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Background: The baseline series includes common allergens, evolves over time, and differs by location. Our study aims to characterize allergen sensitization trends among the Israeli population during the last two decades, compare our results to American and European registries, as well as to highlight significant allergens in additional series outside the European baseline series (OEBS). Methods: We analysed patch test results of 2086 patients from a designated contact dermatitis clinic in Tel Aviv between 2019 and 2022, compared them to European and North American registries and to 2156 patch test results conducted in Israel two decades ago. Results: 38.6% of patients had at least one positive reaction to an allergen in the European baseline series (EBS), nickel sulphate (14.6%), fragrance mix I (4.6%), and Methylchloroisothiazolinone methylisothiazolinone (MCI/MI; 3.7%) were the most common among them. N‐Isopropyl N‐Phenyl‐4‐Phenylenediamine (NIPPD; 0%), Propolis (0.1%), Sesquiterpene lactone mix (0.1%), and Budesonide (0.1%) elicited a sensitization frequency significantly lower than the proposed threshold for baseline inclusion. Chi‐square test revealed a statistically significant decrease (p < 0.05) in the sensitization frequency of fragrance mix I, Formaldehyde, Potassium dichromate, Neomycin sulphate, Myroxylon pereirae, Sesquiterpene lactone, and NIPPD during the last two decades. The overall sensitization frequency to the majority of allergens was lower in our cohort in comparison to the North American and European registries. Conclusions: MCI/MI and 2‐hydroxyethyl methacrylate‐2 (HEMA) are common, relevant allergens, with high SPIN (significance and prevalence index number) and should be better regulated by the authorities. While among the EBS, NIPPD, Propolis, Sesquiterpene lactone, and Budesonide usually do not elicit a positive reaction and therefore should be reconsidered in baseline series, among the OEBS, Chloramphenicol, Quaternium 15, Propyl gallate, and Amerchol L101 have elicited high SPIN values and should be vigilantly examined in the suitable clinical scenario. Significantly lower sensitization frequency to propolis raises the possibility of a protective effect due to early oral exposure among the Israeli population. [ABSTRACT FROM AUTHOR]

Human papillomavirus (HPV) is ubiquitously distributed in the population worldwide and its most frequent clinical presentation is cutaneous warts. Despite various treatment options currently available, many patients experience persistent and refractory disease. We sought to evaluate the clinical effectiveness and safety profile of intralesional HPV 9‐valent vaccine for the treatment of recalcitrant warts. A retrospective study was performed for all cases of cutaneous warts treated with intralesional 9‐valent HPV vaccine between January 2017 and March 2021. Epidemiologic, clinical, and treatment data, including safety and effectiveness scores, were reviewed. Our cohort was composed of 20 patients: 13 adults and seven children. Twelve patients (60%) displayed a complete response whereas 8 patients (40%) showed a partial response. Older age was associated with a better response to treatment, while a history of laser therapy was associated with a worse prognosis. Adverse events were local, transient, and negligible. No systemic adverse effects were reported. Intralesional 9‐valent HPV vaccine may be considered for the treatment of recalcitrant cutaneous warts. Controlled studies are required to confirm these results. [ABSTRACT FROM AUTHOR]

Delayed‐onset T‐cell‐mediated cutaneous adverse drug reactions are an uncommon but potentially serious result of medication exposures. Identification of culprit medications is crucial, but clinical diagnosis is often difficult. Patch tests and interferon‐gamma release assays (IFNγ‐RA) were previously reported as potentially useful ancillary tests, while rechallenges remain the reference standard test. We compared the number of positive test results with patch testing and IFNγ‐RA for drugs implicated as possible causes of cutaneous reactions. Fifty‐one patients with a suspected cutaneous drug eruption underwent patch testing and IFNγ‐RA for suspected drugs. Participants were followed up at least 9 months after the onset of the rash with results compared with the clinical diagnosis. Forty‐two patients presented with morbilliform/eczematous eruptions; five were diagnosed with fixed drug eruption (FDE) and four with erythema multiforme. None had positive patch testing to the drugs tested. A total of 8/51 (15.6%) patients had positive reaction by the IFNγ‐RA, and an additional 11 (21.6%) patients had borderline results. Positive or borderline results were more likely in patients with FDE (80%) than morbilliform/eczematous eruptions (30.9%) or erythema multiforme (25%). Our study emphasizes the necessity of additional effective ancillary tests in the evaluation of drug eruptions and supports the use of IFNγ‐RA for drug testing as a tool for identifying medications associated with cutaneous drug eruptions. [ABSTRACT FROM AUTHOR]

