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Contact Dermatitis Sep 2022Allergic contact dermatitis to corticosteroids can be a challenging diagnosis as corticosteroids are used in the treatment of dermatitis. The prevalence of contact...
BACKGROUND
Allergic contact dermatitis to corticosteroids can be a challenging diagnosis as corticosteroids are used in the treatment of dermatitis. The prevalence of contact allergy to corticosteroid varies between previous studies.
OBJECTIVE
To study the prevalence of sensitization to budesonide, tixocortol-21-pivalate and hydrocortisone-17-butyrate in a Danish patient population from 2006-2020, cross-sensitization, risk factors and clinical relevance.
METHODS
A retrospective analysis of patch test data and MOAHLFA index was performed among 6823 patients consecutively patch tested with TRUE test as part of the baseline series.
RESULTS
A positive patch test for corticosteroids was found in 185 patients (1.2% budesonide, 1.6% tixocortol-21-pivalate, 1.0% hydrocortisone-17-butyrate) without gender difference. For women, the prevalence of tixocortol-21-pivalate sensitization increased significantly from 1.3% in 2006-2008 to 2.9% in 2018-2020. Tixocortol-21-pivalate sensitization had more frequently clinical relevance in women (61.3%) compared to men (34.5%). Age above 40 years was positively associated to corticosteroid sensitization. Budesonide and hydrocortisone-17-butyrate accounted for 67.7% of co-sensitizations.
CONCLUSIONS
The prevalence of corticosteroid sensitization was 2.7%. Age was the only risk factor for corticosteroid sensitization. The frequency of corticosteroid sensitization was stabile over time except for tixocortol-21-pivalate sensitization for women. About one third of sensitized patients had co-sensitizations to other corticosteroid groups.
Topics: Adrenal Cortex Hormones; Adult; Anti-Inflammatory Agents; Budesonide; Denmark; Dermatitis, Allergic Contact; Female; Humans; Hydrocortisone; Male; Patch Tests; Prevalence; Retrospective Studies
PubMed: 35460519
DOI: 10.1111/cod.14135 -
Journal of Asthma and Allergy 2021Chronic spontaneous urticaria (CSU) is a common debilitating condition. Although not completely understood, the main pathomechanism involves autoimmune-related mast-cell...
BACKGROUND
Chronic spontaneous urticaria (CSU) is a common debilitating condition. Although not completely understood, the main pathomechanism involves autoimmune-related mast-cell degranulation. Patch test (PT) is the gold standard for the diagnosis of type IV cutaneous hypersensitivity. The relevance of PT to the diagnosis of CSU is debatable.
OBJECTIVE
We aimed at determining the role of PT in selected patients with CSU.
METHODS
In this retrospective study, we reviewed cases of patients referred for patch testing at our clinic. We compared results of patients with CSU (n = 134) and patients with suspected allergic contact dermatitis (n = 680; control group).
RESULTS
Among patients in the CSU group, 3% of patients had relevant reactions to PT, indicating that contact allergen avoidance resulted in resolution of all skin findings. Metals and textile dyes were the most relevant allergens. No significant differences were found between the groups with regard to the percentage of patients with positive PT and hapten reaction profiles. Patients from the CSU group were significantly older (4.1 years on average, < 0.05), consisted of more females, and were less likely to have atopic trait (46% vs 58%, P<0.05).
CONCLUSION
In some of patients, PT may assist in determining the cause of CSU.
PubMed: 34456574
DOI: 10.2147/JAA.S325657 -
Indian Dermatology Online Journal 2019Allergic contact dermatitis (ACD) is a growing concern due to increased use of cosmetics and topical medications routinely and exposure to a large number of allergens on...
Clinicoepidemiological and Patch Test Profile of Patients Attending the Contact Dermatitis Clinic of a Tertiary Care Hospital in North India: A 7-Year Retrospective Study.
INTRODUCTION
Allergic contact dermatitis (ACD) is a growing concern due to increased use of cosmetics and topical medications routinely and exposure to a large number of allergens on day-to-day basis. Patch testing is a reliable method for detecting the causative antigens in suspected cases.
AIMS AND OBJECTIVES
To assess the demographic profile, pattern of ACD, and patch test profile of suspected cases of ACD attending contact dermatitis clinic of our department.
