High rate of sensitization to Kathon CG, detected by patch tests in patients with suspected allergic contact dermatitis

Abstract Background: Kathon CG, a combination of methylchloroisothiazolinone and methylisothiazolinone, is widely used as preservative in cosmetics, as well in household cleaning products, industrial products such as paints and glues. It has emerged as an important sensitizing agent in allergic contact dermatitis. Objectives: This study evaluated the reactivity to this substance in patients subjected to patch tests at the Dermatology Institute in Bauru, São Paulo from 2015 to 2017 and its correlation with other preservatives, the professional activity and location of the lesions. Methods: The patients were submitted to standard series of epicutaneous tests, standardized by the Brazilian Group Studies on Contact Dermatitis. Results: Out the 267 patients tested, 192 presented positivity to at least one substance and 29 of the patients (15.10%) presented reaction to Kathon CG, with predominance of the female gender (n = 27); main professional activity associated with Kathon CG sensibilization was cleaning (17.24%), followed by aesthetic areas (13.79%) and health care (10.34%). The most prevalent sensitizations among the substances tested were nickel sulphate (56.3%), followed by cobalt chloride (23.4%), neomycin (18.2%), potassium dichromate (17.7%), thimerosal (14.5%), formaldehyde (13.2%), paraphenylenediamine (9.3%), and fragrance mix (8.3%). Study limitations: We do not have data from patients that were submitted to patch test a decade ago in order to confront to current data and establish whether or no sensitization to Kathon CG has increased. Conclusion: High positivity to Kathon CG corroborates the recent findings in the literature, suggesting more attention to concentration of this substance, used in cosmetics and products for domestic use.

Tubercúlide papulonecrótica: um relato de caso / Papulonecrotic tuberculids: a case report / Tubercúlide papulonecrótica: un informe de caso

As tubercúlides são reações de hipersensibilidade cutânea aos antígenos do Mycobacterium tuberculosis. Este é o caso de uma mulher de 45 anos que procurou a Unidade Básica de Saúde (UBS) com um quadro de eritema nodoso com mais de 10 anos de evolução, de etiologia desconhecida, e que evoluía como nódulos em pescoço e membros, que se tornavam úlceras necróticas, cicatrizavam e recidivavam periodicamente. Biópsias das lesões evidenciavam um processo inflamatório granulomatoso com extensa necrose, sugestivo de tuberculose, mas sem a presença do bacilo. Após anos sem tratamento adequado, finalmente levantou-se a hipótese de tubercúlide papulonecrótica. A paciente iniciou tratamento com o esquema básico (2RHZE/4RH) e dessensibilização vacinal, recebendo alta por cura.

Las tubercúlides son reacciones de hipersensibilidad cutánea a los antígenos del Mycobacterium tuberculosis. Este es el caso de una mujer de 45 años que buscó la Unidad Básica de Salud (UBS) con un cuadro de eritema nodoso con más de 10 años de evolución, de etiología desconocida, y que evolucionaba como nódulos en cuello y miembros, que se tornaban úlceras necróticas, cicatrizaban y recidivaban periódicamente. Las biopsias de las lesiones evidenciaban un proceso inflamatorio granulomatoso con una extensa necrosis, sugestiva de tuberculosis, pero sin la presencia del bacilo. Después de años sin tratamiento adecuado, finalmente se levantó la hipótesis de tubercúlide papulonecrótica. La paciente inició tratamiento con el esquema básico (2RHZE / 4RH) y desensibilización vacunal, recibiendo alta por curación

The tuberculids are cutaneous hypersensitivity reactions to Mycobacterium tuberculosis antigens. This is the case of a 45-year-old woman who sought the Basic Health Unit (BHU) with erythema nodosum with a 10-year evolution, of unknown etiology, that evolved as nodules in the neck and limbs, which became necrotic ulcers, cicatrized and recurred periodically. Biopsies of the lesions revealed a granulomatous inflammatory process with extensive necrosis, suggestive of tuberculosis, but without the presence of the bacillus. After years without adequate treatment, the hypothesis of papulonecrotic tuberculids finally arose. The patient started treatment with the basic regimen (2RHZE/4RH) and vaccine desensitization, receiving discharge by cure.

