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Abstract: The etiology of pompholyx (dyshidrotic eczema) is a challenging diagnostic problem. The only established etiological link is between dyshidrosis and tinea pedis. Here, we report the results of a review of the causes of dyshidrosis in our patient population, focussing on allergic aspects. This was a prospective study carried out between June, 2003 and May, 2004. Epidemiological and clinical data were obtained for all the patients. They all had patch tests with the European patch test series. Sixty-two patients with pompholyx were included. Gender distribution was equal and the mean age of the patients was 31 years. Tinea pedis was reported in 35.5% of the patients. The patch tests were positive in 35.5% and relevant in 19% of the cases. The statistical analysis showed, on one hand, a significant relationship between gender and a positive patch test to nickel, and on the other hand, between work in a hot, wet environment and a positive patch test to chromium. These results revealed evidence of an increased frequency of tinea pedis and of sensitization to metals in patients with pompholyx compared to the general population. This suggests that in the development of pompholyx, sensitization to metals may be involved in a multifactorial process that includes both environmental and personal factors. However, we could not demonstrate a causal relationship between metal sensitization and pompholyx. Nevertheless, common factors might be involved in generating these two skin conditions. [Copyright &y& Elsevier]

Abstract: The diagnosis of allergic contact dermatitis to cosmetics is based on a careful history (anamnesis), taking into account all the cosmetic products that have been used by the patient, on inspection of the clinical symptoms and localisation of the lesions, and on the performance of epicutaneous tests or patch tests. In addition, other types of tests such as open and semi-open testing with products having a certain irritant potential as well as repeated open application tests (ROAT) on the forearm can also be very useful in the diagnosis of contact dermatitis caused by cosmetic products. [Copyright &y& Elsevier]

Abstract: Aim of the study. – The capacity of fungi to induce eczema in head and neck dermatitis has already been studied. Malassezia has often been implicated in two other dermatitis of the cephalic region (seborrhoeic dermatitis and sebopsoriasis). We have explored the cellular and IgE dependant reactions to different groups of fungi in these three dermatitis using “patch” and “prick” tests. Tested allergens were: Alternaria, Penicillium, Aspergillus, Cladosporium, Trichophyton, Epidermophyton, Candida albicans, Malassezia, Saccharomyces cerevisiae. Material and methods. – Seventy persons including 42 females (60%) and 28 males (40%) aged 40 years old in average were distributed in four groups: Head and neck dermatitis (24 patients), seborrheic dermatitis of the face (21 patients) and sebopsoriasis of the face (10 patients) compared to 15 controls without these dermatoses. Results and conclusions. – Globally, in “prick” and “patch” tests, yeasts had the highest number of positivity comparing to the two other groups. Malassezia was the leader in “prick tests”. In “patch tests”, the global results showed a positivity rate, which was clearly lower than those in “prick tests”. Detailed analysis of the results revealed that in the head and neck dermatitis the highest number of positive “patch tests” for all of these allergens is found. For the three other groups, no significant difference for these two techniques for any of these allergens has been detected. [Copyright &y& Elsevier]

Abstract: Occupational dermatitis (irritant dermatitis, contact urticaria and contact eczema) is frequent among healthcare workers. Irritant hand dermatitis, the most common occupational dermatitis, occurs often in individual who work in a humid environment, who handle disinfectants, and who are required to wash their hands frequently; atopic dermatitis is a risk factor for this condition. Natural rubber latex present in rubber gloves is the most common cause of contact urticaria. Contact eczema can be induced by rubber accelerators (for example, thiurams) present in gloves, and also by disinfectants (glutaraldehyde, dodecyldimethylammonium), disinfectants and detergents, hand creams, acrylates (in dentists), and echography gels. Nurses sometimes develop contact dermatitis to drugs they handle; these allergies should be diagnosed by appropriate skin testing because sensitized individuals may develop a severe, generalized cutaneous adverse reaction if they are subsequently exposed systemically to the sensitizing drug. [Copyright &y& Elsevier]

Contact dermatitis to gold has rarely been reported. This precious metal is generally considered as inert, insoluble and resistant to corrosion. Nevertheless, gold salts have a strong potential for sensitization. This condition can occur after contact with gold jewellery and dental alloys, after systemic therapy with gold salts and after occupational contact. The lesions may be expressed as contact dermatitis on the face, ear, neck and/or fingers, and as lichen planus and/or lichenoid stomatitis. The dermatitis is usually not very irritating and the lesions are rarely persistent. Diagnosis is based on the clinical history and examination, on the nature of the exposure sources, and on the results of patch tests with gold sodium thiosulfate (GSTS) at 0.5% in petrolatum. The patch test is read on days 2 and 3 and again after 1 and 3 weeks. Allergen avoidance can be expensive and tiresome, and improvement is not guaranteed. We report the case of a female patient who came to us complaining of burning in her mouth. She had polymetallism and lichenoid lesions facing gold tooth crowns. Patch tests were positive to GSTS at 72 h and at 1 week. Replacement of the gold crowns led to total disappearance of her symptoms within 1 year. Local factors, including humidity, temperature, acid pH, abrasion and contact with substance such as amino acids, bring about the liberation of the sensitizing metallic salts, which may be enhanced by galvanic corrosion secondary to the polymetallism. [Copyright &y& Elsevier]