Empleo de la ciclosporina en la dermatitis por contacto severa / Cyclosporin in acute contact dermatitis

Tratamos a un paciente con dermatitis por contacto severa por terpenos, con ciclosporina A (CyA) 5 mg/kg/día. Durante 28 años recibió corticoides por vía general; presentaba aspecto cushingoide e hipertensión arterial. Las pruebas de fotosensibilidad e histopatología permitieron desechar un reticuloide actínico o reactor persistente a la luz. La CyA produjo involución total de las lesiones permitiendo la supresión del corticoide y sus complicaciones. Esta droga es un recurso terapéutico en dermatitis de contacto prolongadas y resistentes a otros tratamientos

Empleo de la ciclosporina en la dermatitis por contacto severa / Cyclosporin in acute contact dermatitis

Tratamos a un paciente con dermatitis por contacto severa por terpenos, con ciclosporina A (CyA) 5 mg/kg/día. Durante 28 años recibió corticoides por vía general; presentaba aspecto cushingoide e hipertensión arterial. Las pruebas de fotosensibilidad e histopatología permitieron desechar un reticuloide actínico o reactor persistente a la luz. La CyA produjo involución total de las lesiones permitiendo la supresión del corticoide y sus complicaciones. Esta droga es un recurso terapéutico en dermatitis de contacto prolongadas y resistentes a otros tratamientos

Dermatitis por contacto alérgica a la etilenimina en la industria farmacéutica veterinaria / Allergic contact dermatitis to ethylenimine in the pharmaceutical veterinary industry

Se estudiaron cuatros operarios sobre un total de diez afectados, que trabajaban en una empresa de productos farmacéuticos para veterinaria que manipulaban etilenimina para la elaboración de vacuna antiaftosa. El objeto del presente trabajo fue determinar si la E. es el agente causal en diez operarios afectados por dermitis por contacto alérgica en una industria que la emplea y, en caso de confirmar esta participación, indicar las medidas de profilaxis respectiva

Dermatitis por contacto alérgica a la etilenimina en la industria farmacéutica veterinaria / Allergic contact dermatitis to ethylenimine in the pharmaceutical veterinary industry

Se estudiaron cuatros operarios sobre un total de diez afectados, que trabajaban en una empresa de productos farmacéuticos para veterinaria que manipulaban etilenimina para la elaboración de vacuna antiaftosa. El objeto del presente trabajo fue determinar si la E. es el agente causal en diez operarios afectados por dermitis por contacto alérgica en una industria que la emplea y, en caso de confirmar esta participación, indicar las medidas de profilaxis respectiva

Role of the fourth complement component (C4) in the regulation of contact sensitivity. III. In vivo effect of purified C4.

Lymph node cells obtained from CBA/J mice 4 days after painting with contact sensitizing agents such as picryl chloride or oxazolone ("4-day" cells), induce contact sensitivity into naive recipient mice by membrane-associated immunocomplexes. This immunizing capacity is abolished after incubation of the cells in serum from mice with high C4 levels (C4H), but not in serum from mice with low C4 levels (C4L), and the inhibitory activity of C4H serum is due to the activation of the early components of the classical complement pathway. The presence of 4-day cells depends on C4 levels: in fact, C4H mice lack these cells because they activate their own complement in vivo, whereas C4L mice fail to activate complement in vivo and possess 4-day cells. CBA/J (C4L) mice injected with purified C4 preparations from the C4H mice BALB/c, lose 4-day cells and show a short-term contact-sensitivity reaction, exactly as BALB/c mice, thus indicating that C4 levels play a role in the control of contact-sensitivity reaction to simple chemical haptens.

Occupational dermatoses in workers exposed to resins based on phenol and formaldehyde.

During December 1985 and February 1986, an investigation was carried out into skin diseases among workers in a plant producing decorative equipment built of paper sheets impregnated with resol resins based on phenol and formaldehyde (P-F-R). A questionnaire was sent to all 238 employees and it was answered by 218 (91.6%). Previous and current dermatoses were reported by 98 workers and 89 of these were examined and patch tested. The patch testing was conducted with a standard test series and products from the working environment and revealed contact allergy to P-F-R in 9 persons and to formaldehyde in 1. Besides these 10 individuals with occupational allergic contact dermatitis, occupational dermatoses were diagnosed in an additional 20 workers; irritant contact dermatitis in 19 and chemical burn in 1. In total, the figure for occupational dermatoses was 30 (12.6%).

Occupational sensitization to epichlorohydrin and epoxy resin.

Sensitization to epichlorohydrin (ECH) is reported in 6 patients with occupational contact allergy. In 2 cases, an isolated positive test to ECH was found. In the remaining 4 cases, concomitant positive reactions were seen to "ICDRG epoxy resin" (MW 385) and to liquid epoxy resin (MW 370). Allergy to bisphenol A was not seen in the patients. 5 patients worked in an epoxy resin plant. Adequate preventive measures to avoid skin contact with ECH are required to prevent ECH sensitization becoming a more serious industrial hazard.

Dermatitis in rubber manufacturing industries.