Sorafenib Induces Delayed-Onset Cutaneous Hypersensitivity: A Case Series

Sorafenib is an oral multikinase inhibitor with clinical activity against hepatocellular carcinoma (HCC) and renal cell carcinoma. Administration of sorafenib carries a variety of adverse cutaneous reactions. Common adverse effects induced by sorafenib include hand-foot skin reactions, facial erythema, splinter subungual hemorrhage, and alopecia. Although erythema multiforme (EM) related to sorafenib has been reported, delayed-type cutaneous hypersensitivity reactions are rare in patients treated with sorafenib and there has been no case of Stevens-Johnson syndrome (SJS) reported so far. We recently experienced 3 cases of delayed-type cutaneous hypersensitivity related to administration of sorafenib. The first case was a 47-year female had targetoid erythematous rashes on her arms 12 days after starting sorafenib for HCC. The rashes spread from the arms to the trunk rapidly except for the hands and feet, and erosive lesions developed in the oral mucosa and lips. She was diagnosed as SJS. The second case was an 81-year-old male had maculopapular eruptions with multiple targetoid lesions on the trunk, arms, and legs 10 days after starting sorafenib for his HCC. There was no evidence of mucosal involvement. He was diagnosed with EM. The last one was a 20-year-old female developed generalized maculopapular eruptions in the whole body 10 days after starting sorafenib for the treatment of HCC. All 3 patients completely recovered after discontinuation of sorafenib.

Especificidad de la prueba intradérmica de Montenegro en pacientes infectados por Trypanosoma cruzi procedentes de diferentes regiones del Perú / Specificity of the intradermal Montenegro test in patients infected by Trypanosoma cruzi from different regions of Peru

Con el objetivo de evaluar la especificidad de la leishmanina en pacientes con enfermedad de Chagas, sin antecedente clínico de leishmaniosis, actual o antigua. Una muestra de 102 personas infectadas por Trypanosoma cruzi (14 casos agudos con diagnóstico parasitológico y 88 casos crónicos a través de la demostración de anticuerpos IgG por ELISA e inmunofluorescencia indirecta (IFI) fueron evaluados con leishmanina, antígeno soluble que contenia Leishmania (Viannia) peruviana a la concentración de 25-30 ug/mL. Solo cinco personas presentaron reacción de hipersensibilidad cutánea a la aplicación del antígeno a las 48-72 h. La leishmanina evaluada fue negativa en 97 personas infectadas con T. cruzi, con lo cual se alcanzó una especificidad del 95,1%. En conclusión, la prueba intradérmica de Montenegro es una herramienta diagnóstica simple y eficaz, que además podría ser utilizada para discriminar infecciones por Leishmania o T. cruzi, en áreas geográficas del Perú donde ambos parásitos están presentes.

In order to assess the specificity of the leishmanin skin test in Chagas disease patients without clinical history of leishmaniasis, present or former. A sample of 102 persons infected with Trypanosoma cruzi (14 acute cases with parasitological diagnosis and 88 chronic cases) through the demonstration of IgG antibodies by ELISA and indirect immunofluorescence (IIF) were evaluated with leishmanin soluble antigen which contained Leishmania (Viannia) peruviana concentration of 25-30 ug/mL. Only five people showed cutaneous hypersensitivity reaction to the application of the antigen between hours 48 and 72. The Leishmanin skin test evaluated was negative in 97 people infected with T. cruzi, thus specificity of 95.1% was achieved. In conclusion, the intradermal Montenegro test is a simple and effective diagnostic tool that also could be used to discriminate infections by Leishmania or T. cruzi, in Peruvian geographic areas where both parasites are present.

Cellular immune responses induced by DNA vaccine against Chlamydia trachomatis E serotype / 中华皮肤科杂志

Objective To study cellular immune responses induced by DNA vaccine against Chlamydia trachomatis (Ct) serotype E. Methods BALB/c mice were divided into three groups to be intramuscularly immunized by blank plasmid (negative control group), DNA vaccine against Ct serotype E (vaccine group), and inactivated Ct elementary body (positive control group), respectively. Two weeks after the last immunization,delayed-type hypersensitivity (DTH) response was evaluated; MTT assay was performed to detect the proliferation of spleen lymphocytes, ELISA to measure the serum level of interferon-γin mice. Some immunized mice underwent a genital challenge with Ct elementary body followed by isolation of Ct from exfoliated epithelial cells in genital tract and pathological examination of cervical tissue from the challenged mice. Results Compared to negative control group, vaccine group and positive control group experienced a stronger DTH response.The lymphocyte stimulating index and serum level of IFN-γwere highest in the positive control group (3.81 ±0.30, 2891.7 ± 1048.8 μg/L), followed by vaccine group (2.35 ± 0.25, 593.3 ± 342.6 μg/L) and negative control group (1.48 ± 0.15, 309.2 ± 157.9 μg/L), and significant difference was observed between the three groups (P ＜ 0.05 or 0.01 ). After Ct challenge, Ct was isolated from exfoliated epithelial cells and cervical tissue was damaged in the negative control group, while in the other two groups, Ct was undetected and genital tract tissue was intact. Conclusions The DNA vaccine against Ct serotype E could induce Ct-specific cellular immune responses to some extent, and offer a protection against vaginal challenge with Ct.

