ABSTRACT
BACKGROUND: The "gold standard" for diagnosing allergic contact dermatitis is patch testing. Previous studies have not adequately addressed the validity and usefulness of the North American Contact Dermatitis Group (NACDG) Standard 65-allergen series alone as a screening tool in the evaluation of contact dermatitis. OBJECTIVE: The purpose of this study is to examine the usefulness of the NACDG series of 65 allergens as an exclusive screening method in the diagnosis of contact allergy. METHODS: A retrospective chart review of 794 patients referred for patch testing with the NACDG Screening Series with or without additional allergens was performed to determine the number of positive patch-test results. The study groups were analyzed to identify whether the positive reactions were to allergens in the NACDG Standard Series or to allergens in the supplementary group. RESULTS: Of the 794 patients patch-tested between July 1, 2004, and July 1, 2006, 590 (74.31%) had a positive reaction to either an NACDG patch-tested allergen or a supplemental allergen; 386 (65.42%) patients testing positive for an allergen were positive to an NACDG allergen only, and 534 (90.51%) of the total positive reactors were positive for at least one NACDG test allergen. CONCLUSION: As a screening tool, the NACDG Standard Series is substantially more efficacious than are more limited standard series when used exclusively in the evaluation of patients with allergic contact dermatitis. More extensive testing, including testing with suspected supplementary allergens determined by thorough history and physical examination, can improve upon the NACDG series as a means to investigate the full causes of contact dermatitis in any individual patient.
Subject(s)
Allergens/adverse effects , Dermatitis, Allergic Contact/diagnosis , Patch Tests/methods , Adult , Dermatitis, Allergic Contact/etiology , Female , Humans , Male , Retrospective Studies , Sensitivity and SpecificityABSTRACT
A 59-year-old woman with arthritis presented to the Skin Institute of New York with a 2-month history of asymptomatic, small, skin-colored papules that erupted symmetrically on the chest, back, and proximal extremities. Histopathologic examination of a biopsy specimen showed findings of interstitial granulomatous dermatitis. Clinical correlation suggested a diagnosis of interstitial granulomatous dermatitis with arthritis. No change in the lesions resulted from application of clobetasol 0.05 percent ointment to the affected areas.
Subject(s)
Dermatitis/pathology , Granuloma/pathology , Skin/pathology , Biopsy , Diagnosis, Differential , Female , Humans , Middle AgedABSTRACT
Contact allergic reactions to topical corticosteroids are common. Cutaneous hypersensitivity reactions to systemically administered corticosteroids might occur though less frequently. The purpose of this literature review is to examine reported cases of cutaneous reactions to systemically administered corticosteroids. The data are presented considering route of administration, type of drug, type of reaction, and testing results. Corticosteroid classifications, cross-reactions, and allergy testing methods are also discussed.
São comuns as reações alérgicas de contato a corticóides tópicos. Podem ocorrer reações cutâneas de hipersensibilidade a corticóides sistêmicos, mas são menos frequentes. O objetivo desta revisão da literatura é examinar relatos de casos de reações cutâneas a corticóides sistêmicos. Os dados apresentados levam em consideração a via de administração, tipo de medicamento, tipo de reação e resultados dos testes. A revisão discute também sobre classificações de corticóides, reações cruzadas e testes alérgicos.
Subject(s)
Conjunctivitis, Bacterial/drug therapy , Dermatitis, Allergic Contact/etiology , Drug Eruptions/etiology , Eyelid Diseases/chemically induced , Tobramycin/adverse effects , Aged , Aged, 80 and over , Conjunctivitis, Bacterial/diagnosis , Dermatitis, Allergic Contact/physiopathology , Drug Eruptions/physiopathology , Eyelid Diseases/physiopathology , Female , Follow-Up Studies , Humans , Ophthalmic Solutions/adverse effects , Patch Tests , Risk Assessment , Tobramycin/therapeutic useABSTRACT
Contact allergies to foods, spices, and food additives can occur to individuals in the workplace or at home. Seven different reaction types have been described. These include irritant contact dermatitis, allergic contact dermatitis, contact urticaria, protein contact dermatitis, phototoxic contact dermatitis, photo-allergic contact dermatitis, and systemic contact dermatitis. The causes of each of these are reviewed and an approach to the diagnosis and management of contact allergy to foods, spices, and food additives is formulated.
