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PubMedDate not supplied

Patch test response to house dust mites is positive in children with atopic dermatitis and in their parents.

We studied the patch test response to Dermatophagoides pteronyssinus in 79 atopic children and in their parents. The atopic children were divided into 3 groups: 1) children with atopic dermatitis (group 1); 2) children who had suffered from atopic dermatitis but the disease was cured (group 2); and 3) atopic children with asthma and without atopic dermatitis (group 3). Our data show that a significantly higher proportion of children with atopic dermatitis (groups 1 and 2) have positive patch tests to Dermatophagoides pteronyssinus in comparison to atopic children without atopic dermatitis (group 3) and the controls (p < 0.001). In addition, we have shown that a positive patch test to Dermatophagoides pteronyssinus is significantly more common in parents of children with atopic dermatitis with respect to parents of children with asthma or parents of control children.

Adolescent↗
PubMed1996

Outbreak of contact dermatitis related to Acticide EP paste in a paint manufacturing factory.

An outbreak of severe itching, erythematous and edematous dermatitis over the extremities and upper back developed in 8 of 17 workers in the raw-materials department of a paint manufacturing factory. The outbreak occurred during a 2-month period when Acticide EP paste (Thor Chemical, Cheshire, UK) was used in place of Metatin as a microbiocide (Acima Chemical, Buchs, Switzerland). To evaluate the frequency and the etiologic agent of this outbreak, a plant walk-through, examination and review of photographs of skin lesions followed by statistical analysis for association between the development of dermatitis and exposure to Acticide paste were performed. Three guinea pigs were subjected to patch tests comparing the dermatotoxicity of Acticide EP and Metatin. The results showed that 8 out of 17 workers (47%) suffered from contact dermatitis during the 2-month period. Stratification by occupational exposure further confirmed the association between the development of dermatitis and exposure to the Acticide paste. The dermatotoxicity test on guinea pigs revealed the marked corrosive effect of the paste and the absence of dermatotoxicity of Metatin. After the removal of the paste from the raw material, there were no new cases of contact dermatitis at the 6 month follow-up. We conclude that Acticide EP paste was the responsible offending agent. Because isothiazolinone derivatives are well-known antigens and 2-n-octyl-4-isothiazolin-3-one is the active ingredient in Acticide EP paste, 2-n-octyl-4-isothiazolin-3-one is the likely cause of the dermatitis.

Animals↗
PubMed1997

Lymphomatoid contact dermatitis caused by nickel.

Lymphomatoid contact dermatitis is a rarely reported entity consisting of allergic contact dermatitis that resembles mycosis fungoides pathologically. Although the histopathology has been previously described, there have been no attempts to reproduce the dermatitis for pathologic evaluation. A 68-year-old woman presented with a papular rash on her neck after exposure to a nickel-containing necklace. A biopsy specimen was suspicious for mycosis fungoides. However, the dermatitis responded quickly to topical steroids and avoidance of the necklace. A patch test to nickel was positive, and a biopsy specimen from the patch test site had no findings of mycosis fungoides. Although we were able to reproduce the contact dermatitis at a distant site, the disease was dissimilar. Lymphomatoid contact dermatitis has an excellent prognosis and resolves completely simply by avoiding the offending agent.

Administration, Topical↗
PubMed1997

[Candida albicans sensitization in patients with atopic bronchial asthma and atopic dermatitis].

Candida albicans, a component of normal human microflora, can induce synthesis of specific IgE-antibodies in patients with atopic bronchial asthma and atopic dermatitis. The study included 25 patients with atopic dermatitis sensitized to C.albicans and 23 patients with atopic dermatitis non-sensitized to C.albicans. The sensitization was determined by the skin test and enzyme immunoassay. The patients had the history of atopic dermatitis exacerbation after taking food containing baking yeasts. Atopic dermatitis with sensitization to C.albicans is characterized by severe course correlating with the following indices: high total IgE (r = 0.6), level of IgE antibodies to C.albicans (r = 0.6), level of serum IgG (r = 0.46) and IgA (r = 0.33). Contrary to adults, children with sensitization to C.albicans had decreased relative number of CD4+, CD8+ and CD72+ of lymphocyte subpopulations. Thus, sensitization to C.albicans manifests in severe atopic dermatitis which in children is often associated with immune deficiency.

