Contact with metal working fluids (MWF) is an important factor in the development of occupational hand dermatitis in patients working in the metal processing industry. Biocides are added to MWF as preservatives and ar...Contact with metal working fluids (MWF) is an important factor in the development of occupational hand dermatitis in patients working in the metal processing industry. Biocides are added to MWF as preservatives and are known sensitizers. We analysed 318 patch test reactions to N,N-methylene-bis-5-methyl-oxazolidine 1% in petrolatum (5-methyloxazolidine, Grotan OX , CAS no. 66204- 44- 2, a formaldehyde releasing biocide) present in coolant oils in patients exposed to MWF and with suspected occupational dermatitis (OD). Positive allergic reactions were noted in 15 (4.7% ) cases. In 7 (47% ) cases, we were able to confirm relevance by examining the material safety data sheets and these showed that N,N-methylene-bis-5-methyloxazolidine was present in the oils used by the patients. No certain relevance could be proved in 8 cases, but in these instances, further information on the biocides used in the oils could not be obtained. Positive reactions to formaldehyde were seen in 11 (73% ) patients. Sensitization either to this biocide and/or formaldehyde allergy was considered to have been likely to have made a contribution to the workers’ dermatitis.展开更多
The validity, reproducibility, and specificity of patch-testi-ng in the diagnosis of allergic contact dermatitis (ACD) have repeatedly been addressed. In vivo reflectance confocal microscopy (RCM) has been used for re...The validity, reproducibility, and specificity of patch-testi-ng in the diagnosis of allergic contact dermatitis (ACD) have repeatedly been addressed. In vivo reflectance confocal microscopy (RCM) has been used for real-time evaluation of the histopathologic features of ACD. This pilot study was designed to determine the sensitivity and specificity of RCM in diagnosing ACD in reference to patch-testing. Sixteen participants were patch tested with allergens and control substances. Clinical scoring, digital photography, and RCM evaluation were performed at 72 hours, and RCM images were subjected to blinded evaluation. RCM evaluation parameters included stratum corneum (SC) disruption, parakeratosis, stratum spinosum (SS) and stratum granulosum (SG) spongiosis, and exocytosis. Overall, there was high specificity for all RCM features, ranging from 95.8% to 100% . Sensitivity ranged from 51.9% to 96.3% . Significant parameters with high sensitivity and specificity included spongiosis and exocytosis at the level of SS. Logistic regression analysis was performed on significant variables; P values were determined by χ 2 analysis. RCM is a promising noninvasive technology for the evaluation of ACD. SC changes are not helpful in the diagnosis of ACD, although the presence of SG spongiosis and SS spongiosis shows high sensitivity in diagnosingACD. Larger sensitivity and specificity studies are needed and the identification of ACD has to be based In addition, individual allergens have to be subjected to further evaluations in order to demonstrate the applicability of our findings for other contact allergens. I on a defined diagnostic algorithm. A limitation of this study is the small sample size; larger sensitivity and specificity studies are needed to confirm these findings. In addition, individual allergens have to be subjected to further evaluations in order to demonstrate the applicability of our findings for other contact allergens. In that regard, RCM may be considered as an adjunctive tool, rather than a substitute, to clinical evaluation.展开更多
Objective: Tolerability and safety of 0.1% tacrolimus ointmentin treating nickel-induced allergic contact dermatitis (ACD)-were evaluated. Methods: Patients allergic to nickel applied nickel patches to each upper inne...Objective: Tolerability and safety of 0.1% tacrolimus ointmentin treating nickel-induced allergic contact dermatitis (ACD)-were evaluated. Methods: Patients allergic to nickel applied nickel patches to each upper inner aspect of the arm for 4 to 8 hours daily. Tacrolimus was applied to patch site on one arm and vehicle to patch site on the other, twice daily. Physician’ s Global assessment, signs and symptoms of ACD, pruritus scores, and adverse events were evaluated. Results: After 8 weeks, dermatitis in 45% of patients was clear or almost clear (Physician’ s Global Assessment) with tacrolimus; and 1% with vehicle (P < .001). Significant results were achieved as early as day8. Tacrolimus was superior in ACD signs and symptoms improvement and pruritus reduction (P < .001). Adverse events were similar between treatments. Limitations: This model,involving one agent, may not be generalizable for other agents.Conclusions: Tacrolimus ointment 0.1% is well tolerated and significantly more effective than vehicle in treating chronically exposed, nickel-induced ACD.展开更多
