Contact Dermatitis最新文献

Introduction: Patients with non-immediate hypersensitivity to beta-lactam antibiotics (βL) often avoid all βL, with limitations for future therapy.

Objectives: Assess cross-reactivity between βL in non-immediate cutaneous adverse drug reactions (ni-CADRs).

Methods: Retrospective analysis (2000-2022) of patients with suspected ni-CADR with βL as a possible culprit who underwent patch testing (PT) with an extended antibiotic series (10% pet., Chemotechnique Diagnostics or prepared in-house) according to European Society of Contact Dermatitis (ESCD) recommendations. Fisher exact test was used with a significance of 0.05 corrected for multiple testing; positive associations were quantified with odds ratio (OR) with 95% confidence interval (CI).

Results: Four hundred and fourteen patients (270 female/144 male; age 52 ± 19 years) were included, mostly with maculopapular exanthema (367; 89%), drug reaction with eosinophilia and systemic symptoms (DRESS) (22; 5%) and acute generalised exanthematous pustulosis (AGEP) (12; 3%). Eighty-six patients (21%) had positive results to at least one drug. Fifty-eight patients (14%) had 110 positive results to βL, mostly amoxicillin (33). Co-reactivity within penicillins was almost universal, including piperacillin with other penicillins (p = 0.007; OR 25; CI 3-56). There was co-reactivity to aminopenicillins and aminocephalosporins (p = 0.006; OR 33; CI 4-74) and within the cephalosporin subclass, including between aminocephalosporins and non-aminocephalosporins. Within carbapenems, 1 patient reacted to meropenem and ertapenem, with no extension to imipenem, as confirmed with a provocation test. Two patients reacted both to ceftriaxone and meropenem (p = 0.013; OR: 68; CI:15-612).

Conclusion: PT is useful to confirm a probable culprit in ni-CADR to βL. Co-reactivity, interpreted mostly as cross-reactivity, occurred within cephalosporin and, particularly, with penicillin subclasses, including between piperacillin-tazobactam and remaining penicillins, which has seldom been described. There was no association between penicillins and cephalosporins as a whole, except between aminopenicillins and aminocephalosporins, attributable to a similar lateral chain amino group. We found an unexpected association between meropenem and ceftriaxone, probably a concomitant sensitization.

Background: Children are particularly susceptible to environmental pollutants. This study assessed the skin sensitisation risk associated with polycyclic aromatic hydrocarbons (PAHs), prevalent in toys.

Objectives: To evaluate the skin sensitisation potential of PAHs using the KeratinoSens assay.

Methods: Individual PAHs (acenaphthylene, anthracene, benzo[a]anthracene, benzo[a]pyrene (B[a]P), benzo[b]fluoranthene (B[b]F), benzo[e]pyrene, benzo[g,h,i]perylene, benzo[k]fluoranthene (B[k]F), chrysene, fluoranthene, fluorene, naphthalene, phenanthrene, pyrene and triphenylene) and ternary mixtures containing B[a]P were assessed for their ability to activate the Keap1-Nrf2-ARE pathway in human keratinocytes. The concentration addition model and additive index were used to predict and analyse mixture effects.

Results: Among the individual PAHs, B[k]F demonstrated the most potent activation of the pathway, exhibiting a 34-fold higher potency relative to B[a]P. B[b]F, chrysene and B[a]P also exhibited significant activation, while the remaining PAHs displayed negligible or weak activation. Notably, PAH mixtures exhibited synergistic effects, except for those composed solely of potent sensitizers.

Conclusions: This study provides the first assessment of the skin sensitization potential of these PAHs. The findings suggest that B[k]F, B[b]F and chrysene may pose a higher risk of skin sensitisation than previously thought. Additionally, the synergistic effects observed in mixtures highlight the importance of considering combined exposures when assessing PAH exposure risk.

Background: Hand eczema (HE) is described as a common disease in Greenland, but studies on its epidemiology and severity are lacking.

Objectives: To investigate the point prevalence and severity of HE among adults in East Greenland in relation to age, sex, and occupation.

Methods: In May 2022, we conducted a cross-sectional study in Tasiilaq, East Greenland. All adults aged ≥ 18 years were invited (n = 1311 individuals).

Results: A total of 295 participants accepted the invitation. Among these, the point prevalence of HE was 22.4% (95% confidence interval [CI]: 18.0-27.5, n = 66/295), and 5.0% based on the total invited population (n = 66/1311). The median age of participants with HE was 40 years (interquartile range [IQR]: 30-54), and the median age at disease onset was 25 years ([IQR]: 19-40). Females were more frequently affected than males (65.2%, n = 43/66). Atopic dermatitis was diagnosed in 7.6% of participants with HE. The mean Hand Eczema Severity Index (HECSI) score was 21 (range 2-112), and exposure to wet work was reported by 57.4% of the participants with HE.

Conclusions: Hand eczema is common in East Greenland, with a point prevalence similar to that in Nordic countries. The severity and distribution of HE in relation to age, sex, and occupation were comparable to those reported in other European studies.