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Biomedical subjects

S M Wilkinson

Publications and source records attributed to S M Wilkinson.

At least 37 records · Page 2Linked to original sources
PubMed2002

Type-IV hypersensitivity to betamethasone valerate and clobetasol propionate: results of a multicentre study.

BACKGROUND: Most studies investigating steroid allergy have been performed with tixocortol pivalate, hydrocortisone butyrate and budesonide. Betnovate and Dermovate are widely prescribed in the U.K. but little is known about the frequency of sensitization to them. OBJECTIVES: To determine the optimum method to detect contact allergy to betamethasone valerate (BV) and clobetasol propionate (CP). METHODS: Seven centres tested consecutive patients attending for investigation of suspected allergic contact dermatitis to these steroids at a range of concentrations in different vehicles. RESULTS: Of 1562 patients tested, 16 (1%) reacted to either BV or CP. Ten patients (0.7%) reacted to BV and 13 (0.8%) to CP. Two patients of a further centre were included in analysis of dilutions and vehicles. Sixteen of a total of 25 reactions (64%) were identified with a 1% dilution in ethanol. CONCLUSIONS: Consideration should be given to adding BV and CP to a standard allergy series, given that both are frequently used in the treatment of eczema and that most patients sensitized to them are not identified with currently used markers of steroid allergy. If patch tests to BV and CP are initially negative, but an allergy is suspected, the patient should be further investigated. Further studies are required to identify the ideal patch test material.

Adult↗
PubMed2001

Diluted Compositae mix versus sesquiterpene lactone mix as a screening agent for Compositae dermatitis: a multicentre study.

The objective of this study was to compare diluted Compositae mix with sesquiterpene lactone mix as a marker for Compositae dermatitis. Patients undergoing diagnostic patch testing in 8 British Isles patch test centres were also patch tested to sesquiterpene lactone mix (0.1% pet.) and Compositae mix (3% pet. or 0.6% pet.). Of a total of 5574 patients tested, 71 (1.3%) reacted to Compositae mix, 57 (1.0%) reacted to sesquiterpene lactone mix, and 45 to both. Diluted Compositae mix remained a more sensitive screening marker for Compositae allergy. We recommend that patients are patch tested to both agents.

Allergens↗
PubMed2001

Photopatch test method: influence of type of irradiation and value of day-7 reading.

118 consecutive patients were photopatch tested with 5J UVA and 10mJ UVB. In addition, day 7 readings were taken. Testing with UVB and performing late readings conferred no advantage. The current recommendations of the British Photodermatology Group regarding photopatch testing remain the most recent guide to photopatch test methodology.

Adult↗
PubMed2001

Chronic urticaria associated with intra-articular methylprednisolone.

Reports of allergic reactions following treatment with systemic corticosteroids are rare, despite their widespread use. A 47-year-old man developed widespread urticaria, resistant to antihistamines, coinciding with injections of local anaesthetic and methylprednisolone for cervical spondylosis. He underwent immediate and delayed hypersensitivity tests. Intradermal tests showed immediate-type sensitivity to methylprednisolone and hydrocortisone. Patch tests were positive to 21 of 26 corticosteroids tested. A diagnosis of both an immediate and a delayed-type hypersensitivity to corticosteroids was made. With avoidance of all corticosteroids he has been free from urticarial rash for 9 months and has been able to stop all medication.

Administration, Topical↗
PubMed2001

Opiate use to control bowel motility may induce chronic daily headache in patients with migraine.

OBJECTIVES: To investigate whether opiate overuse might cause chronic daily headache in those with migraine, we studied patients who were taking codeine (or other opiates) for control of bowel motility after colectomy for ulcerative colitis. BACKGROUND: Analgesic overuse is considered by many to be one factor which can result in the transformation of migraine into a chronic daily headache pattern. Most of the evidence for this comes from patients with migraine who are taking increasing amounts of analgesia for headache. Many of these patients revert to an intermittent migraine pattern once the analgesics are stopped. METHODS: Women who were 1 year postcolectomy for ulcerative colitis were identified in several colorectal surgery practices in Calgary. They were sent a questionnaire designed to determine if they had a history of migraine prior to surgery, if they currently had chronic daily headache, what medications they were taking to control bowel motility, and what medications they were taking for headache. RESULTS: Twenty-eight patients who met our inclusion criteria returned completed questionnaires. Eight of these exceeded the recommended limits for opiate use in patients with headache. Eight patients met diagnostic criteria for migraine. Two patients had chronic daily headache starting after surgery. Both used daily opiates beginning after their surgery, and both had a history of migraine. The other six patients who used opiates daily did not have a history of migraine and did not have chronic daily headache. All patients with migraine who used daily opiates to control bowel motility following surgery developed chronic daily headache after surgery. CONCLUSIONS: Patients with migraine who use daily opiates for any reason are at high risk of developing transformed migraine with chronic daily headache. This risk appears much lower in patients without a history of migraine who use opiates for nonpain indications.

Adolescent↗
PubMed2000

Sweet's syndrome presenting as palmoplantar pustulosis.

Sweet's syndrome was initially described as a reactive dermatosis characterized by sudden onset of fever, leucocytosis, and raised erythematous plaques infiltrated with neutrophils, and therefore called acute febrile neutrophilic dermatosis. However, later it became obvious that fever and neutrophilia are variable features, and a number of other characteristics have been described. Although the dorsa of the hands are frequently affected, the palmoplantar involvement mimicking pustulosis observed in our case appears to be unusual.

Administration, Topical↗
PubMed2000

Corticosteroid cross-reactions: an alternative view.

An alternative view of corticosteroid cross-reactivity is proposed, based on 2 immune recognition sites on the corticosteroid molecule, 1 influenced by C 6/9 substitution and 1 by C 16/17 substitution. A case report is adduced in support of such a hypothesis.

Administration, Topical↗
PubMed2000

Allergic contact dermatitis to plant extracts in patients with cosmetic dermatitis.

Cosmetic contact allergy is commonly seen in patients undergoing patch testing, with fragrance one of the most frequently implicated ingredients. Many cosmetics contain plant extracts either as a fragrance or for medicinal properties. With a vogue for natural products there is an increase in their use. We have performed a prospective study over a 2-year period looking at the prevalence of contact allergy to plants in patients diagnosed with cosmetic dermatitis. In addition, we have performed a review of the products of two popular cosmetic companies, examining product labelling and the prevalence of use of plant extracts. We suggest that patients allergic to fragrance be advised to avoid plant extracts, which are separately labelled, in their personal care products.

Adolescent↗
PubMed2000

Evaluation of a contact allergy clinic.

This study aims to assess the value of patch testing in a specialist contact allergy clinic as compared to testing carried out by general dermatologist for the diagnosis of contact allergy. One hundred consecutive patients referred for patch testing were tested to the European standard and specialized series. A comparison was made between patch tests read and interpreted by a consultant dermatologist with an interest in contact allergic dermatitis and by an experienced registrar who had not yet received any formalized specialized training. Results of testing with additional allergens acquired following the establishment of the specialist clinic were examined. In addition patients with a hand problem and/or symptoms suggestive of contact urticaria underwent skin prick testing. There was a variation in patch test reading and interpretation between the consultant and registrar in 10 patients. Patch testing using allergens from the additional series revealed additional relevant contact allergies in 19 patients. In 14 patients, allergies would have been missed by a limited additional series. Contact urticaria was detected in seven patients. This study has confirmed the value of a specialist contact clinic in the diagnosis of contact allergy. The importance of formalized training in patch test reading and interpretation, testing with additional series and prick testing for the diagnosis of contact urticaria are highlighted.

Ambulatory Care↗