Contact Dermatitis最新文献

Background: Despite legislation aimed to protect the population against skin sensitization in the European Union (EU), over one quarter of the general population is sensitised to at least one chemical.

Objectives: To provide an overview and comparison of European legislation concerning skin sensitization. In addition, we gathered the opinions of experts and stakeholders regarding improvements in the legislation and risk assessment process in the EU, to provide suggestions for improvement.

Methods: Legislation was identified and compared. Four questionnaires were created towards industry, competent authorities and regulators, researchers/clinicians, and non-governmental organisations. The questions concerned the legislation, the risk assessment process, data collection and potential improvements.

Results: Seven areas of legislation were analysed. The legislation was found to be unharmonised, for example, differing modes of restriction and accepted tests for skin sensitization. Approximately 40% of the questionnaire respondents found that the EU legislation and tools were not sufficiently protective. To improve the legislation 83% suggested harmonisation and 68% suggested better data sharing. Other areas were: improved exposure data (78%), better understanding of the skin sensitization mechanism (67%) and non-animal tests (66%).

Conclusions: Stakeholders had varying confidence towards the protection of European citizens against skin sensitization. Multiple areas for improvement regarding the legislations and the risk assessment process were identified.

Background: Chronic prurigo (CP) is a condition characterised by chronic pruritus and pruriginous lesions. While frequently associated with atopic dermatitis (AD), its link with allergic contact dermatitis (ACD) is less understood.

Objectives: To describe the clinical features, diagnostic findings, and therapeutic outcomes of CP associated with ACD.

Patients/materials/methods: This case series included patients diagnosed with CP or prurigo nodularis, identified through medical records from a specialised ACD clinic. Inclusion criteria were positive patch tests identifying relevant allergens, complete medical histories, and resolution or improvement of CP lesions after allergen avoidance. Patch testing was performed using the Spanish Extended Baseline Series and additional allergen panels as needed, following International Contact Dermatitis Research Group guidelines.

Results: Six patients were identified: four cases of CP associated with fragrances and two with textile dyes. All patients improved significantly with allergen avoidance; two required dupilumab. Histological findings and clinical responses suggested a Th2-driven immune response in fragrance-induced ACD and a Th2/Th17 involvement in azo dye-related cases.

Conclusions: ACD caused by textile dyes and fragrances may manifest as papular dermatitis with features consistent with CP. Patch testing should be considered for idiopathic CP or cases associated with AD. Further studies are needed to clarify the immune mechanisms underlying this association.

Background: Parachute riggers are specialised tradesmen involved in packing parachutes. Occupational dermatoses have never been studied in them despite their job entailing hard manual work.

Objectives: To observe, diagnose, record and characterise various hand and nail changes and diseases in parachute riggers.

Methods: Parachute riggers working at Paratrooper Training School (PTS), Agra, India, consenting to participate in the study were enrolled. A brief history and hand and nail changes seen using a hand-lens were recorded. Data were analysed using R-Project for Statistical Computing version R 3.6.2 for Windows.

Results: A total of 76 participants were examined. The mean age was 29.6 years and the mean duration of employment was 29.7 months. All were males. Callosities and loss of cuticle were the commonest abnormalities present in 61 (80.2%) and 57 (75%) participants, respectively. Other common changes were pitted scars 24 (31.5%), xeroderma 23 (30.2%), pigmentary changes 21 (27.6%), onychoschizia 10 (13.1%) and splinter haemorrhages 5 (6.5%). The most common diseases observed were dermatitis (21%) and onychomycosis. The odds ratio for occurrence of callosities decreased with age (OR 0.889, 95% CI 0.825-0.957, p = 0.002). Spearman's rank coefficient of correlation showed a statistically significant negative association between the number of hand and nail changes observed and duration of employment (Spearman's ρ = - 0.25, p = 0.03).

Conclusion: Most of the changes observed were secondary to repeated friction, pressure and dryness of hands. Emphasising adequate corrective measures involving barrier creams, good quality gloves and health education may significantly reduce the incidence of these changes.

Positive patch test responses to benzoyl peroxide (BPO) have been reported from patients without and with known exposure. Up to 6.5% were found in the United States and 7.8% in a study including patients from Germany, Austria and Switzerland. We provide an overview of the skin sensitisation potential and potency of BPO based on animal experiments and non-animal methods. BPO tested positive in Guinea Pig Tests and the Local Lymph Node Assay. Application of the current OECD guideline to identify a skin sensitizer by combining non-animal method results gave differing outcomes. Moreover, patch test responses of patients to BPO were considered to determine the importance of BPO as a relevant occupational contact allergen. Another well-known BPO exposure is the topical application to treat acne. Despite widespread use, extensive and long-term skin exposure, we found for this group only studies reporting few positive patch test reactions. Further, occupational handling of BPO and contact allergy is reported by dental technicians. In-depth evaluation of the prevalence of contact allergy in different professions with suspected BPO exposure did not reveal an association with occupational handling of BPO. Consequently, a generally increased risk for those professions is not supported.