NES 220701 Allergic contact dermatitis (ACD) to Tamanu oil is rare, but two recent cases underline that an increase in frequency of use could bring out more cases of ACD to this vegetable oil. [Extracted from the article]

Background. Drug patch tests (DPTs) with medicaments suspected of causing an allergic reaction represent a method of diagnostic testing that is low risk; DPTs can reproduce delayed hypersensitivity to drugs, and entail only a moderate re-exposure of patients to potential offending drugs. We assessed the non-irritating concentrations of DPTs and determined the amounts of active ingredient (AI) contained in the drugs used in the tests. Objectives. The objectives were to assess the non-irritating concentration of DPTs and determine the amounts of active ingredient (AI) contained in the drugs used in the tests. Methods. From a retrospective, single-centre study of all patients investigated during a 6-year period with a drug eruption, each potentially responsible drug was tested with the commercially available preparation diluted to 30% in water, petrolatum, or alcohol. Data collection was performed with a customized computer database. For each type of DPT studied, the numbers of positive and negative test results were recorded. The amount of AI contained in the DPT (as a percentage) was then calculated after weighing of each tablet. Results. Of the 5558 DPTs studied, all were non-irritant. The average concentration of AI was 9.8%; 25% of DPTs had an AI concentration of <2%, and 25% had an AI concentration of >16%. The AI concentration ranged from 0.05% (digoxin) to 30% (paracetamol lyophilisate). Conclusion. These data provide thresholds for the non-irritating concentration of AI of 68 different drugs, and thresholds for the non-irritating dilution for 82 drugs, and will help to standardize DPT methods. [ABSTRACT FROM AUTHOR]

The article presents a study which examines whether there are any cross-reactivity between tetrazepam and other benzodiazepines in patients with a cutaneous adverse drug reaction. In this study, researchers conducted skin tests and oral provocation tests with other benzodiazepines. From the nine patients with confirmed sensitization to tetrazepam on patch testing, researchers found that there were no cross-reactions on patch testing or intradermal testing with other benzodiazepines.

Skin tests with drugs can be of value in investigating patients who have developed cutaneous adverse drug reactions (CADR), but their specificity and relevance remain to be determined. A false-positive result on skin testing can happen if it is not compared to results in control subjects. When performing intradermal tests (IDT), we have determined the lowest concentrations that induce false-positive results for many drugs, including betalactam antibiotics, cephalosporins, other antibiotics or non-steroidal anti-inflammatory drugs. Some drugs in their commercialized form contain sodium lauryl sulfate and can induce irritation when patch tested as such. When patch tested with colchicine at 10% in pet. or with a Cytotec® pill (containing misoprostol) at 30% in pet., respectively, 80% of the 29 and 9 of the 10 negative controls developed false-positive results. Lastly, positive results of patch tests with drugs can be related to contact allergy to one of the components of the commercialized form of the drug, without any relevance to the investigation of a CADR, as observed in 2 cases with iodine or avocado oil. [ABSTRACT FROM AUTHOR]

Reports on the medical case of a 46-year-old woman with a maculopapular rash while taking Panos which contained tetrazepam. Patch test results; Usefulness of patch testing on the previously most severely affected site in a cutaneous adverse drug reaction to tetrazepam.

Background Modern dressings ( MDs) may have a low sensitization rate, but there is a lack of prospective studies in patients with chronic leg ulcers ( CLUs) to evaluate this. Objectives To determine the rate of sensitization (contact allergy) to MDs and substances present in dressings. Patients and methods A prospective multicentre study was carried out in patients with CLUs at five French dermatology departments; patch tests were performed with the European baseline series and with an additional 27 individual allergens and 10 MDs. Results Among 354 patients (226 women and 128 men) with CLUs, 59.6% had at least one positive patch test reaction to an MD and 19% had at least one sensitization to an MD. The number of positive test reactions per patient was correlated with the duration of ulcerative disease, but not with ulcer duration, the cause of the ulcer, or the presence of surrounding eczematous lesions. For 11 of 45 patients sensitized to Ialuset cream®, more detailed information could be obtained with sensitization to sodium dehydroacetate (5 cases) or Lanette SX® (3 cases). Conclusions Sensitization to MDs is not rare. It is absolutely necessary to label all components of MDs on their packaging and to avoid some sensitizing molecules, such as colophonium derivatives or any strong sensitizers. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 28-year-old woman who had history of pruritic erythematous scaly dermatitis on both hands and on the neck, after keeping a rabbit as pet. She fed her rabbit with chicory leaves, dandelion, hay, and dry food, and the dermatitis disappeared when the patient stopped feeding her rabbit with chicory.

