ABSTRACT
Patch testing is an invaluable diagnostic tool in the evaluation of allergic contact dermatitis. While TrueTest has simplified the technique for many practitioners, there remains potential for error. We asked 4 experts to describe their approach to several dilemmas encountered in patch testing. Their responses will be helpful to both the veteran and tyro.
Subject(s)
Dermatitis, Allergic Contact/diagnosis , Dermatitis, Allergic Contact/etiology , Patch Tests/methods , Bias , Climate , False Negative Reactions , False Positive Reactions , Humans , Patch Tests/adverse effects , Patch Tests/instrumentation , Reproducibility of Results , Time FactorsABSTRACT
Peanut allergy is acute and severe with symptoms of immediate hypersensitivity. This allergy is very common, affecting 1% of preschoolers. The incidence has increased with succeeding generations, and is possibly due to the increasing exposure of children to peanuts at a young age. Diagnosis is via history, skin prick test, and serum IgE level. The mainstay of therapy is avoidance. Treatment of anaphylaxis includes epinephrine and antihistamines. Children usually will not outgrow this food allergy. Novel treatment with rush immunotherapy and enzyme-potentiated desensitization is not currently acceptable. We describe a 27-month-old Asian boy with a typical presentation of peanut hypersensitivity. A good understanding of the epidemiology of this illness is necessary for treatment and prevention.
Subject(s)
Allergens/adverse effects , Angioedema/etiology , Arachis/adverse effects , Food Hypersensitivity/etiology , Orbital Diseases/etiology , Angioedema/diagnosis , Angioedema/therapy , Child, Preschool , Food Hypersensitivity/diagnosis , Food Hypersensitivity/therapy , Humans , Male , Orbital Diseases/diagnosis , Orbital Diseases/therapy , Skin TestsABSTRACT
OBJECTIVE: To determine the efficacy of the 585-nm flashlamp-pumped pulsed-dye laser and silicone gel sheeting in the treatment of hypertrophic scars in lighter- and darker-skinned patients. DESIGN: Prospective, single-blind, randomized, internally controlled, comparison investigation. SETTING: Large academic dermatology department. PATIENTS: Twenty patients with hypertrophic scars (19 completed the laser treatments and 18 completed the silicone gel sheeting treatments). MAIN OUTCOME MEASURES: Clinical measurements included hypertrophic scar blood flow, elasticity, and volume. Patients' subjective complaints of pruritus, pain, and burning were also monitored. Histological assessment of fibrosis, number of telangiectasias, and number of mast cells was performed. Statistically significant improvements in clinical measurements and patients' subjective complaints determined treatment success. RESULTS: Mean scar duration was 32 months (range, 4 months to 20 years). There was an overall reduction in blood flow, volume, and pruritus over time (P = .001, .02, and .005, respectively). However, no differences were detected among treatment and control groups. There was no reduction in pain or burning (0-40 weeks), elasticity (8-40 weeks), or fibrosis (0-40 weeks, n = 5 biopsies) in the treated or control sections of the scars. Unlike in a previous study, the number of mast cells in the scars was similar to the number of mast cells in healthy skin. CONCLUSION: Clinical results demonstrate that the improvements in scar sections treated with silicone gel sheeting and pulsed-dye laser were no different than in control sections.
Subject(s)
Cicatrix, Hypertrophic/therapy , Laser Therapy , Silicone Gels , Adult , Aged , Aged, 80 and over , Cicatrix, Hypertrophic/pathology , Coloring Agents , Female , Humans , Male , Middle Aged , Prospective Studies , Single-Blind MethodABSTRACT
Authors report in connection with two cases, operated on with an operative procedure rather rare in the practice in this country. The deltoid paralysis, developed following the injury of the axillary nerve, was successfully treated with the transposition of the bony insertion of the trapezius muscle to the proximal part of the humerus.
