Cases reported "Hand Dermatoses"

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1/101. garlic-related dermatoses: case report and review of the literature.

    BACKGROUND: garlic is widely appreciated as a spice and as a vegetable as well as an over-the-counter phytotherapeutic. From a dermato-allergological standpoint, several garlic-related adverse reactions have to be distinguished. OBJECTIVE: The corresponding literature is reviewed briefly, with regard to our present observation of a cook, who contracted garlic-induced contact dermatitis being analyzed for its complex pathomechanism. methods: The patient showed a positive type-IV patch test reaction for diallyl disulfide, a low molecular weight garlic ingredient; and strong, non-irritant reactions after 20 min and 24 hrs in the scratch chamber test with fresh total garlic. RESULTS: Thus, in this case of an occupational dermatosis, protein contact dermatitis had to be considered, as well as allergic type-IV contact dermatitis as a co-existing pathomechanism. CONCLUSIONS: The spectrum of garlic-related adverse reactions comprises irritant contact dermatitis, with the rare variant of zosteriform dermatitis; induction of pemphigus, allergic asthma and rhinitis; contact urticaria; protein contact dermatitis; allergic contact dermatitis, including the hematogenic variant; as well as combinations thereof, as evidenced by our present case observation.
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ranking = 1
keywords = patch test, patch
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2/101. Occupational protein contact dermatitis to cornstarch in a paper adhesive.

    BACKGROUND: Protein contact dermatitis is better known in food-service and health-care workers than in industrial workers. Cornstarch has seldom been a problem, although it can cause contact urticaria to glove powder. OBJECTIVE: To present the case of a paper-bag maker who developed severe occupational (protein) contact dermatitis within two-three hours after returning to work. She lacked any evidence of urticaria and demonstrated largely negative patch-test results. methods: Following a history of occupational exposure to a cornstarch-based adhesive, the patient was patch-tested to materials with which she had worked, which she contacted, and with which she had attempted treatment. Following patch testing, she was prick-tested to cornstarch, the principal ingredient in the adhesive. RESULTS: Patch testing was negative except for a very mild reaction to the adhesive. Prick testing to cornstarch was more severe than the histamine control. The test site became eczematous and remained so for more than ten weeks. Avoidance of cornstarch and the adhesive was followed by clearing. CONCLUSION: Workup for prominent occupational contact dermatitis without urticaria may sometimes require testing for type 1 allergy.
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ranking = 0.026189732777841
keywords = patch
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3/101. Occupational allergic contact dermatitis from unsaturated polyester resin in a car repair putty.

    BACKGROUND: Unsaturated polyester (UP) resins are widely used as cements in car repair painting to produce a smooth surface before the final painting. We report two car painters with hand and face dermatitis who were sensitized to a UP resin used for car repair cements. methods: Patch testing with commercial substances and ingredients and extracts from UP resins was used to verify the sensitivity. RESULTS: Both patients showed an allergic patch test reaction to a UP resin. They also had an allergic patch test reaction to diethyleneglycol maleate (DEGM), an extract of a UP resin. CONCLUSIONS: Both patients had been patch tested elsewhere with negative results because UP resins had not been used for patch testing. Accordingly, patients with dermatitis who have been exposed to UP resins need to be patch tested with UP resins. The specific chemical causing allergic contact dermatitis in our patients was DEGM.
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ranking = 5
keywords = patch test, patch
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4/101. Occupational allergic contact dermatitis from olive oil in a masseur.

    Contact allergy to olive oil is considered rare. There are 20 cases of contact allergy to olive oil described, and 3 of these had an occupational hand eczema as a result of olive oil. We describe a masseur who was allergic to olive oil, resulting in an occupational hand eczema. Both patch tests and a use test with olive oil was undertaken. An oral provocation with olive oil was also performed. Both patch tests were positive, as was the use test after 2 days. The oral provocation test was negative. Despite contact allergy to olive oil being rare, sensitization occurs. The external use of olive oil should be discouraged, at least in masseurs, when used under occlusion, and in long-standing dermatoses.
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ranking = 2
keywords = patch test, patch
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5/101. Allergic contact dermatitis caused by parabens: 2 case reports and a review.

    parabens, methyl, ethyl, propyl, benzyl, and butyl, are the most common preservatives in use today. They are the alkyl esters of p-hydroxybenzoic acid and are used extensively because they are relatively nonirritating and nontoxic and offer good antimicrobial coverage. Testing for paraben allergen can be done by patch testing. Two cases of allergic contact dermatitis (ACD) to parabens are used to discuss the background of parabens, their allergenicity, patch testing issues, and several "paraben paradoxes." Although ACD to parabens has been reported, given the widespread use, it is relatively uncommon. Because of their low rate of allergenicity and their favorable preservative profile and efficacy, parabens remain the number one preservative in use.
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ranking = 2
keywords = patch test, patch
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6/101. 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.
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ranking = 2
keywords = patch test, patch
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7/101. Finger 'pebbles'. A dermatologic sign of diabetes mellitus.