Subject(s)
Dermatitis, Allergic Contact/epidemiology , Dermatitis, Allergic Contact/etiology , Food Additives/adverse effects , Food Hypersensitivity/diagnosis , Food Hypersensitivity/epidemiology , Adolescent , Adult , Age Distribution , Child , Dermatitis, Allergic Contact/prevention & control , Female , Food Hypersensitivity/prevention & control , Humans , Incidence , Male , Middle Aged , New York City/epidemiology , Patch Tests , Primary Prevention , Prognosis , Risk Assessment , Severity of Illness Index , Sex DistributionSubject(s)
Dermatitis, Allergic Contact/etiology , Fingers , Hand Dermatoses/etiology , Music , Adult , Female , Humans , Nickel/adverse effects , Resins, Plant/adverse effects , WoodABSTRACT
Although allergic contact dermatitis to topical preparations of doxepin has been published, systemic contact dermatitis from oral doxepin is more of a theoretical consideration and is rarely reported. We report a case of a patient with contact allergy to doxepin hydrochloride 5% cream who developed a systemic contact dermatitis to oral doxepin.
Subject(s)
Anti-Anxiety Agents/adverse effects , Dermatitis, Allergic Contact/etiology , Doxepin/adverse effects , Administration, Oral , Aged , Anti-Anxiety Agents/administration & dosage , Dermatitis, Allergic Contact/physiopathology , Doxepin/administration & dosage , Humans , MaleABSTRACT
Although phototoxic reactions to plants are common, photoallergic contact dermatitis to plants and plant products rarely occurs. Our objective was to review the importance of including diallyl disulfide in the evaluation of patients with suspected photosensitivity. Phototests for ultraviolet B, ultraviolet A, and visible light as well as patch tests and photopatch tests for 49 allergens from the New York University Skin and Cancer Unit Photopatch Test Series were performed. Three patients had positive photopatch-test results to diallyl disulfide, which is the allergen in garlic. The authors conclude that although photocontact allergy to diallyl disulfide is rare, this allergen should be included in photopatch-test series.
Subject(s)
Allergens/adverse effects , Allyl Compounds/adverse effects , Dermatitis, Occupational/diagnosis , Dermatitis, Photoallergic/diagnosis , Disulfides/adverse effects , Facial Dermatoses/diagnosis , Garlic , Adult , Dermatitis, Occupational/etiology , Dermatitis, Occupational/pathology , Dermatitis, Photoallergic/etiology , Dermatitis, Photoallergic/pathology , Diagnosis, Differential , Facial Dermatoses/chemically induced , Facial Dermatoses/pathology , Humans , Male , Middle Aged , Patch Tests , Ultraviolet Rays , WoodABSTRACT
BACKGROUND: Temporary black henna tattoos are very popular as body adornment. Although contact allergy to natural henna is unusual, the inclusion of hair dye, p-phenylenediamine (PPD), increases the risk of contact sensitization. OBJECTIVE: This study was performed to identify the presence and concentration of PPD in a black henna tattoo mixture to which our patient developed contact allergy. METHODS: The presence of PPD in a black henna tattoo mixture, various samples of commercially available henna powders, and several hair dye products was qualitatively and quantitatively detected using high performance liquid chromatography (HPLC). RESULTS: This study demonstrated that PPD was present in the black henna tattoo mixture at a concentration of 15.7%, which is significantly higher than commercial hair dye preparations. CONCLUSION: The presence of PPD in black henna tattoo mixtures in high concentration poses a health hazard and a risk of allergic contact sensitization with potential long-term consequences.
