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Skin pigmentation due to minocycline treatment of facial dermatoses.

Fifty-four patients taking minocycline for acne or rosacea were assessed for adverse effects. Their mean duration of treatment was 17 months, and their average cumulative dose was 47 g. No symptoms attributable to the therapy were reported. Biochemistry and haematology profiles were normal. There was no evidence of an adverse effect on thyroid function. Skin pigmentation was detected in eight patients (14.8%). Five patients had diffuse facial pigmentation, and three patients had localized pigmentation at the site of a scar or injury. Diffuse pigmentation occurred only in patients who had been on treatment for 3 years or more; 50% of such patients were affected. Age and solar damage may also have been factors in this type of pigmentation. Localized pigmentation occurred at sites of previous tissue damage, and was not directly related to the duration of therapy. Patients who receive long-term minocycline therapy should be regularly monitored for the development of pigmentation.

Acne Vulgaris↗

Contact dermatoses in healthcare workers: reduction in type I latex allergy in a UK centre.

Natural rubber latex (NRL) allergy has been recognized as a public health concern. NRL allergy frequently occurs in healthcare professionals. In this retrospective study we report the changing frequency of Type I NRL allergy amongst healthcare workers suffering from hand dermatitis referred to our department between 1996 and 2003. We identified 224 healthcare workers from the patch test database with a diagnosis of hand dermatitis who had undergone NRL skin prick testing (SPT). We report the SPT results, patch test results and diagnoses for each individual. The percentage of positive SPT to NRL in healthcare workers decreased from 62% in 1996 to 10% in 2003. Type IV allergy to fragrance mix (13%) was the most frequent cause of allergic contact dermatitis. Thiuram mix (8%) and carba mix (4%) were the most frequent indicators of type IV allergy to chemicals in rubber gloves. Fragrance allergy was the most frequent type IV allergen found in healthcare workers with hand dermatitis. We conclude that hand care preparations free from fragrance allergens should be available in all areas of clinical work.

Dermatitis, Occupational↗

A retrospective study comparing the histopathological features and response to treatment in two canine nasal dermatoses, DLE and MCP.

Canine discoid lupus erythematosus (DLE) and mucocutaneous pyoderma (MCP) have overlapping clinical and histopathological changes, often making diagnosis difficult. Histopathological features of 27 nasal planum biopsies were scored to determine whether DLE and MCP were histopathologically distinguishable. Long-term follow-up, enabling assessment of clinical diagnoses, was available on 15 cases; 11/15 cases were immunomodulatory responsive (ImR) and 4/15 were antibiotic responsive (AbR). Clinical diagnosis, determined by response to treatment for 15/27 cases, was not predictable based on scoring of histopathological features. Distinct histopathological patterns were observed: 2/11 ImR cases had a lymphocyte-rich interface dermatitis. All other cases had the same histopathological changes: a band-like diffuse superficial plasmacytic to lymphoplasmacytic dermatitis +/- focal basal cell damage, but different clinical diagnoses (4/4 AbR, 9/11 ImR). German shepherd dogs/crosses were over-represented (44.4% of the cases) and tended to have more multifocal lesions (41.7% vs. 26.7% of all other breeds). Longer duration of disease was associated with a preponderance of plasmacytic infiltrate (P = 0.026).

Animals↗

Hand dermatoses and contact allergic reactions in construction workers exposed to epoxy resins.

In 23/135 (18%) workers exposed to epoxy resins, a work-related dermatosis on the hands and/or forearms had been present during the past 3 years. In 9 persons, the occupational dermatosis was still present at the time of investigation. In all workers, patch tests were performed with epoxy resin, isophoronediamine, triethylenetetramine and xylenediamine. Positive patch tests were observed in 27 of the 135 exposed workers (20%) 13 of whom had never previously experienced skin problems. Epoxy resin accounted for the majority of the positive reactions. There was no relation between a history of atopy and the development of contact allergy. Only half of all workers had received any safety instructions. The wearing of gloves (mostly cotton), intended to protect the skin, had an adverse effect.

Construction Materials↗

Hand dermatoses in Tromsø.

As a parallel project to a coronary risk factor survey in northern Norway, 14,667 men and women aged 18-55 years answered questions concerning the occurrence of allergic hand eczema. 364 men (4.9%) and 961 women (13.2%) had had allergic hand eczema during the previous 12 months. 49 men (0.7%) and 105 women (1.4%) claimed to have had one or more sick leaves because of hand eczema during the preceding 3 years. 114 subjects reported both eczema last year and sick leave during the preceding 3 years, of whom 74 were already registered in the files of the regional department of dermatology. The majority had irritant contact dermatitis. The incidence of hand eczema appears to be high in this part of Norway and the possibility that the subarctic climate may increase skin irritancy is discussed.

Absenteeism↗