Background The preservative methylisothiazolinone ( MI) is used in combination with methylchloroisothiazolinone ( MCI), but the MCI/MI mixture has been identified as highly allergenic. MI is considered to be less allergenic, and since the mid-2000s has been widely used alone, but is now clearly identified as a contact allergen. The French Vigilance Network for Dermatology and Allergy of the Study and Research Group on Contact Dermatitis ( REVIDAL-GERDA) added MI to its baseline patch testing series in 2010. Objective To evaluate the change in the proportion of MI-positive tests in France between 2010 and 2012. Patients/materials/methods We conducted a nationwide, multicentre, retrospective study of all MI-tested patients between 2010 and 2012. Results Sixteen centres participated in the study (7874 patients were tested). Patch tests were performed mainly at a concentration of MI 200 ppm aq. We observed a significant increase in the proportion of MI-positive tests in 2012 and 2011 as compared with 2010 (5.6%, 3.3%, and 1.5%, respectively; p < 0.001). Conclusions We report a significant increase in the number of MI-positive tests. MI is confirmed to be a rapidly emerging allergen, as also observed in other European countries. [ABSTRACT FROM AUTHOR]

The article presents a case study of patients with contact dermatitis, who underwent patch testing with the European baseline. It compares the efficiency of a 550 parts per million (ppm) concentration of methylisothiazolinone (MI) for contact allergy diagnosis with a 220ppm solution. It says that the low rate of positive patch test reactions indicate that the patch tests are not irritant.

The article presents a case study of a 26-year-old male cook who was presented due to fixed eruption caused by contact or ingestion of freshwater fish and seafood. It states that bullous lesions appear on his forearms when he handles or eat fish. It mentions that normal skin on the forearm had underwent prick tests with commercial extracts or fresh food. Meanwhile, it mentions that the case will be classified as neutrophilic fixed food eruption.

Background: There is a lack of prospective studies investigating contact sensitization in patients with chronic leg ulcers. Objectives: To determine the frequency of contact sensitization in patients with chronic leg ulcers using a special series of patch tests and to determine whether the number of sensitizations was correlated with the duration of the chronic leg ulcers. Patients/methods: Multicentre study carried out in patients with chronic leg ulcers; patch tests with the European baseline series and with an additional 34 individual allergens or mixes and 3 commercial products. Results: Of the 423 patients (301 women, 122 men, mean age 68.5 years) with chronic leg ulcers, 308 (73%) had at least one positive patch test with 3.65 positive patch tests per patient. The main allergens were Myroxylon pereirae (41%), fragrance mix I (26.5%), antiseptics (20%), and corticosteroids (8%). The number of positive tests per patient was not correlated with the cause of ulcer but was increased with the duration of the ulcer with a statistical difference between the group of the <1 year compared with the group >10 years duration. Conclusions: From this large prospective multicentre study, polysensitization is frequent in patients with chronic leg ulcers, increasing with the duration of the ulcer. We propose avoidance of topical antiseptics and ointments containing perfumes in patients with chronic leg ulcers and an updated patch test series for investigating these patients. [ABSTRACT FROM AUTHOR]

