ABSTRACT
Abstract Background Hand eczema (HE) is a highly prevalent, recurrent, and multifactorial disease. It encompasses a group of eczematous diseases that affect the hands, etiologically classified into irritant contact dermatitis (ICD), allergic contact dermatitis (ACD) and atopic dermatitis (AD). Few epidemiological studies in Latin America have investigated the characteristics of patients with this condition and the origin of the disease. Objectives To analyze the profile of patients diagnosed with HE submitted to patch tests aiming to determine its etiology. Methods A retrospective descriptive study was carried out on epidemiological data and patch tests of patients with HE treated at a tertiary hospital in the city of São Paulo from January 2013 to December 2020. Results A total of 173 patients were studied, whose final diagnosis was 61.8% of ICD, 23.1% of ACD and 5.2% of AD, with diagnostic overlap in 42.8% of the cases. The main positive and relevant patch tests were: Kathon CG (42%), nickel sulfate (33%), and thiuram mix (18%). Study limitations The number of treated cases and socioeconomic profile was limited to a vulnerable population group. Conclusion HE is a diagnosis in which overlapping etiologies are frequent, with the main sensitizers identified in ACD being Kathon CG, nickel sulfate and thiuram mix.
ABSTRACT
BACKGROUND: Hand eczema (HE) is a highly prevalent, recurrent, and multifactorial disease. It encompasses a group of eczematous diseases that affect the hands, etiologically classified into irritant contact dermatitis (ICD), allergic contact dermatitis (ACD) and atopic dermatitis (AD). Few epidemiological studies in Latin America have investigated the characteristics of patients with this condition and the origin of the disease. OBJECTIVES: To analyze the profile of patients diagnosed with HE submitted to patch tests aiming to determine its etiology. METHODS: A retrospective descriptive study was carried out on epidemiological data and patch tests of patients with HE treated at a tertiary hospital in the city of São Paulo from January 2013 to December 2020. RESULTS: A total of 173 patients were studied, whose final diagnosis was 61.8% of ICD, 23.1% of ACD and 5.2% of AD, with diagnostic overlap in 42.8% of the cases. The main positive and relevant patch tests were: Kathon CG (42%), nickel sulfate (33%), and thiuram mix (18%). STUDY LIMITATIONS: The number of treated cases and socioeconomic profile was limited to a vulnerable population group. CONCLUSION: HE is a diagnosis in which overlapping etiologies are frequent, with the main sensitizers identified in ACD being Kathon CG, nickel sulfate and thiuram mix.
Subject(s)
Dermatitis, Allergic Contact , Dermatitis, Atopic , Dermatitis, Irritant , Eczema , Humans , Retrospective Studies , Thiram , Patch Tests , Brazil/epidemiology , Dermatitis, Allergic Contact/diagnosis , Dermatitis, Allergic Contact/epidemiology , Dermatitis, Allergic Contact/etiology , Eczema/diagnosis , Eczema/epidemiology , Eczema/chemically induced , Dermatitis, Atopic/diagnosis , Dermatitis, Atopic/epidemiology , Dermatitis, Irritant/diagnosis , Dermatitis, Irritant/epidemiology , Dermatitis, Irritant/etiology , Allergens/adverse effectsABSTRACT
This case series describes the development of morbilliform drug eruption after breast surgery.
Subject(s)
Anti-Bacterial Agents , Dermatitis, Allergic Contact , Humans , Anti-Bacterial Agents/adverse effectsABSTRACT
Abstract: Melanoma Guidelines of the Brazilian Dermatology Society recommend histologic review by pathologists trained in melanocytic lesions whenever possible. Out of 145 melanoma cases identified at a private clinic in São Paulo/Brazil, 31 that had been submited to histologic review were studied to evaluate whether revision had led to change in therapeutic approach.. Differences in original/reviewed reports were found in 58.1% (n=18) of the reports, leading to changes in therapeutic approach in 41.9% (n=13). Change in diagnosis was observed in 6 out of 31 (19,3%) cases. These findings suggest that second opinion by pathologists trained in melanocytic lesions is likely to show significant differences from the original report.