MATERIALS AND METHODS
It was a retrospective study in which all the data enrolled in the contact dermatitis clinic of our department over a 7-year period were analyzed. Patch testing was done using the Indian Standard Series of 20 antigens primarily, and other batteries were used depending on patient requirement and availability.
RESULTS
A total of 582 patients were enrolled in the contact dermatitis clinic over a period of 7 years. Hand eczema was the most common pattern seen in 268 cases followed by feet eczema, hand and foot eczema, facial eczema, forearm and leg eczema and photoallergic contact eczema. A total of 177 patients (30.4%) gave positive patch test results, with nickel sulfate being the most common allergen identified followed by potassium dichromate, cobalt sulfate, paraphenylenediamine, neomycin sulfate, and fragrance mix.
CONCLUSION
Common allergens identified in our study were more or less similar to studies from other parts of India. However, due to the unique climate of the valley, the profile of parthenium sensitivity was low in our study when compared to the rest of the country.
PubMed: 31807446
DOI: 10.4103/idoj.IDOJ_26_19 -
Arthroplasty (London, England) Sep 2022To assess the Nickel sensitizing potential of total knee arthroplasty (TKA), explore the relationship between hypersensitivity and clinical outcomes, and evaluate the... (Review)
Review
BACKGROUND
To assess the Nickel sensitizing potential of total knee arthroplasty (TKA), explore the relationship between hypersensitivity and clinical outcomes, and evaluate the utility of skin patch testing pre- and/or postoperatively.
MATERIALS AND METHODS
A literature search was performed through EMBASE, Medline and PubMed databases. Articles were screened independently by two investigators. The level of evidence of studies was assessed using the Oxford Centre for Evidence-Based Medicine Criteria and the quality evaluated using the Methodological Index for Non-randomized Studies and Cochrane risk-of-bias tools.
RESULTS
Twenty studies met the eligibility criteria, reporting on 1354 knee arthroplasties. Studies included patients undergoing primary or revision TKA, pre- and/or postoperatively, and used patch testing to identify Nickel hypersensitivity. Prevalence of Nickel hypersensitivity ranged from 0% to 87.5%. One study compared the prevalence of Nickel hypersensitivity in the same patient group before and after surgery and noted newly positive patch test reactions in three patients (4.2%). Three studies reported lower prevalence of Nickel hypersensitivity in postoperative patients compared to preoperative ones. Seven studies suggested that hypersensitivity might cause adverse clinical outcomes, but six did not support any relationship. Seven studies recommended preoperative patch testing in patients with history of metal allergy, and nine concluded that testing may be valuable postoperatively.
CONCLUSIONS
Patients undergoing TKA with no prior history of metal hypersensitivity do not seem to be at an increased risk of developing Nickel hypersensitivity, and there is conflicting evidence that patients with pre-existing hypersensitivity are more likely to experience adverse outcomes. Patch testing remains the most commonly used method for diagnosing hypersensitivity, and evidence suggests preoperative testing in patients with history of metal allergy to aid prosthesis selection, and postoperatively in patients with suspected hypersensitivity once common causes of implant failure have been excluded, since revision with hypoallergenic implants may alleviate symptoms.
PubMed: 36050799
DOI: 10.1186/s42836-022-00144-5 -
International Journal of Molecular... Aug 2023Drug hypersensitivity reactions can be classified as immediate or delayed. While diagnostic options for immediate reactions are well developed and standardized, delayed...
Drug hypersensitivity reactions can be classified as immediate or delayed. While diagnostic options for immediate reactions are well developed and standardized, delayed reactions (in many cases type IV according to Gell and Coombs) are a challenge for allergy work-up. In recent years, some in vitro markers have been proposed and used for delayed reactions, such as contact dermatitis. Primary strategy: Avoidance is difficult to achieve, especially for COVID-19 vaccinations, when immunity against infection is extremely important. The aim of our study was to evaluate the application of in vitro delayed hypersensitivity tests in COVID-19 vaccines. Seven patients with a positive history of severe delayed drug allergy were enrolled. Vein blood was collected to stimulate cells with the tested vaccines (Comirnaty, Janssen, Spikevax) and excipients with the assessment of CD40L, CD69, IL-2, IL-4, IL-6, IL-10, IFNgamma, TNFalfa, and intracellular markers: granulysin and INFgamma. In addition, basophile activation tests, patch tests, skin prick tests, and intradermal tests were performed with the tested vaccine. Finally, the decision was made to either administer a vaccine or resign. Two out of seven patients were considered positive for drug hypersensitivity in the in vitro test according to the high vaccine stimulation index measured with CD69 (6.91 and 12.18) and CD40L (5.38 and 15.91). All patch tests, BATs, and skin tests were negative. Serum interleukin measurements were inconclusive as the impact of the vaccine itself on the immunity system was high. Intracellular markers gave uncertain results due to the lack of stimulation on the positive control. CD69 and CD40L could be reliable in vitro markers for delayed hypersensitivity to COVID-19 vaccines. Patch tests, skin tests, BATs, and serum interleukins did not confirm their usefulness in our study.