Cutaneous adverse drug reactions (CADR) during chemotherapy are not rare, but difficult to manage. Case 1, a 49-year-old man was treated with 5-fluorouracil, irinotecan, and oxaliplatin for a pancreatic tumour. He developed a generalized urticaria during his seventh course of chemotherapy. 2 months later, skin tests determined a granisetron allergy with an ondansetron cross-reaction. Substituting the anti-emetic allowed continuation of the chemotherapy. Case 2, a 44-year-old woman, having recurring breast cancer that was treated with doxorubicin, and docetaxel developed a maculo-papular rash (MPR) the day after the first chemotherapy treatment. 2 weeks later, skin tests determined a corticosteroid class A allergy. Using a class C corticosteroid, no other reaction occurred. Case 3, a 44-year-old woman, having breast cancer treated with 5-fluorouracil, cyclophosphamide, and epirubicin developed an MPR after the second chemotherapy treatment. 12 days later, skin tests showed a granisetron allergy. Using alizapride, chemotherapy was continued with no further reaction. CADR necessitate a thorough investigation, modified according to the patient’s chemotherapy treatment chronology and precautions while testing the molecules. Tests are rarely carried out, however, these tests allow for continuation of effective chemotherapy once the responsible agent has been determined. The 3 cases reported underline the role of complementary treatment and the necessity to test those molecules. [ABSTRACT FROM AUTHOR]

We report the first case of immediate-type hypersensitivity caused by Emla® cream. A 55-year-old woman, after using Emla® cream, went on to develop urticaria. An open test was positive to Emla® cream. Patch tests and prick tests were performed with Emla® cream, the components of Emla® cream (lidocaine, prilocaine and castor oil) and other local anaesthetics. The patch test with lidocaine and the prick test with Emla® cream were both positive. An intradermal test and subcutaneous administration of 3 anaesthetics that had negative patch tests and prick tests were performed and well tolerated, allowing their use. In the literature, anaphylactic reactions to lidocaine injections, delayed-type hypersensitivity after lidocaine subcutaneous injections and contact dermatitis from Emla® cream have all been described. This first case of contact urticaria from Emla® cream was due to lidocaine and did not show any cross-reaction with other local anaesthetics. [ABSTRACT FROM AUTHOR]

Delayed reactions to radio-contrast media (RCM) with positive skin tests are rare. We report the study of a series of 15 patients who presented delayed reactions to RCM, with an analysis of the clinical features and the results of standardized drug skin tests. Patch tests were performed with RCM and iodized antiseptics (lAs). If negative, prick tests were performed, followed by intradermal tests (IDTs), then intravenous administration under hospital surveillance. The main clinical features were maculopapular rashes or a macular rubella-like rashes. Patch tests were positive with RCM in 2 of 15 cases and with lAs in 4 of 15 cases. All the prick tests were negative. IDTs were positive at 24 h in 8 of 15 cases. 5 of 12 patients had a non-severe relapse of the rash upon receiving an RCM despite clearly negative skin tests with the readministered RCM. Visipaque® cross-reacted with Iopamiron®, lomeron®, Telebrix®, Omnipaque®, Xenetix® and Hexabrix®. Omnipaque® cross-reacted with Hexabrix® and Iopamiron®. IDTs with delayed readings are of better value than patch tests in such patients. The readministration of RCM with negative IDTs must be performed with progressive amounts under hospital surveillance. Cross-reactions between various classes of RCM are frequent. The responsible epitopes are unknown. Iodine itself could be involved. [ABSTRACT FROM AUTHOR]

The present study was made to determine the value of drug skin tests in patients with cutaneous adverse drug reactions (CADRs) due to a synergistin (pristinamycin) and to determine the frequency of cross-reactions between synergistins. 29 patients were referred during the onset of the CADR due to pristinamycin: 18 with maculopapular rash, 9 erythrodermas, 1 angioedema and 1 Stevens–Johnson syndrome. They all had patch tests with pristinamycin and, in most cases, with other synergistins [virginiamycin and dalfopristin–quinupristin (DQ)], prick tests (10 cases) and intradermal tests (IDT) (5 cases). Skin tests with synergistins were positive in 27 cases, patch tests with pristinamycin in 20/29 cases (69%), prick tests with pristinamycin in 3/9 cases on immediate (1 case) or on delayed (2 cases) readings, and IDT with DQ in 4/5 cases. Cross-reactions between synergistins occurred in 9/22 with virginiamycin and in 7/8 cases with DQ. Skin tests with synergistins are useful in investigating CADR due to pristinamycin. Synergistins are composed of 2 chains (1 depsipeptide and 1 macrocyclic lactone) with many structural analogies between all synergistins. According to the chemical structures and our results, it seems advisable to avoid all synergistins in patients with CADR due to pristinamycin. [ABSTRACT FROM AUTHOR]

Provides information on a study which examined the role of the phenothiazine component of the Neuriplege ointment in contact dermatitis. Information on patients; Results of the patch tests and photopatch tests with chlorproethazine.

