ABSTRACT
A female patient with a long history of erythropoietic protoporphyria developed progressive rapid derangement of hepatic function requiring urgent orthotopic liver transplantation. In the immediate post-operative period the patient developed unusual and serious complications, including a generalized axonal neuropathy, intestinal ulceration and a large second-degree phototoxic burn of the abdominal wall. Recovery was achieved only after prolonged intensive hospital care and rehabilitation. Attention is drawn to the need for protecting such patients from phototoxic injury during prolonged surgery and the importance of rapid transfer to a specialized unit at the earliest sign of hepatic failure.
Subject(s)
Liver Diseases/etiology , Porphyrias/complications , Protoporphyrins/blood , Adult , Female , Humans , Intraoperative Complications/etiology , Lighting/adverse effects , Liver Transplantation , Operating RoomsABSTRACT
Computer data on 4721 consecutive patients patch tested with an extended standard series were analysed for the frequency of allergic reactions to each substance. Particular attention was given to the negative first reading at day 2 (D2) which later became positive at day 4 (D4). A total of 4210 allergic reactions were recorded. 993 of which were negative on D2 (24%). The most frequent positive reactions were to nickel sulphate (18%), fragrance-mix (8%), colophony (6%), neomycin (6%), cobalt chloride (6%), thiuram-mix (4%) and potassium dichromate (3%). The frequency of negative D2, positive D4 readings was sizeable for all but one substance, primin, with a range of 14% for fragrance-mix to 64% for neomycin. All of 21 positive reactions to primin were recorded on D2. In our opinion, it is unjustified to perform D2-only patch test readings.
Subject(s)
Hypersensitivity/epidemiology , Patch Tests/methods , England/epidemiology , Epidemiologic Methods , False Negative Reactions , Humans , Hypersensitivity/diagnosis , Hypersensitivity, Delayed/diagnosis , Hypersensitivity, Delayed/epidemiology , Time FactorsSubject(s)
Dermatitis, Atopic/immunology , Immunoglobulin E/analysis , Immunoglobulin G/analysis , Urticaria/immunology , Adult , Allergens/immunology , Female , Humans , MaleSubject(s)
Culture Techniques , Leg Ulcer/surgery , Skin Transplantation , Aged , Epithelium , Female , Humans , MaleABSTRACT
The case of a patient with a 1-year history of recurrent, severe facial dermatitis is reported. The role of ultraviolet radiation from arc welding or other equipment at work in inducing dermatitis is discussed.
Subject(s)
Dermatitis, Occupational/etiology , Facial Dermatoses/etiology , Photosensitivity Disorders/etiology , Ultraviolet Rays/adverse effects , Welding , Adult , Humans , MaleABSTRACT
A female patient with a protracted history of multitudinary symptoms more recently developed granulomatous cheilitis (GC) and underwent extensive investigations. Her Kveim test was positive.
