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Biomedical subjects

D Perrenoud

Publications and source records attributed to D Perrenoud.

16 recordsLinked to original sources

The efficacy of a protective cream in a real-world apprentice hairdresser environment.

The object of this study was to compare the protective action of a new barrier cream (Excipial Protect, Spirig Pharma AG, Egerkingen, Switzerland) to its vehicle in the context of hand irritation of apprentice hairdressers caused by repeated shampooing and exposure to hair-care products. This was a double-blind cross-over comparing Excipial Protect (containing aluminium chlorohydrate 5% as active ingredient) against its vehicle alone. The efficacy of the creams was evaluated taking into account: (1) clinical scores by researchers, (2) biometric measurements, (3) subjective opinions of the subjects. An analysis of variance was performed considering order of application, degree of atopy, and reported number of shampoos. We observed very little difference in efficacy between the protective cream and its vehicle. The presence, however, of aluminium chlorhydrate in the protective cream was shown to have a positive effect against work-related irritation. The cosmetic qualities of the creams seemed, to the participants, to be as important as their real protective and hydrating properties, an important factor in compliance issues.

Cross-Over Studies↗

[Skin diseases related to work: how to approach them?].

Work-related skin problems are frequent and mainly affect the hands. They can be approached by looking for indications of the 3 principal underlying types of dermatitis: irritant, allergic, or chronic. Irritation and contact allergy are closely associated: the irritation facilitates the flowering of the allergy. Skin irritation due to working conditions is often multi-causal and repetitive. Cutaneous atopy--but not that which is only respiratory or mucosal--is the main genetic risk factor for the development of a work-related skin disease. The characteristics of irritation and allergy tend to merge when the lesions become chronic. An 8-step process is suggested to establish the causal relationship between potentially damaging substances in the workplace and the resulting skin problems. In Switzerland, professional dermatitis falls under the purview of the accident insurance laws. These laws recognize causal responsibility whenever the work substances or activities are preponderant over non-professional causes.

Accidents, Occupational↗

Severe, chronic anorexia and extensive leg ulcerations as presenting signs of primary Sjögren's syndrome.

We report the case of a 75-year-old woman with a 15-year history of inappetance resulting in weight loss of approximately 40 kg. On physical examination, the skin of the lower extremities was markedly hyperpigmented with a brown-greyish hue. In addition, the skin of the legs was infiltrated, erythematous, riddled with erosions and necrotic ulcers. Clinical and laboratory evaluation revealed sicca syndrome, a pronounced polyclonal hypergammaglobulinemia (60 g/l), high levels of antinuclear, anti-SSA and anti-SSB antibodies. Histological examination of involved skin demonstrated a leukocytoclastic vasculitis.

Adenosine Triphosphatases↗

[Contact allergies due to drugs].

Topically applied drugs which can cause contact dermatitis are numerous and diverse. The ingredients for vehicles, base components and additives, are as frequently the cause of drug eruptions as active ingredients. Patients with chronic leg ulcers are particularly exposed to the risk of developing allergic contact dermatitis. The diagnosis is based on the analysis of causative association between the localisation (often limited) of the lesions, the moment of their appearance and the application of a drug into the skin. Use tests and/or patch-tests are tools for determining the diagnosis. The exact knowledge of the offending ingredient, of its potential sources and the possibility of cross-allergy are essential in order to prevent recurrence. Indeed, the causative treatment of drug contact dermatitis is based on the prescription and effective application of strict avoidance of the causative allergen, a procedure which necessitates special informative measures to both the patient and to his medical care environment.

Administration, Topical↗

Contact hypersensitivity to corticosteroids in routine patch test patients. A multi-centre study of the Swiss Contact Dermatitis Research Group.

BACKGROUND: Contact hypersensitivity to corticosteroids is increasingly reported and has been identified as a problem of considerable clinical relevance. The prevalence of positive patch tests to corticosteroids ranges from 0.2 up to 5%. OBJECTIVE: The prevalence of positive patch tests to corticosteroids in Switzerland was determined in a multi-centre study of patients undergoing routine patch tests. METHODS: As representatives of corticosteroid groups, the following substances were used for screening: tixocortol pivalate and hydrocortisone for group A (hydrocortisone type), hydrocortisone butyrate for group D (hydrocortisone butyrate type) and budesonide for both groups B (triamcinolone type) and D. Patients positive for at least one corticosteroid were retested with the screening series and 12 corticosteroids commonly used in Switzerland. RESULTS: Among 3,016 consecutive patients, 65 individuals (2.2%) with a total of 106 positive reactions were found. Retesting showed a concordance of 70-98%, depending on the corticosteroid and the score of the positive reaction. In the subsequently tested corticosteroid series including 12 substances, 19 out of 56 screening-positive patients had a positive result to one or several corticosteroids. There were only few evident cross-reactive patterns in between the corticosteroids tested. CONCLUSIONS: Corticosteroids should be included in routine patch testing, because contact sensitization to a corticosteroid is of considerable practical importance. We confirm that as markers of corticosteroid sensitization tixocortol pivalate, budesonide and hydrocortisone butyrate may be suited, because there is no single corticosteroid which is a marker for all four corticosteroid groups. Patch test reactions of 2+ or higher have a better reproducibility than 1+ reactions.

