Allergic contact dermatitis to cocamidopropyl betaine in shampoo.
Explore the source record for details and available documents.
Adult↗
Biomedical subjects
B Przybilla
Publications and source records attributed to B Przybilla.
A naturally occurring opioid peptide from cow's milk, beta-casomorphine-7, is a direct histamine releaser in man.
beta-Casomorphine-7, a naturally occurring product of cow's milk with opiate-like activity, was studied for possible direct histamine liberation activities in humans. It was found to cause concentration-dependent in vitro histamine release from peripheral leukocytes of healthy adult volunteers. Intradermal injection of beta-casomorphine-7 induced a wheal and flare reaction in the skin similar to histamine or codeine. Oral pretreatment with the H1 antagonist terfenadine significantly inhibited the skin responses to beta-casomorphine-7. The intradermal injection of an opiate receptor antagonist, naloxone, inhibited in vitro histamine release and skin reactions only in a 100-fold excess over beta-casomorphine-7. These findings suggest that beta-casomorphine-7 can be regarded as a noncytotoxic, direct histamine releaser in humans. The clinical relevance of these findings deserves further studies.
Adult↗
Malignant melanoma in association with phototherapy.
A 54-year-old Caucasian male suffering from psoriasis had been treated in 1978 and 1980 with PUVA (cumulative UVA dose 492.5 J/cm2) and from 1980 to 1989 with UVB (cumulative UVB dose 264.5 J/cm2). Other occasional treatment had comprised the topical administration of glucocorticosteroids, dithranol or tar. In 1989, on the upper part of the patient's back a newly developed pigmented skin lesion was excised under the clinical diagnosis of a pigmented, dysplastic nevus. Histological examination revealed a superficial spreading malignant melanoma (0.4 mm thick, Clark level II). In this case, exposure to high cumulative doses of therapeutic UV irradiation might have played an etiological role for the development of malignant melanoma.
Humans↗
Acute mercury intoxication with lichenoid drug eruption followed by mercury contact allergy and development of antinuclear antibodies.
A 31-year-old black man was examined for evaluation of a suspected occupational disease. Three years earlier he had been suffering from acute mercury intoxication during work in a mercury recycling factory. Skin symptoms then had been a lichenoid drug eruption, patchy alopecia and stomatitis, which had all disappeared rapidly after systemic glucocorticosteroid treatment. The examination revealed positive patch test reactions to metallic mercury and inorganic mercury compounds, an elevated titre of serum antinuclear antibodies and normal IgE levels. The induction of antinuclear antibodies by mercury has been shown in animal experiments. It can be hypothesized that this patient, who may have had an increased individual susceptibility, became allergic to mercury by the mercury intoxication.
Acute Disease↗
Demonstration of olaquindox phototoxicity in vitro.
Olaquindox is an oral anti-bacterial agent used as an additive to animal food. It is known to cause photosensitization in pig breeders, probably due to a photoallergic mechanism. Also, olaquindox was found to be phototoxic in animal experiments. We have evaluated the phototoxic properties of olaquindox in vitro with a photohemolysis test using different light sources. Irradiation with a source rich in ultraviolet A (UVA) and, to a lesser degree, with a lamp emitting mainly visible light induced photohemolysis, which depended on the concentration of olaquindox and the radiation dose. Exposure to radiation rich in UVB caused no olaquindox-dependent hemolysis. The absorption spectrum of olaquindox changed prominently after irradiation, indicating photodegradation of the compound.
Dermatitis, Phototoxic↗
[Impaired work capacity in dermatologic expert assessment].
Loss of earning capacity caused by skin diseases frequently has to be assessed by accredited dermatological experts. Assessments must take account of the appropriate legal situation in each case. Each case needs to be carefully and individually evaluated; tabulated estimations can only be used as a basis.
Dermatitis, Contact↗
[Diagnosis of photoallergic exanthema in the symptom-free interval].
Explore the source record for details and available documents.
Exanthema↗
Two-year double-blind trial of a monomethoxy polyethylene glycol (mPEG) modified grass pollen extract at different dose levels.
The aim of this study was to compare the efficacy and safety of a monomethoxypolyethylene glycol (mPEG) modified grass pollen mix allergen preparation (mPEG-gm) and a partly purified grass pollen mix allergen preparation (gm) in hyposensitization (HS), evaluating both products at two dose levels. Thirty adult patients with allergic rhinoconjunctivitis were allocated into two treatment groups based on their sensitivity to conjunctival provocation tests (CPT). Treatment was given in a double-blind manner. The starting dose was 20 BU and was approximately doubled weekly up to 20,000 BU the first year and 120,000 BU the second year. Skin testing and CPT were performed before treatment and at each dose level. All patients reached 20,000 BU the first year. Twenty-five patients continued the second year. Twenty-one of those reached 120,000 BU (9/12 on mPEG-gm and 12/13 on gm). The frequency of general side effects was reduced by about 50% with the mPEG grass mix compared with native grass mix. A significant improvement in the conjunctival sensitivity was found in both treatment groups the second year (120,000 BU) but not the first year (20,000 BU). Seventy-eight percent of the patients in the gm group and 50% in the mPEG-gm group improved by CPT (not statistically significant). The skin sensitivity was reduced after 1 year at low dose in 69% of the gm-treated patients and 33% of the mPEG treated patients. After the second year at high dose levels, the skin sensitivity decreased in all patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
[Arndt-Gottron scleromyxedema. Case report and review of therapeutic possibilities].
