Photosensitizing properties of compounds related to benzophenone.

Benzophenone is a phototoxic compound with absorption maxima in the ultraviolet A (UVA) and ultraviolet B (UVB) range. Many benzophenone derivatives are known to be photosensitizing. On the other hand, 2-hydroxy-4-methoxybenzophenone is used as a photoprotective agent. The aim of the present study was to analyse a range of benzophenone derivatives and thus examine the effects of molecular changes in the benzophenone molecule on phototoxic behaviour. Phototoxicity was tested by an in vitro photohaemolysis test. The tested compounds were benzophenone itself and the derivatives 2-hydroxybenzophenone, 2-aminobenzophenone, 2-benzoylbenzoic acid, 3-hydroxybenzophenone, and 4-hydroxybenzo-phenone, as well as the structurally similar compounds 9-fluorenone, 9-fluorenone-2-carboxylic acid, cyclohexyl phenyl ketone, and 1,4-naphtho-quinone. It was shown that minor changes in molecular structure can result in highly different phototoxic characteristics.

Evaluation of phototoxic properties of fragrances.

Fragrances are widely used in topical formulations and can cause photoallergic or phototoxic reactions. To identify phototoxic effects, 43 fragrances were evaluated in vitro with a photohaemolysis test using suspensions of human erythrocytes exposed to radiation sources rich in ultraviolet (UV) A or B in the presence of the test compounds. Haemolysis was measured by reading the absorbance values, and photohaemolysis was calculated as a percentage of total haemolysis. Oakmoss caused photohaemolysis of up to 100% with radiation rich in UVA and up to 26% with radiation rich in UVB. Moderate UVA-induced haemolysis (5-11%) was found with benzyl alcohol, bergamot oil, costus root oil, lime oil, orange oil, alpha-amyl cinnamic aldehyde and laurel leaf oil. Moderate UVB-induced haemolysis was induced by hydroxy citronellal, cinnamic alcohol, cinnamic aldehyde, alpha-amyl cinnamic aldehyde and laurel leaf oil. The phototoxic effects depended on the concentration of the compounds and the UV doses administered. We conclude that some, but not all, fragrances exert phototoxic effects in vitro. Assessment of the correlation of the clinical effects of these findings could lead to improved protection of the skin from noxious compounds.

Mastocytosis and Hymenoptera venom allergy.

PURPOSE OF REVIEW: Mastocytosis is a rare disease characterized by increased mast cells in skin and/or internal organs. We evaluate the impact of mastocytosis on diagnosis and treatment of Hymenoptera venom allergy. RECENT FINDINGS: Patients with Hymenoptera venom allergy who suffer from mastocytosis develop life-threatening sting reactions more often than those who do not. When patients with Hymenoptera venom allergy were systematically examined for mastocytosis, it was found to be represented to an abnormally high extent. Most patients with mastocytosis tolerate venom immunotherapy with no or only minor systemic symptoms. Venom immunotherapy was found to be marginally less effective in patients with mastocytosis than in those without evidence of mast cell disease (defined as absent cutaneous mastocytosis combined with a serum tryptase concentration of <11.4 microg/l). Several deaths from sting reactions were reported in patients with mastocytosis after venom immunotherapy was stopped. These patients should have venom immunotherapy for the rest of their lives. SUMMARY: Patients suffering from mastocytosis and Hymenoptera venom allergy are at risk from a particularly severe sting anaphylaxis. They need optimal diagnosis and treatment. In patients presenting with Hymenoptera venom allergy, screening tests by measurement of serum tryptase concentration, and a careful skin examination, are highly recommended.

Elevated 17-hydroxyprogesterone serum values in male patients with acne.

