1/20. Intolerance of osteosynthesis material: evidence of dichromate contact allergy with concomitant oligoclonal T-cell infiltrate and TH1-type cytokine expression in the peri-implantar tissue.BACKGROUND: We report on a 37-year-old man without history of previous allergic disease who developed an aseptic intolerance reaction to a chromium-cobalt alloy, with local discomfort, loosening, and absence of fracture healing. Both in vivo and in vitro allergoimmunologic diagnostic tests were performed. methods: Patch testing was done with a European standard series. Specific serum IgE was measured by CAP-FEIA. In addition to immunohistology (APAAP method), peri-implantar tissue was further analyzed by PCR to determine T-cell-receptor-gamma rearrangement and thus the potential clonal (antigen-driven) T-cell repertoire. The actual tissue mRNA expression for IL-4, IL-6, and IFN-gamma was visualized by RT-PCR. RESULTS: skin testing gave a delayed-type reaction to dichromate. Specific serum IgE to natural rubber latex and grass pollen was found--but without clinical symptoms. Immunohistology revealed a monocytic and dense T-cell infiltrate. The latter, instead of being random, showed an oligoclonal T-cell receptor rearrangement. In addition, there was TH1-type mediator expression (IL-6 and IFN-gamma, but not IL-4). CONCLUSIONS: skin test, examination of peri-implantar tissue, and the prompt healing after replacement of the osteosynthesis material suggest an allergic reaction. PCR analysis of peri-implantar tissue can further help to identify and understand allergy-mediated implant intolerance reactions.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
2/20. Fingertip dermatitis in a retail florist.prevalence of plant contact dermatitis in retail florists varies with exposure, and the number of reports of contact allergy to cut tulips is rather small. Alpha-methylene-gamma-butyrolactone is better known as the cause of both alstroemeria dermatitis in retail florists and tulip finger in wholesale floral workers who handle the bulbs. Our patient presented with prominent erythema, scaling, and peeling of the skin of the thumb, index, and middle fingers of his right hand. Results of a patch test to alpha-methylene-gamma-butyrolactone were strongly positive, and the patient determined that the exposure had occurred when he stripped leaves from the tulip stems to arrange cut flowers. Other natural sources of the antigen include alstroemeria; Bomarea; dioscorea hispida; Erythronium; Gagea; fritillaria; and at least one species of onion, allium triquetrum.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
3/20. Contact urticaria caused by heat-sensitive raw fish allergens.patients allergic to fish usually present with skin reactions after handling raw fish. Less frequently, these reactions are seen without symptoms after oral intake, often in chefs and food handlers. We have attempted to explain the skin selectivity of such reactions in a 36-year-old woman with contact urticaria after handling raw fish. We obtained aqueous extracts of raw and cooked fish (sole and hake) for in vivo (prick test) and in vitro (SDS-PAGE, IgE Immunoblot) tests. Prick-by-prick test, 20-min closed patch test, rub test with fresh and cooked fish (sole, hake and cod) and specific IgE (CAP-system) to sole, cod and hake were performed. The strength of positive reaction to raw fish was greater than to cooked fish on both prick and prick-by-prick testing. Rub tests showed positive responses only to raw fish. Specific IgEs to sole (45 KU/l), hake (66.9 KU/l) and cod (18.7 KU/l) were obtained. IgE immunoblot recognized 3 antigens of 25, 48, 56 kDa in raw sole and 1 of 42 kDa in raw hake extracts. No IgE binding was observed with the cooked extracts or control sera. Our findings strongly suggest a Type-I hypersensitivity to fish. Immunoblot analyses demonstrated a loss of specific IgE binding to cooked extracts. We have reported a case of contact urticaria caused by heat-sensitive raw-fish allergens in a patient who probably became sensitized via the cutaneous route.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
4/20. Combined contact and photocontact allergic dermatitis to etofenamate in flogoprofen gel.We report a case of combined contact and photocontact allergic dermatitis to etofenamate in Flogoprofen gel (Chiesi Wasserman, Barcelona, spain). Patch test results were positive at the nonirradiated site, but there was a stronger reaction at the irradiated site with etofenamate 0.05% in petrolatum (pet.) at d2 and d4. The use frequent of topical agents containing etofenamate and sun exposure can result in a predisposition to contact photoallergy. Clinical findings caused by etofenamate are uncommon. Allergic contact dermatitis is the most common cutaneous reaction reported. In American studies observed, no reactions were observed to etofenamate in subjects with photosensitivity because it was not included in the series of antigens used in testing.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
5/20. Clinical review: thioureas and allergic contact dermatitis.Thioureas are an uncommon underrecognized cause of allergic contact dermatitis (ACD). This article presents the findings in 3 individuals with ACD to thioureas and reviews the medical literature concerning thiourea-induced ACD. Thioureas are often the allergenic sources in ACD involving high-grade rubber products made of neoprene. Standard patch test series and rubber allergen patch test series usually do not contain thiourea allergens and will fail to diagnose these causes of ACD. Thioureas--most notably diethylthiourea, dibutylthiourea, and diphenylthiourea--should be considered in individuals with potential rubber allergy who fail to react to antigens in the standard allergen patch test tray.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
6/20. Allergic contact dermatitis to latanoprost.An 85-year-old male with glaucoma presented with a 1-1/2 year history of tearing; red eyes; and pruritic, edematous, eczematous eyelids. Treatment for presumed ocular rosacea and seborrhea was unhelpful. Patch testing to our standard 64 antigens yielded a positive reaction to Balsam of peru. Notably, benzalkonium chloride, thimerosal, and other preservatives elicited negative reactions. Repeat open application testing elicited positive results to Xalatan (latanoprost) 0.005% ophthalmic solution (Pharmacia & Upjohn, Kalamazoo, MI). A second session of patch tests to 10 personal products, in addition to Xalatan 0.005% solution and the Xalatan vehicle (provided by the manufacturer), elicited a strong positive reaction only to the full preparation of Xalatan 0.005% solution. This report describes the first known case of ACD to latanoprost, a new prostaglandin analog that is widely prescribed for treatment of glaucoma.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
