Speciality
Spotlight

   




 

Dermatology & Venereology

 

     














Contact
Dermatitis


     

  • Bourke JF, Batta K, Prais L, et al [City Hosp, Birmingham, England]

    The Reproducibility of Patch Tests

    Br J Dermatol 140: 102-105, 1999



    Based on clinical evaluation patch testing was carried to determine its accuracy. The emphasis was on discordant findings. Material to be tested was applied in order and duplicate to the opposites of the back. 383 consecutive subjects were evaluated. Complete discordance comprised a definite positive result on one side and a definite negative one on the opposite side. A definite positive or negative on one side an equivocal response on the other constituted partial discordance.



    14 subjects were partially discordant to 5% Nickel, 6 to 25% of Balsam of Peru, 8 to 0.1% thiomersal , 5 to 1% cobalt chloride, 9 to 1% paraphenylenediamine, 3 to 8% fragrance mix, 3 to 1% formaldehyde, 11 to 5% potassium dichromate, 9 to 30% lanolin 2 with 1% Kathon CG. Complete discordance was observed in 28 subjects to one of the listed 10 allergens and 2 to 2 allergens. Concordance was best for fragrance [84%], nickel [80%] and Balsam of Peru [ 75%]. It was least for formaldehyde 36% and lanolin 56%. Clinical relevance to patch testing discordance was less than 2%. Factors such as error in observation, method, differences in patients reactivity and local factors may be contributing to discordance.



    A Clinical suspicion may need the procedure to be repeated or an alternative test to be looked into.

       
  • Shah M, Lewis FM, Gawkrodger DJ [Royal Hallamshire Hosp, Sheffield, England]

    Nickel as an Occupational Allergen: A Survey of 368 Nickel-Sensitive Subjects

    Arch Dermatol 134: 1231-1236, 1998

       

    Contact with nickel in the form of jewelry and possibly ear-piercing have been regarded as the most common associates of nickel induced allergy.

       

    This article looks at the subject differently, trying to correlate it with occupations. Cashiers, retail clerks, hairdressers, metal workers, domestic cleaners, food handlers, bar workers and painters were included in a group of 368 patients [ 34 men and 334 women] allergic to nickel. They were studied in 2 groups depending on whether they contacted nickel in their occupation or not. 84 patients [ 9 men and 75 women with a mean age of 34.2 years] had a distinct nickel exposure based on the medical amnesis. 

      

    284 [25 men and 259 women with a mean age of 38.4 years] did not come in contact with nickel. The two groups did not differ in their histories of other allergies. In the occupational group hand dermatitis was the most common presentation.

       

    The most surprising result is the small number of subjects developing nickel allergy as an occupational hazard.

       
  • Schnuch A, Uter W, Geier J, et al [ Univ of Gottingen, Germany; Univ of Osnabruck, Germany; Univ of Witten/Herdecke, Germany]

    Contact Allergies in Healthcare Workers: Results From the Information Network of Departments of Dermatology

    Acta Derm Venereol 78: 358-363, 1998

      

    Health care workers have occupation related dermatitis to the tune of 30%. 

      

    Information on 31849 patients registered in the Network of Dermatology Departments were evaluated against controls from 1992 to 1995.

       

    Increased incidence as follows was noted. Figures in brackets indicate controls. Thiomersal 12.6% [ 4.9%], glutardialdehyde 9.9% [ 2.6%], formaldehyde 3.6% [ 2.1%], glyoxal 4.2% [ 1.4%] and thiuram-mix in rubber gloves 6.7% [2.6%]. Occupation-wise dental laboratory workers showed a sensitivity of 40% as compared to 27% of dentists. Irritant contact dermatitis rates in dental assistants and theater nurses were 14 and 33 percent respectively. Contact urticaria was found in 11% of theater nurses. 5% of dental assistants and 4 % physician as compared to less than 1% of the general patch tested population.

