Estudio del efecto citotóxico e irritativo de jabones para la limpieza cutánea / Study of the cytotoxic and irritant effects of skin cleansing soaps

Resumen Introducción: El jabón para el aseo cutáneo es de empleo común entre la población, sin embargo, es posible que cause daño a las células de la piel y modifique la barrera cutánea. Objetivo: Determinar el efecto citotóxico de los jabones en queratinocitos cultivados in vitro y correlacionarlo con la irritación clínica. Método: Se realizó una encuesta para conocer los jabones comerciales más utilizados y su cantidad; posteriormente, se evaluó su citotoxicidad en cultivos de queratinocitos humanos mediante el método de resazurina. Los jabones con mayor y menor citotoxicidad se aplicaron en piel de voluntarios sanos para evaluar su efecto en la barrera cutánea mediante ensayos de colorimetría y pérdida transepidérmica de agua. Resultados: De los jabones analizados, 37 % demostró ser tóxico para los queratinocitos in vitro. El jabón con mayor toxicidad indujo el mayor índice de eritema y pérdida transepidérmica de agua, en comparación con el jabón menos tóxico y el vehículo empleado como solución control. Conclusión: Los jabones comercializados para el aseo cutáneo pueden incluir ingredientes químicos que dañan los queratinocitos humanos y causan irritación subclínica de la barrera cutánea. Su utilización puede agravar dermatosis preexistentes, generar dermatitis xerósica o de contacto irritativa y causar atrofia y dermatoporosis.

Abstract Introduction: The use of soap for skin cleansing is common among the population. However, it is possible that it causes damage to skin cells and disrupts the skin barrier. Objective: To determine the cytotoxic effect of soaps on in vitro-cultured keratinocytes and to correlate it with clinical irritation. Method: A survey was conducted to find out the most widely used commercial soaps and their number. Subsequently, their cytotoxicity was evaluated in human keratinocyte cultures using the resazurin assay. The soaps with the highest and lowest cytotoxicity were applied to the skin of healthy volunteers to assess their effect on the skin barrier using colorimetry and transepidermal water loss (TEWL) assays. Results: Of the analyzed soaps, 37 % were shown to be toxic to keratinocytes in vitro. The soap with the highest toxicity induced the highest rate of erythema and TEWL, in comparison with the least toxic soap and the vehicle used as the control solution. Conclusion: Soaps marketed for skin cleansing can contain chemical ingredients that damage human keratinocytes and cause skin barrier subclinical irritation. Their use can worsen preexisting dermatoses, generate xerotic or irritant contact dermatitis, and cause atrophy and dermatoporosis.

Sweet syndrome-like cutaneous drug reaction

Abstract: Cutaneous drug reactions are adverse reactions to medications that may present with different clinical features, ranging from localized to generalized lesions. In this report we describe a case of an unusual drug reaction, resembling the morphology of Sweet syndrome lesions. The patient had a psychiatric illness and was using thioridazine hydrochloride for one year. He developed infiltrated and grouped erythematous lesions on the elbows and knees three days after commencing multiple drugs (promethazine, haloperidol, mirtazapine and levomepromazine). After suspension of these four drugs and after the use of glucocorticoids, the patient had significant clinical improvement.

Interferon-gamma-induced local leukocytoclastic vasculitis at the subcutaneous injection site

Abstract Cutaneous reactions associated with interferons (IFNs) treatment are either localized or generalized. The most common presentation of localized reactions at IFNs injection site is usually an erythematous patch or plaque. Local leukocytoclastic vasculitis presenting with cutaneous necrosis is extremely rare. We report a 19-year-old man with hepatitis B who had local leukocytoclastic vasculitis induced by interferon-gama injection at the injection site. After changing the injection sites and using the combined treatment of prednisone and colchicine, the previous lesion healed and no other cutaneous lesion occurred. We also made a mini review of such cases.

Persistent docetaxel-induced supravenous erythematous eruption

AbstractTaxanes are drugs used to treat many types of cancer, including breast and lung cancer. The most common side effects of these drugs are neutropenia and mucositis. Signs of skin toxicity are observed in about 65% of cases and include alopecia, hypersensitivity reactions, persistent supravenous erythematous eruption, nail changes, scleroderma reactions and others. We report two cases of skin reaction to docetaxel and warn that it is not necessary to interrupt the treatment in these cases.

