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Contact dermatitis reactions to the cosmetic preservative imidazolidinyl urea and other formaldehyde releasers. A 48-year-old cleaning woman presented in October 1984 with a severe chronic hand eczema, showing intensively itchy red, scaly lesions on the back of both hands where the lesions began and on the palm associated with marked fissuring and lichenification. She also had some redness and edema on the face. She had used several strong corticosteroids creams and ointments, as well as a glycerin hand cream with silicone to protect her hands.

Contact allergic reactions to Primula obconica have been detected for the past several years with a patch test to synthetic primin 0.01% pet. Since most such cases are clinically undetectable, primin has been included in the European standard series. Since February 1985, the authors have routinely tested primin 0.01% pet, in 4253 consecutive patients. It was positive 13 times, but the authors would have missed primula allergy in 2 patients if they had relied exclusively on primin. A 28-year-old woman had recurring outbreaks of itchy vesicles on the fingertips, from February to May 1988, which progressively worsened and extended to the palms and the backs of her hands.

The case of a 40-year-old woman with severe edema of the lace and neck after the injection of a local dental anesthetic is presented. The reaction is attributed to the presence of sodium metabisulfite, and antioxidant, in the local anesthetic. Both the anesthetic and the sodium metabisulfite gave a delayed positive patch-test response. [ABSTRACT FROM AUTHOR]

This article presents a study of 29-year-old woman who was suffering itching erythematopapular to urticarial lesions after the birth of her second child. The appearance suggested allergic contact eczema and the location suggested intolerance to a hair product. Upon questioning, the patient revealed that she regularly had itching lesions on her face, ears and neck for the previous 2 months, possibly associated with shampooing with a new shampoo. The conduct of a patch test yielded a positive reaction to nickel sulphate and cobalt chloride. Therefore it was suggested that allergic reactions to hydrolyzed protein derivatives might be more common than one might expect.

Itraconazole, a new orally active triazole antifungal, has been tested in patients with pityriasis versicolor. A comparison of different dose schedules was carried out in 73 patients. A regime of too mg itraconazole daily for 15 days gave a 100% response rate; 200 mg daily for 5 days gave an 80% response rate. Two patients, who had received 50 mg itraconazole for 14 days, relapsed within 2 months of finishing treatment. Only two patients reported minor side-effects. [ABSTRACT FROM AUTHOR]

Cutaneous Melanoma (CM) has been the subject of many investigators since this neoplasm shows a dramatic world-wide increase in incidence since the past 25 years. Although CMs, harboring well-defined growth phases, are an ideal model to study tumor progression, most studies up till now used extracts from whole tumors, or cell lines derived from an unknown growth phase, and do not allow to study the chronology of genetic alterations. Therefore, we used microdissection to analyse tumor progression, such as oncogene activation in the distinct growth phases of CM. In this study, we found that Ras oncogene activation is an important mechanism in the initiation and progression of CM and that some mutations preferentially occur in specific growth phases. A clonal relationship could be confirmed between the different tumor progression stages of CM and even between primary CM and associated nevi. We also detected a novel mutation in the N-ras gene in 10% of the CM. Melanomas with this mutation were significantly thinner and identified a group with better prognosis than melanoma patients with the classical Ras mutations or even without Ras mutations. Our results show that tumor progression occurs stepwise in CM and that different mechanisms are responsible for different steps in the development of CM. We also showed that oncogene mutations can also inhibit tumor formation, and in our case contribute to a better prognosis for these melanomas. [ABSTRACT FROM AUTHOR]

A pharmaceutical test battery applied to a leg ulcer patient gave results in which all the substances diluted in yellow petrolatum were positive, while those diluted in alcohol, water, or olive oil were negative. The European Standard series was negative, except for wool alcohols. Chronic dermatitis and hyperpigmentation caused by petrolatum have been reported by researcher H. Maibach in a black patient in the year 1978. Contact dermatitis reactions to both yellow and white petrolatum have been described.

Contact allergy is found to occur due to an emulsifier that is used in a cosmetic lotion. The emulsifier is an anionic oil-in-water emulsifier which contain DEA-dihydroxypalmityl phosphate and isopropyl hydroxypalmityl ether. It is available only as a mixture. The case was studied in a 54-year-old woman who had acute itchy dermatitis on the face with edema of eyelids. An another case was studied in a 38-year-old woman with an itchy erythematosquamous eruption on both eyelids. Patch tests were carried out on her.

This article reports a case on cosmetic dermatitis due to methyl glucose sesquisterarate. A 22-year-old female presented with a severe itchy papular and vesicular eruption on her legs. The lesions had begun a week after she had stopped Lotion A, which she had applied for 3 weeks to tan her legs. The allergy turned out to be the emulsifier, methyl glucose sesquistearate. Tests on 20 control subjects were negative. Lotion A was the manufacturer's only product that contained emulsifier. Methyl glucose sesquistearate is a mixture of mono-and di-esters of a methyl glucoside and stearic acid.

