Labilin--a little-known contact allergen.
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Biomedical subjects
Publications and source records attributed to H Ippen.
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Diseases of the skin related to the use of swimming pools do not appear very often in medical reports. In this review of such diseases we designate changes in the skin and hair as being infectious, toxic or allergic in origin. Particular attention is given to allergenic additives in the water. There is no indication that public swimming pools in the Federal Republic of Germany present any danger to the skin.
T-lymphocytes and their subsets were determined in three patients with classical Kaposi's sarcoma. A reduction of pan-T-lymphocytes, including both a reduction of T-helper and T-suppressor cells, was found in one patient. None of the patients showed a reduction of the T-helper/T-suppressor cell ratio, as described in the lymphadenopathic disseminated type of Kaposi's sarcoma. Intradermal testing with tuberculin and trichophytin gave no indication of humoral immunodeficiency or anergy. In addition to electron beam irradiation, one female patient was treated with rIFN-alpha-interferon, 6 X 10(6) IU 3 times a week over a period of 3 months, and 18 X 10(6) IU 3 times weekly over 1 month. Under this therapy, irradiated as well as nonirradiated lesions become flatter, reduced in size and faded. The number of T-suppressor cells diminished.
This is a review on contact allergy to nickel, based on the new literature (56 references) and our own case studies of 29 patients. The great majority of persons having an eczematous reaction to nickel are women. To what extent these allergies are due to occupation or to constant contact with nickel-containing articles such as buckles , jeans buttons and jewelry is examined in detail. An opinion is given as to whether nickel eczema should be recognized as an occupational disease. Its importance in selecting one's profession is also discussed. The professions which frequently bring one into contact with nickel are summarized on a table. The various localisations and their causes are included on another table. The cases analyzed here indicate that nearly all patients with nickel eczema acquired their contact allergy outside their occupations, often before they had even entered professional life. It is therefore very important for one entering a "nickel profession" to be given a predictive test for nickel allergy, but above all to be inquired as to any eczematous conditions the prospective employee has experienced previously.
This report is on two patients with contact allergy to bergamot oil, which owing to the volatility of its individual components could only be determined by patch tests after skin stripping. One is a case of occupational disease related to the patient's job in a perfume factory warehouse, and the other is obviously a case of sensitization due to cosmetics. In the former instance patch-test results were positive to alpha-pinene and beta-pinene, and in the latter to citral and alpha-pinene. As could be expected, contact allergy to turpentine oil was confirmed in the first case, whereas the actual eczematogenic in the second case, in which turpentine oil was negative, may have been citral.
Infections having atypical mycobacteria are occurring more frequently for 2 main reasons. First there are the disturbances of the immunity system, whether due to the acquired immune deficiency syndrome (AIDS) or the result of therapeutic measures taken against malignant processes, other diseases or after organ transplantation. Second, travel and free-time activities increase the risk of an infection. In many cases such infections become localized on the skin, but can also develop changes in the lungs, depending on the patient's occupation. For this reason we provide a review of the new literature on the microbiology of mycobacteria as well as on the symptoms of diseases of the skin and other organs which are caused by atypical mycobacteria, such as swimming pool granuloma or Buruli ulcer.
Chronic graft-versus-host reaction is reported in a 19-year-old woman who developed poikilosclerodermic skin lesions within a few months following transplantation of bone marrow donated by her brother as she had acute lymphatic leukemia. The literature and the various clinical features and cutaneous manifestations of graft-versus-host reactions are reviewed.
Two observed cases indicate atypical forms of phyto-photodermatitis (photodermatitis bullosa striata). Unusual localisations or generalised outbreaks have to be taken into account in cases of sunbathing without clothes on. Power lawn mowers with rotating blades spread heracleum and other phototoxic juices via freshly cut grass, causing diffuse - as opposed to striped - manifestations on the uncovered skin areas. The most certain prevention of such a reaction is to known which few plants are responsible for phyto-photodermatitis and to avoid them in sunny weather. The plants should by no means be exterminated, even those (such as Heracleum mantegazzianum, "giant hogweed") which have a tendency to spread.
