Low-molecular-weight heparins are used extensively in acute medicine. They are generally well tolerated but may cause a rare, eczema-like type IV hypersensitivity reaction. We report 3 cases of this eruption and specu...Low-molecular-weight heparins are used extensively in acute medicine. They are generally well tolerated but may cause a rare, eczema-like type IV hypersensitivity reaction. We report 3 cases of this eruption and speculate that it may be significantly under-reported due to misidentifying the causal drug, which may have serious consequences. We discuss treatment alternatives such as fondaparinux sodium, which may rarely cross-react.展开更多
Background: Despite having a positive patch test reaction to para-phenylenediamine (PPD), some patients continue to dye their hair, while others are forced to give up or abandon this practice. This difference in patie...Background: Despite having a positive patch test reaction to para-phenylenediamine (PPD), some patients continue to dye their hair, while others are forced to give up or abandon this practice. This difference in patient behaviour could be due to the degree of sensitization. Objectives: To establish whether the ability to continue dyeing hair in PPD allergic patients is related to the strength of patch test reaction. To note differences in other clinical features in relation to the strength of patch test reaction. Methods We analysed retrospectively the patch test records of 400 sequential PPD-positive patients for the strength of patch test reaction (+, ++, +++) and different clinical features. Data were analysed using Cochran-Mantel-Haenszel χ2 tests. Results: There was a strong linear relationship between the strength of patch test reaction and continuation with hair dyeing. Patients were more likely to report a history of hair dye reaction with increasing strength of patch test reaction. There was no difference in strength of patch test reaction in relation to age, site of rash, occupation (hairdressing) or history of atopic eczema. Overall concomitant reactivity with related aromatic amine allergens (benzocaine,N-isopropyl-Nphenyl-para-phenylenediamine, para-aminobenzoic acid) was infrequent. Conclusions: Patients with stronger patch test reactions (++, +++) are more likely to have a clear history of reacting to hair dye and are less likely to still be dyeing their hair.展开更多
The results of a 7-year retrospective study(1998-2004)frompatch testing with the European Standard Series(ESS)establishingthe frequency of sensitization in a contact dermatitisclinic in Israel are presented.23 allerge...The results of a 7-year retrospective study(1998-2004)frompatch testing with the European Standard Series(ESS)establishingthe frequency of sensitization in a contact dermatitisclinic in Israel are presented.23 allergens were patch tested on 2156 patients,1462 females(67.8%)and 694 males(32.2%)-.Atopy and asthma were present in 21.9%of the patients.One or more allergic reactions were observed in 937 patients(43.5%).The highest yield of patch test positives from the 1076 positive reactions were obtained from nickel sulfate(13.9%),fragrance mix(7.1%),potassium dichromate(3.8%),Balsam of Peru(3.6%),CL +Me-isothiazolinone(3.4%)and cobaltchloride(3.4%).Allergens which produced the least amount of positive results were primin and clioquinol.Allergic contact dermatitis(ACD)was established in 32.8%,whereas occupationally related allergic(8.0)and irritant contact dermatitis(5.6%)affected a total of 13.6%of the cases studied.The most common clinical forms of dermatitis were chronic dermatitis(47.7%)followed by acute dermatitis(22.8%),and lichenification and hyperkeratosis(7.9%).The hands(30.7%),face and neck(23.9%)and extremities(11.3%)were the most frequently affected areas.Four allergens in our study differed from the top 10 allergens in Europe namely:Cl +Me-isothiazolinone,formaldehyde,4-tert-butylphenol formaldehyde resin and sesquiterpene lactone mix reflecting an existing difference in environmental exposure.Our study is the first to provide data on the frequency of sensitization and important allergens in the aetiology of ACD in Israel.In spite of the existing differences with Europe,we conclude that ESS is an appropriate screening system for the diagnosis of ACD in Israel.展开更多
文摘Low-molecular-weight heparins are used extensively in acute medicine. They are generally well tolerated but may cause a rare, eczema-like type IV hypersensitivity reaction. We report 3 cases of this eruption and speculate that it may be significantly under-reported due to misidentifying the causal drug, which may have serious consequences. We discuss treatment alternatives such as fondaparinux sodium, which may rarely cross-react.
文摘Background: Despite having a positive patch test reaction to para-phenylenediamine (PPD), some patients continue to dye their hair, while others are forced to give up or abandon this practice. This difference in patient behaviour could be due to the degree of sensitization. Objectives: To establish whether the ability to continue dyeing hair in PPD allergic patients is related to the strength of patch test reaction. To note differences in other clinical features in relation to the strength of patch test reaction. Methods We analysed retrospectively the patch test records of 400 sequential PPD-positive patients for the strength of patch test reaction (+, ++, +++) and different clinical features. Data were analysed using Cochran-Mantel-Haenszel χ2 tests. Results: There was a strong linear relationship between the strength of patch test reaction and continuation with hair dyeing. Patients were more likely to report a history of hair dye reaction with increasing strength of patch test reaction. There was no difference in strength of patch test reaction in relation to age, site of rash, occupation (hairdressing) or history of atopic eczema. Overall concomitant reactivity with related aromatic amine allergens (benzocaine,N-isopropyl-Nphenyl-para-phenylenediamine, para-aminobenzoic acid) was infrequent. Conclusions: Patients with stronger patch test reactions (++, +++) are more likely to have a clear history of reacting to hair dye and are less likely to still be dyeing their hair.
文摘The results of a 7-year retrospective study(1998-2004)frompatch testing with the European Standard Series(ESS)establishingthe frequency of sensitization in a contact dermatitisclinic in Israel are presented.23 allergens were patch tested on 2156 patients,1462 females(67.8%)and 694 males(32.2%)-.Atopy and asthma were present in 21.9%of the patients.One or more allergic reactions were observed in 937 patients(43.5%).The highest yield of patch test positives from the 1076 positive reactions were obtained from nickel sulfate(13.9%),fragrance mix(7.1%),potassium dichromate(3.8%),Balsam of Peru(3.6%),CL +Me-isothiazolinone(3.4%)and cobaltchloride(3.4%).Allergens which produced the least amount of positive results were primin and clioquinol.Allergic contact dermatitis(ACD)was established in 32.8%,whereas occupationally related allergic(8.0)and irritant contact dermatitis(5.6%)affected a total of 13.6%of the cases studied.The most common clinical forms of dermatitis were chronic dermatitis(47.7%)followed by acute dermatitis(22.8%),and lichenification and hyperkeratosis(7.9%).The hands(30.7%),face and neck(23.9%)and extremities(11.3%)were the most frequently affected areas.Four allergens in our study differed from the top 10 allergens in Europe namely:Cl +Me-isothiazolinone,formaldehyde,4-tert-butylphenol formaldehyde resin and sesquiterpene lactone mix reflecting an existing difference in environmental exposure.Our study is the first to provide data on the frequency of sensitization and important allergens in the aetiology of ACD in Israel.In spite of the existing differences with Europe,we conclude that ESS is an appropriate screening system for the diagnosis of ACD in Israel.