Administration, Topical↗

Frequency of sensitization to 13 common preservatives in Switzerland. Swiss Contact Dermatitis Research Group.

From February 1989 to January 1990, the Swiss Contact Dermatitis Research Group conducted a 1-year study to examine the frequency of sensitization to a series of 13 common preservatives. A group of 2295 consecutive outpatients with suspected allergic contact dermatitis (age range 7-90 years, with a mean age of 42; 911 males, 1384 females) was tested. The %s of positive reactions to the preservatives studied are as follows, in descending order: formaldehyde 5.7%, benzalkonium chloride 5.5%, Kathon CG 5.5%, thimerosal 4.2%, chlorhexidine digluconate 2.0%, DMDM hydantoin 1.7%, paraben mix 1.7%, chloroacetamide 1.5%, Bronopol 1.2%, imidazolidinyl urea 1.0%, quaternium 15 1.0%, triclosan 0.8%, 2,4-dichlorobenzyl alcohol 0.4%. These relatively high values suggest a heavy exposure of the Swiss population to topical preservatives. Compared to previous studies, the sensitization rate to Kathon CG has stabilized in Switzerland over the last 2 years. Sensitization to formaldehyde portrayed impressive geographical variation, with sensitization rates up to 9% in western and only 3% in eastern Switzerland. The low sensitization rate to parabens argues for their inclusion in a medicament or preservative series, rather than in the standard series.

Administration, Cutaneous↗

An epidemic outbreak of papular and follicular contact dermatitis to tocopheryl linoleate in cosmetics. Swiss Contact Dermatitis Research Group.

BACKGROUND: In Spring 1992, an epidemic outbreak of papular and follicular rashes caused by a new line of cosmetics occurred throughout Switzerland. OBJECTIVE: Epidemiological and clinical data were collected in order to identify the offending agent and to specify the pathophysiological mechanisms. METHODS: The data concerning 263 patients seen by dermatologists plus 642 additional cases directly reported by consumers to the manufacturer were analyzed. Seventy-seven patients were patch-tested, 26 extensively, and 15 performed a repeated open application test for a duration of 4 weeks. Control patch and use tests were performed in 73 and 25 patients, respectively. The results were analyzed statistically. In addition, 12 skin biopsies were performed for histological examination. Biochemical studies on the cosmetics (final products and offending ingredient) supplemented the clinical studies. RESULTS: The lesions were mainly papular and follicular, widely distributed, with pronounced pruritus, which was aggravated by sweating or heat exposure, and were long lasting. In a few cases, the papules were located on intensely erythematous, well-defined plaques, suggesting irritation rather than allergy. Both immediate and delayed onsets of the lesions were observed. Skin biopsies showed signs of folliculitis and perifolliculitis with little alteration of the interfollicular epidermis. Patch and use testing disclosed vitamin E linoleate (a mixture of tocopheryl esters, mainly tocopheryl linoleate) as the offending agent. An in vitro time-dependent formation of oxidative products under storage or oxidation-stimulating conditions was observed. CONCLUSION: Though vitamin E esters have been widely and safely used for decades in dermatological preparations and in cosmetics, vitamin E linoleate was the cause of about 1,000 cases of unusual papular mainly follicular contact dermatitis. Oxidized vitamin E derivatives could act in vivo as haptens and/or irritants, possibly with synergistic effects.

Adolescent↗

A comparative study of formaldehyde detection using chromotropic acid, acetylacetone and HPLC in cosmetics and household cleaning products.

Chromotropic acid and acetylacetone methods for qualitative determination of formaldehyde were tested in parallel on 48 commercial samples, with high-performance liquid chromotography (HPLC) implemented for quantitative measure. In addition, interference with the detection of formaldehyde was investigated by analyzing 12 other aldehydes and ketones, 7 essential oils and 3 polysorbates. Throughout this comparative study, the disadvantages of the chromotropic acid method, of which 2 variants were used, were delineated and we found that the acetylacetone test proved to be a more efficient screening method for formaldehyde detection in a clinical laboratory.

Chromatography, High Pressure Liquid↗

Sensitization to the isothiazolinone biocide. Report of the Swiss Contact Dermatitis Research Group 1988-1990.

The rate of sensitization to isothiazolinones (Kathon CG) detected in Switzerland rose from 3.5% (out of 2,491 patients) in 1987 to 6.3% (out of 982 patients) in 1988 and 5.6% (out of 2,295 patients) in 1989-90. This rate of sensitization appears to be related to the more and more widespread use of isothiazolinone biocide in cosmetics, domestic products and in industry.

Cosmetics↗