Possibly drug-induced palpable migratory arciform erythema

Palpable migratory arciform erythema is an entity of unknown etiology, with few published cases in the literature. The clinical and histopathological features of this disease are difficult to be distinguished from those of Jessner’s lymphocytic infiltration of the skin, lupus erythematous tumidus and the deep erythema annulare centrifugum. We describe here the first two Brazilian cases of palpable migratory arciform erythema. The patients presented with infiltrated annular plaques and erythematous arcs without scales. These showed centrifugal growth before disappearing without scarring or residual lesions after a few days. They had a chronic course with repeated episodes for years. In addition, these cases provide evidence of a drug-induced etiology.

Síndrome de DRESS: eritema cutáneo, fiebre y hepatitis asociado a lamotrigina: reporte de dos casos y revisión de la literatura / DRESS syndrome: skin rash, fever and acute hepatitis associated to lamotrigine: report of two cases and review of the literature

DRESS syndrome is an infrequent adverse drug reaction but in some cases may be life-threatening. It is characterized by cutaneous rash, systemic symptoms and eosinophilia. It is usually caused by aromatic anticonvulsants, sulfonamides and some antiviral drugs, among others. In this article we present two cases of drug induced hypersensitivity syndrome with rash, systemic symptoms (DRESS) associated to lamotrigine therapy with hepatic involvement and a review of the literature. The first case is a 78 year-old woman, presenting with myalgia, fever, abdominal pain and skin rash on her face and extremities. Labora¬tory tests revealed alteration of hepatic profile with hepatocellular pattern. After ruling out other causes, she recognized recent use of lamotrigine. The drug was withdrawn and she had a favourable evolution. The second case is a 30 year-old woman being treated for depression who presented with rash, adenopathies, fever and alteration of hepatic profile twenty four days after starting lamotrigine. Infectious causes were ruled out and she had a good response to corticosteroid treatment.

El síndrome de DRESS es una reacción adversa a medicamentos, poco frecuente pero potencialmente letal. Se caracteriza por eritema cutáneo, síntomas sistémicos y eosinofilia. Suele ser producido por los anticonvulsivantes aromáticos, sulfonamidas y algunos fármacos antivirales, entre otros. En este artículo presentamos dos casos de DRESS secundario a lamotrigina con compromiso hepático y revisión de la literatura. El primero de ellos, una mujer de 78 años, consulta por mialgias, fiebre, dolor abdominal y eritema maculopapular en cara y extremidades. Los exámenes de laboratorio revelaron alteración de pruebas de función hepática con patrón hepatocelular. Luego de descartar otras causas, la paciente reconoció uso reciente de lamotrigina. Se suspendió la droga y evolucionó favorablemente. El segundo caso es una mujer de 30 años en tratamiento por trastorno depresivo quien, veinticuatro días post-inicio de lamotrigina, comienza con eritema, adenopatías, fiebre y alteración de pruebas de función hepática, excluyéndose etiologías infecciosas; se inicia tratamiento corticoesteroidal con buena respuesta.

Terapia fotodinámica en pacientes con acné inflamatorio facial leve a moderadamente severo: estudio abierto en 30 pacientes chilenos / Photodynamic therapy in patients with inflammatory mild to moderate-severe acne

Introducción: La terapia fotodinámica es un procedimiento útil en el manejo del acné inflamatorio. Diversos esquemas terapéuticos se han usado. Objetivo: Demostrar eficacia y tolerancia de una sesión de TFD-MAL en el manejo del acné inflamatorio. Métodos: Una sesión de TFD-MAL y luz roja por cuatro minutos e incubación de tres horas fue realizada en 30 pacientes portadores de acné inflamatorio, leve, o moderadamente severo. Resultados: Resolución clínica de las lesiones o las seis semanas fue considerada buena (mejoría > 50%) en un 70% según evaluación médica y en un 66,6% según evaluación por el paciente. Se consignaron efectos adversos de eritema, descamación y rezumación leves dentro de las primeras 48 horas de la terapia en una gran proporción de pacientes. No se presentaron efectos adversos residuales o la semana 6. La encuesta de satisfacción relacionada a tolerancia y rapidez de acción demostró aceptación de la terapia en un 56% de los casos. Conclusión: La TFD-MAL con una sesión, incubación de tres horas y cuatro minutos de iluminación con luz roja constituye una buena alternativa terapéutica para el manejo del acné inflamatorio recalcitrante o en pacientes con contraindicaciones a terapias habituales.

