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Imiquimod 5% cream is an approved treatment for actinic keratoses, superficial basal cell carcinomas, and anogenital warts. Severe systemic side effects associated with imiquimod 5% cream are rare, although a few cases of erythema multiforme and Stevens-Johnson syndrome have been described. We present a case of Stevens-Johnson syndrome associated with topical treatment with imiquimod of two superficial basal cell carcinomas. [ABSTRACT FROM AUTHOR]

The article discusses a case report of a 77-year-old woman with atopic dermatitis and asthma who developed hypereosinophilia while being treated with dupilumab. The patient's condition improved after switching to tralokinumab, which targets interleukin-13. Tralokinumab was found to be effective in controlling the symptoms of atopic dermatitis and asthma without causing hypereosinophilia. The study highlights the potential of tralokinumab as an alternative treatment for patients with atopic dermatitis and asthma who develop hypereosinophilia. [Extracted from the article]

Facial follicular scales, dandruff, scalp itching and ocular alterations are lesser-known signs of rosacea and demodicosis. The aim of this prospective original study was to investigate the presence of these signs and symptoms in patients with almostclear, mild and moderate papulopustular rosacea (PPR) and to study the differences between Demodex-positive (D+) and Demodex-negative (D-) rosacea. Twenty-seven out of 60 patients (45%) presented follicular scales, 24 (40%) ocular involvement and 22 (36.67%) scalp involvement. Follicular scales were more frequently observed in mild and moderate than in almost-clear rosacea (P<0.001). Itching of the scalp was more frequently reported in patients with moderate rosacea than in those with mild disease (P=0.05). Follicular scales (P=0.002) and scalp itching (P=0.05) were more frequently reported in D+ than in D- patients. Among D+ patients, scalp itching was more frequently reported in mild than in almost clear rosacea (P=0.01) and ocular symptoms associated to scalp itching were more frequently reported in moderate than in almost-clear rosacea (P=0.05). We suggest looking for these signs and symptoms in all patients with PPR, because they can be a sign of a more severe form of rosacea or of demodicosis. [ABSTRACT FROM AUTHOR]

In common with many other members of this family, they contain sesquiterpene lactones (SLs) as allergens.[2] CASE REPORT A 35-year-old male greengrocer was referred from the Emergency Ward for severe "angioedema-like" periorbital eczema (Figure 1). Keywords: airborne ACD; artichoke; case report; Compositae; Cynara cardunculus; occupational; sesquiterpene lactones EN airborne ACD artichoke case report Compositae Cynara cardunculus occupational sesquiterpene lactones 120 122 3 07/11/23 20230801 NES 230801 Artichokes ( I Cynara cardunculus i L.) are known to cause allergic contact dermatitis (ACD) on exposed skin by direct contact but also by airborne spread.[[1], [3]] Formerly known as I Cynara scolymus i L., or I Cynara cardunculus i subsp. I scolymus i (L.) Hegi, or I Cynara cardunculus i var. I scolymus i (L.) Benth., or by other names all now regarded as synonyms, these vegetables belong the Compositae (or Asteraceae) family. The main SLs allergens in artichokes are reported to be cynaropicrin, grosheimin and its derivative 8-deoxy-11,13-dihydroxygrosheimin[2] but the specific SLs responsible for ACD to artichoke and their possible co- or cross-reactivity with other well-known SLs allergens remain unknown. [Extracted from the article]

12 Napolitano M, Fabbrocini G, Patruno C. Allergic contact dermatitis to Compositae: a possible cause of dupilumab-associated facial and neck dermatitis in atopic dermatitis patients? Artichoke, airborne allergic contact dermatitis, case report, chronic actinic dermatitis, dupilumab, Parthenium hysterophorus, sesquiterpene lactone mix Keywords: airborne allergic contact dermatitis; artichoke; case report; chronic actinic dermatitis; dupilumab; Parthenium hysterophorus; sesquiterpene lactone mix EN airborne allergic contact dermatitis artichoke case report chronic actinic dermatitis dupilumab Parthenium hysterophorus sesquiterpene lactone mix 156 158 3 01/13/23 20230201 NES 230201 Parthenium hysterophorus is a recognized cause of airborne allergic contact dermatitis (ACD) in the Indian subcontinent. [Extracted from the article]