Focuses on several case reports on contact dermatitis. Development of hyperpigmentation due to Juglans regia; Side effects of benzocaine ointment used in the treatment herpes zoster; Manifestations of dermatitis due to corticosteroids diagnosed by repeated open application test.

Allergic contact dermatitis caused by acyclovir is rare. We report the 5th case of systemic acyclovir reaction subsequent to acyclovir contact dermatitis, with investigations made to determine an alternative antiviral treatment. A 23-year-old woman, after dermatitis while using Zovirax® cream, went on to develop urticaria after oral acyclovir. Patch tests were performed with the components of Zovirax® cream (acyclovir, propylene glycol and sodium lauryl sulfate) and with other antiviral drugs. Patch tests were positive to Zovirax® cream, acyclovir, valacyclovir and propylene glycol. Patch and prick tests with famciclovir were negative, but its oral administration caused an itchy erythematous dermatitis on the trunk and extremities. Our patient developed a systemic acyclovir reaction subsequent to acyclovir allergic contact dermatitis, with cross-reactions to valacyclovir and famciclovir. Their common chemical structure is the 2-aminopurine nucleus. It is probably this part of the molecule that provokes both contact allergy and systemic reactions. The only antiviral drugs not having this core are foscarnet and cidofovir, and these could therefore be alternatives. [ABSTRACT FROM AUTHOR]

The article presents a case study of a woman with acute eczema of upper and lower eyelids which caused Allergic contact dermatitis (ACD) was given intravitreal injections containing aflibercept and ranibizumab. It notes that IQ Ultra Chambers was applied with Mefix and repeated open application tests. The article discusses ACD is caused by an anti-vascular endothelial growth factor (VEGF) intravitreal injection.

In order to confirm the mechanism of skin sensitization to propacetamol, a pro-drug of acetaminophen, 3 patients with allergic contact dermatitis from propacetamol were patch tested with N,Ndiethylglycine phenyl ester, an activated form of N,N-diethylglycine. Positive patch tests were observed in all the patients at 10% in pet., while 20 control patients remained negative. This strongly suggests that propacetamol is acting as an activated form of N,N-diethylglycine, transferring this part of the molecule to nucleophilic residues of proteins. This also explains why reactions to acetaminophen have never been observed in patients sensitized to propacetamol. [ABSTRACT FROM AUTHOR]

Patch tests (PT) were performed with the European Baseline, a cosmetic and an EO series (Chemotechnique Diagnostics, Vellinge, Sweden), and the personal beard products. 3 Kurihara F, Soria A, Lepoittevin JP, Chasset F, Barbaud A, Pecquet C. Thymoquinone as a causative allergen in Nigella sativa oil contact dermatitis with cross-reactivity to tert-butylhydroquinone. Allergic contact dermatitis from Nigella Sativa Seed Oil (NSO) may present in different patterns such as severe polymorphic lesions mimicking acute bullous drug reactions.[[1], [3]] However, proving its use and its responsibility may be difficult. [Extracted from the article]

Keywords: acyclovir; adverse drug reaction; allergic contact dermatitis; antiviral drugs; case report; drug allergy EN acyclovir adverse drug reaction allergic contact dermatitis antiviral drugs case report drug allergy 203 205 3 02/25/21 20210301 NES 210301 CASE REPORT A 27-year-old woman was referred to our department because of a 1-year history of recurrent episodes of edema and eczema of the face. 7 Vernassiere C, Barbaud A, Trechot PH, Weber-Muller F, Schmutz JL. Systemic acyclovir reaction subsequent to acyclovir contact allergy: which systemic antiviral drug should then be used? Acyclovir, adverse drug reaction, allergic contact dermatitis, antiviral drugs, case report, drug allergy. [Extracted from the article]

The article presents a case study of a 22-year-old female lottery employee with airborne facial dermatitis that spread over her trunk and limbs. She had a history of contact allergy to nickel and was diagnosed with airbone occupational contact dermatitis (OCD) caused by nickel exposure in lottery scratchcards. The role of nickel in the development of OCD and rare cases of OCD caused by nickel are discussed.