Two female patients with histories of contact dermatitis to nickel-containing jewelry (dime-thyiglyoxime test positive) failed to react to patch testing with 5 % nickel sulphate in yellow petrolatum. Further patch testing was performed with nickel sulphate 2.5 % and 5 % in water and with 2.5% in DMSO 50%, but no positive reactions were obtained. An intradermal test with a 1/10,000 dilution in water was also negative. Both patients were again patch tested with 10% nickel sulphate in yellow petrolatum, which resulted in ++ reactions after 48 and 96 hours.

Xerogel films such as TRUE Test offer obvious practical advantages in patch testing. Since corticosteroids are frequent allergens, and especially critical as regards their patch test concentrations and vehicles, they are good candidates for xerogel testing. Xerogel formulations may well avoid some of the pitfalls in patch testing corticosteroids. The results with hudesonide seem promising, but more research is needed to standardize the quality. This test system certainly deserves study for other corticosteroids. Preliminary data developed by authors of this article indicates that it also works well for substances such as tixocortol pivalate etc. but less well for hydrocortisone which is perhaps the most difficult of allergens to demonstrate.

A 25-year-old female student, with no previous dermatological history, was carrying out immunological research. As she had contact with several irritants, including a stock solution for polyacrylamide gel electrophoresis containing acrylamide, she wore latex gloves. After 4 months, she began to develop eczema, which appeared first on the left arm and later on the back of both hands and fingers. The patient was diagnosed as having a contact allergy to acrylamide, which is used in the preparation of polyacrylamide gel electrophoresis. Indeed wearing latex gloves gave her a false sense of security, as it did not protect from exposure to acrylamide.

The article cites the case of a 22-year-old female student who suffered with airborne allergic contact dermatitis from kitasamycin and midecamycin. Two weeks after she began her work, she suddenly erupted in a burning eczema on the face. The eczema disappeared when she went on vacation, but recurred promptly when she returned to the laboratory to work. Apart from suspected contact allergy to nickel intolerance of cheap jewelry, she had no personal dermatological history. The case demonstrates that an active contact eczema often proceeds sensitization to other, chemically unrelated, substances at the same sites.

Presents a case on the term of therapy for onychomysis by itraconazole and terbinafine. Pharmacokinetic properties of itraconazole; Existence of black box warning for blood dyscrasia and liver monitoring; Relevance of fungicidal activity in the treatment of dermatophytosis.

Two elderly female patients with fatal calciphylaxis, despite nearly normal renal functions, occurring during treatment for giant cell arteritis, are described. The possible mechanisms for this association are discussed. [ABSTRACT FROM AUTHOR]

The purpose of this retrospective study was to test whether the initial pattern of clinical presentation of shoe dermatitis could indicate the causative allergen(s) and to estimate the odds on foot dermatitis in patients with a positive patch test versus those with a negative patch-test result. Between 1990 and 2002, 8543 patients were patch tested with the standard series (and additional allergens, if appropriate). Of them, 1168 (14%) had been referred because of foot dermatitis and 474 of these patients (5.5% of the total group) presented a positive reaction to one or more substances related to shoes. We found that 6 standard allergens in the male group and 8 standard allergens in the female group were statistically significant for the shoe dermatitis group. The data showed a relationship between the distribution pattern of the foot lesions and most of the allergens. These results have clinical applications since the gender of the patients and the localization of the foot eruptions can, indeed, indicate what allergen is involved. [ABSTRACT FROM AUTHOR]

Although numerous studies have evaluated risk factors associated with cutaneous malignant melanoma (CMM), no such study has been carried out in Belgium.To identify individuals who are at high risk of developing malignant melanoma in Belgium, which could enhance the efficacy of screening interventions and avoid unnecessary skin inspections.We prospectively included patients who were diagnosed with invasive malignant melanoma between 1998 and 2001 at the Department of Dermatology in a case–control study. Controls were selected from the outpatient dermatology clinic. Participants were interviewed and clinically examined by a dermatologist. We asked questions concerning most known risk factors associated with malignant melanoma such as phenotypical and skin characteristics, and environmental and lifestyle exposures. To adjust for confounding variables and to estimate odds ratios (ORs) and 95% confidence intervals (CIs), a multivariate model was used.Although sunburn in childhood and substantial occupational solar exposure were modestly, but significantly, associated with malignant melanoma risk, clinical examination yielded several stronger risk factors. In a multivariate model, which adjusted for age, gender and skin phototype, phenotypical characteristics such as skin, hair and eye colour were significantly associated with the development of malignant melanoma. In the multivariate model, people with three or more atypical naevi were at more than 10-fold risk of developing a malignant melanoma (≥ 3 atypical naevi; adjusted OR = 11.40, 95% CI = 4.79–17.53) compared to those without an atypical naevus. The presence of one or more palpable naevi on the upper extremities or having solar lentigines increased the odds of developing malignant melanoma at least twofold.In Belgium, risk factors associated with malignant melanoma appear to be in accordance with previous studies. To assess peoples’ risk profile, clinical skin examination is likely to yield the most important sporadic malignant melanoma risk factors. Therefore, focusing screening campaigns on individuals with predefined findings on skin self-examination may increase its efficacy. [ABSTRACT FROM AUTHOR]