[Costaś acrokeratoelastoidosis: an attenuated familial form].
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During a 3-year period 3332 patients were patch tested with ICDRG standard series including 4 rubber mixes. Additional tests were performed with individual rubber chemicals and suspected solid rubber products. Rubber sensitivity was detected in 158 (4.7%) patients. Thiuram mix caused most of the positive reactions (73) followed by carba mix (51), PPD mix (40) and mercapto mix (19). From the individual rubber chemicals TMTM, TETD and IPPD caused allergic reactions most frequently. Rubber mixes, especially thiuram and PPD mix appeared to be better screening agents than any individual chemical to detect rubber allergy. However, MBT is recommended to be tested separately. Carba mix caused several irritant reactions. Three immediate type rubber reactions were seen. Gloves were the most common individual sources of rubber sensitivity.
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Clinical features of a case of finger and toe nail infection due to Hendersonula toruloidea and the characteristics of the isolate are described. The isolate was sensitive to clotrimazole at a concentration of 10 micrograms ml-1. The patient responded well to topical application of a lotion of this antimycotic.
Psoriasis of the hands may be triggered by work, especially in occupations involving physical trauma or contact with irritants. When limited to the hands and in absence of other typical lesions, diagnosis can be difficult particularly when coexisting with contact eczema. It is necessary to establish diagnostic criteria which help to establish a relationship between clinical manifestations and noxious stimuli at work. Prevention should be directed to early identification of cases and adequate preemployment physical examinations in order to avoid permanent disability.
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The immunologic events of pustule formation in pustulosis palmoplantaris (and in pustular psoriasis) have been discussed with special reference to demonstrating the presence of immunoglobulins and complement within vessels walls, at the epidermo-dermal junction, in the horny layers and around the pustule, as well as its possible significance for the accumulation of leukocytes.
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In 11 of 15 patients suffering from chronic dermatoses of the palms and soles (psoriasis inversa, palmoplantar pustulosis, palmoplantar hyperkeratotic eczema and idiopathic pompholyx), an improvement was achieved with "aqua-SUP" therapy. Trials using this therapeutic modality, which is a combination of balneotherapy and selective UV phototherapy (SUP), have only rarely been reported so far. In addition, five patients received internal medication (mainly aromatic retinoid) that had previously not been effective enough, three of them in combination with local corticosteroids. Four more patients were administered local corticosteroids in addition to "aqua-SUP". Four patients experienced local pain in the treated area, especially in the initial phase of phototherapy, and a mild erythematobullous reaction occurred in three of them. No other side-effects were observed. The efficacy of "aqua-SUP" for the treatment of the above-mentioned dermatoses lies in the same range as that of local PUVA, which has been used up to now. However, as "aqua-SUP" is easily manageable, it is more convenient for the patient and does not involve the problems of photosensitization.
Painful palmar and plantar erythema is an uncommon systemic complication of chemotherapy and has been reported in association with methotrexate, cystosine arabinoside, doxorubicin, and 5-fluorouracil. The authors report a case in which the syndrome was precipitated by hepatic artery infusion of 5-FUdR. The previous recommendation that treatment of patients developing painful palmar-plantar erythema from other drugs may be successfully resumed using intrahepatic arterial infusion of FUdR must be reconsidered in light of the present report.
Personal hygiene is considered traditionally important in the prevention of occupational skin disease. Contact dermatitis may result not only from the correct use of soaps and detergents, leading to excessive or inappropriate exposure, but also from incorrect or inappropriate use of these products.
As offices have become more complex environments, the number of skin problems among office workers has increased. Among the agents implicated are carbonless copy paper, duplicating machines, formaldehyde, video display terminals, and rubber bands. Accurate diagnosis can be difficult but usually results in complete cure.