Subject(s)
Humans , Pathology, Clinical/standards , Pathologists , Melanocytes/pathology , Melanoma/pathology , Referral and Consultation , Brazil , Observer Variation , Retrospective Studies , Histological Techniques/methods , Histological Techniques/standards , Dermatology/standards , Dermatologists , Melanoma/diagnosis , Melanoma/therapy , Neoplasm Staging/classificationABSTRACT
Melanoma Guidelines of the Brazilian Dermatology Society recommend histologic review by pathologists trained in melanocytic lesions whenever possible. Out of 145 melanoma cases identified at a private clinic in São Paulo/Brazil, 31 that had been submited to histologic review were studied to evaluate whether revision had led to change in therapeutic approach.. Differences in original/reviewed reports were found in 58.1% (n=18) of the reports, leading to changes in therapeutic approach in 41.9% (n=13). Change in diagnosis was observed in 6 out of 31 (19,3%) cases. These findings suggest that second opinion by pathologists trained in melanocytic lesions is likely to show significant differences from the original report.
Subject(s)
Melanocytes/pathology , Melanoma/pathology , Pathologists , Pathology, Clinical/standards , Brazil , Dermatologists , Dermatology/standards , Histological Techniques/methods , Histological Techniques/standards , Humans , Melanoma/diagnosis , Melanoma/therapy , Neoplasm Staging/classification , Observer Variation , Referral and Consultation , Retrospective StudiesABSTRACT
Keys are a significant source of exposure to metal allergens and can be a relevant problem for nickel-allergic individuals. This study aimed to perform nickel and cobalt spot testing among the 5 most common Brazilian brands of keys. Among the tested keys, 100% showed positive result to nickel spot test, 83,3% presented strong positive reaction. 50% exhibited cobalt release as well. Nickel release from keys is very common in our country and may cause a negative impact on sensitized individual's quality of life. Study's results highlight the importance of establishing directives to regulate nickel release in Brazil.
Subject(s)
Cobalt/administration & dosage , Dermatitis, Allergic Contact/etiology , Nickel/administration & dosage , Brazil , Cobalt/analysis , Consumer Product Safety , Environmental Exposure , Household Articles , Humans , Nickel/analysis , Patch TestsABSTRACT
Abstract: Keys are a significant source of exposure to metal allergens and can be a relevant problem for nickel-allergic individuals. This study aimed to perform nickel and cobalt spot testing among the 5 most common Brazilian brands of keys. Among the tested keys, 100% showed positive result to nickel spot test, 83,3% presented strong positive reaction. 50% exhibited cobalt release as well. Nickel release from keys is very common in our country and may cause a negative impact on sensitized individual's quality of life. Study's results highlight the importance of establishing directives to regulate nickel release in Brazil.
Subject(s)
Humans , Cobalt/administration & dosage , Dermatitis, Allergic Contact/etiology , Nickel/administration & dosage , Brazil , Patch Tests , Cobalt/analysis , Consumer Product Safety , Environmental Exposure , Household Articles , Nickel/analysisSubject(s)
Hypopigmentation/pathology , Nevus, Pigmented/pathology , Skin Neoplasms/pathology , Adult , Biopsy, Needle , Dermoscopy/methods , Diagnosis, Differential , Female , Humans , Hypopigmentation/diagnosis , Immunohistochemistry , Male , Microscopy, Confocal/methods , Middle Aged , Nevus, Pigmented/diagnosis , Sampling Studies , Skin Neoplasms/diagnosisABSTRACT
Silicone oil injections are often used for soft tissue augmentation and local and general adverse effects occurring from a few months to 15 years after injection have been reported. Here, we present a case of delayed granuloma formation due to liquid injectable silicone with large extent of involvement, which precluded surgical removal. Our patient was successfully treated with minocycline, considering its anti-inflammatory, immunomodulating and antigranulomatous properties. This case presents minocycline monotherapy as a useful treatment option for the management of severe granuloma induced by silicone use when surgical excision is not possible.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Granuloma, Foreign-Body/drug therapy , Minocycline/therapeutic use , Skin Diseases/drug therapy , Adult , Female , Granuloma, Foreign-Body/chemically induced , Humans , Silicone Oils/adverse effects , Skin Diseases/chemically inducedABSTRACT
A retrospective study was carried out between 2006-2011. Six hundred and eighteen patients with suspected allergic contact dermatitis underwent the standard patch test series recommended by the Brazilian Contact Dermatitis Research Group. The aim of our study was to evaluate the variation of positive patch-test results from standard series year by year. The most frequently positive allergens were: nickel sulfate, thimerosal and potassium bichromate. Decrease of positive patch-test results over the years was statistically significant for: lanolin (p=0.01), neomycin (p=0.01) and anthraquinone (p=0.04). A follow-up study should be useful in determining which allergens could be excluded from standard series, as they may represent low sensitization risk.
