Contact allergy in the population of patients with chronic inflammatory dermatoses and contact hypersensitivity to corticosteroids.

INTRODUCTION: Clinical studies indicate that contact allergy to glucocorticosteroids (GCS) is not rare and has been increasingly reported over the past decade. Among the risk factors for developing contact hypersensitivity to topical corticosteroids, chronic inflammatory skin diseases and polyvalent contact allergy seem to be most important. AIM: To present the structure of contact allergy in the population of patients with chronic inflammatory dermatoses (CID) and contact hypersensitivity to corticosteroids. MATERIAL AND METHODS: Twenty-seven patients with contact allergy to GCS and chronic inflammatory dermatoses were patch tested with 28 European Baseline Series allergens and 8 corticosteroid allergens. This study group consisted of 5 patients with atopic dermatitis (AD), 15 patients with contact eczema (CE) and 7 with chronic leg eczema (CLE). Nineteen (70.4%) patients were females and 8 (29.6%) were males. RESULTS: In the study group, the most sensitizing non-steroidal allergens were nickel sulfate (51.8%), cobalt chloride (33.3%) and balsam of Peru (29.6%). The most sensitizing corticosteroid allergens were budesonide (77.8%), betamethasone valerate and clobetasol propionate (55.5% each). A total of 77.8% of patients allergic to GCS also showed sensitivity to at least one non-steroidal allergen from the European Baseline Series. CONCLUSIONS: The most important risk factors for developing contact allergy to corticosteroids appear to be chronic inflammatory dermatoses, long disease duration, extended on-and-off topical corticosteroid use, patients presenting two or more positive patch test results and polyvalent contact allergy to metal salts and to other non-steroidal haptens.

Contact Hypersensitivity to European Baseline Series and Corticosteroid Series Haptens in a Population of Adult Patients with Contact Eczema.

Contact eczema (CE) is one of the most common skin diseases and is regarded as a reaction pattern. However, the skin can react in the same way to different stimuli, some of which may act together. The golden standard in the diagnosis of allergic contact dermatitis (ACD) is the patch test. Contact allergy to topical corticosteroids is known to be gradually rising, and this represents a significant problem in the treatment of contact eczema. The aim of this study was to evaluate the prevalence of contact allergy to European Baseline Series and Corticosteroid Series haptens in a population of patients with CE. A group of 126 patients with the clinical diagnosis of contact eczema were patch tested with 28 European Baseline Series allergens and 8 corticosteroid allergens in different concentrations and in different media: 80 (64.5%) women and 46 (36.5%) men, mean age 50.4 years. The average duration of CE was 6.9 years. In total, 65 patients (51.6%) demonstrated an allergic reaction to at least one European Baseline Series allergen, and 22 patients (17.4%) to at least one corticosteroid. The most common allergens giving positive results were nickel sulfate (26.2%), cobalt chloride (15.1%), budesonide (14.3%), potassium dichromate (13.5%), and myroxylon pereirae resin (MPR) (11.9%). According our data, the European Baseline Series tests allow the cause of ACD to be identified in over 50% of cases.

Morbus Behçet - a rare disease in Central Europe.

Behçet's disease (BD) is a multiorgan inflammatory disease of complex and not entirely elucidated etiology, which was originally diagnosed in patients with aphthous stomatitis, genital ulcerations and ocular manifestations. The entity is endemic in countries of Eastern and Central Asia, especially Turkey and Iran, but rarely seen in Central Europe. As there are no specific diagnostic laboratory tests or histopathologic findings which confirm the preliminary diagnosis, the final diagnosis should be based on clinical criteria. Frequently a definitive diagnosis is established within several years or months after the first manifestations appear. The increased number of cases, recently described worldwide also in the Polish population, indicates that the disease could spread out of endemic areas. The aim of this manuscript is to present the clinical picture, diagnosis criteria and therapeutic approaches of this "international disease" which currently is observed not only in emigrants from Asia but also in native Polish citizens.

Contact hypersensitivity to haptens of the European standard series and corticosteroid series in the population of adolescents and adults with atopic dermatitis.

BACKGROUND: Until recently, it was thought that in patients with atopic dermatitis (AD), contact hypersensitivity phenomenon occurs less frequently than in the general population because of the impaired cellular immune response. OBJECTIVE: The aim of this study was to evaluate the incidence of contact dermatitis in the population of patients with AD. METHODS: A total of 39 patients with clinical diagnosis of AD during remission were patch tested with 28 European Baseline Series allergens and 8 corticosteroids allergens in different concentrations and media. Twenty-nine (74.3%) patients were female and 10 (25.6%) patients were male. Thirty-three (84.6%) patients were older than 18 years. The mean duration of AD was 20 years. RESULTS: Nineteen (48%) patients had an allergic reaction to at least 1 European Standard Series allergen, and 5 (12.8%) patients had an allergic reaction to at least 1 corticosteroid. The most common allergens giving positive results were nickel sulfate (28.2%), potassium dichromate (20.5%), cobalt chloride (12.8%), and phenylenediamine, budesonide, betamethasone, clobetasol, and dexamethasone (7.7% each). CONCLUSIONS: This study shows that allergic contact hypersensitivity is common among patients with AD and affects up to 40% of cases. Contact allergy to corticosteroids becomes a serious problem in the treatment of chronic inflammatory dermatoses such as AD.

Behçet's disease leaves the silk road.

Behçet's disease is rarely recognized among Caucasians, while it is endemic in countries of the Eastern and Central Asia, especially in Turkey. The aim of the manuscript is to present the clinical picture, diagnosis criteria and therapeutic approaches of this rare disease which, because of intensive migration, can occur not only in particular regions of the world.