Topics: Humans; COVID-19 Vaccines; CD40 Ligand; COVID-19; In Vitro Techniques; Drug Hypersensitivity; Hypersensitivity, Delayed; COVID-19 Testing
PubMed: 37686102
DOI: 10.3390/ijms241713296 -
Postepy Dermatologii I Alergologii Jun 2020Atopic dermatitis (AD) is a chronic inflammatory disease caused by the complex interaction of genetic, immune and environmental factors such as food and airborne...
INTRODUCTION
Atopic dermatitis (AD) is a chronic inflammatory disease caused by the complex interaction of genetic, immune and environmental factors such as food and airborne allergens. The atopy patch test (APT) is a useful way to determine delayed-type hypersensitivity reactions to food and aeroallergens. Many studies have also suggested that food additives are associated with dermatologic adverse reactions and the aggravation of pre-existing atopic dermatitis symptoms.
AIM
To elucidate the contact sensitivity to food additives in children suffering from AD by using standardized atopy patch testing.
MATERIAL AND METHODS
A total of 45 children with AD and 20 healthy children have been enrolled. All the children have regularly consumed food containing additives, and were subjected to atopy patch tests.
RESULTS
In total, 28 (62%) children with AD and 4 (20%) healthy children have had positive patch test reactions to ≥ 1 allergens. There has been a significant difference ( = 0.04) between the groups in terms of the positivity rate in the patch test and the most common allergen that elicited positive patch test results in the AD group was azorubine ( = 11, 24.4%, = 0.014).
CONCLUSIONS
In our study, contact sensitivity was detected more frequently in AD patients. Food additives may play a role in the development and exacerbation of AD. Atopy patch testing with food additives can be useful in the treatment and follow-up of children with AD.
PubMed: 32792881
DOI: 10.5114/ada.2020.96112 -
Materials (Basel, Switzerland) May 2020In order to ensure the safety of traffic, asphalt pavement is commonly required to utilize aggregates with excellent anti-abrasion property. This results in the lack of... (Review)
Review
In order to ensure the safety of traffic, asphalt pavement is commonly required to utilize aggregates with excellent anti-abrasion property. This results in the lack of high-quality aggregates. The incorporation of solid waste in the aggregates is regarded as a high potential alternative for solving this problem. Since its material properties, such as rough surface, high Polished Stone Value (PSV) and the excellent adhesion property of asphalt, Basic Oxygen Furnace (BOF) slag can effectively improve the skid resistance of asphalt mixtures. First, the material properties of BOF slag are reviewed in this study. Then, the skid resistance of asphalt mixtures and aggregates are commendably evaluated by the Polished Stone Value test, Wehner/Schulze Tester, Aachen Polishing Machine, British Pendulum Test and Sand Patch test. The physical and mechanical properties of BOF slag play a key role in asphalt mixtures. This review found that the skid resistance mechanism of the BOF slag asphalt mixture is governed by factors such as BOF slag properties, incorporation methods and gradation types. Finally, the economic and environmental benefits of BOF slag asphalt mixtures were discussed. In addition, the function of gas catalysis and the melting of ice and snow can be added to the BOF slag asphalt mixture for a cleaner development in engineering. Furthermore, the existing problems, research directions and corresponding measures in this field are directed towards more durable and functional asphalt pavement construction.
PubMed: 32397170
DOI: 10.3390/ma13092169 -
Life (Basel, Switzerland) May 2022Atopic dermatitis (AD) is a chronic inflammatory disease characterised by an impaired skin barrier. The prolonged use of topical preparations containing medications,...
