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The diagnosis of eczema ('dermatitis') is mostly clinical and depends on the clinical history and exploratory objective findings (primary lesions, patterns). Contact dermatitis remains as an important condition in the group of eczematous disorders, with important socioeconomic and occupational relevance. Although irritant and allergic contact dermatitis have a different pathogenesis, both are characterized by a rather typical morphology, are triggered by external factors and tend to occur primarily in the area of contact with the exogenous agent. In addition, allergic and irritant dermatitis may also co-exist. The importance of diagnosing contact dermatitis, especially when allergic in nature, is both due to the possibility of avoiding the trigger, and due to its role in aggravating other skin conditions. Nevertheless, the heterogeneity of clinical presentations in daily practice may pose an important challenge for the suspicion and correct diagnosis of contact dermatitis. Furthermore, other conditions, with different pathogenesis and treatment, may clinically simulate contact dermatitis. The Task Force aims to conduct a review of the unifying clinical features of contact dermatitis and characterize its main clinical phenotypes, and its simulators, in order to contribute to an early suspicion or recognition of contact dermatitis and enable a correct differential diagnosis., (© 2024 The Authors. Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.)

Non-alcoholic fatty liver disease (NAFLD) is the most common liver pathology in the western countries. Psoriatic patients are at higher risk of having NAFLD, and at higher risk of experiencing a more severe form of the disease with poorer outcomes. The components of the metabolic syndrome - obesity, lipid abnormalities, hypertension, and type 2 diabetes - significantly correlate with NAFLD progression. The inflammatory state present in psoriasis plays a significant role in development of NAFLD and the metabolic syndrome. All patients with psoriasis and insulin resistance and risk factors for metabolic syndrome should also been screened for NAFLD, and planning of the treatment options should always take into consideration the possible risks related to the liver, especially in patients with NAFLD., Competing Interests: The authors declare no conflict of interest., (Copyright: © 2019 Termedia Sp. z o. o.)

Introduction: The study presents the case report of a Wells Syndrome in a 18-year -ld female. Wells Syndrome is a rare inflammatory skin disorder which seems to present an abnormal eosinophilic response to a number of triggers., Objective: The aim of the study is to discuss several problems related to the diagnosis and treatment of Wells Syndrome., Material and Methods: Medical examination, blood tests, abdominal ultrasound and skin biopsy were performed., Results: Medical examination revealed plaques with tense blisters on feet and erythematous lesions on trunk. Blood tests showed raised anti-streptolysin O level. Skin biopsy revealed features of eosinophilic cellulitis. Oral administration of 0.5 mg per day prednisolone and antihistaminics with local therapy resulted in good clinical response., Conclusions: Sometimes several biopsy are required to establish diagnosis. In some cases lower doses of corticosteroids with antihistaminics and local anti-inflammatory treatment can by sufficient in treatment.

Background: Work-related skin diseases (WSD) are caused or worsened by a professional activity. Occupational skin diseases (OSD) need to fulfil additional legal criteria which differ from country to country. OSD range amongst the five most frequently notified occupational diseases (musculoskeletal diseases, neurologic diseases, lung diseases, diseases of the sensory organs, skin diseases) in Europe., Objective: To retrieve information and compare the current state of national frameworks and pathways to manage patients with occupational skin disease with regard to prevention, diagnosis, treatment and rehabilitation in different European countries., Methods: A questionnaire-based survey of the current situation regarding OSD patient management pathways was carried out with experts on occupational dermatology and/or occupational medicine from 28 European countries contributing to the European Cooperation in Science and Technology (COST) Action TD 1206 (StanDerm) (www.standerm.eu)., Results: Besides a national health service or a statutory health insurance, most European member states implemented a second insurance scheme specifically geared at occupational diseases [insurance against occupational risks (synonyms: insurance against work accidents and occupational injuries; statutory social accident insurance)]. Legal standards for the assessment of occupationally triggered diseases with a genetic background differ between different countries, however, in most European member states recognition as OSD is possible. In one-third of the countries UV light-induced tumours can be recognized as OSD under specific conditions., Conclusion: OSD definitions vary between European countries and are not directly comparable, which hampers comparisons between statistics collected in different countries. Awareness of this fact and further efforts for standardization are necessary., (© 2017 European Academy of Dermatology and Venereology.)

Background: Until recently, it was thought that in patients with atopic dermatitis (AD), contact hypersensitivity phenomenon occurs less frequently than in the general population because of the impaired cellular immune response., Objective: The aim of this study was to evaluate the incidence of contact dermatitis in the population of patients with AD., Methods: A total of 39 patients with clinical diagnosis of AD during remission were patch tested with 28 European Baseline Series allergens and 8 corticosteroids allergens in different concentrations and media. Twenty-nine (74.3%) patients were female and 10 (25.6%) patients were male. Thirty-three (84.6%) patients were older than 18 years. The mean duration of AD was 20 years., Results: Nineteen (48%) patients had an allergic reaction to at least 1 European Standard Series allergen, and 5 (12.8%) patients had an allergic reaction to at least 1 corticosteroid. The most common allergens giving positive results were nickel sulfate (28.2%), potassium dichromate (20.5%), cobalt chloride (12.8%), and phenylenediamine, budesonide, betamethasone, clobetasol, and dexamethasone (7.7% each)., Conclusions: This study shows that allergic contact hypersensitivity is common among patients with AD and affects up to 40% of cases. Contact allergy to corticosteroids becomes a serious problem in the treatment of chronic inflammatory dermatoses such as AD.