Benzoyl peroxide preparations have proven to be effective agents in the treatment of acne. In comparison to the numerous clinical communications, very few reports exist concerning the pharmacokinetics of benzoyl peroxide. The benzoyl peroxide content of abraded horny layers and its metabolite benzoic acid were investigated by high-pressure liquid chromatography after application (1-2 min) of emulsion containing benzoyl peroxide. It was found that benzoyl peroxide penetrates the stratum corneum very quickly where it is rapidly degraded to benzoic acid. No benzoyl peroxide depot in the stratum corneum could be demonstrated.
Five patients with T-cell lymphoma of the skin (mycosis fungoides; Sézary syndrome) were given parenterally arotinoid ethyl ester (Ro 13-6298) at a daily dose of 0.5-4.0 micrograms/kg body weight, to a total dose of 20 mg over maximally 31 weeks. In three patients, among them one with tumourous mycosis fungoides, there was complete regression of the cutaneous lesions. In another patient the cutaneous changes, some of them with ulceration, regressed so that there were only residual infiltrates. In the case of the Sézary syndrome there was no response. Most important side-effects of treatment were cheilitis, moist and sticky skin, paronychia and dry mucosae. The most serious side-effect was pain in muscles, joints and bones. There were no significant changes in biochemical values during the treatment.
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In Europe, as opposed to North America, poison-ivy rash is hardly known. For this reason a detailed review of the allergenic members of the Anacardiaceae family is given, and the misleading nomenclature of "poison ivy", "poison oak", and some other species of this family are discussed. An up-to-date representation of the chemical structure of the allergenic substance group (denoted as "Urushiol") from this family is provided as well as botanical information regarding the plants themselves. Prevention of this dangerous sensitization and the therapy of this allergic reaction are discussed. The four cases presented are as follows: a young German woman who became sensitized to poison ivy or poison oak while in the USA and showed a cross reaction to other Rhus species (R. copallina, R. javanica (semialata), R. trichocarpa) as well as to Choerospondias axillaris var. japonica and to mangoes; a landscape gardener with an occupationally acquired allergy to Anacardium occidentale; and two control persons giving positive results to skin tests with Urushiol and Rhus trichocarpa respectively, to which the source of sensitization could not be clarified. Tests with three kinds of pistachio and two native-European Anacardiaceae (Rhus typhina and Cotinus coggygria) yielded negative results in each case. Prophylaxis to sensitization requires familiarity with the numerous Anacardiaceae and derivative products to which one could come in contact. These substances, summarized in a table, include mango, cashew and "sweet pepper".
Cheilitis glandularis simplex is a rather rare disease which has to be differentiated from cheilitis granulomatosa. The histological characteristics of cheilitis glandularis simplex are hypertrophy and hyperplasia of mucous and/or heterotopic salivary glands. The therapy is the excision of the tumor.
Report on a 51-year-old adipose patient suffering from a rapidly progressing lipatrophia semicircularis. The lipoatrophy occurred in the form of numerous lesions on the trunk and limbs.
Acne-like changes were observed on a child's cheeks after colouring them with a red felt-tip pen. Numerous comedos appeared around a red tattoo coloured with felt-tip pen ink on a 16 year old girl. In animal experiments using rabbits' ears, two organic pigment inks found in these types of felt-tip pens could be proved to be the cause of a comedo-producing reaction. We are concerned here with quinacridone dye, pigment violet 19 (C.I.46.500), and the chlorine containing azo dye, pigment red 7 (C.I. 12.420).
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This study reports comparative results of the effects of an aromatic retinoid, etretinate (RO 10-9359), on various disorders of the skin and mucous membranes. One hundred thirteen patients suffering from psoriasis, lichen planus, keratosis follicularis, and various other disorders were treated and examined. The patients received 25 to 100 mg/day of oral etretinate for up to 30 months. Patients with erythrodermic psoriasis, pustular psoriasis, and keratosis follicularis showed the best response. The conditions of patients with psoriasis vulgaris, palmoplantar psoriasis, and lichen planus also improved, but less impressively. The mucous membrane lesions of lichen planus and leukoplakia showed only moderate improvement. The most striking adverse clinical reactions observed were cheilitis (70%), dryness of the mucous membranes (27%), and hair loss (27%).