Atopic dermatitis (AD) is a chronic inflammatory disease characterised by an impaired skin barrier. The prolonged use of topical preparations containing medications, emollients, fragrances and preservatives may increase the risk of contact hypersensitivity (CHS). In the Allergy Outpatient Unit of the Department of Dermatology, Venereology and Dermatooncology of Semmelweis University, 5790 adult patients were patch tested between 2007-2021 with the European Environmental Baseline Series according to international standards. Among all the tested adult patients, 723 had preservative CHS (PCHS) and 639 had AD. Among the 723 PCHS patients, 68 (9.4%) had AD; the female to male ratio was 3:1 in this group. Out of 639 AD patients, 68 had PCHS (10.6%). In the AD-PCHS group, 83.8% had CHS to methylisothiazolinone (MI) (tested from 2014), 36.8% to Kathon CG, 16.2% to methyldibromo-glutaronitrile, 11.8% to paraben, 7.4% to formaldehyde, 4.4% to para-tert-butylphenol-formaldehyde resin and 1.5% to Quaternium-15. The most common concomitant PCHS combination was Kathon CG + MI. Most patients (32.4%) belonged to the age group of 21-30, and skin symptoms affected mostly the limbs and face. The most common other concomitant allergens were nickel, lanolin alcohol and balsam of Peru. Preservatives (especially MI and Kathon CG) are important contact allergens in adult AD, mostly among young women. The rate of AD in the PCHS group and the rate of PCHS in the AD group is remarkable; thus, the role of PCHS should be highlighted in the topical therapy and in the prevention of possible AD exacerbations.
PubMed: 35629382
DOI: 10.3390/life12050715 -
Journal of Dental Sciences Jul 2022Distinguishing oral lichenoid contact lesions (OLCLs) from oral lichen planus (OLP) is challenging. This study aimed to identify clinicopathological findings to...
BACKGROUND/ PURPOSE
Distinguishing oral lichenoid contact lesions (OLCLs) from oral lichen planus (OLP) is challenging. This study aimed to identify clinicopathological findings to distinguish OLCLs from OLP, and to evaluate the effectiveness of removing metal allergens in the treatment of OLCLs.
MATERIALS AND METHODS
This study retrospectively evaluated 30 patients diagnosed with OLCLs, and 30 age- and sex-matched OLP patients. We also evaluated the effectiveness of removing dental metal containing positive metal allergen, confirmed by skin patch test and metal component analysis in patients with OLCLs.
RESULTS
Palladium and gold were the most common patch test-positive metals observed in the oral cavity of patients with OLCLs. The patients with OLCLs were more likely to present with white type lesions in the buccal mucosa and gingiva than were the patients with OLP (p = 0.030, 0.009, respectively). Overall, 50.0% of patients with OLCLs failed to meet the histopathological diagnostic criteria of OLP. Twenty-three of 24 (95.8%) patients with OLCLs showed a complete or partial improvement after the removal of dental metal.
CONCLUSION
The present findings suggest the importance of a skin patch test and metal component analysis to confirm suspected OLCLs related to dental metal allergy, as these lesions may improve with the removal of the allergy-inducing metal.
PubMed: 35784139
DOI: 10.1016/j.jds.2021.11.008 -
Diagnostics (Basel, Switzerland) Sep 2023One of the most common types of cancer among in women is cervical cancer. Incidence and fatality rates are steadily rising, particularly in developing nations, due to a...
One of the most common types of cancer among in women is cervical cancer. Incidence and fatality rates are steadily rising, particularly in developing nations, due to a lack of screening facilities, experienced specialists, and public awareness. Visual inspection is used to screen for cervical cancer after the application of acetic acid (VIA), histopathology test, Papanicolaou (Pap) test, and human papillomavirus (HPV) test. The goal of this research is to employ a vision transformer (ViT) enhanced with shifted patch tokenization (SPT) techniques to create an integrated and robust system for automatic cervix-type identification. A vision transformer enhanced with shifted patch tokenization is used in this work to learn the distinct features between the three different cervical pre-cancerous types. The model was trained and tested on 8215 colposcopy images of the three types, obtained from the publicly available mobile-ODT dataset. The model was tested on 30% of the whole dataset and it showed a good generalization capability of 91% accuracy. The state-of-the art comparison indicated the outperformance of our model. The experimental results show that the suggested system can be employed as a decision support tool in the detection of the cervical pre-cancer transformation zone, particularly in low-resource settings with limited experience and resources.
PubMed: 37761252
DOI: 10.3390/diagnostics13182884