Background: Contact allergy among adolescents is an important issue., Objectives: To assess the prevalence of contact allergy to metals in adolescents aged 15 years and nickel release from metal accessories that are in direct contact with the skin., Methods: Three hundred and nine females and 219 males, all 15 years old, from randomly selected secondary schools were examined and patch tested with nickel sulfate, cobalt chloride, palladium chloride, and potassium dichromate. Three hundred and ninety-nine metal accessories were tested with the dimethylglyoxime (DMG) test., Results: 'Metal dermatitis' was reported by 19.4% of females and 0.5% of males. Positive patch test reactions were found in 8.5% of the adolescents (12.9% in females; 2.3% in males), namely to: nickel (12.3% of females; 1.4% of males); palladium (5.2% of females; 0.5% of males); cobalt (3.2% of females; 1.4% of males); and chromium (1.3% of females; 0.9% of males). Allergic contact dermatitis caused by metals was diagnosed in 9.7% of females and in 0.5% of males. Of the metal items, 26.1% gave positive DMG test results: 10.0% of earrings, 11.4% of snaps, and 56.2% of belt buckles., Conclusions: Despite the implementation of the Nickel Directive in Poland, nickel still remains an important causal factor for allergic contact dermatitis. Numerous metal accessories do not comply with the Directive., (© 2012 John Wiley & Sons A/S.)

Systemic contact dermatitis can be elicited in nickel sensitive individuals by oral nickel exposure from food with high content of this metal, such as cocoa. We present a case report of a nonatopic teenager who developed allergic contact dermatitis due to nickel, cobalt, copper, and palladium, but exacerbations of skin lesions were mainly related to cocoa consumption., (© 2011 Wiley Periodicals, Inc.)

Background: High prevalence of occupational dermatoses among hairdressers has been confirmed in many studies, while work-related skin disorders in apprentice hairdressers are less known., Objectives: The aim of the study was to investigate the frequency of work-related skin disorders among apprentice hairdressers, and to identify the factors contributing to the development of dermatoses during vocational training., Patients and Methods: One hundred thirty-nine apprentice hairdressers, aged 17-19 years, were included in the study. A questionnaire survey, personal interview, dermatological examination and patch tests were conducted., Results: Present or past work-related skin conditions affecting the hands were reported by 43.9% of individuals, and diagnosed in 25.9% on dermatological examination. Positive patch test results were found in 38.1%. The most frequent allergens were nickel (29.3% of all tested) and ammonium persulfate (8.3%). Allergic contact dermatitis was recorded in 27.3%, and was of occupational origin in 87.9% of all tested individuals. Irritant contact dermatitis was diagnosed in 51.1% of participants (this prevalence was higher than that based only on an interview). Survey responses revealed inadequate knowledge of the risk of occupational skin diseases and protective measures., Conclusions: It is necessary to implement an educational programme for apprentice hairdressers, in order to increase their knowledge of the risk of skin damage and to promote appropriate use of protective measures, starting from the earliest stages of their training., (© 2011 John Wiley & Sons A/S.)

Background: A constantly growing social demand for orthopedic implants has been observed in Poland. It is estimated that about 5% of patients experience post-operation complications. It is suspected that in this group of patients an allergic reaction contributes to rejection of metal implants., Materials and Methods: The aim of our study was to assess contact allergy to metals in 14 people (9 women and 5 men) suffering from poor implant tolerance. In some of them, recurrent skin eruptions, generalized or nearby implants, have occurred and in 3 patients skin fistula was observed. These complaints appeared one year after operation. The patients underwent patch tests with allergens from the Chemotechnique Diagnostics (Malmö, Sweden), including nickel, chromium, cobalt, palladium, copper, aluminum. In addition, allergens, such as titanium, vanadium and molybdenum prepared by chemical laboratory in the Nofer Institute of Occupational Medicine, Lódiź, Poland, were introduced., Results and Conclusions: Of the 14 patients, 8 persons (5 women and 3 men) were sensitized to at least one metal, mostly to nickel (7/14) and chromium (6/14). Of the 8 sensitized patients, 3 were reoperated. Owing to the exchange of prosthesis the complaints subsided, including healing up skin fibulas. These facts weight in favor of the primeval sensitizing effect of metal prosthesis and the relation between allergy and clinical symptoms of poor tolerance to orthopedic implants.