       

    Occupational hazard includes development of contact dermatitis especially to products contacted frequently.

       
  • Katz AS, Sherertz EF [Wake Forest Univ, Winston-Salem, NC]

    Facial Dermatitis : Patch Test Results and Final Diagnoses

    Am J Contact Dermatitis 10 : 153-156, 1999

        

    Irritant or allergic contact dermatitis [ ACD] is the usual question raised at clinical examination. This retrospective study addresses itself to the latter [ACD].

        

    Between 1995 and 1997 patients presenting with a facial dermatitis as the main feature were patch tested. They belonged to the age group 14-91 years with a female dominance of 63%. 383 subjects were studied. Common allergens identified were Balsam of Peru in 12, fragrance mix in 10, propylene glycol in 6 and formalin in 10. Reaction to personally used material was seen in 32 patients. Shampoos moisturizers, foundations and mascara comprised the products of personal use. 

        

    Seborrheic and irritant dermatilits were other diseases seen as facial dermatitis.

        
  • Held E, Johansen JD, Agner T, et al [ Gentofte Univ, Denmark]

    Contact Allergy to Cosmetics : Testing With Patients Own Products

    Contact Dermatitis 40: 310-315, 1999

       

    This two year retrospective study of the nature of patch test results [positive, doubtful and irritant] is based on a previous report of 4.2% positivity to a cosmetic ingredient in eczema in Danish women. 531 subjects including 127 males were thus patch tested to their own cosmetics with results being evaluated after 2,3 and 7 days. 1-5 products were tested thus, in 40 patients including 10 males.

        

    A positive patch test to at least one cosmetic was observed in 40 patients. Doubtful reactions were seen in 82.

        

    The commonest allergens were formaldehyde and fragrances.

        
  • Thomson KF, Wilkinson SM [ General Infirmary at Leeds, England]

    Allergic Contact Dermatitis to Plant Extracts in Patients With Cosmetic Dermatitis

    Br J Dermatol 142 : 84-88, 2000

       

    Allergy to cosmetics often implies a reaction to fragrance possibly representing essential oils and plant products. 29 patients [ 27 females and 2 males] of an average age of 29 year with cosmetic associated dermatitis were patch tested, using their own cosmetic and a standard plant series. Questioning included plant contactants and use of cosmetics with natural ingredients or even aroma therapy. Labelled cosmetic products and those saying that no additional fragrance had been added were also looked into as some patients had an overlap of fragrance and plant extract allergy.

       

    The sites of disease were the face neck and fingertips. 23 subjects tested positive to Balsam of Peru as well as fragrance mix. 17 patients were reactive to fragrance mix, most commonly from tea-tree oil. 9 reactions in 6 patients to different species of the compositae species were recorded. 

       

    Of the labelled cosmetics comprising 24 products 11 contained plant material 71 fragrance free products showed 54 plant extracts of which essential oils comprised 26.

       

    Fragrance free cosmetics, cosmetics with added fragrance those containing medicaments, preservatives and others need to be used and advised with a full knowledge of possible adverse effects.

       
  • Egan CA, Rallis TM, Meadows KP, et al [ Univ of Utah, Salt Lake City]

    Low-dose Oral Methotrexate Treatment for Recalcitrant Palmoplantar Pompholyx

    J Am Acad Dermatol 40: 612-614, 1999

        

    Pompholyx is a vesicular to bullous eruption of the palms and soles possibly related to eczema often needing large doses of prednisone to control it. 

        

    Side effects of therapy often outweigh usefulness. 5 patients successfully treated with methotrexate are referred to.

        

    A single case report brings this out well. Man 39 years had gross restriction in work capacity due to long standing pompholyx. Control needed 60 mgm of prednisone in 2 divided doses and local clobetasol. The condition improved but in 4 weeks the blood pressure was recorded as 200/110 mmHg. Methotrexate in a dose of 15 mgm/wk was introduced to allow of prednisone reduction. With gradual withdrawal of prednisone, it was found that methotrexate could replace it totally. The patient is controlled thus; no corticosteroid ointment is being used.

