1/63. Delayed hypersensitivity to enoxaparin.A 65-year-old woman experienced immediate itchy erythematous patches at the subcutaneous injection sites of sodium enoxaparin. An erythematous and infiltrated 40 x 20 mm lesion on the abdominal wall could be observed at the site of enoxaparin injection when she was referred to our clinic 48 h after injection. Lesions subsided spontaneously within 1 week. She had been on this treatment 1 and 3 years before without any adverse reaction. To clarify the nature of the reaction, epicutaneous tests with sodium enoxaparin, calcium nadroparin and calcium heparin were performed, all with negative results. Skin prick test with sodium enoxaparin was also negative. biopsy of the cutaneous lesion showed spongiotic dermatitis, strongly suggesting a delayed hypersensitivity mechanism. We report here on a new case of delayed hypersensitivity to enoxaparin. Being female, overweight and having prolonged application of the drug were suggested risk factors present in our patient. biopsy was essential for diagnosis. Although type IV hypersensitivity reactions to enoxaparin are rare, we should start to suspect this condition in order not to underdiagnose it.- - - - - - - - - - ranking = 1keywords = dermatitis (Clic here for more details about this article) |
2/63. Cutaneous allergic reaction to intramuscular vitamin K1.A 40-year-old woman with no pre-existing hepatic disease developed a cutaneous allergic reaction to intramuscular vitamin K1. She received this medication prophylactically prior to surgery, developed severe localized, and subsequently generalized, dermatitis, beginning 5 days after administration of the Konakion Cremophor-EL form of vitamin K1 by intramuscular injection at four sites on her thighs. Investigation by patch and intradermal testing revealed delayed-type hypersensitivity to Konakion Cremophor-EL, Konakion Mixed micelles and pure vitamin K1, but not Cremophor-EL vehicle alone. This case is unusual because the patient was also shown to be patch test positive to vitamin K3 sodium bisulfite.- - - - - - - - - - ranking = 1keywords = dermatitis (Clic here for more details about this article) |
3/63. Delayed cutaneous reaction to jellyfish.A 57-year-old woman presented with a widespread papulonodular eruption. The dermatitis had appeared about 1 week after her return from a trip to the Red Sea, where she had come into contact with a shoal of unidentified jellyfish; however, that contact had not been followed by cutaneous lesions and/or symptoms. The patient also stated that she had had previous contacts with jellyfish during other trips to exotic seaside resorts. The dermatitis was characterized by papulonodular lesions, round or oval in shape, of a few millimeters in diameter, with a color ranging from pink to red to brown, and with a smooth and regular surface. The lesions were grouped in an apparently random fashion (Fig. 1) or arranged linearly (Fig. 2). The patient complained of pruritus and burning. Histopathologic examination showed the presence of some necrotic keratinocytes; in the upper and mid dermis, edema and a predominantly perivascular and periadnexal lymphohistiocytic infiltrate, with numerous neutrophils and eosinophils, were observed (Fig. 3). The patient was treated with hydroxyzine (37.5 mg/day) and hydrocortisone butyrate, which resulted in the rapid disappearance of the symptoms; however, the cutaneous lesions persisted for about 3 weeks.- - - - - - - - - - ranking = 2.1807662358616keywords = dermatitis, contact (Clic here for more details about this article) |
4/63. Delayed type hypersensitivity to intralesional triamcinolone acetonide.Corticosteroids are the most widely used class of drugs in dermatology. In the past, allergic contact dermatitis to topical corticosteriods was rarely reported. In this article, we present a case of delayed type hypersensitivity to triamcinolone acetonide.- - - - - - - - - - ranking = 1.0602554119539keywords = dermatitis, contact (Clic here for more details about this article) |
5/63. Type III and type IV hypersensitivity reactions due to mitomycin C.A 71-year-old man developed an exfoliative dermatitis of the palms of the hands and soles of the feet, and a generalized itch, during treatment with intravesical instillations of mitomycin C for an undifferentiated carcinoma of the bladder. patch tests with mitomycin C 0.03%, 0.1% and 0.3% aq. were positive. Because of the serious consequences of this finding, the patient was retested with mitomycin C in pet. (same concentrations), a more stable preparation. This showed clear positive reactions. During this last series of patch tests, he developed palpable purpura on the legs. We postulated that this reaction was an immune-complex-mediated reaction, caused by the 2nd series of patch tests with mitomycin C. To prove this, we performed histopathological and immunofluorescence investigations, and these showed the reaction to be consistent with Henoch-Schonlein-type purpura. We therefore conclude that this patient developed systemic reactions to mitomycin C, characterized by an eczematous dermatitis as well as purpuric reactions. The intravesical installations with mitomycin C have been stopped. The patient's skin problems (the purpura as well as the eczema) have completely resolved and have not recurred.- - - - - - - - - - ranking = 2keywords = dermatitis (Clic here for more details about this article) |