A Case of Delayed Severe Hypersensitivity Reaction during Genexol-PM(R) Infusion / 결핵및호흡기질환

Although Taxol(R) is one of the most successful drugs in current cancer chemotherapy against solid tumors, a major problem is hypersensitivity reactions that arises as a consequence of activation of the complement (C) system, "C activation-related pseudo-allergy". Most severe hypersenstivity reactions occur within the first few minutes of Taxol(R) administration, usually after the first or second dose. Here we report a case of a severe hypersensitivity reaction in a 72-year-old man undergoing Genexol-PM(R) infusion. Hypotension and polymorphic pruritic skin rash appeared 2 hours after the start of Genexol-PM(R) infusion (with an appropriate premedication). Treating with methylprednisolone, epinephrine and inotropic agents, reduced the hypotension and the skin rash disappeared. We report this case with a review of the literature.

Suppression of Delayed Type Hypersensitivity Response to DNP_6OVA in Mouse by UV --Irradiated Urocanic Acid / 中华皮肤科杂志

In order to investigate the effects of cis-UCA on cell -mediated immunity, we established a murine model of DTH response to DNP6OVA which is indicated by the increasing in the ear thickness of the mouse after resensitization, compared with those of the mouse injected with 200 g cis - UCA and trans -UCA intraperitoneally (i. p. ). The average of the increasing in ear thickness of each group was 9. 1 1. 13 10-2 mm (n=8, the number of ears) for the group administrated with cis-UCA; 17. 45 0. 88 10 - 2 mm (n= 8) for the group administrated with trans-UCA ; 16. 43 + 1. 83 10 - 2 mm(n= 7) for control group. It is suggested that there are immunosuppression of DTH response to DNP6OVA in mouse administrated with ets-UCA and no effecs of trans-UCA on this response.

Adhesion of mice lymphocytes to extracellular matrix in delayed-type hypersensitivity / 中国病理生理杂志

AIM: To investigate the adhesion between lymphocytes and extracellular matrix (ECM) in delayed-type hypersensitivity (DTH) in mice as well as the regulatory effect of several cytokines on it. METHODS: DTH was induced by the application of picryl chloride (PCl) to mice that had been sensitized twice by PCl, followed by isolating the spleen lymphocytes at different times. The adhesion of spleen lymphocytes to fibronectin or typeⅠcollagen were examined. In some cases, spleen lymphocytes obtained at 18 h were incubated with various concentrations of IL-2, IFN-?, and TNF-? for 4 h at 37℃ before the adhesion assay. T cells purified from the spleen lymphocytes were also used for the assay in the presence of TNF-?. RESULTS: The adhesion of spleen lymphocytes to ECM began to increase at 6 h after PCl challenge, reached a peak at 18 h, then decreased and returned to normal level at 36 h. IL-2 significantly increased the adhesion of lymphocytes to ECM at a dose of 1?10 5 U/L and TNF-? enhanced the adhesion in a concentration-dependent manner. The combined use of TNF-? and IFN-? showed a significantly enhanced adhesion. TNF-? was more effective to accelerate the adhesion of spleen T Cells than that of total spleen lymphocytes. CONCLUSION: In the process of DTH, the adhesion of lymphocytes to ECM was regulated by several cytokines and associated with the development of inflammation.

Suppressive effect of Chuankezhi (CKZ) injection on murineal lergic contact dermatitis / 中国病理生理杂志

AIM: To study the suppressive effect of c hu ankezhi (CKZ) injection, a Chinese medicine, on murine allergic contact dermatit is (type IV hypersensitivity). METHODS: Mice were divided into 6 groups according to different medicine treatments: CKZ high, middle, low dose ( CKZⅠ,Ⅱ,Ⅲ) groups, dexamethasone(DEX), benadryl and saline groups. Murine alle rgic contact dermatitis was induced by intraperitoneal injection of 2, 4-dinitro fluorobenzene. Different medicines were administrated at 2 h before sensitizatio n on day 0 and day 1, day 2, 2 h before elicitation and 6 h after on day 5. The six experimental groups were compared according to left ear thickness difference (S1), left ear weight difference (S2), body weight difference (S3) and dermal i nflammatory infiltration cell number. RESULTS: Compared with saline group, the left ear swelling and d ermal inflammatory infiltration cell number were significantly reduced in CKZⅠ, Ⅱ,Ⅲ and DEX groups (P