Adolescent↗
PubMed1998

Hand dermatitis and symptoms from the fingers among Swedish dental personnel.

Hand dermatitis among dental personnel has been an issue in recent years. Dental personnel manually handle polymer materials which are known to irritate skin, and also cause allergy. In addition, dental personnel wash their hands frequently, and use latex gloves, and are therefore at risk to develop hand dermatitis. To survey the occurrence of hand dermatitis among dental personnel, questionnaires were sent to all dental teams (dentist + chair assistant) working in the two northern Swedish counties. Referents were; researchers, teachers, and secretaries from a university and high schools, from the same geographical area. The response rate was 76% for dental teams, and 66% for referents. The results show that male dentists reported a significantly higher prevalence of hand dermatitis than male reference. In contrast to chair assistants and referents, dentists (both male and female) reported a higher extent of hand dermatitis on the left than on the right hand. There was an association between hand dermatitis among dental personnel and; age, eczema in childhood, and hay fever but, not with; sex, asthma, frequent washing of the hands, and glove use. Whitening of the fingers increased with increasing age among dental personnel. Pricking was also associated with frequent glove use. Pricking of the fingers was associated with sex, and 3.5 times more common among female dental personnel than male dentists. Numbness of the fingers, and finger pain was reported by more dentists than chair assistants and referents.

Adult↗
PubMed1998

Circulating soluble CD5 in atopic dermatitis.

The CD5/Leu-1 is involved in the activation of the T-cell helper function through T/B-cell collaboration by CD5/CD72 interaction. T-cell function is known to be dysregulated in atopic dermatitis. However, to date, the role of CD5 has not been investigated in atopic dermatitis, nor has the presence of circulating soluble CD5 been reported in atopic dermatitis. Five patients with atopic dermatitis who showed typical symptoms, 5 acute febrile patients and 5 normal subjects were tested. Peripheral blood mononuclear cells and plasma were separated. The T- and B-cells were separated using immunomagnetic beads. Reverse transcription polymerase chain reaction was performed using CD5 specific primers. Immunoblotting with the mouse antiCD5 monoclonal antibody was done. Circulating soluble CD5 was present only in 4 out of 5 atopic patients. However, it was not detected in acute febrile patients nor in normal subjects. CD5 mRNA expression was detected in all atopic patients and acute febrile patients. CD5 mRNA expression in T- and B-cells was tested in patients with atopic dermatitis and was detected only in the T-cells. In this study, circulating soluble CD5 was detected in atopic patients and soluble CD5 was suspected to participate in the pathogenesis of atopic dermatitis. CD5 mRNA expression was detected only in T-cells, which suggests that circulating soluble CD5 might be produced from T-cells.

B-Lymphocytes↗
PubMed2000

Efficacy of a skin-protective foam in the treatment of chronic hand dermatitis.

BACKGROUND: Irritant and/or allergic hand dermatitis in individuals who are unable to avoid causative exposures is difficult to control. Usefulness of protective creams has been generally unsatisfactory. OBJECTIVE: To determine if hand dermatitis, primarily of an occupational nature, could be improved by the use of a protective foam containing dimethicone and glycerin. METHODS: Adult male and female subjects with chronic hand dermatitis for at least 12 months, felt to be either allergic, irritant, or combined in nature were given the study foam for routine application after a 2-week observation period. At 2 and 6 weeks the skin was evaluated by the investigator and subject for parameters including redness, scaling, fissuring, blistering, and pruritus on a numerical scale. A global evaluation also was performed. Photographs were taken at each visit. Usage of topical corticosteroids was recorded. No systemic therapies other than antihistamines were allowed. RESULTS: Thirty-one subjects were enrolled in the study and 28 completed it. The physician and subject's initial global evaluations averaged 6.13 and 5.48, respectively (0-10 scale). The final scores were 3.68 and 4.75, respectively (P < .001 for physician rating; P = .259 for subject rating). Topical corticosteroid usage was reduced in 16 of 30 (53.6%) subjects. Twenty-one of 30 subjects (70.0%) had improved over the course of the study. No adverse effects were noted. CONCLUSION: This protective foam greatly or moderately improved chronic hand dermatitis in a sizable number of individuals with previously uncontrolled dermatitis despite continuing in their regular occupation.

