[Contact allergy due to insulin pumps and glucose sensor systems]. / Kontaktallergie auf Glukosemesssysteme und Insulinpumpen.

The design and development of insulin pumps and various glucose sensor systems has an enormous impact on life quality of diabetic patients. Surveillance and therapy of diabetes has improved due to the new diabetic devices, which are affixed to the patients' skin for several days. Since their introduction, irritant and allergic contact dermatitis have been frequently reported. Patients often acquire contact sensitization to isobornyl acrylate, N,N-dimethylacrylamide or formerly to 2­ethyl-cyanoacrylate. These contact allergens were found in the patch, in the glue to affix the box on the patch or in the casing of the system itself. Development of contact allergy to substances of these systems may result in the need to abandon modern diabetic devices.

Pimecrolimus cream (1%) efficacy in perioral dermatitis - results of a randomized, double-blind, vehicle-controlled study in 40 patients.

BACKGROUND: Perioral dermatitis (POD) is a common skin disease and difficult to treat. Pimecrolimus cream (1%) successfully controls atopic eczema. OBJECTIVE: Our aim was to investigate its efficacy in POD. STUDY DESIGN: Single-centre, randomized, double-blind, vehicle-controlled study including 40 POD patients with a 4-week treatment and a 4-week follow-up. Efficacy was assessed by a novel Perioral Dermatitis Severity Index (PODSI) and Finlay's Dermatology Life Quality Index (DLQI). SETTING: Outpatient clinics of a large dermatological hospital in Munich, Germany. RESULTS: During treatment, the PODSI was significantly lower in the pimecrolimus group compared with vehicle (P = 0.005-0.02) whereas at follow-up, no significant differences were observed. At week 2, the responder rates (> or = 50% PODSI improvement) were 50% with pimecrolimus cream (1%) and 25% with vehicle (P = 0.095). DLQI was improved in pimecrolimus group compared with vehicle. CONCLUSION: Results suggest that pimecrolimus cream (1%) effectively treats acute-stage POD.

[Eczema herpeticum: Pathogenesis and therapy]. / Eczema herpeticatum: Pathogenese und Therapie.

Eczema herpeticum is an acute, disseminated herpes simplex virus infection which remains a feared complication of eczematous skin diseases, especially atopic dermatitis. The vesicular and erosive clinical picture is often accompanied by systemic signs and symptoms. Why some atopic patients experience multiple attacks of eczema herpeticum and others never have the disorder remains a mystery. Patients with severe or untreated atopic dermatitis are more likely to be affected. The pathogenesis appears to involve a complex interplay of factors, including demasking of binding sites for the virus through the dermatitis, failure to up-regulate antiviral proteins and a lack of plasmacytoid dendritic cells. Treatment of choice is systemic acyclovir therapy.

[Anaphylaxis caused by omeprazole]. / Anaphylaxie auf Omeprazol.

Omeprazole is a proton pump inhibitor which reduces both basal and stimulated gastric acid secretion by inhibiting the parietal cell enzyme H(+)-K(+)-adenosine triphosphatase. Typical adverse effects of proton pump inhibitors are nausea, diarrhea, constipation and endocrinologic abnormalities such as gynecomastia. Cutaneous side effects are rare but may include contact dermatitis, lichenoid eruption, leukocytoclastic vasculitis or toxic epidermal necrolysis; anaphylaxis is rare. We identified omeprazole as the causative agent by oral challenge test in a patient who had developed anaphylaxis while taking several drugs.