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Biomedical subjects

D Sasseville

Publications and source records attributed to D Sasseville.

15 recordsLinked to original sources

Allergic contact dermatitis to epoxy resin in microscopy immersion oil: cases from Canada.

The presence of epoxy resin in a reformulated immersion oil for microscopy has caused an epidemic of occupational contact dermatitis in laboratory technicians from some European centers. We report 6 additional cases, the mode of presentation of which was similar to the European patients. All patients were patch tested to the undiluted oil, and some were tested to the European or North American standard series and to an extensive series of glues and adhesives allergens. At 96 hours, all 6 patients displayed a strong 2+ to 3+ reaction to the undiluted oil. Two patients were not further tested, but in the remaining 4, positive reactions were seen to epoxy resin from the standard tray. One patient reacted to cycloaliphatic epoxy resin, and 2 displayed positive tests to the reactive diluents phenyl glycidyl ether and cresyl glycidyl ether. These further cases confirm the strong sensitizing properties of this particular immersion oil. The product, manufactured by Leica Microsystems (Wetzlar, Germany), since has been withdrawn from sale.

Adult↗

Allergic contact dermatitis to tea tree oil with erythema multiforme-like id reaction.

The commercial production of tea tree oil, extracted from Melaleuca alternifolia Cheel, has considerably increased over the past 15 years in response to a strong demand for natural remedies and aromatic substances. The number of case reports that describe allergic contact dermatitis (ACD) to this essential oil is also on the rise. We report an additional case of ACD to tea tree oil that presented with an extensive erythema multiforme-like reaction. A skin biopsy was performed from a targetlike lesion distant from the site of the initial dermatitis. The patient was treated with systemic and topical corticosteroids. Five months later, he was patch tested to the North American standard series, to his own tea tree oil, to a fresh batch of tea tree oil, and to some related allergens. The skin biopsy showed a spongiotic dermatitis without histological features of erythema multiforme. Patch testing elicited a 3+ reaction to old, oxidized tea tree oil, a 2+ reaction to fresh tea tree oil, a 2+ reaction to colophony, a 1+ reaction to abitol, and a 1+ reaction to balsam of Peru. We believe this is the first report of erythema multiforme-like reaction secondary to ACD from tea tree oil. Other interesting features are the stronger reaction to oxidized than to fresh tea tree oil, and concomitant reactivity to colophony, abitol, and balsam of Peru.

Allergens↗

Pseudoporphyria induced by propionic acid derivatives.

BACKGROUND: Pseudoporphyria is a photosensitive bullous skin disease that is distinguished from porphyria cutanea tarda (PCT) by its normal porphyrin profile. Drugs are a major cause of this disease, and the list of culprits is continually expanding. Nonsteroidal antiinflammatory agents (NSAIDs), especially naproxen and other propionic acid derivatives, appear to be the most common offenders. OBJECTIVE: The study was carried out to increase awareness about the etiology and characteristic features of pseudoporphyria. METHODS: We report two cases of pseudoporphyria caused by naproxen and oxaprozin. We review the current English language literature on this entity and discuss its clinical features, histology, ultrastructure, etiology, and pathophysiology. RESULTS: A 44-year-old man taking naproxen for chronic low back pain and a 20-year-old woman on oxaprozin for rheumatoid arthritis presented with tense bullae and cutaneous fragility on the face and the back of the hands. In both, skin biopsy showed a cell-poor subepidermal vesicle with festooning of the dermal papillae. Direct immunofluorescence revealed staining at the dermal-epidermal junction and around blood vessels with IgG in the first case and with IgG, IgA, and fibrin in the second case. Urine collections and serum samples yielded normal levels of uro- and coproporphyrins. CONCLUSIONS: Most cases of pseudoporphyria are drug-induced. Naproxen, the most common offender, has been associated with a dimorphic clinical pattern: a PCT-like presentation and one simulating erythropoietic protoporphyria in the pediatric population. Other NSAIDs of the propionic acid family can also cause pseudoporphyria.

Adult↗

Phytodermatitis.

