Reações aos diferentes pigmentos de tatuagens: relato de dois casos / Reactions to the different pigments in tattoos: a report of two cases

A tatuagem é definida como deposição de pigmento intencional ou acidental na pele. Os pigmentos têm sido associados a diversas dermatoses, como a dermatite de contato alérgica, a dermatite liquenoide e as reações fotoinduzidas, granulomatosas, sarcoídeas e pseudolinfomatosas. Enfocam-se os diversos tipos de reações aos pigmentos e a importância de reconhecê-los clinicamente. São relatados dois casos: um de dermatite liquenoide sobre o pigmento vermelho e outro de pseudolinfoma sobre os pigmentos vermelho e lilás e de reação fotoinduzida sobre o amarelo. A remoção geralmente requer múltiplos tratamentos, e a maioria não retira as cores completamente.

Tattoos are defined as the intentional or accidental deposit of pigment into the skin. These pigments have been associated with various dermatoses such as allergic contact dermatitis, lichenoid dermatitis, photoinduced reactions, and granulomatous, sarcoid and pseudolymphomatous reactions. The objective of this report was to describe the various types of reactions to pigments and the importance of recognizing them clinically. Two cases are reported: one of lichenoid dermatitis resulting from a reaction to the red pigment of a tattoo and the other of a pseudolymphoma resulting from a reaction to red and lilac pigments and a photo-induced reaction to a yellow pigment. Removal generally requires multiple forms of treatment, most of which fail to remove the colors completely.

Phototoxicity of new psoralen-containing gels and creams versus bath PUVA.

BACKGROUND: Bath-PUVA-photochemotherapy has become a useful alternative to oral PUVA therapy due to a number of advantages over systemic PUVA, for example, no ophthalmologic risk and nausea, and a lower cumulative UVA doses. However, its major disadvantage is the logistical requirement for bath tubs in practice and some patients feel uncomfortable to share the same bath with others. Topical psoralen contained preparation may be a good candidate for safe, convenient, and useful regimen in the topical PUVA therapy. OBJECTIVES: The purpose of the present study was to investigate the intensity of the phototoxic response of 8-MOP bath solution to different concentrations of preparations of 8-MOP gels and creams. MATERIAL AND METHOD: Following informed consent, the test bath solution (0.375%), gels (0.0025% to 0.010%) and creams (0.0025% to 0.010%) were applied to the normal-appearing skin of the upper back of 23 volunteers who had no history of photosensitivity. The escalating UVA doses (0.25 to 7.0 J/cm2) were given 15 minutes after application of test substances. Seventy-two hours after UVA exposure minimal phototoxic doses (MPD) were defined visually and the intensity of the erythema response was also assessed by using a narrowband spectrophotometer The MPD and the dose-response curves for erythema response of the gels and creams were compared with those of the bath. RESULTS: There were no significant differences between the overall mean MPD of tested gels and that of bath solution (p > 0.05). On the contrary, the cream preparations induced phototoxic response (MPDs) to a lesser degree than bath solution and gels (p < 0.05). When comparing the slope of the dose-response curve for erythema of 0.0025% and 0.0100% gel to that of the bath solution, the correlation is very strong (R2 = 0.987 and 0.936, respectively, p < 0.0001). CONCLUSION: The present study shows that the threshold of phototoxic response of 0.0025% 8-MOP gel indicated by MPD is well correlated with those of the bath solution. The slope of the dose-response curve for erythema of this preparation also significantly corresponded to that of the bath solution. Thus, the penetration and drug delivery of 0.0025% 8-methoxypsoralen gel may be similar to 8-methoxypsoralen bath solution. This preparation may be a good candidate for a useful therapeutic modality for topical PUVA therapy, and further clinical trial should be performed.

Fitodermatitis: aspectos epidemiológicos en Temuco-Chile / Phytophotodermatitis: epidemiological aspects in Temuco-Chile

La fitodermatitis provocadas por ruda (Ruta graveolens) son un motivo de consulta frecuente para los dermatólogos que ejercen en Temuco. Estas consultas predominan durante el período estival y sus manifestaciones clínicas pueden ser variadas y en algunas circunstancias presentarse de un modo severo. Se estudian 107 pacientes con diagnóstico de fitodermatitis que asisten a la consulta privada del autor desde mayo de 1990 a abril del 2003. En más de la mitad de los casos la planta involucrada era la ruda. La mayoría de los pacientes consultaron durante los meses de primavera y verano. La patología afecta a cualquier edad, incluyendo los lactantes, aunque predomina en personas de la segunda década de la vida. Este estudio muestra una alta incidencia de fitofotodermatosis por ruda en la IX Región de Chile, a diferencia de la literatura internacional, donde los casos publicados son escasos. Esta conclusión puede ser relevante desde el punto de vista epidemiológico para la región y avala la importancia de advertir a la población sobre el cuidado que se debe tener en la manipulación de la planta.

Phototoxic reaction due to clarithromycin.

An unusual case of phototoxic reaction caused by clarithromycin is being presented here as it is not reported in medical literature.

Relato de caso: dermatite de contato causada por arruda (Ruta graveolens L.) / Case report: contact dermatitis caused by to (Ruta graveolens L.)

Um homem de 26 anos desenvolveu uma reaçäo fototóxica em suas pernaas, após utilizar as partes aéreas frescas da arruda (Ruta graveolens L.), para repelir pernilongos, depois de se expor ao sol. A hipersensibilidade foi causada devido às furanocumarinas (psoralenos) presentes no óleo essencial da arruda.