We report on a 54-year-old patient with an 11-year history of Arndt-Gottron scleromyxoedema. We found typical lichenoid papules, diffuse skin thickening and skin hardening. Clinical and laboratory investigations revealed a monoclonal gammopathy of the IgG1 type, normal histology of the bone marrow and normal urine. Therefore, a diagnosis of monoclonal gammopathy of undetermined significance was recorded. Phimosis and stenosis of the urethra were the only other pathologic findings. Systemic treatment with chlorambucil and PUVA had little beneficial effect on the skin thickening after 9 months.
Biopsy↗
Photopatch testing: the 5-year experience of the German, Austrian, and Swiss Photopatch Test Group.
A cooperative photopatch test study was conducted by 45 dermatologic centers in Austria, Germany, and Switzerland. Results obtained from 1985 to 1990 are presented. A standard photopatch test tray of 32 substances was applied to the back of patients with suspected photosensivity. After applications for 24 hours, test sites were irradiated with 10 joules/cm2UVA. Unirradiated controls were included. Readings were performed immediately and 24, 48, and 72 hours after irradiation; responses were qualitatively graded on a 4-point scale. All data were stored and processed by a computer. With computer-assisted analysis of reaction patterns photoallergic reactions were identified and distinguished from phototoxic reactions. Data of 1129 patients were evaluated. Among a total of 2859 positive test reactions in 870 patients, 2041 in 778 patients were found to be photoinduced and 818 in 413 patients were contact reactions; 108 reactions in 83 patients were classified as photoallergic. Nonsteroidal anti-inflammatory drugs, disinfectants, sunscreens, phenothiazines, and fragrances caused most often photoallergic reactions. Many unspecific phototoxic reactions were induced by tiaprofenic acid, promethazine, carprofen, chlorpromazine, fenticolar, wood balsam of Peru, and perfumes. Despite the distinction between photoallergic and phototoxic responses, many test reactions lacked relevance for the patients' dermatoses.
Adolescent↗
Inhibition of 12(S)-hydroxyeicosatetraenoic acid [12(S)-HETE] binding to epidermal cells by ultraviolet-B.
12-hydroxyeicosatetraenoic acid (12-HETE), the main eicosanoid in skin, is assumed to have both pathophysiologic effects in inflammatory skin diseases such as psoriasis and atopic eczema and a physiologic role in the biology of cutaneous reparative processes. Because 12-HETE exerts its effects via specific high-affinity epidermal receptors, and ultraviolet-B (UV-B) is capable of modulating various cell-surface molecules, the effects of single and repeated UV-B irradiations on the 12(S)-HETE binding sites in a human epidermal cell line, SCL-II, were studied. UV-B (100-300 J/m2) induced a large decrease in 12(S)-HETE binding in a dose-dependent manner. The inhibition occurred after a latency period of 6 h, reached its maximum at 18 h and slowly declined thereafter. A single UV-B dose of 300 J/m2 or repeated irradiation with 50 J/m2 of UV-B resulted in a 70% decrease in the number of binding sites (Bmax), whereas receptor affinity remained unaffected. The modulation of epidermal 12-HETE receptors by UV-B may partly explain the therapeutic effects of UV-B, but possibly also contribute to photodamage to skin.
Cell Count↗
Emergency treatment of allergic reactions to Hymenoptera stings.
Allergic reactions to Hymenoptera stings are frequently observed all over Europe. Rarely they may induce long-standing morbidity or even be fatal. Several investigations have shown that the emergency treatment given to these patients is often inadequate. Cutaneous symptoms respond well to antihistamines and also to adrenaline. Adrenaline is the mainstay for outside hospital treatment of more severe reactions involving the respiratory tract (bronchial asthma, laryngeal oedema) and the cardiovascular system (anaphylactic shock). Inhaled adrenaline is especially useful in respiratory symptoms, while parenteral application of adrenaline is prefered for shock treatment. All patients with severe respiratory or cardiovascular reactions must be hospitalized, treated under intensive care conditions and observed for at least 24 hr. Emergency medications including adrenaline for inhalation or for self-injection must be given to all patients with a history of systemic allergic reactions to hymenoptera stings. These patients must also get instructions for safety measures to avoid further stings. They should be referred to an allergist in order to evaluate the indication for venom immunotherapy.
Anaphylaxis↗
Clinical characteristics of patients with repeated systemic reactions during specific immunotherapy with hymenoptera venoms. A retrospective study.