BACKGROUND: Most dermatologists can recognize the classic patterns of presentation of plant contact dermatitis; however, few can recognize the offending plants or know the name and chemical structure of the allergens or irritants that they contain. OBJECTIVE: Five basic clinical patterns of phytodermatitis are reviewed: 1) allergic phytodermatitis, 2) photophytodermatitis, 3) irritant contact dermatitis, 4) pharmacologic injury, and 5) mechanical injury. The plants responsible for each pattern are presented by families, according to current scientific taxonomy. The chemical structure of the offending substances is described, and principles of investigation, prevention, and treatment are outlined. CONCLUSIONS: Plant contact dermatitis remains an extremely vast and complex topic. Exotic plants and woods are now present in our gardens and homes. The newfound interest in aromatherapy, phytotherapy, and so-called "natural" therapies is the cause of a tremendous increase in exposure to plant products and extracts. This is responsible for the appearance of atypical patterns of plant contact dermatitis with which the practising dermatologist must become familiar.

Dermatitis, Allergic Contact↗

Interferon-induced cutaneous necrosis.

BACKGROUND: Due to advances in recombinant DNA technology, interferons are now readily available and are frequently used in all branches of medicine. These potent biologic response modifiers carry a number of systemic and local side effects. These cytokines are usually administered subcutaneously, and recent studies have described the occurrence of inflammation or necrosis at the site of injection. OBJECTIVE: We report a case of cutaneous necrosis at the sites of interferon injections in a 35-year-old man treated for chronic myeloid leukemia with high, daily doses of interferon alfa. In addition, we review the existing literature on interferon-induced cutaneous necrosis and discuss preventive strategies. CONCLUSION: Cutaneous inflammation or necrosis at interferon injection sites is not uncommon. Although interferon beta-1b is most commonly responsible for this complication, it is now increasingly reported with interferon alfa. It appears to be secondary to the proinflammatory effects of these cytokines or to their unmasking of a subtle hypercoagulable state.

Adult↗

Allergic contact dermatitis from hydrocolloid dressings.

BACKGROUND: Hydrocolloid wound dressings have been in use for nearly two decades, and have rarely caused allergic contact dermatitis. DuoDERM E (DuoDERM CGF) is a newer version of DuoDERM (ConvaTec Ltd, a division of Bristol-Myers Squibb Co, Princeton, NJ) that contains a sensitizing derivative of colophony. OBJECTIVE: We describe three patients who developed eczematous lesions under this type of wound covering. METHODS: The patients were patch tested to the European standard series, to a glues and adhesives series, and to pieces of various adhesive dressings. RESULTS: The patients displayed positive patch tests to colophony and to DuoDERM E or DuoDERM CGF hydrocolloid dressings. CONCLUSION: These dressings contain the pentaerythritol ester of hydrogenated rosin as a tackifying agent, and this substance retains the sensitizing potential of colophony. The addition of this compound is an important change that may negatively alter the good safety record of ConvaTec dressings.

Adult↗

Clinicopathological relevance of the association between gastrointestinal and sebaceous neoplasms: the Muir-Torre syndrome.

The association between sebaceous neoplasms of the skin and visceral cancers, known as Muir-Torre syndrome, is described in three patients, including one with an extensive history of cancer in his family. The first patient, a 54-year-old man, developed multiple sebaceous adenomas, epitheliomas, and carcinomas in association with a colonic carcinoma 6 years after cardiac transplantation. Family history in this patient disclosed colon cancer in 17 relatives. The second patient was a 51-year-old man who had recurrent adenocarcinoma of the sigmoid colon, adenocarcinoma arising in Barrett's esophagus, and sebaceous epithelioma during a period of 15 years. The third patient was a 90-year-old man with a sebaceous adenoma followed 5 months later by adenocarcinoma of the sigmoid colon with liver metastases. Muir-Torre syndrome in 129 other patients published in the literature is reviewed. Although it is a rare disease, Muir-Torre syndrome requires recognition because skin lesions may be the first sign of the syndrome and this may lead to early diagnosis of associated visceral cancers. Moreover, because this syndrome appears to be inherited, family members should be screened for visceral cancer, especially colorectal adenocarcinoma.

Adenocarcinoma, Sebaceous↗

Rothmund-Thomson syndrome with osteosarcoma.

Rothmund-Thomson syndrome is a rare genodermatosis that features a progressive, early-onset poikiloderma, a high incidence of juvenile cataracts, stunted growth, and a wide range of skeletal abnormalities. We report the seventh case of osteosarcoma in a patient with Rothmund-Thomson syndrome and review the previous reports describing this association.

Bone Neoplasms↗