        

    Monitoring liver function and looking for drug interaction are mandatory with methotrexate therapy.

        

Contact
Dermatitis to Latex

   


  • Kim KT, Safadi GS, Sheikh KM [Long Beach Mem, Calif, Cleveland Clinic Found Ohio]

    Diagnostic Evaluation of Type I Latex Allergy 

    Ann Allergy Asthma Immunol 80: 66-70, 1998

       

    IgE antibodies specific for natural rubber are responsible for histamine release from mast cells and basophils and are demonstrable by a pin-prick test. On the basis of history a classification was made and adequately tested. Thus of the 49 subjects who gave a positive history, 42 were reactive to Latex challenge, 99 were history negative and only 9 reacted. In the doubtful or ambiguous history group of 59 subjects 19 showed a positive
    result. Thus a good correlation was established. More positive subjects are discovered with greater sophistication in testing.

        

Contact
Dermatitis to Rubber

     


  • Gooptu C, Powell SM [Oxford Radcliffe Hosp, England]

    The Problems of rubber Hypersensitivity [ Type I and IV] in Chronic Leg Ulcer and Stasis Eczema Patients

    Contact Dermatitis 41: 89-93, 1999

        

    Whereas natural rubber latex induces type I immediate hypersensitivity reaction, chemicals e.g. accelerators and antioxidants used during processing lead to type IV sensitivity. 109 patients suffering from stasis eczema or venous ulcers – most from both – were studied for both types of allergies [ pin prick test read at 15 mins and patch test after 2 and 4 days]. Patch test results were negative in 38, positive only to 1 ingredient in 20 and 51 showed multiple positivity [ Rubber chemicals 17, wool wax alcohols 16, aminoglycoside antibiotics 15, and cetyl and stearyl alcohols 6 ]. One with another risk factor showed a type 1 reaction to the natural product.

         

    Type IV reactions are expected in patients with leg ulcers and stasis dermatitis especially the chronic ones partly because of wound dressings and changing concepts of medicatio, e.g. aminoglycoside antibiotics as brought out in this paper. The absence of type I reactions is an important observation.

        

Contact
Dermatitis and Calcipotriol

     

  • Frosch PJ, Rustemeyer T [ Univ of Witten/Herdecke and Stadtische Kliniken Dortmund, Germany]

    Contact Allergy to Calcipotriol Does Exist : Report of an Unequivocal Case and Review of the Literature

    Contact Dermatitis 40: 66-71, 1999

       

    Irritant effects of calcipotriol are known but not allergic reactions.

       

    A 64 year old female applied calcipotriol for treatment of psoriasis, of 10 years duration, twice a day for 2 weeks. It was reduced to once a day because of irritation. As the lesions cleared application was discontinued. Relapse after 6 months was again treated with calcipotriol. This time a prurtic oozing dermatitis evolved. It cleared with topical corticosteroids. Repeated open application test revealed at the end of 6 months a test positive to 0.4% calcipotriol, Punch biopsy of this revealed a spongiotic dermatitis with perivascular collection of lymphocytes, macrophages and
    eosinophils.

         

Contact
Dermatitis to Gold

       

  • Rasanen L, Kaipiainen- Seppanen O, Myllykangas –Luosujarvi R, et al [ Univ Hosp of Kuopio, Finland : Health Center of Kuopio Finland]

    Hypersensitivity to Gold Sodium Thiomalate-Induced Dermatosis

    Br J Dermatol 141: 683-688, 1999

        

    Rheumatoid arthritis and a few other disorders are treated with Gold compounds. A variety of multisystem complications are encountered in this process, and skin is their frequent mirror. Gold dermatosis does not constitute a disease entity sui generis. The rashes may be nondescript papules, lesions simulating pityriasis rosea, lichen planus and other dermatoses. Whether immunological or allergic mechanisms mediate these effects comprise the subject of this paper.

