New progress and challenges in the diagnosis and treatment of cosmetic allergy-related adverse reactions / 中华预防医学杂志

In China, the current standard for cosmetic adverse reactions related skin disease (GB/T 17149.1-1997) was jointly issued by the Ministry of Health and the State Bureau of Technical Supervision in 1997, cosmetic-allergic adverse reactions include allergic contact dermatitis and photo-allergic contact dermatitis according to this standard. The increasing use and changes in cosmetic ingredients or formula lead to a significant increase for the incidence of adverse reactions as the cosmetics industry is developing rapidly in the last 20 years. In the meantime, the clinical manifestations have become more diverse. In recent years, there have been many reports on the special manifestations for cosmetic allergy and allergen test, which provide a reference for the subsequent improvement of the diagnosis and prevention.

Unexpected patch test complication: onset of erythema multiforme-like lesions / Complicação inesperada após teste de contato: aparecimento de lesões eritema multiforme-símile

Erythema multiforme is generally associated with infections and drugs. Although less common, there are also reported cases of this disorder after patch testing. We described a 22 year-old female patient who, 24 hours after patch testing, progressed to erythematous iris-shaped plaques and papules with central crust, symmetrically distributed over her hands, arms, and back, with severe itch. The erythema multiforme-like lesions presented in the case were interpreted as a manifestation of systemic allergic contact dermatitis secondary to the exam. Allergic contact dermatitis may be manifested as an erythema multiforme in a hypersensitive person. Few cases of systemic allergic contact dermatitis after patch testing have been reported, for example, due to diethyl thiourea, some textile disperse dyes, and povidoneiodine. The development of erythema multiforme is not noted in most literature references as a complication after patch testing. Although unusual, this disorder needs to be considered as a potential adverse effect of this exam.

O eritema multiforme está associado comumente a infecções e medicamentos. Embora menos comum, também há casos relatados dessa doença após aplicação do teste de contato. Descrevemos uma paciente de 22 anos que evoluiu, em 24 horas após o teste, com placas e pápulas eritematosas, em formato de íris e crosta central, distribuídas simetricamente nas mãos, braços e costas, além de prurido intenso. As lesões eritema multiformesímile presentes no caso foram interpretadas como uma manifestação alérgica secundária ao exame. Dermatite de contato alérgica pode se manifestar como um eritema multiforme em pessoas hipersensíveis. Poucos casos de dermatite alérgica de contato sistêmica foram relatados após este exame, por exemplo, devido às seguintes substâncias: dietil tioureia, corantes dispersos têxteis e iodopovidona. O desenvolvimento do eritema multiforme não é usualmente apontado como uma complicação do teste de contato alérgico, na maioria das referências literárias. Embora incomum, o surgimento dessa desordem após este exame necessita ser considerado como um efeito adverso.