We report 4 eases of contact sensitization to propacetamol. The presented with lesions on the hands, forearms, crease of the elbows, and neck. They were all sensitized to multiple allergens and 2 of them were atopic. Patch tests to Pro-Dafalgan%reg; and propacetamol were positive; sodium citrate and paracetamol were negative. Our cases were similar to those published for the first time by Barbaud in 1995. The only allergen was propacetamol: patch tests with diethyglycine and paracetamol were negative. Propacetamol chlorhydrate is composed or a complex paracetarnol- diethylglycine, which probably acts like a hapten capable of inducing cutaneous allergy. It is an occupational allergy affecting nurses who work in surgery departments or post-anesthesia recovery rooms, where high doses of analgesics are widely used. The patients were not allergic to oral paracetamol. Despite the usual precautions, the mixture of propacetamol chlorhydrate and solvent leaks onto the nurses' hands, suggesting that health care workers handling propacetamol chlorhydrate should wear gloves. [ABSTRACT FROM AUTHOR]

Presents case studies on allergic contact dermatitis from surgical paints. Components of paints and adhesive tapes; Results of skin patch testing; Comparison of the different brands of surgical paints.

Background: Adverse drug reactions to iodinated contrast media (ICM) have risen due to their increasing use in x‐ray‐based imaging modalities. Delayed hypersensitivity reactions are mainly caused by nonionic monomeric compounds and represent an issue impacting the diagnostic–therapeutic pathways of cancer, cardiology and surgery patients. Objectives: To prospectively evaluate the usefulness of skin tests in delayed hypersensitivity reactions to ICM and to evaluate the tolerability of iobitridol, a monomeric nonionic low osmolality compound, as a possible safe alternative. Methods: Patients with delayed hypersensitivity reactions to ICM referred to us from 2020 to 2022 were prospectively enrolled in the study. All patients underwent patch test and, if negative, intradermal test with the culprit ICM and iobitridol as alternative. Results: A total of 37 patients (females 24, 64.9%) were enrolled in the study. Iodixanol and iomeprol were the most frequently involved ICM (48.5% and 35.2%, respectively); 62.2% of patients presented maculopapular eruption, while 37.8% reported delayed urticaria‐like rash. Skin tests resulted positive to the culprit ICM in 19 patients (51.4%), 16 to patch test and 3 to intradermal test. Skin tests with iobitridol, tested as alternative, resulted positive in 3/19 patients (15.8%). All 16 patients with negative results to iobitridol were administered this ICM and tolerated it. Conclusions: In at least half of patients, delayed‐type hypersensitivity was demonstrated by skin tests, particularly by patch test. This diagnostic approach resulted simple, cost‐effective and safe, not only to confirm the culprit ICM but also to identify iobitridol as feasible alternative. [ABSTRACT FROM AUTHOR]

Background: A popular antiseptic spray in Switzerland (Merfen spray), containing chlorhexidine digluconate, benzoxonium chloride and lauramine oxide, is frequently used to treat skin wounds. However, it is also increasingly reported as a major cause of adverse skin reactions, including allergic contact dermatitis (ACD). Objectives: To investigate the contact allergens responsible for ACD from this antiseptic. Patients/Methods: Patch tests were performed on seven patients with a clinical history compatible with contact dermatitis from this antiseptic mixture. Results: All patients presented with acute eczematous reactions following contact with either Merfen spray alone, or with multiple products including this spray. Patients showed positive reactions to this product in both patch tests and repeated open application tests (ROATs). Four patients showed dose‐dependent reactions to both benzoxonium chloride and lauramine oxide. One patient showed a dose‐dependent reaction to the former and a non‐dose‐dependent reaction to the latter. Finally, two subjects showed responses only to lauramine oxide. One patient reacted to chlorhexidine digluconate 0.5% aq. in addition to both other allergens. Conclusions: Two commercially unavailable allergens, that is, benzoxonium chloride and/or lauramine oxide were identified as major causes of ACD from Merfen antiseptic spray, whereas chlorhexidine digluconate was a contributing culprit in only one patient. [ABSTRACT FROM AUTHOR]