       

    Groups created for this study were [i] 13 with a gold dermatosis starting after introduction of gold sodium thiomalate [GSTM], disappearing after discontinuation and reappearance after reintroduction [ii] 15 patients with arthritis but without ill effects of GTSM therapy and [iii] 11 healthy subjects who had never received gold therapy.

       

    All subjects were patch tested, underwent a lymphocyte proliferation test and enumeration of interferon Y – producing cells [ T-cell ELI spot].

        

    LPT was positive in culture with GMST or Gold thiosulfate. T-cell ELI spot demonstrating interferon Y producing cells was positive in 4 of 6 dermatosis bearing subjects. Others receiving gold and controls did not exhibit these features. However 2 of the control group did show a false positive LPT. Only one subject was patch test positive along with Nickel.

        

    Thus immune alterations occur in gold dermatosis and may be used for diagnosis.

        

Contact
Dermatitis Urticaria and Related
Solar Urticaria

      

  • Uetsu N, Miyauchi-Hashimoto H, Okamoto H, et al [Kansai Med Univ, Moriquchi, Japan]

    The Clinical and Photobiological Characteristics of Solar Urticaria in 40 Patients

    Br J Dermatol 142: 32-38, 2000

         

    40 cases of solar urticaria [ a rare disorder] collected over a 25 year period constitute, this analysis. 16 patients were male and 24 female. Symptoms began at a median age of 32 years [13-76 years]. 24 reacted to visible light, 3 in the UV-A range, 4 in the UV-B, 3 in the UV-B to UV-A range and 1 in the UV-A visible light spectrum. Four subjects fell in the broad UV-B to visible light spectrum. 

         

    24 of 31 patients had an earlier urticarial episode to irradiated autologous serum, and 7 had solar urticaria following use of chlorpromazine. Polymorpous light eruption co-existed with solar urticaria in 2 subjects.

        

    A single modality of treatment does not cure the disease.

         


 



 

    

Speciality Spotlight

   

     

Contact Dermatitis
     

  • Bourke JF, Batta K, Prais L, et al [City Hosp, Birmingham, England]
    The Reproducibility of Patch Tests
    Br J Dermatol 140: 102-105, 1999

    Based on clinical evaluation patch testing was carried to determine its accuracy. The emphasis was on discordant findings. Material to be tested was applied in order and duplicate to the opposites of the back. 383 consecutive subjects were evaluated. Complete discordance comprised a definite positive result on one side and a definite negative one on the opposite side. A definite positive or negative on one side an equivocal response on the other constituted partial discordance.

    14 subjects were partially discordant to 5% Nickel, 6 to 25% of Balsam of Peru, 8 to 0.1% thiomersal , 5 to 1% cobalt chloride, 9 to 1% paraphenylenediamine, 3 to 8% fragrance mix, 3 to 1% formaldehyde, 11 to 5% potassium dichromate, 9 to 30% lanolin 2 with 1% Kathon CG. Complete discordance was observed in 28 subjects to one of the listed 10 allergens and 2 to 2 allergens. Concordance was best for fragrance [84%], nickel [80%] and Balsam of Peru [ 75%]. It was least for formaldehyde 36% and lanolin 56%. Clinical relevance to patch testing discordance was less than 2%. Factors such as error in observation, method, differences in patients reactivity and local factors may be contributing to discordance.

    A Clinical suspicion may need the procedure to be repeated or an alternative test to be looked into.
       
  • Shah M, Lewis FM, Gawkrodger DJ [Royal Hallamshire Hosp, Sheffield, England]
    Nickel as an Occupational Allergen: A Survey of 368 Nickel-Sensitive Subjects
    Arch Dermatol 134: 1231-1236, 1998
       
    Contact with nickel in the form of jewelry and possibly ear-piercing have been regarded as the most common associates of nickel induced allergy.
       