BACKGROUND: Androgen excess may provoke or aggravate acne by inducing seborrhea. In women, androgen disorders are frequently suspected when acne is accompanied by hirsutism or irregularities of the menstrual cycle. In men, however, acne may be the only sign of androgen excess. OBJECTIVE: Our aim was to investigate whether male patients with acne display pathologic androgen blood values. METHODS: This case-control study at a university dermatology department with referred and unreferred patients investigated male acne patients (n = 82, consecutive sample) in whom the diagnosis of mild to severe acne was made, as well as a control group of men without acne (n = 38). The main outcome measures were androgen parameters including morning values of testosterone, luteinizing hormone, follicle-stimulating hormone, dehydroepiandrosterone sulfate, androstenedione, and 17-hydroxyprogesterone; as well as a corticotropin stimulation test. RESULTS: 17-Hydroxyprogesterone levels were significantly higher (P = .01) in acne patients than in the control group, whereas the other parameters did not differ significantly. In addition, the corticotropin stimulation test revealed abnormal 17-hydroxyprogesterone induction values in 10 of 82 patients. LIMITATIONS: The analysis is limited to a selection of androgen parameters. CONCLUSION: The results suggest that in men irregularities of adrenal steroid metabolism may be a factor contributing to acne.

Contact urticaria to giraffe hair.

BACKGROUND: Immediate-type hypersensitivity to animal proteins is a common problem in people occupationally exposed to animals. METHODS: A 19-year-old female working as a voluntary zookeeper in her off-time suffered from hives on her forearms following contact to the fur of a giraffe. For diagnostic evaluation, skin prick tests, assessment of specific serum IgE antibodies, and basophil activation tests were performed. RESULTS: Skin prick tests with a standard series of common aeroallergens were positive for various pollens. Prick testing with native materials was positive for extracts of hair from two different giraffe subspecies in the patient, but not in control subjects. By CAP-FEIA, no specific serum IgE antibodies to dander of a large variety of animals were found in the patient. In the basophil activation test, expression of the activation marker CD63 was induced by extract of giraffe hair on the cells from the patient, but not on those from unaffected controls. CONCLUSIONS: This patient suffers from an 'exotic' immediate-type contact allergy to giraffe hair.

Evaluation of phototoxic properties of antimicrobials used in topical preparations by a photohaemolysis test.

Antimicrobials are widely used in topical formulations as preservatives or as therapeutically active agents. Photosensitization by such compounds has not yet been studied systematically. To identify possible phototoxic properties, antimicrobials (benzyl alcohol, bronopol, chloracetamide, clioquinol, diazolidinyl urea, ethylenediamine dihydrochloride, formaldehyde, glutaraldehyde, imidazolidinyl urea, sodium benzoate, propylene glycol) were evaluated in vitro by means of a photohaemolysis test using suspensions of human erythrocytes. Irradiations were performed with UVA- and UVB-rich light sources. In the presence of bronopol or clioquinol, there was photohaemolysis up to 78.1% or 48.5% with UVA and up to 100% or 34.3% with UVB, respectively. The phototoxic effect depended on the concentration of the compounds and the UV doses administered. None of the other substances tested caused significant photohaemolysis. It is concluded that bronopol and clioquinol exert phototoxic effects in vitro and thus might also cause photosensitization when used on the skin. The clinical significance of this has to be established by further work.

Ultraviolet B-induced DNA damage in human epidermis is modified by the antioxidants ascorbic acid and D-alpha-tocopherol.

DNA damage caused by ultraviolet (UV) irradiation is considered the main etiologic factor contributing to the development of skin cancer. Systemic or topical application of antioxidants has been suggested as a protective measure against UV-induced skin damage. We investigated the effect of long-term oral administration of a combination of the antioxidants ascorbic acid (vitamin C) and D-alpha-tocopherol (vitamin E) in human volunteers on UVB-induced epidermal damage. The intake of vitamins C and E for a period of 3 mo significantly reduced the sunburn reaction to UVB irradiation. Detection of thymine dimers in the skin using a specific antibody revealed a significant increase of this type of DNA damage following UVB exposure. After 3 mo of antioxidant administration, significantly less thymine dimers were induced by the UVB challenge, suggesting that antioxidant treatment protected against DNA damage.