Background: Allergic contact dermatitis to gloves is mostly induced by rubber accelerators. The European baseline series (EBS) appears insufficient to detect glove allergy. Since 2017, it is recommended to use the European rubber series (ERS) and to test the patients' own gloves. Objectives: To investigate the clinical profile of glove‐wearing patients with hand eczema (HE) and to evaluate their sensitisation profile to glove allergens and the value of testing the patients' own gloves. Methods: We conducted a French multicentre study of patients evaluated for HE between 2018 and 2020 and tested with the EBS, the ERS and their own gloves in patch tests and semi‐open (SO) tests. Results: A total of 279 patients were included; 32.6% of patients had positive tests to their own gloves or to glove allergens. Almost 45% of the sensitisations to glove allergens were detected only by the ERS. Among the patients tested both in patch tests and SO tests with their own gloves with positive results, 28% had positive SO tests only. Polyvinylchloride (PVC) gloves were positive in four patients. Conclusion: Our series confirms the need to test the ERS. All the patients' gloves must also be tested including PVC gloves. SO tests with gloves are useful as a complement to patch tests. [ABSTRACT FROM AUTHOR]

Presents a case report on the occurrence of Stevens-Johnson syndrome after the initiation of oral Lamisil, an antifungal drug. Treatment of the syndrome; Performance of immunoallergological investigations; Advantages of skin testing in the investigation of cutaneous adverse drug reactions.

Keywords: case report; cimetidine; DRESS; patch test; polysensitization; racecadotril EN case report cimetidine DRESS patch test polysensitization racecadotril 451 452 2 10/06/22 20221101 NES 221101 Allergy to cimetidine or racecadotril is rarely encountered in clinical practice. In our case, we did not perform OPT for racecadotril because of the positive PT, knowing that we already had six negative PT controls (personal unpublished data), in addition to the negative control reported by Nucera et al.,3 emphasizing the good value of our positive PT. Patch tests (PT) and oral provocation tests (OPT) are both useful to detect the culprit drug(s) in cutaneous adverse drug reactions (CADR). [Extracted from the article]

The article presents a case study of 88 year old patient with hypersensitivity reactions to iodinated contrast media (ICM) with acute exanthema, temperature and intraepidermal pustule with numerous polymorphonuclear cells. Patch test confirmed acute generalized exanthematous pustulosis (AGEP), hence coronary stenting and endovascular valvuloplasty, including ICM administration of iopromide and oral prednisone was recommended.

The article presents a 32-year-old woman with a history of fever with a generalized eruption of non-follicular pustules and erythema. Topics discussed include acute generalized exanthematous pustulosis caused by oxacillin, increased white blood cell count with neutrophilia, and appearance of lesional pattern after patch testing with oxacillin.

Allergic contact dermatitis, case report, microbiome, nummular dermatitis, persulphate, spa Keywords: allergic contact dermatitis; case report; microbiome; nummular dermatitis; persulphate; spa EN allergic contact dermatitis case report microbiome nummular dermatitis persulphate spa 128 130 3 07/11/23 20230801 NES 230801 CASE REPORTS Case 1 A 59-year-old man, with a past history of seborrheic dermatitis, was referred for an extended fluctuating dermatitis with multiple erythematous and itchy coin-shaped lesions. [Extracted from the article]

Patch tests with the oral liquid formulations of alprazolam (0.75 mg/mL), diazepam (5 mg/mL) delorazepam (1 mg/mL), lormetazepam (2.5 mg/mL), bromazepam (2.5 mg/mL), triazolam (0.375 mg/mL), clotiazepam (10 mg/mL) and lorazepam (2 mg/mL) were performed.[6] For diazepam and midazolam also injectable formulations (5 mg/mL) were used. Even if the clinical picture was not typical, clinical history and patch test results were suggestive of a delayed-type hypersensitivity to alprazolam, with eventually cross-reactivity to diazepam, delorazepam, lormetazepam ad bromazepam. Keywords: alprazolam; benzodiazepines; case report; delayed-type hypersensitivity EN alprazolam benzodiazepines case report delayed-type hypersensitivity 56 58 3 06/12/23 20230701 NES 230701 Allergic reactions to benzodiazepines are relatively rare. [Extracted from the article]