文摘Contact with metal working fluids (MWF) is an important factor in the development of occupational hand dermatitis in patients working in the metal processing industry. Biocides are added to MWF as preservatives and are known sensitizers. We analysed 318 patch test reactions to N,N-methylene-bis-5-methyl-oxazolidine 1% in petrolatum (5-methyloxazolidine, Grotan OX , CAS no. 66204- 44- 2, a formaldehyde releasing biocide) present in coolant oils in patients exposed to MWF and with suspected occupational dermatitis (OD). Positive allergic reactions were noted in 15 (4.7% ) cases. In 7 (47% ) cases, we were able to confirm relevance by examining the material safety data sheets and these showed that N,N-methylene-bis-5-methyloxazolidine was present in the oils used by the patients. No certain relevance could be proved in 8 cases, but in these instances, further information on the biocides used in the oils could not be obtained. Positive reactions to formaldehyde were seen in 11 (73% ) patients. Sensitization either to this biocide and/or formaldehyde allergy was considered to have been likely to have made a contribution to the workers’ dermatitis.
文摘The validity, reproducibility, and specificity of patch-testi-ng in the diagnosis of allergic contact dermatitis (ACD) have repeatedly been addressed. In vivo reflectance confocal microscopy (RCM) has been used for real-time evaluation of the histopathologic features of ACD. This pilot study was designed to determine the sensitivity and specificity of RCM in diagnosing ACD in reference to patch-testing. Sixteen participants were patch tested with allergens and control substances. Clinical scoring, digital photography, and RCM evaluation were performed at 72 hours, and RCM images were subjected to blinded evaluation. RCM evaluation parameters included stratum corneum (SC) disruption, parakeratosis, stratum spinosum (SS) and stratum granulosum (SG) spongiosis, and exocytosis. Overall, there was high specificity for all RCM features, ranging from 95.8% to 100% . Sensitivity ranged from 51.9% to 96.3% . Significant parameters with high sensitivity and specificity included spongiosis and exocytosis at the level of SS. Logistic regression analysis was performed on significant variables; P values were determined by χ 2 analysis. RCM is a promising noninvasive technology for the evaluation of ACD. SC changes are not helpful in the diagnosis of ACD, although the presence of SG spongiosis and SS spongiosis shows high sensitivity in diagnosingACD. Larger sensitivity and specificity studies are needed and the identification of ACD has to be based In addition, individual allergens have to be subjected to further evaluations in order to demonstrate the applicability of our findings for other contact allergens. I on a defined diagnostic algorithm. A limitation of this study is the small sample size; larger sensitivity and specificity studies are needed to confirm these findings. In addition, individual allergens have to be subjected to further evaluations in order to demonstrate the applicability of our findings for other contact allergens. In that regard, RCM may be considered as an adjunctive tool, rather than a substitute, to clinical evaluation.
文摘Objective: Tolerability and safety of 0.1% tacrolimus ointmentin treating nickel-induced allergic contact dermatitis (ACD)-were evaluated. Methods: Patients allergic to nickel applied nickel patches to each upper inner aspect of the arm for 4 to 8 hours daily. Tacrolimus was applied to patch site on one arm and vehicle to patch site on the other, twice daily. Physician’ s Global assessment, signs and symptoms of ACD, pruritus scores, and adverse events were evaluated. Results: After 8 weeks, dermatitis in 45% of patients was clear or almost clear (Physician’ s Global Assessment) with tacrolimus; and 1% with vehicle (P < .001). Significant results were achieved as early as day8. Tacrolimus was superior in ACD signs and symptoms improvement and pruritus reduction (P < .001). Adverse events were similar between treatments. Limitations: This model,involving one agent, may not be generalizable for other agents.Conclusions: Tacrolimus ointment 0.1% is well tolerated and significantly more effective than vehicle in treating chronically exposed, nickel-induced ACD.