Background: Atopic dermatitis (AD) is a remitting relapsing chronic eczematous pruritic disease. Several studies suggest that gut microbiota may influence AD by immune system regulation. Methods: We performed the first in‐human efficacy and safety assessment of fecal microbiota transplantation (FMT) for AD adult patients. All patients received 2 placebo transplantations followed by 4 FMTs each 2 weeks apart. AD severity and fecal microbiome profile were evaluated by the Scoring Atopic Dermatitis Score (SCORAD), the weekly frequency of topical corticosteroids usage, and gut microbiota metagenomic analysis, at the study beginning, before every FMT, and 1–8 months after the last FMT. Results: Nine patients completed the study protocol. There was no significant change in the SCORAD score following the two placebo transplants. The average SCORAD score significantly decreased from baseline at Weeks 4–12 (before and 2 weeks after 4 times of FMT) (59.2 ± 34.9%, Wilcoxon p =.011), 50% and 75% decrease was achieved by 7 (77%) and 4 (44%) patients, respectively. At Week 18 (8 weeks after the last FMT) the average SCORAD score decreased from baseline at Week 4 (85.5 ± 8.4%, Wilcoxon p =.018), 50% and 75% decrease was achieved by 7 (77%) and 6 (66.7%) patients respectively. Weekly topical corticosteroids usage was diminished during the study and follow‐up period as well. Two patients had a quick relapse and were switched to a different treatment. Two patients developed exacerbations alleviated after an additional fifth FMT. Metagenomic analysis of the fecal microbiota of patients and donors showed bacterial strains transmission from donors to patients. No adverse events were recorded during the study and follow‐up period. Conclusions: FMT may be a safe and effective therapeutic intervention for AD patients, associated with transfer of specific microbial species from the donors to the patients. Further studies are required to reconfirm these results. [ABSTRACT FROM AUTHOR]

Pyogenic granuloma is a benign acquired vascular tumor that affects the skin and mucous membranes, occurring more often in children and young adults. Treatment is often required due to the associated risk of ulceration and bleeding. There are several publications reporting the use of beta‐blockers for the treatment of pyogenic granuloma. The aim of the present study was to evaluate the clinical effectiveness and safety profile of topical propranolol 4% gel for the treatment of pyogenic granuloma. A retrospective study of all cases of pyogenic granuloma treated with topical propranolol 4% gel between 2014 and 2015 was performed. Epidemiological, clinical and treatment data, including effectiveness score and safety, were reviewed. Of a total of 18 patients with pyogenic granuloma, 11 (61.1%) showed complete resolution of the lesion while two (11.1%) had an almost complete response. In three cases (16.6%), the treatment was discontinued due to bleeding, and the lesions were removed by curettage. Local irritation and lack of compliance led to treatment discontinuation in two cases. Altogether, 13 out of 18 patients (72%) had complete or almost complete response to treatment. There was a correlation between treatment duration and response to treatment. One patient only reported local side‐effects including irritation, redness and scaling of the treated area leading to discontinuation of the treatment and curettage of the pyogenic granuloma. No systemic adverse effects were reported. This is an uncontrolled retrospective study. Propranolol 4% gel may be considered as a safe and efficient topical therapy for pyogenic granuloma. [ABSTRACT FROM AUTHOR]

