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Internationally approved guidelines for the diagnosis and management of Malassezia-related skin diseases are lacking. Therefore, a panel of experts consisting of dermatologists and a microbiologist under the auspices of the Danish Society of Dermatology undertook a data review and compiled guidelines for the diagnostic procedures and management of pityriasis versicolor, seborrhoeic dermatitis and Malassezia folliculitis. Main recommendations in most cases of pityriasis versicolor and seborrhoeic dermatitis include topical treatment which has been shown to be sufficient. As first choice, treatment should be based on topical antifungal medication. A short course of topical corticosteroid or topical calcineurin inhibitors has an anti-inflammatory effect in seborrhoeic dermatitis. Systemic antifungal therapy may be indicated for widespread lesions or lesions refractory to topical treatment. Maintenance therapy is often necessary to prevent relapses. In the treatment of Malassezia folliculitis systemic antifungal treatment is probably more effective than topical treatment but a combination may be favourable. [ABSTRACT FROM AUTHOR]

Background: Contact allergy is frequent among persons with hand eczema and may be associated with a poor prognosis. Objectives: To identify allergens associated with the most severe initial clinical symptoms and the worst prognosis in a cohort of hand eczema patients followed for 6 months. Methods: The study population comprised 799 consecutive hand eczema patients enrolled during January 2006–February 2007. All patients were patch tested with the European baseline series. Severity assessment of the hand eczema was performed initially and at the 6-month follow-up using a validated scoring system (HECSI). With logistic regression analyses, associations of severe hand eczema or a poor prognosis with 15 individual allergens were analysed and adjusted for by sex, age, atopic dermatitis and other allergens. Results: At baseline, greater severity of hand eczema was associated with a positive patch test to formaldehyde, methyldibromo glutaronitrile, sesquiterpene lactone mix, nickel sulfate and potassium dichromate. A poor prognosis was associated with chromate allergy, odds ratio: 4.18 (95% CI: 1.42–12.28). Conclusions: Nickel, chromate, formaldehyde, methyldibromo glutaronitrile and sesquiterpene lactone mix were allergens associated with the greatest severity of hand eczema. Patients with chromate allergy had the worst prognosis. [ABSTRACT FROM AUTHOR]

Background The severity of hand eczema is of interest in epidemiological studies. Ideally, as no validated methods of self-assessment exist, a dermatologist should examine all subjects. However, this is very resource intensive. Objectives To examine if severity grading performed by patients with hand eczema using a self-administered photographic guide was in agreement with the assessment performed by a trained dermatologist. Furthermore, to measure the correlation between the severity of hand eczema expressed on a visual analogue scale (VAS) and the clinical severity assessment, using the photographic guide. Methods Fifty-three consecutive outpatients with hand eczema were included, a number based on a prestudy statistical calculation. The patients were asked to grade current severity of their hand eczema by choosing one of four groups of photographs representing differing severities of hand eczema. On the same day all patients were examined by an experienced dermatologist, who graded the severity using the same photographic guide. The photographic guide was a modified version of a validated guide for use by physicians. In addition, the patients rated the severity of their hand eczema on a VAS. Results Fifty-one of the respondents completed the full questionnaire. For 37 of the 51 patients (73%) the clinical severity assessments of patient and dermatologist were identical. The measure of agreement, Cohen's kappa coefficient, was 0.61, indicating good inter-rater agreement. The correlation between the dermatologist-rated severity and the corresponding score by the patients on the VAS was only moderate (Spearman's rank correlation coefficient rho = 0.52). Conclusions The photographic guide for the self-assessment of hand eczema is an easy instrument to use, and for research purposes can be a reliable tool for patients with hand eczema to grade severity. A VAS can only be considered as a mediocre tool for estimation of the dermatologist-rated clinical severity, but should be validated as an independent instrument to assess severity of hand eczema. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 24-year-old woman who is suffering from atopic dermatitis that is presented with chronic hand eczema. It details the results of the patient's patch testing which revealed an allergic reaction to sorbitan sesquioleate that was found on the vinyl rubber gloves that the patient wore when doing tasks that involves prolonged contact with water. It offers information on sorbitan sesquioleate which is considered as a weak allergen.

A case study of 21-year-old non-atopic woman with face eczema was referred for allergy testing, is presented. It mentions patient's facial contact dermatitis caused by methylchloroisothiazolinone/methylisothiazolinone in a stainless steel aerosol spray. It also mentions the need of legal intervention in allergic contact dermatitis caused by MCI/MI in an occupational setting.

The article focuses on the study related to occupational hand eczema caused by nickel allergy and semi-quantified from dimethylglyoxime testing of the skin. It mentions that nickel is an important cause of occupational allergic contact dermatitis. It states that excessive nickel exposure is shown in many occupations.

The article presents a case study of a 68-year old non-atopic man who was referred from Department of Urology due to suspected allergic skin reaction. It states that the patient had been diagnosed with prostate cancer, and 2 days later developed severe swelling and redness of scrotal and penile skin. It notes that patch testing was performed using extended European baseline series. It mentions that he was informed about contact allergy to cetrimide.