2 cases of dermatitis from rare sources of sensitization to frequent contactants.
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Biomedical subjects
Publications and source records attributed to P Rebandel.
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In 481 patients with atopic dermatitis (AD), 4 major features of Hanifin and Rajka were found in 72%, and in 96% over 6 minor features were seen, which is much more than the minimum required by these authors for making a 'firm diagnosis'. The incidence of particular minor features in all patients was varying significantly, and in subgroups of patients they appeared with different frequency. For example, asthma occurred more often in AD patients with the onset of skin lesions before the 6th month of life, and food intolerance was more frequently observed in patients with very high serum IgE level. In the control groups some minor features also occur but less frequently than in AD patients. We conclude that the anterior neck folds and Dennie-Morgan infraorbital fold should be regarded as minor AD features.
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The frequency of basic and minor features of atopic dermatitis were compared between 86 patients with coexistent asthma, and 269 without asthma. The coexistence of asthma caused a statistically significantly more frequent presence of one of the basic features: personal or family history of atopy and five minor features. The latter included: early age of onset, recurrent conjunctivitis, tendency toward cutaneous infections, elevated serum IgE and keratosis pilaris.
In 365 children and 213 adults the characteristics of atopic dermatitis isolated by Hanifin and Rajka were analysed in relation to a family history of allergy. A positive history in both parents and/or their families was associated with higher IgE titres, earlier appearance of skin changes, more frequent occurrence of urticaria, allergic respiratory diseases, cheilitis, and, in women, nipple eczema. These changes were less frequent and the IgE titre was lower in patients with one atopic parent, and even less frequent (or lower IgE titre) in patients with no family history of atopic disease, although the latter difference was sometimes slight.
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In this study, 333 nurses, 92 dentists and 167 doctors were investigated. Most positive patch tests obtained were unrelated to occupation. Nurses were most often sensitized to penicillins and, of the disinfectants, formaldehyde was the commonest cause of occupational dermatitis. Among dentists, the most common occupational allergens were eugenol and mercuric chloride. Among surgeons, as compared with physicians, there were frequent reactions to mercuric chloride and balsam of Peru, and a higher number of positive patch tests with other contactants. Among those sensitized to chromium, 4 doctors found that contact with chromic catgut was harmful. 6 other doctors were intolerant to surgical gloves. A number of nurses and doctors had an irritant contact dermatitis from chlorhexidine.
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