6/63. Delayed generalized allergic reactions to corticosteroids.A 37-year-old patient presented with a severe allergic local reaction upon inhalation of budesonide for asthma. skin tests were positive for budesonide and amcinonide (group B) and elicited a strong local reaction and a disseminated macular exanthema. Corticosteroids from other groups were well tolerated. A 38-year-old male patient had first an allergic contact dermatitis to topically applied prednisolone acetate and then a disseminated eczematous exanthema upon oral intake of prednisone. A delayed-type sensitization to corticosteroids from group A such as hydrocortisone, prednisone and tixocortol pivalate was identified. A detailed diagnosis in patients with allergic reactions to corticosteroids is crucial with regard to their use in emergency therapy.- - - - - - - - - - ranking = 1.0602554119539keywords = dermatitis, contact (Clic here for more details about this article) |
7/63. Occupational allergic airbone contact dermatitis and delayed bronchial asthma from epoxy resin revealed by bronchial provocation test.Diglycidyl ether of bisphenol A (DGEBA) epoxy resins belong to the most common causes of occupational allergic contact dermatitis. DGEBA has on rare occasions caused occupational asthma. Here we present a patient who first developed occupational allergic contact dermatitis (ACD) caused by a single accidental exposure to DGEBA. Then, on continued occupational exposure to DGEBA, the patient developed occupational asthma from DGEBA, in addition to ACD. A bronchial provocation test with DGEBA caused a 36% drop in the peak expiratory flow, reflecting a delayed type of occupational asthma. This bronchial provocation test caused a strong dermatitis of the exposed skin of the face, in accordance with airborne ACD from DGEBA.- - - - - - - - - - ranking = 7.3615324717232keywords = dermatitis, contact (Clic here for more details about this article) |
8/63. A case of cutaneous delayed-type allergy to oral dexamethasone and to betamethasone.Corticosteroids are drugs that may cause allergic contact dermatitis, but systemic allergic reactions to these drugs are rare. A 29-year-old man developed a maculopapular rash during an oral therapy with betamethasone. patch tests demonstrated a delayed-type allergy to dexamethasone, betamethasone and fluocortolone. Oral, intramuscular or topical provocation tests with other corticosteroids - deflazacort, hydrocortisone, methylprednisolone, fluticasone dipropionate, triamcinolone and prednisone - were all negative. This demonstrates that a patient with a systemic allergy to a group of corticosteroids can tolerate those of other groups.- - - - - - - - - - ranking = 1.0602554119539keywords = dermatitis, contact (Clic here for more details about this article) |
9/63. Generalized lichen nitidus successfully treated with an antituberculous agent.We describe a Japanese girl with generalized lichen nitidus. She had been exposed to mycobacterium tuberculosis at 6 years of age via her teacher. At 8 years of age, she developed severe contact dermatitis on sun-exposed areas after contact with Japanese lacquer trees. Shortly after, numerous tiny, shiny, flesh-coloured papules developed over the upper part of her body. At 10 years of age, she was exposed to a school outbreak of M. tuberculosis. Her eruption showed no response to topical corticosteroids or oral tranilast, but most of the papules completely disappeared after she had received oral isoniazid for 6 months.- - - - - - - - - - ranking = 1.1205108239077keywords = dermatitis, contact (Clic here for more details about this article) |
10/63. Allergic contact dermatitis from transdermal estradiol and systemic contact dermatitis from oral estradiol. A case report.BACKGROUND: About 20% of patients using transdermal estradiol complain of adverse local side effects. CASE: A 47-year-old, postmenopausal woman developed eczematous lesions at the sites of application of a estradiol therapeutic transdermal system and successively at the sites of application of a gel containing estradiol. Due to the topical intolerance, the therapy was switched to oral estrogen, which caused a systemic pruritic rash. Positive patch tests with estradiol led to the diagnosis of type IV allergic dermatitis due to transdermal estradiol and to a gel containing estradiol. Systemic contact dermatitis due to oral estradiol was also diagnosed. CONCLUSION: Even though allergic contact dermatitis from estradiol is extremely rare, local side effects from estradiol systems must be kept in mind and correctly diagnosed. patch tests allow identification of the causative agent. In the case of primary sensitization to topical estradiol, oral estrogens must be prescribed cautiously to avoid systemic reactions.- - - - - - - - - - ranking = 11.602554119539keywords = dermatitis, contact (Clic here for more details about this article) |
| | Next -> |