Administration, Topical↗
PubMed1997

Dermatitis in Ecuadorean farm workers.

Using a cross-sectional survey of potato farm workers in northern Ecuador, we examined the relationship between pesticide exposure and skin disorders. From a farm population census, all pesticide applicators and 1/2 of exposed field workers were selected. Controls were age-matched from urban occupations. Individual exposure measures included overall years and current hours working with pesticides. Farm-level measures included numbers of applications over the last 6 months and an application practices score (range 0-4). Each participant underwent a clinical skin examination, with patch tests to maneb on a sample of dermatitis cases. Exposure-related increases in conjunctivitis (7% of applicators, 0% in other groups), dermatitis (68% of exposed and 55% of applicators versus 31% of controls, p < 0.001) and pigmentation disorders (25% of exposed and applicators vs 10% controls, p = 0.06) were found. Among dermatitis cases (n = 117), 5% were positive to maneb on patch testing. In logistic regression analysis, significant predictors (p < 0.1) of dermatitis included years using fungicides (OR = 1.12 per year) and poor application practices (OR = 1.42 per score unit). Agricultural fungicide application in high-exposure situations can contribute to dermatitis prevalence among farm populations.

Adult↗
PubMed1959

Algerian ivy dermatitis; a California disease.

A hitherto unrecognized cause of contact dermatitis in California is the widely cultivated plant known as Algerian ivy. This plant, which grows in California (and its close relative, English ivy) causes a dermatitis which is similar to although milder than that caused by poison oak. Dermatitis from this cause occurs most frequently when persons who have become sensitive to it by previous contact trim the plant back in the spring after its seasonal spurt of growth. For persons whose occupations require repeated contact with the plant, dermatitis from this cause is an occupational hazard. Dermatitis from this plant is easily diagnosed by means of a simple patch test. In a series of 12 cases the only effective treatment was with corticosteroid agents.

California↗
PubMed2000

Characterization of diaper dermatitis in the United States.

BACKGROUND: Diaper dermatitis is the most common dermatologic disorder of infancy. This study evaluates the frequency of outpatient visits resulting in this diagnosis, specialties of physicians providing services, demographics of patients, and leading agents used in treatment. DESIGN: Records of 272,841 encounters from the National Ambulatory Medical Care Survey (1990-1997) were examined for visits in which diaper dermatitis was diagnosed in children. The likelihood of diagnosis in the general pediatric population was calculated and the leading treatment agents were ranked. RESULTS: There were approximately 8.2 million visits in which diaper dermatitis was diagnosed. For the pediatric population in the at-risk age range, there was a 1 in 4 likelihood of being diagnosed with the skin disorder. Pediatricians provided 75% of services for the treatment of diaper dermatitis; the demographics of patients were similar to those of comparably aged individuals in the general population. Nystatin was the leading treatment agent prescribed (27% of visits), followed by clotrimazole (16%), a combination product of nystatin and triamcinolone (16%), hydrocortisone (8%), and a combination product of clotrimazole and betamethasone dipropionate (6%). CONCLUSIONS: Visits for diaper dermatitis are frequent, and pediatricians are the physicians most often called on to provide treatment. No portion of the pediatric population is disproportionately diagnosed. The frequent use of potent corticosteroids contained in combination agents is a potential target for improving the management of diaper dermatitis.