    A 35-year-old obese man presented with a chief complaint of hand dryness of 5 years' duration. He was a store manager and denied exposure to chemicals, repetitive trauma, chronic irritation, and hard manual labor. However, he did admit to frequent hand washing. He had no itching or swelling in his hands, but on occasion he had tenderness in the dry areas. He had no personal or family history of diabetes, heart disease, or renal disease, and he stated that at his annual physical examination 6 months earlier, routine blood work was normal. He reported polyuria (every 2 hours), nocturia (five times per night), and polydipsia but no weakness, weight loss, visual changes, or neurosensory changes. Examination revealed xerosis of his hands and "pebbles" on the dorsal aspect of his fingers. The papules were most dense over the knuckles and interphalangeal joints (figures 1 through 3). He also had dozens of acrochordons (i.e., cutaneous papillomas, or skin tags) 1 to 4 mm in diameter on his neck, axilla, and groin. No other cutaneous lesions were noted. Specifically, there was no scleredema adultorum, necrobiosis lipoidica diabeticorum, acanthosis nigricans, bullae, or patchy pretibial pigmentation, although he did have several brown macules 1 to 5 mm in diameter on the sides of his lower legs. The macules had been present for years. Levels of hemoglobin A1c and glycated hemoglobin were 7.5% and 9.5%, respectively (normal, 4.4% to 5.9% and 5.0% to 7.3%). The patient was referred to his family physician, and his diabetes has been well controlled with insulin.
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ranking = 0.0087299109259472
keywords = patch
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8/101. 4 cases of photocontact dermatitis due to ketoprofen.

    We report 4 cases of photocontact dermatitis due to ketoprofen, a non-steroidal anti-inflammatory drug derived from propionic acid. We carried out a skin biopsy to examine the amount of ketoprofen in the eruptive skin. We investigated the cross-reactions between tiaprofenic acid, suprofen and ketoprofen by patch and photopatch testing. In case no. 1, 17 days after the discontinuance of Mohrus poultice (containing ketoprofen as an active ingredient), we detected ketoprofen 312.5 ng/g in the area of skin where the poultice was applied. All 4 cases reacted positively to the causative medicaments containing ketoprofen and ketoprofen 1% pet. 3 out of 4 cases reacted positively to tiaprofenic acid 1% pet. Only 1 case out of the ketoprofen and tiaprofenic acid positive cases reacted positively to suprofen 1% pet. Vehicles of patients' medicaments were negative in all 4 cases. We suspected that the key structure of the cross-reaction between ketoprofen and tiaprofenic acid and suprofen was the benzoyl radical.
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ranking = 1.0087299109259
keywords = patch test, patch
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9/101. Alkaptonuric ochronosis presenting as palmoplantar pigmentation.

    We describe a 37-year-old woman who presented with palmoplantar pigmentation, thickening and pitting of 4 years duration. Bluish pigmented patches were seen over the sclera of her eyes. Her lumbar spine showed typical calcification of the intervertebral discs. Addition of Benedict's reagent to a urine sample of the patient gave rise to greenish brown precipitate and brownish black supernatant. Alkalinization of urine turned it black. A biopsy of the palmar lesion demonstrated irregular breaking up, swelling and homogenization of collagen bundles in the reticular dermis. Yellow-brown (ochre coloured) pigment was seen lying within the collagen bundles and also freely in the deeper dermis confirming our clinical diagnosis of alkaptonuric ochronosis. To the best of our knowledge this is probably the second report of alkaptonuria presenting with palmoplantar pigmentation.
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ranking = 0.0087299109259472
keywords = patch
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10/101. Anaerobic sealants: still a problem today.

    Acrylic anaerobic sealants are widely used in engineering and electronic industries. They may induce allergic contact dermatitis of the first three fingers and onycholysis. We report a case of allergic contact dermatitis due to anaerobic sealants and we underline some practical problems connected with the frequency of sensitization, patch-testing and material safety data sheet availability.
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ranking = 0.0087299109259472
keywords = patch
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