7/20. Parthenium dermatitis presenting as photosensitive lichenoid eruption. A new clinical variant.Parthenium hysterophorus is the commonest cause of airborne contact dermatitis (ABCD) in india. The disease usually manifests as itchy erythematous, papular, papulovesicular and plaque lesions on exposed areas of the body. Rarely, however, the disease may present as actinic reticuloid or photocontact dermatitis. We have observed a different clinical variant of this disease where certain patients with Parthenium dermatitis have presented with discrete, flat, violaceous papules and plaques on exposed areas of the body closely simulating photosensitive lichenoid eruption. We had 8 patients, 6 males and 2 females between 30 and 62 years of age, with itchy, violaceous, papules and plaques on the face, neck, ears, upper chest and dorsa of the hands for 6 months to 6.5 years. Four of these patients had a history of improvement of the lesions up to 30% in winter and aggravation of lesions on exposure to sunlight. There was no personal or family history of atopy. Cutaneous examination in all patients revealed multiple flat, violaceous, mildly erythematous papules and plaques on the forehead, sides and nape of neck, ears, 'V' area of the chest, and extensor aspects of the forearms and hands. skin biopsies from these lesions showed features of chronic non-specific dermatitis. Patch testing with standardized plant antigens showed a positive patch test reaction to Parthenium hysterophorus in all patients, with a titre of contact hypersensitivity (TCH) varying from undiluted to 1 : 100. We conclude that Parthenium dermatitis may occasionally present with lesions very similar to the lesions of photosensitive lichenoid eruption in morphology and distribution. This clinical presentation of Parthenium dermatitis needs to be recognized to avoid misdiagnosis.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
8/20. Stereochemical considerations on concomitant allergic contact dermatitis to ester of the cis-trans isomeric compounds maleic acid and fumaric acid.Allergic contact dermatitis from esters of fumaric acid or esters of maleic acid is rare. The case of a chemist with allergic reactions to esters both of fumaric acid and of maleic acid is presented. Extremely high sensitivity of the patient to diethyl fumarate was noted. The formation of identical complete antigens from esters of these two cis-trans isomeric acids may be an explanation of the patient's double allergy. This is discussed from a stereochemical point of view. These stereochemical considerations point to a general mechanism where cis-trans isomeric alpha,beta-unsaturated carbonyl compounds are converted into the same complete antigen.- - - - - - - - - - ranking = 2keywords = antigen (Clic here for more details about this article) |
9/20. Non-occupational allergy caused by the pine processionary caterpillar (Thaumetopoea pityocampa).Contact with the pine processionary caterpillar induces dermatitis, usually located in exposed areas, and, less frequently, ocular lesions through a toxic-irritative mechanism. Recently, the existence of an immediate hypersensitivity mechanism has been demonstrated, mainly in occupationally exposed patients. OBJECTIVE: To present four patients who experienced allergic reactions (urticaria-angioedema and rhinitis-asthma) after non-occupational exposure to pine processionary caterpillar. patients AND methods: The four patients underwent allergy testing through skin prick tests (SPT), specific IgE detection and SDS-PAGE immunoblotting. One patient also underwent a specific bronchial challenge test with the pine processionary antigen. RESULTS: In all patients, both SPT with the caterpillar extract and specific IgE were positive. Western blotting showed several IgE-binding bands with molecular mass values ranging from 18 to 107 kDa. A shift in the electrophoretic mobility of some of the relevant allergens occurred under the presence of a reductive agent (beta -mercaptoethanol). The specific bronchial challenge test with pine processionary antigen performed in one of the patients also produced positive results. CONCLUSIONS: The results of this study show an immunologic IgE-mediated immediate hypersensitivity mechanism in these reactions. The processionary caterpillar's airborne urticating hairs or spicules should be considered, at least in some locations, not only as contact and occupational allergens, but also as seasonal aeroallergens.- - - - - - - - - - ranking = 2keywords = antigen (Clic here for more details about this article) |
10/20. Cutaneous and oral eruption from oral exposure to nickel in dental braces.Oral eruptions due to nickel allergy are rare. A common presentation of intraoral contact dermatitis is the presence of lichenoid plaques on the buccal mucosa adjacent to the offending antigen. We report an unusual case of cutaneous and mucosal nickel allergy arising after placement of dental braces. An 11-year-old boy was referred by his orthodontist to the University of minnesota Occupational and Contact dermatitis Clinic to be evaluated for a possible metal allergy. The patient developed an itchy rash on his abdomen and under his wristwatch 1 week after dental braces were placed. He was diagnosed with allergic contact dermatitis from nickel. The patient avoided cutaneous nickel exposure and had a minimal resolution of his symptoms. One year later, the patient developed swelling and burning of the lips. Secondary to extreme discomfort, the braces, which contained nickel, titanium, and zinc, were removed. The patient underwent standard patch testing; the final reading at 96 hours showed a reaction to nickel, palladium, cobalt chloride, and neomycin. The patient experienced relief of his oral symptoms after removal of the braces. No current relevance to palladium, cobalt, or neomycin has been found.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
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