ABSTRACT
BACKGROUND: The prevalence of contact allergy to various ophthalmic medications appears to be rare; however, data on culprits, clinical relevance of sensitizations, and changes in frequency within recent decades are limited. OBJECTIVE: This study aimed to investigate the clinical relevance, risk factors, and prevalence of contact allergy to topical ophthalmic medications in patients suspected of allergic contact dermatitis to ophthalmic medication. METHODS: We retrospectively analysed patch test results and clinical data for 754 patients patch-tested with an ophthalmic medication series at our tertiary referral centre between January 1992 and December 2022. RESULTS: In total, 37.5% (283/754) of patch-tested patients had a contact allergy to at least one ophthalmic allergen, with 87.3% (247) being clinically relevant sensitization. Phenylephrine (31.8%, 192/604), povidone-iodine (29%, 27/93), and tobramycin (23%, 46/200) were the most important sensitizers. The incidence of contact allergies increased significantly in a linear manner (p = 0.008) from 20% to 44.1% within the study period. Male sex and age above 40 were risk factors for contact allergy to ophthalmic medication. CONCLUSIONS: One third of patch tested patients had allergic contact dermatitis to ophthalmic medication, particularly phenylephrine. Male sex and age above 40 years were independent risk factors and drove the linear increase in contact allergy to ophthalmic medications within the past 31 years.
Subject(s)
Dermatitis, Allergic Contact , Ophthalmic Solutions , Patch Tests , Humans , Dermatitis, Allergic Contact/etiology , Dermatitis, Allergic Contact/epidemiology , Retrospective Studies , Male , Female , Ophthalmic Solutions/adverse effects , Adult , Middle Aged , Risk Factors , Prevalence , Aged , Phenylephrine/adverse effects , Phenylephrine/administration & dosage , Sex Factors , Young Adult , Adolescent , Age Factors , Tobramycin/adverse effects , Tobramycin/administration & dosageABSTRACT
Topical corticosteroids are commonly used to treat inflammatory skin conditions due to their anti-inflammatory properties. However, patients with long-lasting, non-responsive eczema have to be evaluated for a complicating contact allergy to the topical product. Clinical management of allergic contact dermatitis to corticosteroids can be challenging. The preventive measures should be tailored according to the sensitization patterns and supported by currently available classification systems to avoid cross-reactivity, as argued in this review.
Subject(s)
Dermatitis, Allergic Contact , Dermatologic Agents , Humans , Administration, Topical , Adrenal Cortex Hormones/adverse effects , Anti-Inflammatory Agents/adverse effects , Dermatitis, Allergic Contact/drug therapy , Dermatitis, Allergic Contact/etiology , GlucocorticoidsABSTRACT
The clinical presentation of invasive dermatophytosis often mimics other more common skin diseases. We report a case of severe deep dermatophytosis caused by Trichophyton mentagrophytes initially interpreted as herpetiform rash. The diagnosis was established based on fungal culturing and molecular detection using RT-PCR in addition to response to treatment using oral terbinafine. Our case emphasizes the importance of fungal testing at an early point to accelerate diagnosis and initiation of correct treatment. 2012 Elsevier Ltd. All rights reserved.
ABSTRACT
In this review, we discuss pigmented purpuric dermatoses (PPD), which are a group of benign, chronic diseases characterised by purpuric eruption. PPD comprise mb. Schamberg, mb. Majocchi, Gougerot-Blum, lichen aureus, and Doucas and Kapetanakis eczematoid purpura. PPD can be seen in both genders and may affect all age groups. Purpura is often localised to the lower extremities, and it may be asymptomatic or pruritic. PPD is usually diagnosed upon recognition of classical clinical features, but the diagnosis can also be confirmed by a skin biopsy.
Subject(s)
Keratosis , Pigmentation Disorders , Purpura , Female , Humans , Male , Pigmentation Disorders/diagnosis , Pruritus , Purpura/diagnosis , SkinSubject(s)
Antifungal Agents/adverse effects , Drugs, Chinese Herbal/adverse effects , Ointments/chemistry , Psoriasis/drug therapy , Steroids/adverse effects , Striae Distensae/chemically induced , Administration, Topical , Adolescent , Antifungal Agents/administration & dosage , Drugs, Chinese Herbal/administration & dosage , Humans , Male , Ointments/administration & dosage , Steroids/administration & dosageABSTRACT
Modeling complex time-course patterns is a challenging issue in microarray study due to complex gene expression patterns in response to the time-course experiment. We introduce the generalized correlation coefficient and propose a combinatory approach for detecting, testing and clustering the heterogeneous time-course gene expression patterns. Application of the method identified nonlinear time-course patterns in high agreement with parametric analysis. We conclude that the non-parametric nature in the generalized correlation analysis could be an useful and efficient tool for analyzing microarray time-course data and for exploring the complex relationships in the omics data for studying their association with disease and health.
Subject(s)
Gene Expression Profiling/methods , Oligonucleotide Array Sequence Analysis/methods , Cluster Analysis , Humans , Time FactorsABSTRACT
BACKGROUND: The homogeneity of methacrylates in commercial patch test preparations has not yet been investigated. Inhomogeneous patch test preparations may give rise to false-negative or false-positive patch test results in patients suspected of having methacrylate allergy. OBJECTIVES: To investigate the homogeneity of methacrylates in commercial patch test preparations. METHODS: Fresh commercial patch test preparations of methyl methacrylate (MMA) and 2-hydroxyethyl methacrylate (2-HEMA) from three test material suppliers in Europe were analysed quantitatively by means of normal-phase high-performance liquid chromatography. RESULTS: The initial concentration of MMA in all six patch test preparations was lower than stated on the label, whereas four of six patch test preparations of 2-HEMA were in accordance with the stated concentrations. The concentration of MMA increased markedly from the top segment close to the tip of the syringe to the bottom segment adjacent to the piston in four syringes (3-6). In contrast, syringes with 2-HEMA maintained a constant concentration throughout the test preparation, apart from two syringes (11 and 12). CONCLUSION: Variations in concentration and heterogeneous distribution of MMA and 2-HEMA in patch test preparations may be an additional cause of variation in patch test results, besides other technical details and reading.