Antibiotics, case series, children, cutaneous adverse drug reactions, drug hypersensitivity, maculopapular exanthema, patch test, DRESS syndrome, Stevens-Johnson syndrome, toxic epidermal necrolysis Keywords: antibiotics; case series; children; cutaneous adverse drug reactions; DRESS syndrome; drug hypersensitivity; maculopapular exanthema; patch test; Stevens-Johnson syndrome; toxic epidermal necrolysis EN antibiotics case series children cutaneous adverse drug reactions DRESS syndrome drug hypersensitivity maculopapular exanthema patch test Stevens-Johnson syndrome toxic epidermal necrolysis 373 376 4 09/08/22 20221001 NES 221001 Non-immediate cutaneous adverse drug reactions (CADRs) are mostly clinical manifestations of a Type IV hypersensitivity reaction.1,2 In children, diagnosing CADRs is a common challenge for physicians, as childhood rashes are more often due to viral infections but frequently mimic CADRs.1,2 A proper diagnosis and identification of the culprit drug avoids misdiagnosis, therefore, preventing unnecessary drug avoidance or replacement, and guides for potential alternatives reducing morbidity from CADRs.1-3 Patch tests (PT) are considered useful for diagnosing non-immediate CADRs, however, few paediatric studies have been published.2-6 This may be related to the lower incidence of CADRs in children, the lack of PT standardization especially for severe cutaneous adverse reactions (SCARs) and controversies on PT safety, particularly in this population.3-5,7 This study aimed to evaluate the sensitivity and safety of PT for paediatric CADRs. [Extracted from the article]

The literature on positive patch‐test results in acute generalized exanthematous pustulosis (AGEP) is reviewed. Ninety‐three drugs were identified that have together caused 259 positive patch tests in 248 patients with AGEP. The drug classes causing the highest number of reactions are beta‐lactam antibiotics (25.9%), other antibiotics (20.8%), iodinated contrast media (7.3%), and corticosteroids (5.4%), together accounting for nearly 60% of all reactions. The highest number of reactions to individual drugs was to amoxicillin (n = 36), followed by pristinamycin (n = 25), diltiazem (n = 14), amoxicillin‐clavulanic acid (n = 13), clindamycin (n = 11), and iomeprol (n = 8); 59 of the 93 drugs each caused a single case only. The "Top‐10" drugs together caused over 50% of all reactions. The sensitivity of patch testing (percentage of positive reactions) in patients with AGEP is largely unknown, but may generally be ~50%, which also applies to pristinamycin. Patch testing in AGEP appears to be safe, although mild recurrence of AGEP skin symptoms or other rashes may occur occasionally. Clinical aspects of AGEP, including epidemiology, etiology and pathophysiology, clinical features, histology, treatment, and prognosis are briefly presented, as are diagnosing the disease and identifying the culprit drugs with patch tests, intradermal tests, in vitro tests, and challenge tests. [ABSTRACT FROM AUTHOR]

The literature on positive patch test results in drug reaction with eosinophilia and systemic symptoms (DRESS) is reviewed. One hundred and five drugs were identified that have together caused 536 positive patch tests in 437 DRESS patients. By far, the most reactions (n = 145) were caused by carbamazepine, followed by amoxicillin, isoniazid, phenytoin, ethambutol, fluindione, phenobarbital, rifampicin, and ceftriaxone; 43 drugs each caused a single case only. The drug classes causing the highest number of reactions were anticonvulsants (39%), beta-lactam antibiotics (20%), antituberculosis agents (11%), non-beta-lactam antibiotics (6%), and iodinated contrast media (5%). The sensitivity of patch testing (percentage of positive reactions) is high for anticonvulsants (notably carbamazepine), beta-lactam antibiotics (notably amoxicillin), and, possibly, iodinated contrast media. Allopurinol and sulfasalazine frequently cause DRESS but never give positive patch tests. Patch testing in DRESS appears to be safe, although mild recurrence of DRESS symptoms, mostly skin reactions, may not be rare. Multiple drug hypersensitivity was found to occur in 16% of all patients, but it is argued that the true frequency is higher. Clinical aspects of DRESS, including diagnosing the disease and identifying culprit drugs (patch tests, intradermal tests, in vitro tests, challenge tests) are also provided, emphasizing the role of patch testing. [ABSTRACT FROM AUTHOR]