[Contact dermatitis of the hands in housewives: the results of a multicenter study]. / Indagine sulla dermatite da contatto delle mani delle casalinghe: risultato di uno studio multicentrico.

The survey was carried out between January 1988 and June 1990. It consisted in a clinical and allergological study of 1489 housewives, 880 of which had contact dermatitis at their hands. (group of "cases"). The other 609 represented the control group. The anamnesis was gathered with a guided questionnaire: the questions concerned familiar and personnel pathology, use of detergents and cosmetics, use of means of prevention and therapies. Patch tests with haptens of GIRDCA series and with the most common detergent components were performed. In 98% of cases hands were the lace of beginning of symptoms; in the group of "cases" 46% were positive to at least one patch test. Nickel sulphate gave positivities in the 28% of cases. Results of the search of this metal (and of chrome and cobalt) in detergents are described. Other possible occasions of contact are described. Other causes of sensitization are represented by rubber additives, by perfumes and by preservatives. Cutipositivities for detergents are very really limited. Means of protection, in particular barrier creams, are described as scarcely used.

Occupational traumatic lymphedema of the hands.

Secrétan's syndrome is characterized by hard persistent edema of the dorsum of the hands. Usually, the condition is self-inflicted, but the authors have seen four cases that were occupationally related. The patients were fishing divers, and the mechanism appeared to be the constrictive action of the tight diver suit and pricks from sea urchin spines. Lymphographic abnormalities were present in one case.

[Contact dermatitis of the hands in housewives: preliminary data of a multicenter study]. / Indagine sulla dermatite da contatto delle mani delle casalinghe: dati preliminari di uno studio multicentrico.

The preliminary results of a survey carried out by the Institutes of Dermatology of Bari and Florence Universities and by the Clinica del Lavoro of Milan University are analyzed. The survey, whose aim is to identify the causes of contact dermatitis on housewives' hands and whose conclusions are forecasted for June 1990, will examine 1,650 female people, 1,050 of which are ill and 600 are case-controls. The results of the first 617 cases (514 ill and 103 case-controls) are reported. The anamnesis has shown that the hands (in 488 cases) are the most affected part of the body, that the most frequent symptoms are itch and burning sensation (in 410 cases), and that cosmetics, followed by detergents and softeners, are considered by the patients among the products more responsible for these symptoms. The allergic tests, even if with a different percentage of incidence, have shown metals (above all nickel), rubber additives and resins as the main aptens. Another survey, also in progress, concerning the search of metals in detergents and in washing waters for pollution caused by abrasives, pots, Inox sinks, pipes and tabs of the water system, is reported.

Atopic dermatitis in the first six months of life.

1,476/2,320 of our cases of atopic dermatitis (AD) start in the first six months of life. The diagnosis is usually easy, but at this age it is sometimes more difficult, mainly because of lack of or rare evidence of scratching, but also because of the brief clinical history that does not allow observation of the characteristic chronic and relapsing course. Moreover, the major atopic disorders-asthma, rhinitis-usually appears later in the natural history of atopic subjects. From a differential diagnosis point of view, AD is the most definite dermatological disorder at this age. Other not well defined conditions occurring in the first six months of life are usually referred to as infantile seborrheic dermatitis, a name that has been used for at least four different disorders: cradle cap, cradle cap with involvement of inguinal, axillary and retroauricular folds, napkin psoriasis and Leiner's erythroderma. From a clinical point of view, AD in the first months of life is characterized by the prevalence of exudating lesions; moreover, the lack of or the rare evidence of scratching allows us to observe isolated vesicular lesions that are found with difficulty in the further course of the disease.

Frequency of sensitisation to the preservative Kathon CG.

The incidences of sensitisation to Kathon CG are reported for patients routinely tested from 1984 to 1986 in Bari, London, Louvain, Nijmegen, Oulu and San Francisco. For these 3 years, the overall frequency of sensitisation varied for women from 3.3% in Oulu to 0.6% in London and San Francisco and for men from 1.4% in Oulu to 0% in San Francisco. Women were predominantly sensitised, probably by cosmetics, toiletries and domestic cleaners. Occupational sensitisation was much less frequent.

Skin tumors and reactive cellular infiltrate: further studies.

Twenty-two non-ulcerated basal cell carcinomas and 30 non-ulcerated squamous cell carcinomas were selected to study the reactive cellular infiltrate, utilizing histological, histoenzymatic and immunological methods. Substantial differences in cell behaviour were observed between the two tumors: advanced and metastatic squamous cell carcinoma showed prominent presence of T8+ lymphocytes, Leu 7+ cells, macrophages, mast cells and granulocytes, notably eosinophils. Degranulation of mast cells was seen both in the tumor itself and in the adjacent stroma. The basal cell carcinoma presented a low count of T4+, T8+ lymphocytes, whereas Leu 7+ cells and granulocytes were absent.

Allergic contact dermatitis to some medicaments.

Over the years, changes have had to be made in the list of topical drugs most frequently responsible for allergic contact dermatitis. The 4 most common sensitizers in Italy in the past have been penicillin, sulfonamide, promethazine and neomycin. Now the list is headed by neomycin, benzocaine and ethylenediamine. Antihistamines and parabens are less frequently observed as sensitizers. The increasing topical use of new drugs and additives, as well as older sensitizers, produces reactions to other substances, such as non-steroidal anti-inflammatory agents, some antimycotic drugs, propylene glycol and benzoyl peroxide.

Sensitization in traumatized skin.

Patch tests with the standard series of chemical allergens were performed on 8,230 patients having various dermatoses. The frequency of contact sensitization among categories of dermatoses varied markedly. While only 21% of persons whose diagnosis was occupational contact dermatitis reacted allergically to at least one chemical, reactions were observed in 70% of those whose skin had been damaged by mechanical traumas. Cuts, wounds, and abrasions incurred on the job, while not very serious injuries per se, should be regarded as having greater clinical importance insofar as they increase the likelihood of contact sensitization to allergens.

Role of some infectious agents in atopic dermatitis.

Certain infections such as Kaposi's herpetic eruption, impetigo, recurrent cutaneous herpes simplex and warts are more frequent in subjects with atopic dermatitis. It is likely that the continuous alterations of the skin are more important than immunological factors in increasing the frequency of some infections in subjects with atopic dermatitis. Moreover, these infections do not seem to affect significantly the clinical course of atopic dermatitis.