Administration, Topical↗
PubMed2006

Zinc supplementation to improve mucositis and dermatitis in patients after radiotherapy for head-and-neck cancers: a double-blind, randomized study.

PURPOSE: To determine whether zinc supplementation can accelerate the healing of mucositis and dermatitis after radiotherapy. METHODS AND MATERIALS: In this double-blind study, patients were placed into two randomized groups (experimental and control) of 50 patients each. The groups were homogeneous with respect to medical history, tumor characteristics, and therapeutic details. The experimental group received a standard dose of a zinc supplement, and the control group was given a placebo. RESULTS: Patients in the control group developed Grade 2 mucositis and dermatitis earlier and sooner than patients in the experimental group. There was also a significant difference in the development of Grade 3 mucositis and dermatitis between the two groups. Patients in the experimental group were found to have milder mucositis and dermatitis. Zinc supplementation did not show much benefit in those patients receiving concurrent chemotherapy or make a substantial impact on weight changes. CONCLUSIONS: Zinc supplementation used in conjunction with radiotherapy could postpone the development of severe mucositis and dermatitis for patients with cancers of the head and neck. Zinc supplementation can also alleviate the degree of mucositis and dermatitis. The impact of zinc on tumor growth and patient survival is under further investigation.

Double-Blind Method↗
PubMed2006

Looking after the individual to reduce disease in the flock: a binomial mixed effects model investigating the impact of individual sheep management of footrot and interdigital dermatitis in a prospective longitudinal study on one farm.

A total of 160 ewes on one farm in England were studied for 18 months. The incidence of footrot and interdigital dermatitis in individually identified sheep and treatment and flock control measures were recorded. A binomial mixed effect model with the incidence of footrot or interdigital dermatitis as the outcome was used to investigate patterns of association between treatments, flock control measures and the incidence of footrot or interdigital dermatitis. In this one flock, the incidence of footrot and interdigital dermatitis was positively associated with the incidence of footrot and interdigital dermatitis and with trimming of feet and negatively associated with the use of parenteral antibiotics and topical antibiotic sprays in either the first and/or second 2-week period prior to the incidence of interest. These results provide two hypotheses: one that 'footrot and interdigital dermatitis are infectious diseases that can be controlled, in part, through the use of antibiotic therapy, which acts to reduce the infectious period of diseased sheep' and two, that 'routine trimming of diseased and healthy feet exacerbate disease, through environmental contamination and/or through increased susceptibility of sheep with recently trimmed feet'.

Animal Husbandry↗
PubMedDate not supplied

Dermatitis during radiation for vulvar carcinoma: prevention and treatment with granulocyte-macrophage colony-stimulating factor impregnated gauze.

The aim of this study was to determine the effectiveness of granulocyte-macrophage colony-stimulating factor (GM-CSF) impregnated gauze in preventing or healing radiation-induced dermatitis. Sixty-one patients were irradiated for vulvar carcinoma. Thirty-seven applied steroid cream at irradiated areas throughout radiotherapy (Group A) and 24 patients applied additionally GM-CSF impregnated gauze (40 micrcog/cm2 of skin-irradiated area, twice per day) in addition to the steroid cream, after 20 Gy of irradiation (Group B). The score of skin reactions (P=0.008, chi2 test) and the time interval of radiotherapy interruption (P=0.037, Mann-Whitney U test) were statistically significantly reduced in Group B patients. Multivariate analysis of variance showed for this group not only a significant reduction in the Sum of Gross Dermatitis Scoring (P<0.001, adjusted for Duration of Dermatitis) but also a significant reduction of the healing time (P=0.02, adjusted for Sum of Gross Dermatitis Scoring). The pain grading was less (P=0.014, chi2 test) and pain reduction was noticed sooner after the application of GM-CSF impregnated gauze (P=0.0017, Mann-Whitney U test). Multivariate logistic regression analysis showed that the only significant effect on dermatitis score is due to Body Mass Index (P=0.034) and the application of GM-CSF (P=0.008). GM-CSF impregnated gauze can be effective in preventing and healing radiation-induced dermatitis and in reducing the interruption intervals of radiotherapy for vulvar carcinomas.