This review describes the history of rubber technology and the manufacturing techniques used in rubber manufacturing industries. The important aspects of the acquisition of allergic and irritant contact dermatitis within the industry are presented for the reader.

Nickel dermatitis and diet: clinical improvement and a reduction in blood and urine nickel levels with a low-nickel diet.

A 27-year-old nickel-sensitive female who had had continuous spontaneous flare-ups of eczema, including at sites of previous metal contact, experienced a clearing of her eruption after commencing a low-nickel diet. When on the diet, whole-blood and urinary nickel levels fell to half or less of pre-diet values and this coincided with the clinical improvement. Low-nickel diets should be considered for patients who are highly nickel sensitive.

Effects of ultraviolet irradiation on surface marker expression by epidermal immunocompetent cells and contact sensitization to dinitrofluorobenzene in mice.

We studied the effects of ultraviolet (UV) irradiation on murine epidermal Ia-positive Langerhans cells (Ia + LC) and Thy-I-positive dendritic epidermal cells (Thy-I + dEC). We also studied contact hypersensitivity to dinitrofluorobenzene (DNFB) introduced through UV-treated epidermis. C3H/HeN mice were exposed to UVB or 8-methoxypsoralen plus UVA (PUVA). UVB and PUVA treatment led to a dramatic reduction in surface marker expression of both Ia + LC and Thy-I + dEC. High-dose UVB irradiation (360 J/m2) interfered with contact hypersensitivity to DNFB; the density of Ia + LC may thus be related to the sensitizing potential. In contrast, low-dose UVB (120 J/m2) and PUVA treatment had little effect on contact hypersensitivity despite a marked reduction in Ia + LC. The density of Thy-I + dEC appeared not to be associated with contact hypersensitivity. These results suggest that there may be a Langerhans cell density-independent mechanism for the induction of contact hypersensitivity.

Exposure to formaldehyde in anatomy: an occupational health hazard?

The adverse effects of formaldehyde have been discussed very emotionally in public. Anatomists, technicians in histology and embalming laboratories, as well as medical students during their dissection course are all exposed to formaldehyde, which in many situations crosses the threshold for irritation of the eyes and upper respiratory tract. There is no doubt about the acute toxic effects and the occurrence of contact dermatitis caused by formaldehyde. Studies in rats and mice using high concentrations over an extremely long period (which would not be tolerated by humans) resulted in squamous carcinoma of the nose. Epidemiologic studies on the mortality of medical personnel exposed to formaldehyde do not provide sufficient evidence of cancerogenicity. A number of recommendations will be given for defining the exact concentration in a dissecting room or laboratory and for ways of reducing formaldehyde concentrations and thus minimizing adverse health hazards. These data could initiate a discussion among anatomists, and with technicians and students, based on a sound scientific background rather than on emotion.

Nickel-specific T lymphocyte clones derived from allergic nickel-contact dermatitis lesions in man: heterogeneity based on requirement of dendritic antigen-presenting cell subsets.

Inflammatory skin T cells were cloned in an antigen-independent way from lesions of patients with experimentally induced nickel-contact dermatitis. In three experiments 7-15% of the CD4+8- T lymphocyte clones (TLC) appeared to be specific for nickel in a proliferation assay. These proliferative response of nickel-specific TLC required the presence of antigen-presenting cells (APC) and were restricted by HLA class II molecules. All TLC recognized nickel presented by APC from epidermal skin. Remarkably, 5 out of 8 nickel-specific TLC exclusively recognized nickel when presented by these skin-specific APC whereas 3 out of these 8 clones could also recognize nickel presented by APC from peripheral blood. The critical APC within the fractions of epidermal cells and peripheral blood appeared to belong to the family of dendritic cells, i.e. Langerhans cells and circulating dendritic cells, respectively.

Role of the fourth complement component (C4) in the regulation of contact sensitivity. I. Analysis in mice with high and low C4 levels.

Lymph node cells collected from CBA/J mice 4 days after painting the skin with picryl chloride are able to immunize naive recipients by hapten-IgM immuno complexes. These cells ("4-day" cells) activate the early components of the classical pathway of complement from mice of the H-2 Sd haplotype (high-C4), but fail to activate the classical pathway of complement from mice of the H-2 Sk haplotype (low-C4). Incubation of "4-day" cells in complement from mice with high-C4 levels abolishes the induction of contact sensitivity, probably as a consequence of the solubilization of membrane-bound immuno complexes caused by complement activation. The presence of "4-day" cells is determined by the levels of C4. In fact, using strains of mice which differ only at the S region of the H-2 complex, we found that mice of the H-2 Sd (and perhaps H-2 Sb) haplotype (high-C4 levels) lack "4-day" cells in their lymph nodes and this is due to the activation of the early components of the classical complement pathway which occurs in vivo in these mice during sensitization with picryl chloride. The finding that contact sensitivity reaction to picryl chloride in H-2 Sk mice lasts about 21 days, whereas H-2 Sd mice show a contact sensitivity reaction until 7 days after sensitization, strongly suggests that the S region, and in particular C4 levels, controls the persistence of "4-day" immunogenic cells, and so play a role in the duration of the contact sensitivity reaction to picryl chloride in the mouse.