ABSTRACT
No disponible
Subject(s)
Adolescent , Female , Humans , Male , Pharmacovigilance , Pediatrics/education , Pediatrics/methods , Behind-the-Counter Drugs/therapeutic use , Pharmaceutical Preparations/standards , Drug Monitoring , Spain/epidemiology , Drugs from the Specialized Component of Pharmaceutical Care , Legislation, Drug/standardsABSTRACT
BACKGROUND: Cutaneous adverse drug reactions (CADRs) due to bisphosphonates (BPs) have been scarcely described in the literature. OBJECTIVE: To discuss the diagnostic value and limitations of cutaneous provocation tests with BPs. METHODS: A descriptive case series study with a control group of CADRs due to BPs studied using patch testing from 2005 to 2010 is presented. RESULTS: Patient 1 showed a positive D4++ with alendronate at 1% in petrolatum and D4+++ with alendronate at 1 and 0.1% in water. Patient 2 showed a positive intradermal test D3++ with alendronate at 0.1% in water. Patient 3 showed a positive patch test D4+ with ibandronate at 1% in petrolatum and D4++ with ibandronate at 1% in water, and a positive intradermal test D3+++ with ibandronate at 0.1% in water. CONCLUSION: Establishing a correct interpretation of a patch test reaction is difficult based just on cutaneous test results. Too high concentrations of the drug can cause irritation and too low concentrations can be responsible of false-negative test reactions.
Subject(s)
Diphosphonates/adverse effects , Drug Eruptions/diagnosis , Drug Eruptions/etiology , Patch Tests/methods , Aged , Alendronate/adverse effects , Alendronate/therapeutic use , Case-Control Studies , Diphosphonates/therapeutic use , Female , Humans , Ibandronic Acid , Male , Reference Values , Retrospective Studies , Sampling Studies , Sensitivity and Specificity , Severity of Illness IndexABSTRACT
BACKGROUND: Bromo-3-chloro-5,5-dimethylhydantoin (BCDMH) is a chemical used as a disinfectant for recreational water. BCDMH was described as being responsible for an epidemic of irritant contact dermatitis in the UK (1983), and its sensitizing capacity was also discussed. OBJECTIVES: The aim of this study was to assess whether BCDMH used to disinfect swimming pools and spas can cause allergic contact dermatitis among its users. METHODS: Ten patients suffering from dermatitis associated with using swimming pools disinfected with BCDMH and 40 controls were studied. Several dilutions of BCDMH, 10% to 1 ppm, were patch tested. RESULTS: All 10 patients studied showed a positive patch test reaction to BCDMH 1% in petrolatum. At least one case showed occupational relevance, with a positive reaction even at 1 ppm. CONCLUSION: On the basis of the clinical findings, the positive patch test reactions to BCDMH, and the negative patch test reactions in controls, the suggested diagnosis was allergic contact dermatitis caused by BCDMH used as a disinfectant in the swimming pool water. Contact allergy should be taken into consideration when patients suffer from swimming pool-associated itchy dermatitis.
Subject(s)
Dermatitis, Allergic Contact/etiology , Disinfectants/adverse effects , Hydantoins/adverse effects , Adult , Aged , Female , Humans , Male , Middle Aged , Patch Tests , Swimming PoolsABSTRACT
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