Acute Disease↗
PubMed2005

Kampo Medicines for Mite Antigen-Induced Allergic Dermatitis in NC/Nga Mice.

We have established an allergic dermatitis model in NC/Nga mice by repeated local exposure of mite antigen for analyzing atopic dermatitis. We examined how four Kampo medicines, Juzen-taiho-to, Hochu-ekki-to, Shofu-san and Oren-gedoku-to, on the dermatitis model to obtain basic information on their usefulness for treating atopic dermatitis. Mite antigen (Dermatophagoides farinae crude extract) solution at a concentration of 10 mg/ml was painted on the ear of NC/Nga mice after tape stripping. The procedure was repeated five times, at 7 day intervals. An apparent biphasic ear swelling was caused after the fourth and fifth antigen exposures with elevated serum IgE levels and accumulation of inflammatory cells. In the cervical lymph nodes and ear lobes, the five procedures of antigen exposure induced interleukin-4 mRNA expression but reduced interferon-gamma mRNA expression. Oral administration of all four Kampo medicines inhibited the formation of ear swelling and inflammatory cell accumulation. Juzen-taiho-to and Hochu-ekki-to apparently prevented the elevation of serum IgE level. Furthermore, the four Kampo medicines showed a tendency to prevent not only the increase in interleukin-4 mRNA expression but also the decrease in interferon-gamma mRNA expression. The present results indicate that Juzen-taiho-to, Hochu-ekki-to, Shofu-san and Oren-gedoku-to may correct the Th1/Th2 balance skewed to Th2, and this activity helps inhibit dermatitis in NC/Nga mice. The ability of the Kampo medicines to correct the Th1/Th2 balance seems to underlie their effectiveness in treating of atopic dermatitis.

Journal Article↗
PubMed1989

Clinical, immunohistochemical, and electron-microscopic findings in gold dermatitis.

The clinical, immunohistochemical, and electronmicroscopic features of 13 consecutive patients with gold dermatitis were analyzed: 12 developed an eczematous dermatitis and one a lichenoid dermatosis. The patients had received intramuscular sodium aurothiomalate therapy from 1 month to 4 years before the dermatitis broke out. After cessation of gold therapy, the dermatitis persisted for 1-11 months. A relatively sparse perivascular mononuclear cell infiltrate was found in the affected skin in all cases. With immunoperoxidase staining, most of the infiltrating cells were shown to be OKT-4-positive T-helper lymphocytes. A majority of the infiltrating cells were Ia, i.e., HLA class II antigen, positive. Clearly increased numbers of dermal OKT-6-positive Langerhans' cells were also seen. In epidermis, on the contrary, the expression of both OKT-6 and Ia markers on dendritic cells was decreased. However, electron-microscopic examination revealed large numbers of macrophage-like cells and the Langerhans cells were activated, often in apposition to mononuclear cells within the epidermis. No correlation was observed between the immunohistological findings and the amount of gold received, the duration of gold therapy, and the interval between the last gold injection and biopsy, respectively, although peripheral blood eosinophilia was more common during 5-10 months of gold therapy. There were no specific findings in the patients in whom dermatitis lasted several months after discontinuation of the therapy. Our findings support the view that immunological mechanisms operate in the development of gold dermatitis, although the exact mechanisms remain unknown.

Adolescent↗
PubMed2004

Severe radiation dermatitis is related to Staphylococcus aureus.