    This article looks at the subject differently, trying to correlate it with occupations. Cashiers, retail clerks, hairdressers, metal workers, domestic cleaners, food handlers, bar workers and painters were included in a group of 368 patients [ 34 men and 334 women] allergic to nickel. They were studied in 2 groups depending on whether they contacted nickel in their occupation or not. 84 patients [ 9 men and 75 women with a mean age of 34.2 years] had a distinct nickel exposure based on the medical amnesis. 
      
    284 [25 men and 259 women with a mean age of 38.4 years] did not come in contact with nickel. The two groups did not differ in their histories of other allergies. In the occupational group hand dermatitis was the most common presentation.
       
    The most surprising result is the small number of subjects developing nickel allergy as an occupational hazard.
       
  • Schnuch A, Uter W, Geier J, et al [ Univ of Gottingen, Germany; Univ of Osnabruck, Germany; Univ of Witten/Herdecke, Germany]
    Contact Allergies in Healthcare Workers: Results From the Information Network of Departments of Dermatology
    Acta Derm Venereol 78: 358-363, 1998
      
    Health care workers have occupation related dermatitis to the tune of 30%. 
      
    Information on 31849 patients registered in the Network of Dermatology Departments were evaluated against controls from 1992 to 1995.
       
    Increased incidence as follows was noted. Figures in brackets indicate controls. Thiomersal 12.6% [ 4.9%], glutardialdehyde 9.9% [ 2.6%], formaldehyde 3.6% [ 2.1%], glyoxal 4.2% [ 1.4%] and thiuram-mix in rubber gloves 6.7% [2.6%]. Occupation-wise dental laboratory workers showed a sensitivity of 40% as compared to 27% of dentists. Irritant contact dermatitis rates in dental assistants and theater nurses were 14 and 33 percent respectively. Contact urticaria was found in 11% of theater nurses. 5% of dental assistants and 4 % physician as compared to less than 1% of the general patch tested population.
       
    Occupational hazard includes development of contact dermatitis especially to products contacted frequently.
       
  • Katz AS, Sherertz EF [Wake Forest Univ, Winston-Salem, NC]
    Facial Dermatitis : Patch Test Results and Final Diagnoses
    Am J Contact Dermatitis 10 : 153-156, 1999
        
    Irritant or allergic contact dermatitis [ ACD] is the usual question raised at clinical examination. This retrospective study addresses itself to the latter [ACD].
        
    Between 1995 and 1997 patients presenting with a facial dermatitis as the main feature were patch tested. They belonged to the age group 14-91 years with a female dominance of 63%. 383 subjects were studied. Common allergens identified were Balsam of Peru in 12, fragrance mix in 10, propylene glycol in 6 and formalin in 10. Reaction to personally used material was seen in 32 patients. Shampoos moisturizers, foundations and mascara comprised the products of personal use. 
        
    Seborrheic and irritant dermatilits were other diseases seen as facial dermatitis.
        
  • Held E, Johansen JD, Agner T, et al [ Gentofte Univ, Denmark]
    Contact Allergy to Cosmetics : Testing With Patients Own Products
    Contact Dermatitis 40: 310-315, 1999
       
    This two year retrospective study of the nature of patch test results [positive, doubtful and irritant] is based on a previous report of 4.2% positivity to a cosmetic ingredient in eczema in Danish women. 531 subjects including 127 males were thus patch tested to their own cosmetics with results being evaluated after 2,3 and 7 days. 1-5 products were tested thus, in 40 patients including 10 males.
        
    A positive patch test to at least one cosmetic was observed in 40 patients. Doubtful reactions were seen in 82.
        
    The commonest allergens were formaldehyde and fragrances.
        
