Use and misuse of sunscreens.
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Biomedical subjects
Publications and source records attributed to C Patruno.
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Increasing attention has been focused on contact sensitization to topical corticosteroids in the past several years. In most cases, allergy to topical corticosteroids occurs in patients with long-lasting eczematous diseases. Cross-allergy between topical corticosteroid molecules is very common, and four groups of cross-reacting molecules have been recognized. In this report, we describe a girl with atopic dermatitis and sensitized to hydrocortisone-17-butyrate who became sensitized to 6 alpha-methylprednisolone aceponate. Cross-sensitization between the two molecules is suggested.
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Numerous studies have focused attention on the influence of various biological and environmental factors on contact hypersensitivity. In order to evaluate the persistence and/or modification of allergic contact sensitivity to a number of common contact sensitizers, the same standardized patch tests were repeated on 174 subjects with contact sensitivity after a time lapse of 5 years (1987-1992). In 18.4% of the cases, 1 or more sensitivities were lost; 28.7% of the patients had a higher number of positive patch tests after 5 years, while the remaining 52.9% of the patients showed no change in the number of positive patch tests. In 88%, the positive allergens were unchanged, whereas in the remaining 12% of the subjects, they showed 1 or more variations. The association between the allergens most often positive was calculated for both the 1st and the 2nd patch test results. Moreover, to evaluate the frequency of an allergen's positivity, we studied the disappearance of old sensitivities and the appearance of new sensitivities by the McNemar test. Cobalt chloride was the only allergen with a significant frequency of new positivities over the period of observation (p < 0.01). Logistic regression analysis was performed to evaluate the possible influence of positive tests to other allergens, and of some clinical findings associated with contact dermatitis, on the sensitivity to cobalt chloride in 1987 and in 1992.
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The results of 7 months of patch testing with a standard series of 26 allergens in 323 children with eczematous conditions or itching palmoplantar psoriasis under the age of 14 years are reported. 114 (35.3%) of the children had 1 or more positive reactions to this standard series. 28 children (8.7%) were polysensitive. On the basis of personal history, additional series of allergens and/or specific allergens were also tested. 61.7% (90/146) of positive reactions were considered relevant to the current dermatitis. Metals, medicaments, preservatives or fragrances, and shoe components were the major sources of contact sensitization. It is suggested that patch testing be done more frequently in evaluating dermatitis in children.
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Two cases of bullous mastocytosis in children are described. This form must be differentiated from the more common mastocytosis with bullae: in the latter form, blisters occur on previously existing papillar or nodular lesions, whereas in bullous mastocytosis the blisters occur on apparently normal skin.
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