Acute radiation dermatitis commonly occurs following local radiation therapy for various cancers and, when severe, may necessitate disruption of treatment. Intense inflammatory reaction may result in a breakdown of the skin's barrier function and accompanying bacterial colonization. Bacterial superantigens may exacerbate inflammation through activation of T-cells and subsequent cytokine release. We report six cases of severe radiation dermatitis in cancer patients. Four of the six grew pathogenic bacteria, and three had psoriasiform or eczematous reactions at distant sites. Both the radiation dermatitis and the distant cutaneous reactions resolved rapidly on a combination of topical steroids and oral plus topical antibiotic therapy. We suggest that staphylococcal superinfection of acute radiodermatitis intensifies the inflammatory process and hinders repair of the epidermal barrier. Patients with acute radiation dermatitis should be investigated for secondary infection. We emphasize the importance of including topical and oral antibiotic therapy in conjunction with topical corticosteroids to eradicate infection as well as hasten repair of the skin's barrier function. These cases are presented to call attention to the role of Staphylococcus aureus in the pathogenesis of severe radiation dermatitis and the need to include appropriate antibiotic therapy based on culture in the management of acute radiation dermatitis.

Aged↗
PubMed1979

Perioral dermatitis: a 12-year review.

A continuing study of perioral dermatitis over a period of 12 years is presented. A distinction is made between various patterns of circumoral and paranasal dermatitis and the clinical picture that we describe as "perioral dermatitis". No cases were seen before 1966 but the number of patients presenting to hospital clinics or in private practice rose dramatically until 1970-1972, after which there has been a progressive fall in numbers. In this period, 259 patients were diagnosed as having the condition and of these 203, resident in an area of some 275,000 population and seen by one or other of us on at least two occasions, form the basis of this study. There were 173 females, fifteen males and fifteen children under 12 years of age. In many cases it was possible to suggest the primary lesion for which patients sought treatment. In sixty-nine patients this consisted of a para-oral eruption on the side of the chin and, in forty-one a paranasal erythematous dermatitis. The characteristic appearance and spread of the eruption to the glabella and eyelids are described. A few patients, mostly male, showed lesions around the eyelids only, from treatment of seborrhoeic dermatitis. All but nine of the patients acknowledged the use of potent (not necessarily fluorinated) topical corticosteroids over long periods; in many cases these were self-administered. Some of the children had been treated with preparations intended for their mothers. The numerous aetiological agents that have been incriminated as causes of this eruption are examined. We believe that the prolonged use of topical potent corticosteroids is the only one tenable from our observations. The role of hormonal factors and of local irritant agetns is examined in this context. Tetracyclines are curative in the great majority of patients in 6 weeks if local corticosteroids are discarded. Relapses are rare. Perioral dermatitis is a most satisfying condition to treat but several questions remain unanswered. The current "revolt" against all forms of cortisone may enable us to answer some of these in the near future.

Administration, Topical↗
PubMed1992

Evaluation of a self-administered questionnaire on hand dermatitis.

The purpose of the study was to evaluate a self-administered questionnaire on hand dermatitis that was developed to identify persons with hand dermatitis in epidemiological studies. A total of 109 nurses were subject to dermatological examination of the hands within 1 month of returning the questionnaire. 2 types of questionnaire diagnoses were made: a 'symptom-based' diagnosis and a 'self-reported diagnosis'. These were compared to the medical diagnosis of hand dermatitis. The prevalence of hand dermatitis in the 12 months before the study, based on the medical diagnosis, was 18.3%. The prevalence according to the symptom-based diagnosis and the self-reported diagnosis was 47.7% and 17.4%, respectively. The sensitivity and specificity of the symptom-based diagnosis were 100% and 64%, respectively. It is concluded that the symptom-based diagnosis can be used as screening instrument for the detection of cases in large study populations, if followed by dermatological examination of persons with a positive diagnosis. The sensitivity and specificity of the self-reported diagnosis were 65% and 93%, respectively. It is concluded that the self-reported diagnosis can be used to obtain a rough estimate of the prevalence, although comparison of prevalence figures between study populations may be distorted due to a difference in reporting of hand dermatitis. The results of the study illustrate the size of the differences in prevalence estimates that may arise as a result of differences in the definition and method of diagnosing hand dermatitis.

Adolescent↗