  • Thomson KF, Wilkinson SM [ General Infirmary at Leeds, England]
    Allergic Contact Dermatitis to Plant Extracts in Patients With Cosmetic Dermatitis
    Br J Dermatol 142 : 84-88, 2000
       
    Allergy to cosmetics often implies a reaction to fragrance possibly representing essential oils and plant products. 29 patients [ 27 females and 2 males] of an average age of 29 year with cosmetic associated dermatitis were patch tested, using their own cosmetic and a standard plant series. Questioning included plant contactants and use of cosmetics with natural ingredients or even aroma therapy. Labelled cosmetic products and those saying that no additional fragrance had been added were also looked into as some patients had an overlap of fragrance and plant extract allergy.
       
    The sites of disease were the face neck and fingertips. 23 subjects tested positive to Balsam of Peru as well as fragrance mix. 17 patients were reactive to fragrance mix, most commonly from tea-tree oil. 9 reactions in 6 patients to different species of the compositae species were recorded. 
       
    Of the labelled cosmetics comprising 24 products 11 contained plant material 71 fragrance free products showed 54 plant extracts of which essential oils comprised 26.
       
    Fragrance free cosmetics, cosmetics with added fragrance those containing medicaments, preservatives and others need to be used and advised with a full knowledge of possible adverse effects.
       
  • Egan CA, Rallis TM, Meadows KP, et al [ Univ of Utah, Salt Lake City]
    Low-dose Oral Methotrexate Treatment for Recalcitrant Palmoplantar Pompholyx
    J Am Acad Dermatol 40: 612-614, 1999
        
    Pompholyx is a vesicular to bullous eruption of the palms and soles possibly related to eczema often needing large doses of prednisone to control it. 
        
    Side effects of therapy often outweigh usefulness. 5 patients successfully treated with methotrexate are referred to.
        
    A single case report brings this out well. Man 39 years had gross restriction in work capacity due to long standing pompholyx. Control needed 60 mgm of prednisone in 2 divided doses and local clobetasol. The condition improved but in 4 weeks the blood pressure was recorded as 200/110 mmHg. Methotrexate in a dose of 15 mgm/wk was introduced to allow of prednisone reduction. With gradual withdrawal of prednisone, it was found that methotrexate could replace it totally. The patient is controlled thus; no corticosteroid ointment is being used.
        
    Monitoring liver function and looking for drug interaction are mandatory with methotrexate therapy.
        

Contact Dermatitis to Latex
   

  • Kim KT, Safadi GS, Sheikh KM [Long Beach Mem, Calif, Cleveland Clinic Found Ohio]
    Diagnostic Evaluation of Type I Latex Allergy 
    Ann Allergy Asthma Immunol 80: 66-70, 1998
       
    IgE antibodies specific for natural rubber are responsible for histamine release from mast cells and basophils and are demonstrable by a pin-prick test. On the basis of history a classification was made and adequately tested. Thus of the 49 subjects who gave a positive history, 42 were reactive to Latex challenge, 99 were history negative and only 9 reacted. In the doubtful or ambiguous history group of 59 subjects 19 showed a positive result. Thus a good correlation was established. More positive subjects are discovered with greater sophistication in testing.
        

Contact Dermatitis to Rubber
     

  • Gooptu C, Powell SM [Oxford Radcliffe Hosp, England]
    The Problems of rubber Hypersensitivity [ Type I and IV] in Chronic Leg Ulcer and Stasis Eczema Patients
    Contact Dermatitis 41: 89-93, 1999
        
    Whereas natural rubber latex induces type I immediate hypersensitivity reaction, chemicals e.g. accelerators and antioxidants used during processing lead to type IV sensitivity. 109 patients suffering from stasis eczema or venous ulcers – most from both – were studied for both types of allergies [ pin prick test read at 15 mins and patch test after 2 and 4 days]. Patch test results were negative in 38, positive only to 1 ingredient in 20 and 51 showed multiple positivity [ Rubber chemicals 17, wool wax alcohols 16, aminoglycoside antibiotics 15, and cetyl and stearyl alcohols 6 ]. One with another risk factor showed a type 1 reaction to the natural product.
         