Background: Because Myroxylon pereirae (MP), or balsam of Peru, is nowadays almost not used "as such," and fragrance mix 1 (FM1) apparently is more sensitive in detecting fragrance allergy, the usefulness of testing MP in baseline series was recently questioned. Objectives: Identification of the number of clinically relevant patch test reactions to MP not detected by FM1. Methods: Retrospective analysis of 12 030 patients patch tested with MP and FM1 for contact dermatitis between January 2018 and December 2019 in 13 Italian dermatology clinics. Results: Four hundred thirty‐nine patients (3.6%) had a positive patch test reaction to MP; 437 (3.6%) had a positive patch test reaction to FM1. Positive reactions to both MP and FM1 were observed in 119 subjects (1.0%), 310 (2.6%) reacted to MP only, 304 (2.5%) to FM1 only, 5 to MP and sorbitan sesquioleate (SSO), 9 to FM1 and SSO, and 5 to MP, FM1, and SSO. Single sensitizations were clinically relevant in 75.2% of cases for MP (62.9% current, 12.3% past) and 76.3% for FM1 (70.1% current, 6.2% past). Conclusions: Based on our results, MP appears to be still worth testing along with FM1 in baseline series, because it allows detection of a remarkable number of fragrance allergies, often relevant, which would be otherwise missed. [ABSTRACT FROM AUTHOR]

Alitretinoin is the only systemic agent approved to treat moderate‐severe chronic hand eczema (CHE) unresponsive to potent topical corticosteroids. No nationwide Italian data regarding real‐life efficacy, safety, and tolerability of treatment are available. The DECISA project (DErmatology Clinics in Italy: Survey on Alitretinoin) retrospectively examined data from a registry including 15 Dermatology Clinics authorized to prescription of alitretinoin for CHE patients. Disease severity was assessed at baseline, and after 3 and 6 months of treatment, using the 5‐point Physician Global Assessment (PGA) and the modified Total Lesion‐Symptoms‐Severity (mTLSS) scores. Between November 2010 and July 2018, data of 248 male and 190 female patients (mean age 49.71 ± 13.20 years) treated with alitretinoin were collected. Of them, 43.2% had irritant contact dermatitis, 22.2% allergic contact dermatitis, 18.0% atopic dermatitis, 16.7% mixed (irritant/allergic) type of eczema. At 3 months, the 420 re‐evaluated patients showed significantly reduced mTLSS and PGA (P <.0000001 vs baseline for both); PGA was clear/almost clear in 35.6% of cases. At 6 months, the 341 re‐evaluated patients showed significant (P <.0000001) improvement of mTLSS and PGA vs baseline and 3 months (PGA clear/almost clear: 41.4%). Relapses occurred in 125 patients; 58 underwent an additional course of alitretinoin, with similarly good results. No relevant safety issues were reported; 86 patients experienced adverse effects, which forced 40 to prematurely stop treatment. The DECISA project results confirm the real‐life efficacy, safety and tolerability of alitretinoin in the treatment of moderate to severe CHE refractory to standard topical therapies. [ABSTRACT FROM AUTHOR]

Paradoxically, this follow-up gives additional evidence that severe SLs-induced allergic contact dermatitis can be adequately treated with dupilumab when allergen exposure avoidance is impossible.[7] To the best of our knowledge, this is the first report of a SLs allergic patient who was patch tested both before and on dupilumab. Dupilumab treatment in two patients with severe allergic contact dermatitis caused by sesquiterpene lactones. Follow-up of patch test reactivity to sesquiterpene lactone mix in a patient successfully treated with dupilumab for severe airborne allergic contact dermatitis. [Extracted from the article]