ABSTRACT
BACKGROUND: Allergic contact dermatitis is a frequent, often disabling disease caused by countless substances. Patch testing remains the gold standard test to identify the causative agent; however, it is subjective, time-consuming and not completely safe. Alternative methods were tried, but significant success has only been achieved with nickel. OBJECTIVE: Develop an alternative or complementary allergic contact dermatitis diagnostic test. METHODS: We compared the lymphocyte proliferative rate and cytokine production (IFN-γ, IL-2, IL-4, IL-5, IL-10, IL-12, IL-13, IL-17 and RANTES) between 18 chromium allergic patients and 19 controls. RESULTS: The lymphocyte proliferation test and some of the cytokines tested (IFN-γ, IL-2, IL-5, IL-12 and IL-13) were able to discriminate allergic patients. However, striking results were only achieved using IL-13, leading to an accuracy of about 90%. CONCLUSIONS: If further studies confirm the data found, IL-13 could be used as an alternative or complementary test to detect chromium contact allergy whereas lymphocyte proliferation test, IFN-γ, IL-2, IL-5 and IL-12 detections may serve as additional diagnostic tests.
Subject(s)
Biomarkers/blood , Chromium/adverse effects , Dermatitis, Contact/diagnosis , Interleukin-13/blood , Adult , Aged , Case-Control Studies , Cell Proliferation , Dermatitis, Contact/blood , Female , Humans , Lymphocytes/pathology , Male , Middle Aged , Patch TestsABSTRACT
BACKGROUND: Lymphocyte proliferation testing (LPT) has some advantages over patch testing to diagnose allergic contact dermatitis. It is harmless, objective and can be used in clinical situations where patch testing is not recommended. Unfortunately, significant success has only been achieved with nickel. There are few studies on chromium LPT and they were performed with different methods, leading to inconsistent results. METHODS: To determine the best parameters for chromium LPT, we tested 20 patients with allergic contact dermatitis to the metal and 20 controls, using various protocols. RESULTS: The best sensitivity and specificity ratios were achieved with 6-day cultures stimulated with a range from 7.5 x 10(-4) to 5 x 10(-3) mol/L of nonfiltered chromium chloride solutions. The sensitivity, specificity and accuracy values found within this range were 65%, 95% and 80%, respectively. CONCLUSION: Further investigation is necessary to achieve better sensitivity values.
Subject(s)
Chromium , Dermatitis, Allergic Contact/diagnosis , Patch Tests/methods , Adult , Chromium/adverse effects , Dermatitis, Allergic Contact/etiology , Dermatitis, Allergic Contact/immunology , Humans , Lymphocyte Activation , Male , Middle Aged , Sensitivity and SpecificityABSTRACT
Sao estudados 16 doentes de penfigo foliaceo endemico (PFE), sob tratamento com corticosteroides, que ainda apresentavam lesoes eritemato-papulo-verrucosas, geralmente hiperpigmentadas, que foram caracterizadas como lesoes resistentes a corticoterapia (LRC). O estudo destas lesoes foi feito atraves de anatomopatologia de imunofluorescencia direta (IFD). Anatomopatologicamente essas lesoes mostraram tendencia a hiperplasia epitelial e clivagem em niveis variaveis na epiderme o que difere dos achados nas lesoes recentes do PFE e coincide com os achados nas lesoes cronicas do PFE da era pre-corticoide. A IFD da pele lesada foi positivada para IgG em 93,75 por cento dos casos, como ocorre nas fases iniciais do PFE, tendo sido negativa no unico caso em que nao houve clivagem. Adicionalmente, em oito desses doentes, foram estudados a IFD da pele sa e a imunofluorescencia indireta (IFI). A IFD foi positiva em tres destes casos e a IFI foi negativa nos oito.