    Type IV reactions are expected in patients with leg ulcers and stasis dermatitis especially the chronic ones partly because of wound dressings and changing concepts of medicatio, e.g. aminoglycoside antibiotics as brought out in this paper. The absence of type I reactions is an important observation.
        

Contact Dermatitis and Calcipotriol
     

  • Frosch PJ, Rustemeyer T [ Univ of Witten/Herdecke and Stadtische Kliniken Dortmund, Germany]
    Contact Allergy to Calcipotriol Does Exist : Report of an Unequivocal Case and Review of the Literature
    Contact Dermatitis 40: 66-71, 1999
       
    Irritant effects of calcipotriol are known but not allergic reactions.
       
    A 64 year old female applied calcipotriol for treatment of psoriasis, of 10 years duration, twice a day for 2 weeks. It was reduced to once a day because of irritation. As the lesions cleared application was discontinued. Relapse after 6 months was again treated with calcipotriol. This time a prurtic oozing dermatitis evolved. It cleared with topical corticosteroids. Repeated open application test revealed at the end of 6 months a test positive to 0.4% calcipotriol, Punch biopsy of this revealed a spongiotic dermatitis with perivascular collection of lymphocytes, macrophages and eosinophils.
         

Contact Dermatitis to Gold
       

  • Rasanen L, Kaipiainen- Seppanen O, Myllykangas –Luosujarvi R, et al [ Univ Hosp of Kuopio, Finland : Health Center of Kuopio Finland]
    Hypersensitivity to Gold Sodium Thiomalate-Induced Dermatosis
    Br J Dermatol 141: 683-688, 1999
        
    Rheumatoid arthritis and a few other disorders are treated with Gold compounds. A variety of multisystem complications are encountered in this process, and skin is their frequent mirror. Gold dermatosis does not constitute a disease entity sui generis. The rashes may be nondescript papules, lesions simulating pityriasis rosea, lichen planus and other dermatoses. Whether immunological or allergic mechanisms mediate these effects comprise the subject of this paper.
       
    Groups created for this study were [i] 13 with a gold dermatosis starting after introduction of gold sodium thiomalate [GSTM], disappearing after discontinuation and reappearance after reintroduction [ii] 15 patients with arthritis but without ill effects of GTSM therapy and [iii] 11 healthy subjects who had never received gold therapy.
       
    All subjects were patch tested, underwent a lymphocyte proliferation test and enumeration of interferon Y – producing cells [ T-cell ELI spot].
        
    LPT was positive in culture with GMST or Gold thiosulfate. T-cell ELI spot demonstrating interferon Y producing cells was positive in 4 of 6 dermatosis bearing subjects. Others receiving gold and controls did not exhibit these features. However 2 of the control group did show a false positive LPT. Only one subject was patch test positive along with Nickel.
        
    Thus immune alterations occur in gold dermatosis and may be used for diagnosis.
        

Contact Dermatitis Urticaria and Related Solar Urticaria
      

  • Uetsu N, Miyauchi-Hashimoto H, Okamoto H, et al [Kansai Med Univ, Moriquchi, Japan]
    The Clinical and Photobiological Characteristics of Solar Urticaria in 40 Patients
    Br J Dermatol 142: 32-38, 2000
         
    40 cases of solar urticaria [ a rare disorder] collected over a 25 year period constitute, this analysis. 16 patients were male and 24 female. Symptoms began at a median age of 32 years [13-76 years]. 24 reacted to visible light, 3 in the UV-A range, 4 in the UV-B, 3 in the UV-B to UV-A range and 1 in the UV-A visible light spectrum. Four subjects fell in the broad UV-B to visible light spectrum. 
         
    24 of 31 patients had an earlier urticarial episode to irradiated autologous serum, and 7 had solar urticaria following use of chlorpromazine. Polymorpous light eruption co-existed with solar urticaria in 2 subjects.
        
    A single modality of treatment does not cure the disease.
         

 

 

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