ABSTRACT
Melasma is a common disorder of hyperpigmentation that presents a therapeutic challenge for clinical dermatologists. The pathogenesis is complex, but previous studies have demonstrated vascular proliferation is a key factor in the development of the classic hyperpigmented patches. Studies have revealed reduction of erythema by oral tranexamic acid; however, there has been no direct comparison to placebo. This 24-week randomised placebo-controlled trial demonstrates oral tranexamic acid may improve erythema in melasma. This mechanism of action may be the reason for the success of tranexamic acid in complex and difficult to treat melasma.
Subject(s)
Dermatologic Agents/therapeutic use , Erythema/drug therapy , Melanosis/drug therapy , Tranexamic Acid/therapeutic use , Administration, Oral , Adult , Erythema/etiology , Humans , Melanosis/complications , Middle Aged , Severity of Illness IndexABSTRACT
BACKGROUND: The European Chemical Agency (ECHA) definition of prolonged contact was introduced in 2014 and has not been evaluated clinically. OBJECTIVES: To assess whether nickel-sensitized individuals react on patch testing with high nickel-releasing metal discs for short and repetitive periods. MATERIALS AND METHODS: We patch tested 45 nickel-sensitized individuals double-blind with 2 different types of high nickel-releasing discs for 10, 30 and 60 minutes on 3 occasions over a period of 2 weeks, and for 1 longer period. Discs were tested for nickel release. RESULTS: Nickel release from both discs significantly exceeded the 0.5 µg Ni/cm2 /week limit of the EU REACH nickel restriction. However, only 1 individual tested had a largely dose-dependent allergic reaction. CONCLUSIONS: The majority of nickel-allergic subjects did not react to nickel discs after 2 hours or after repetitive exposures of up to 30 minutes on 3 occasions over a period of 2 weeks. The length of time needed to cause nickel allergic contact dermatitis in most nickel-allergic individuals is longer than the ECHA guidance definition. Longer test times are needed to define the time required to cause dermatitis in most nickel-allergic individuals. As a limitation, the test conditions did not adequately assess real-life factors such as friction, which is relevant for some uses of nickel.
Subject(s)
Dermatitis, Allergic Contact/diagnosis , Dermatitis, Allergic Contact/etiology , Nickel/administration & dosage , Nickel/adverse effects , Adult , Double-Blind Method , European Union , Female , Humans , Male , Middle Aged , Patch Tests/statistics & numerical dataSubject(s)
Antibodies, Monoclonal, Humanized/adverse effects , Drug Eruptions/etiology , Photosensitivity Disorders/chemically induced , Psoriasis/drug therapy , Antibodies, Monoclonal, Humanized/therapeutic use , Biopsy, Needle , Drug Eruptions/pathology , Female , Follow-Up Studies , Humans , Immunohistochemistry , Middle Aged , Patient Safety , Photosensitivity Disorders/pathology , Psoriasis/pathology , Risk Assessment , Severity of Illness IndexABSTRACT
Chlorhexidine is a widely used and effective antiseptic agent. Although skin contact is usually well tolerated, it may cause both immediate and delayed hypersensitivity reactions. We report a case of immediate hypersensitivity to chlorhexidine causing both skin and respiratory symptoms following occupational exposure to chlorhexidine in a health-care worker.
Subject(s)
Anti-Infective Agents, Local/adverse effects , Chlorhexidine/adverse effects , Dermatitis, Occupational/etiology , Drug Hypersensitivity/etiology , Hypersensitivity, Immediate/chemically induced , Occupational Exposure/adverse effects , Female , Hand Dermatoses/chemically induced , Humans , Middle Aged , Urticaria/chemically inducedABSTRACT
We report two cases of Caucasian women who developed folliculocentric pustulosis after exposure to amoxycillin. A literature review found that most amoxycillin-related pustular eruptions were reported as acute generalised exanthematous pustulosis (AGEP) or acute localised exanthematous pustulosis (ALEP). Histopathology from both our cases showed sterile suppurative folliculitis, which resolved on the cessation of amoxycillin.