Introduction: Photodynamic therapy is useful in the treatment of inflammatory acne. Several modalities have been used. Objective: To prove efficacy and tolerance of one session of PDT-MAL in the management of inflammatory acne. Methods: One session of PDT-MAL, for 4 minutes of red light, with an incubation period of 3 hours was performed in 30 patients with inflammatory mild to moderate-severe acne. Results: Clinical resolution at 6 weeks was considered good (resolution > 50%) in 70% of the patients under dermatologist evaluation and in 66.6% under patient evaluation. Adverse effects such as erythema, desquamation, oozoning were light and present in the first 48 hrs in o great proportion of cases. No adverse effects were seen at week 6. Satisfaction interview related to tolerance and speed of action showed good therapy acceptance in 56% of the patients. Conclusion: One session of PD T-MAL after 3 hours of incubation period and 4 minutes of red light is o good therapeutic option for the management of resistant inflammatory acne or to be used in patients with contraindication of common therapies for acne.

Reação orbitopalpebral em resposta a injeção subtenoniana profunda de triancinolona: relato de caso / Orbito-palpebral reaction after subtenonian injection of triamcinolone: case report

Relata-se o caso de reação local após injeção subtenoniana profunda de1 ml de suspensão contendo 40 mg de triancinolona, realizada em uma criança de seis anos de idade, portadora de uveíte intermediária. Observou-se edema e eritema das pálpebras superior e inferior, aproximadamente 30 minutos após a injeção. Houve recuperação completa, sem complicações, ao longo das 24 a 48 horas seguintes.

A case of a local reaction related to a subtenonian deep injection of triamcinolone is reported. The patient was a 6 year old child, with intermediate uveitis. Intense edema and erythema of the eyelids appeared approximately 30 minutes after the injection. Complete resolution occurred among 24 to 48 hours after the injection.

Anti-inflammatory activities of methanol extracts from various seaweed species.

Thirty-seven species of common seaweeds from the coast of Korea were screened for anti-inflammatory activity Methanol extracts of the seaweeds were tested against mouse ear edema and erythema induced by phorbol myristate acetate. At 40 mg ml(-1) of extract, edema was strongly suppressed by the seaweeds Undaria pinnatifida and Ulva linza, with relative inhibition of 85 and 84%, respectively These two seaweeds also showed the greatest suppression of erythema, with inhibition of 78 and 70%, respectively IC50 values of U. pinnatifida were 10, 15, and 18 mg ml(-1) when inflammation symptoms of edema, erythema, and blood flow, respectively were measured. The IC50 of U. linza was 20, 26, and 31 mg ml(-1) when edema, erythema, and blood flow, respectively, were measured. A linear correlation among inhibition rates of edema, erythema, and blood flow was observed with high confidence.

Transmission electron microscopy of the preclinical phase of experimental phytophotodermatitis

OBJECTIVE: To examine the epidermis in induced phytophotodermatitis using transmission electron microscopy in order to detect histologic changes even before lesions are visible by light microscopy. INTRODUCTION: In the first six hours after the experimental induction of phytophotodermatitis, no changes are detectable by light microscopy. Only after 24 hours can keratinocyte necrosis and epidermal vacuolization be detected histologically, and blisters form by 48 hours. METHODS: The dorsum of four adult rats (Rattus norvegicus) was manually epilated. After painting the right half of the rat with the peel juice of Tahiti lemon, they were exposed to sunlight for eight minutes under general anesthesia. The left side was used as the control and exposed to sunlight only. Biopsies were performed immediately after photoinduction and one and two hours later, and the tissue was analyzed by transmission electron microscopy. RESULTS: No histological changes were seen on the control side. Immediately after induction, vacuolization in keratinocytes was observed. After one hour, desmosomal changes were also observed in addition to vacuolization. Keratin filaments were not attached to the desmosomal plaque. Free desmosomes and membrane ruptures were also seen. At two hours after induction, similar changes were found, and granular degeneration of keratin was also observed. DISCUSSION: The interaction of sunlight and psoralens generates a photoproduct that damages keratinocyte proteins, leading to keratinocyte necrosis and blister formation. CONCLUSIONS: Transmission electron microscopy can detect vacuolization, lesions of the membrane, and desmosomes in the first two hours after experimental induction of phytophotodermatitis.