ABSTRACT
BACKGROUND: An aqueous antiseptic containing "chlorhexidine digluconate/benzalkonium chloride/benzyl alcohol" (CBB) is widely used in France. The only previous documented study dealing with allergic contact dermatitis (ACD) to this antiseptic is one small case series in children. The French Vigilance Network for Dermatology and Allergy (REVIDAL-GERDA) has collected many cases in the last few years. OBJECTIVES: To evaluate the clinical and sensitization profiles of patients diagnosed with ACD to CBB. METHODS: We performed a retrospective study of patients with contact dermatitis to CBB and positive tests to CBB and/or at least one of its components. All patients had to be tested with all components of CBB. RESULTS: A total of 102 patients (71 adults and 31 children) were included. The lesions were extensive in 63% of patients and 55% had delayed time to diagnosis. CBB patch tests were positive in 93.8% of cases. The allergen was identified in 97% of patients, mainly benzyl alcohol in adults (81.7%) and chlorhexidine digluconate in children (54.8%). About 32.4% of the patients were sensitized to several components. CONCLUSION: CBB is a cause of ACD at all ages. The components of the antiseptic should be tested. The sensitization profile seems to be different between adults and children.
Subject(s)
Anti-Infective Agents, Local , Dermatitis, Allergic Contact , Adult , Allergens , Anti-Infective Agents, Local/adverse effects , Benzalkonium Compounds , Benzyl Alcohols , Child , Chlorhexidine/adverse effects , Chlorhexidine/analogs & derivatives , Chlorides , Dermatitis, Allergic Contact/diagnosis , Dermatitis, Allergic Contact/etiology , Humans , Patch Tests/adverse effects , Retrospective StudiesABSTRACT
Cutaneous lymphoid hyperplasia (pseudolymphoma) on tattoo is rare. The diagnosis is histological. We report a case of cutaneous lymphoid hyperplasia within the red ink of a tattoo found on a 35-year-old man presenting multiple infiltrated nodules confined to the red areas of his tattoo, which he had done 2 months ago. The pathological examination showed a diffuse lympho-histiocytic dermo-hypodermal infiltrate, associated with a lichenoid reaction. Immunohistochemistry displayed T-cell infiltration (CD3+, CD5+, CD8+). The treatment is difficult, knowing that the spontaneous regression seems possible, and the progression into a lymphoma is exceptional in the case of a chronic evolution over a number of years.
Subject(s)
Coloring Agents/adverse effects , Lichenoid Eruptions/chemically induced , Pseudolymphoma/chemically induced , Tattooing , Adrenal Cortex Hormones/therapeutic use , Adult , Biopsy , Diagnosis, Differential , Drug Eruptions/diagnosis , Drug Eruptions/etiology , Drug Eruptions/pathology , Gene Rearrangement, T-Lymphocyte , Humans , Hydroxychloroquine/therapeutic use , Lichenoid Eruptions/diagnosis , Lichenoid Eruptions/drug therapy , Lichenoid Eruptions/pathology , Lymphoma, Non-Hodgkin/diagnosis , Male , Pseudolymphoma/diagnosis , Pseudolymphoma/drug therapy , Pseudolymphoma/pathology , Skin Neoplasms/diagnosis , T-Lymphocytes/pathology , Treatment FailureABSTRACT
We describe a female patient with an acute purpuric and bullous eruption mainly affecting the lower aspect of the legs. Skin biopsy specimens demonstrated microvascular occlusions with fibrin thrombi but no dermal inflammation. Intermediate hyperhomocysteinemia and transient antiphospholipid antibodies were evidenced as factors of thrombophilia. The responsibility of the latter in the onset of the cutaneous lesions is discussed.