A case of disseminated allergic contact dermatitis in a screen process printer is presented. The skin lesions were caused by multifunctional acrylates (methylpropane triacrylate and pentaerythritol triacrylate--highly positive patch tests (+ + +) after 48 and 96 h) present in ultraviolet cured transparent lacquer used in coat printed posters to make them weather-resistant. Patch tests with lacquer were also highly positive (+ + +) after 48 and 96 h. According to the safety sheet of the product, lacquer contained 85-90% of multifunctional acrylates. The patient showed disseminated dermatitis, however, no hypertrophied lesions on the hand skin, a characteristic symptom in persons exposed to acrylates, were observed.

A case of the hands and face dermatitis in a patient employed in a store with motor-car spare parts is presented. Both the patient and her doctor were convinced that skin lesions were caused by the contact with metals, oils and greases. After detecting allergy to primine (after 48 and 96 h, + +), the patient recalled that two months earlier she had started to grow primrose (Primula obconica) at home. Patch tests with the primrose leaf and flower were also positive (+ +). The presented case provides evidence that routine primine testing is essential in all patients with suspected contact allergy dermatitis. In Poland like in the majority of countries, primina is not included in the standard kit.

Dermatological examinations were performed in 81 workers involved in the manufacture of electric coils for television displays, who had worked for 4 years in contact with a glue containing isobornyl acrylate, acrylic acid, N,N dimethyleneacrylamide, phosphine oxide, bis(2,6-dimethoxybenzoyl) (2,4,4-trimethylpentyl)- and beta-carboxyethyl acrylate. The glue was cured by 350-500-nm ultraviolet and visible radiations. Acrylate-specific dermal lesions were detected in 21 (25.9%) people. Occupational irritant contact dermatitis was diagnosed in 12 (15%) of the workers and occupational allergic contact dermatitis in 9 (11.2%). 12 people reacted to acrylates. Cross-reactions with methacrylates were not observed. The highest number of positive tests was obtained with triethyleneglycol diacrylate (10 people) and diethyleneglycol diacrylate (9), followed by 1,6-hexanediol diacrylate (5), 1,4-butanediol diacrylate (4), beta-carboxyethyl acrylate (3), tripropyleneglycol diacrylate (2) and pentaerythritol triacrylate (2). No cases of allergy to isobornyl acrylate, N,N-methylenebisacrylamide or phosphine oxide were noted.

Allergy to acrylic plastics is rather frequent among doctors and dental technicians. A rare case of allergy to acrylates in a dental nurse (only one reports can be found in the literature) is presented. The patient reacted to eight chemical compounds of the group under study. UV-cured composites used in conservative dentistry for tooth filling was the source of allergy in the case under report.

We examined 223 nurses from the Lódź region, referred to the Nofer Institute of Occupational Medicine in 1995-99 because of suspected occupational dermatoses. The diagnosis of contact allergy was based on the positive results of patch tests, and immediate allergy to common allergens and latex on the results of prick tests, as well as on the determinations of specific IgE antibodies. Contact allergy was diagnosed in 66.4% of nurses. The most frequent sensitisers were quaternary ammonium compounds (benzalkonium) (23.8%), nickel (21.5%) and formaldehyde (20.6%); allergy was somewhat less frequently caused by thimerosal (14.3%), fragrances (12.1%), glutaraldehyde (10.8%), cobalt (9.9%), thiurams (6.7%) or glyoxal (4.9%). Allergy to rubber was diagnosed in 40 patients (17.9%), including 25 cases of immediate allergy to latex, 8 cases of contact dermatitis from thiuram rubber curing accelerators, and 7 cases of mixed allergy. It has been concluded that the contact with disinfectants (40.8% of allergic nurses), metals (30.9%) and rubber (17.9%) was the most frequent source of allergy in this group of medical personnel.

The incidence of allergy to aldehydes (formaldehyde, glutaraldehyde, glyoxal) was examined in 280 health care workers suffering from skin lesions. Allergy was diagnosed in 64 (22.8%) patients. The majority of them (85.9%) were sensitive only to 1 aldehyde. Formaldehyde caused allergy slightly more frequently (13.9%) than glutaraldehyde (12.4%). Only 5 (1.9%) patients were sensitive to glyoxal. The irritant effect of aldehydes to the rabbit eye and skin was tested by the Draize and OECD methods. Formaldehyde and glutaraldehyde showed stronger irritant effect than glyoxal. The sensitizing activity of aldehydes was also confirmed in guinea pigs (using the Maximization Test and the OECD methods). Formaldehyde showed the strongest and most persistent reactions. Significantly higher eosinophil and basophil counts were found in the blood samples of the sensitized guinea pigs. Cytotoxicity of glutaraldehyde and glyoxal was tested on mouse 3T3-L1 fibroblasts by the Neutral Red Uptake and MTT Reduction Assay. It was shown that both aldehydes were cytotoxic, and that the cytotoxic effect of glutaraldehyde was stronger than that of glyoxal.