Summary: Background: Actinic cheilitis (AC) is a common, chronic premalignant condition resulting from protracted sun exposure affecting the vermilion border of the lower lip. Treatment of AC aims at terminating the progression to squamous cell carcinoma by obliterating the primary lesion, and includes ablative methods; nonablative modalities such as cryotherapy, electrodessication, chemical peeling, topical imiquimod and 5‐fluorouracil; and photodynamic therapy (PDT). Daylight‐activated PDT, in which natural daylight serves as the light source, showed promising results in the treatment of actinic keratoses with substantially less pain than conventional PDT. Purpose: To determine the safety and efficacy of daylight PDT in a series of patients with AC. Methods: Eleven patients with AC were treated with daylight PDT. All patients underwent repeated treatment sessions until clinical and histological remission were achieved. Results: Cure rate was 91% (10 of 11 patients, three females/eight males; mean age 59.2 ± 14.4 years). Mean number of treatments to attain cure was 2.7. Patients experienced mild erythema and minimal to no pain during treatment. Conclusions: Daylight PDT is a promising modality for the treatment of AC, with impressive cosmetic results and few side effects. Actinic cheilitis is a common premalignant condition of the lower lip that requires treatment to prevent its progression to squamous cell carcinoma. We describe our therapeutic experience using a daylight photodynamic therapy. Treatment sessions continued until achieving clinical and histological remission. Symptoms were resolved in 10 of 11 patients (91%) after a median of two (range 1‐6) treatments, with only few adverse effects. Daylight photodynamic therapy is a promising modality for the treatment of actinic cheilitis. [ABSTRACT FROM AUTHOR]

Objective: Asthma is one of the most common chronic diseases globally. Atopy, and especially allergic rhinitis (AR), was found as an important risk factor for asthma. The purpose of this study was to examine the association between different atopic parameters and military professions to the incidence of asthma. Methods: In a retrospective study, we included 128 591 Israel Defense Forces soldiers drafted between the mid-nineties to the early-2000s. We examined the incidence rates of asthma in relation to atopic background and to military profession. Results: The relative risk (RR) for the development of asthma in persons with a history of AR and the RR for asthma in atopics vs. nonatopics was 1.86 (95% CI: 1.57-2.21) and 1.73 (95% CI: 1.47-2.04), respectively. The RR for the development of asthma in persons with a history of AR was higher in Combat Units (CU) and Administrative and Driving units (ADU) (RR=2.80; 95% CI: 2.09-3.76 and RR=1.58; 95% CI: 1.19-2.12, respectively) than in Maintenance Units (MU) (RR=1.27; 95% CI: 0.93-1.74). When comparing the risk for asthma amongst persons with AR, we found it lower in MU compared to ADU (RR=0.65; 95% CI: 0.43-0.97). In atopics vs. non-atopics, the risk for asthma was higher in ADU as compared to other occupations. Conclusions: Atopy, particularly AR, is a risk factor for the development of new-onset asthma in young adults. Atopy has the highest significant effect in CU where the physical demands are higher. [ABSTRACT FROM AUTHOR]

Introduction: Whether individuals with atopic diseases have a different risk of contact allergy compared to those who are non-atopic is controversial and data are conflicting., Aim: To explore the association between atopy and allergic contact dermatitis (ACD)., Material and Methods: This retrospective cross-sectional study included 301 patients referred to a tertiary clinic to evaluate ACD. Demographic details including personal and familial mucosal or cutaneous atopic status were recorded. Patch tests were tailored to their clinical presentations and relevant exposures., Results: At least 1 positive patch test reaction was observed in 177 patients (59% of the study cohort), of which 52% had a history of atopic diseases, compared with 44% of patients with a negative patch test result ( p = 0.2). Additionally, 147 patients had an atopic background, of which 92 (62%) had ≥ 1 positive patch test result, compared with 55% of non-atopic patients ( p = 0.2). Nickel sulphate was the most common contact allergen (13.4% of the patch test reactions)., Conclusions: We identified a positive tendency for atopic diseases among individuals with ACD and vice versa. Our study supports the aggregate data from previous studies despite the non-significant differences between the study and control groups. However, further research performed in larger populations of patients is necessary to evaluate the real association between atopy and ACD on a solid basis. Our results indicate the necessity of systematic patch testing in patient setups with atopic background and chronic dermatitis., Competing Interests: The authors declare no conflict of interest., (Copyright © 2022 Termedia.)