In general, specific immunotherapy with hymenoptera venoms can be considered as safe, but occasionally there are patients who cannot reach the maintenance dose due to repeated systemic reactions (RSR) or who suffer from RSR during maintenance therapy. In a multicenter retrospective study comprising seven departments in Germany, Austria and Switzerland 23 patients with RSR were reported from approximately 3000 patients treated with hymenoptera venoms (bee and wasp venom to approximately equivalent frequency). From these, 22 were allergic to bee venom and only one to vespid venom. In general the clinical symptoms of RSR were milder than the initial reaction. But 4/23 (18%) exhibited cardiovascular reactions up to full shock. Neither anamnestic details, reactivity in skin tests or in vitro tests revealed a special pattern of patients with RSR. In some patients, however, an extremely high reactivity in the skin test was found and may indicate the possibility of further RSR.
Adolescent↗
Association of features of atopy and diagnostic parameters in hymenoptera venom allergy.
In a total of 525 patients with hypersensitivity reactions to hymenoptera stings diagnostic parameters of hymenoptera venom (HV) allergy (severity of reactions, skin test threshold and RAST for bee and vespid venoms) were investigated for their relationship to the following indicators of atopy: positive history of atopic diseases, elevated (less than or equal to 100 kU/l) total serum IgE and positive prick test reactions to common inhalant allergens (CIA) (grass pollen, cat epithelium, house dust mite). There was a conclusive history of atopic disease in 25%, a total serum IgE greater than or equal to 100 kU/l in 48%, and at least one positive reaction to CIA in 53%. Total IgE greater than or equal to 100 kU/l correlated with a higher frequency of RAST classes greater than or equal to 2 (P less than 0.01) and with less severe reactions to hymenoptera stings (P less than 0.05). In the presence of at least one positive reaction to CIA, there were more frequently skin test thresholds less than or equal to 10 micrograms/ml (P less than 0.05) and RAST classes greater than or equal to 2 (P less than 0.01) for HV than in CIA prick test negative individuals. There was no significant, relationship between the other pairs of parameters evaluated. Thus, reactivity to HV in diagnostic tests is increased in the presence of certain indicators of atopy. This has to be considered in the interpretation of skin test and RAST results obtained with HV.
Adolescent↗
Patch testing with fragrance-mix and its constituents: discrepancies are largely due to the presence or absence of sorbitan sesquioleate.
Explore the source record for details and available documents.
Dermatitis, Contact↗
Ethylenediamine contact dermatitis.
Explore the source record for details and available documents.
Dermatitis, Contact↗
Atopic eczema, Langerhans cells and allergy.
While the pathomechanisms of respiratory atopy are rather well established, the role of IgE-mediated hypersensitivity in the elicitation and maintenance of eczematous skin lesions in atopic eczema is still controversial. Few diseases are characterized by an equally elevated production of IgE antibodies as atopic eczema. Many authors, however, regard this only as epiphenomenon. On the other hand, there is clearcut clinical evidence for exogenous elicitation of atopic eczema by contact with aero or food allergens. A variety of hypotheses may help to explain the participation of IgE antibodies in the induction of eczema: vasoactive mediators secreted by skin mast cells or basophils after allergen contact may produce itch, contact urticaria or a 'late-phase-reaction' with consequent eczematous skin changes further maintained by scratch responses. Recent investigations stress a possible role of Langerhans cells in the epidermis with a low affinity receptor for IgE with possible function for antigen presentation, mediator release or regulatory interactions. Certain cytokines such as interleukin-4 or gamma-interferon are able to enhance the expression of the IgE-receptor on the surface of Langerhans cells. IL-4 and gamma-interferon act synergistically in this respect on Langerhans cells, contrary to B cells. Furthermore lymphocytes may act directly via certain cytokines (e.g. histamine releasing factor, chemotactic factors etc.) on mast cells or eosinophil granulocytes in a proinflammatory sense. Eosinophils seem also to be involved in the inflammatory response in atopic eczema by releasing products such as major basic protein (MBP) or eosinophil cationic protein (ECP) which has been found to be elevated in severe atopic eczema.(ABSTRACT TRUNCATED AT 250 WORDS)
Allergens↗
Stigmata of atopic constitution in patients with atopic eczema or atopic respiratory disease.
In the diagnosis of atopic eczema, minor physical markers (stigmata) frequently provide valuable clues. The prevalence of nine stigmata (dry skin, hyperlinearity of the palms or soles, infraorbital fold, white dermographism, facial pallor, orbital darkening, Hertoghe's sign, low hairline) was evaluated in 34 atopic eczema patients without atopic respiratory disease, in 16 patients with allergic rhinitis and/or asthma without atopic eczema, and in 23 controls without atopic respiratory or eczematous disease, and with negative results at prick testing with three common aeroallergens. Compared with controls, all features except Hertoghe's sign were significantly (p less than 0.01) more frequent in atopic eczema, and, except for Hertoghe's sign, dry skin and white dermographism, they were significantly (low hairline, p less than 0.05; others, p less than 0.01) more frequent also in respiratory disease. The prevalence of most stigmata did not differ significantly (p greater than 0.05) in cutaneous vs. respiratory atopic disease, only dry skin being more frequent in atopic eczema (p less than 0.05). Although not specific, most stigmata are characteristic markers not only of atopic eczema, but of atopy as such.
Adolescent↗