<p>A 38-year-old women was referred to allergist doctor for a possible anaphylactic reaction to an ingredient contained in a topical antiacne gel, Cutacnyl® (<i>Benzoyl peroxide 5%, Carbomère 940, Copolymère méthacrylique, Docusate sodique, Eau purifiée, Glycérol, Poloxamère 182, Propylèneglycol, Silice colloïdale anhydre, Sodium hydroxyde solution</i>) (Galderma International, Paris, France).</p><p>On 3 April 2024, she had started a new topical antiacne treatment with a gel containing 5% benzoyl peroxide (BP) for acne. She began to experience facial pruritus on Day 2 and she stopped the treatment.</p><p>On Day 3, the patient experienced bright red erythema across her face with severe eyelid edema and strong pruritus (Figure 1A). She went to the emergency room due to the growing edema.</p><p>On the emergency report, a voluminous edema of eyelids, dysphonia, tachycardia and low arterial blood pressure were noted (Figure 1B,C). Suspecting anaphylaxis, the patient received an intramuscular adrenaline injection, an inhaled adrenaline spray, an intravenous antihistamine and intravenous corticosteroids. However, these treatments were not effective.</p><p>Emergency physicians also suggested bradykinin-induced angioedema. Diagnostic laboratory examinations for angioedema (serum levels of C3, C4 and C1INH) were normal.</p><p>In the emergency room, tryptase was also normal with a value of 3.26 μg/L, excluding anaphylaxis.</p><p>The reaction finally resolved in 1 week, with a desquamative rash.</p><p>She was then referred to allergy consulting in July 2024.</p><p>She mentioned she did not use any other topical treatments or cosmetics.</p><p>However, she had previously applied anti-acne creams, but could not remember which molecule she had used.</p><p>The patient applied Cutacnyl® all over her face, not just to the lesions as recommended by her general practioner. A prick-test to topical antiacne gel was performed and was negative at 20 min.</p><p>Patch testing was performed with the European and cosmetic series (Chemotechnique Diagnostics, Vellinge Sweden), BP 1% petrolatum and the Cutacnyl gel® (5% BP-containing) ‘as is’.</p><p>The haptens were applied on the back using IQ Ultra chambers (Chemotechnique Diagnostics), and following by an occlusion of 2 days, readings were performed on day (D)2 and D3.</p><p>Positive strong reactions were observed on D2 and D3 to BP 1% pet. (+++) and also, to topical antiacne cream as is (++) (Figure 2A,B).</p><p>A diagnostic of allergic contact dermatitis from BP was confirmed with an angioedema clinical aspect.</p><p>A positive patch test (+) reaction to nickel sulfate was found, relevant with reactions to costume jewellery in the past (Figure 2C).</p><p>ACD is a type IV hypersensitivity reaction which may also present as facial and eyelid edema.</p><p>Whereas anaphylaxis is a sudden IgE-mediated reaction occurring typically within 1–2 h, following contact with the allergen with several organ systems involved.<span><sup>1<
{"title":"Allergic contact dermatitis to benzoyl peroxide mimics anaphylactic reaction","authors":"Magalie Coco-Viloin, Françoise Giordano","doi":"10.1111/cod.14720","DOIUrl":"10.1111/cod.14720","url":null,"abstract":"<p>A 38-year-old women was referred to allergist doctor for a possible anaphylactic reaction to an ingredient contained in a topical antiacne gel, Cutacnyl® (<i>Benzoyl peroxide 5%, Carbomère 940, Copolymère méthacrylique, Docusate sodique, Eau purifiée, Glycérol, Poloxamère 182, Propylèneglycol, Silice colloïdale anhydre, Sodium hydroxyde solution</i>) (Galderma International, Paris, France).</p><p>On 3 April 2024, she had started a new topical antiacne treatment with a gel containing 5% benzoyl peroxide (BP) for acne. She began to experience facial pruritus on Day 2 and she stopped the treatment.</p><p>On Day 3, the patient experienced bright red erythema across her face with severe eyelid edema and strong pruritus (Figure 1A). She went to the emergency room due to the growing edema.</p><p>On the emergency report, a voluminous edema of eyelids, dysphonia, tachycardia and low arterial blood pressure were noted (Figure 1B,C). Suspecting anaphylaxis, the patient received an intramuscular adrenaline injection, an inhaled adrenaline spray, an intravenous antihistamine and intravenous corticosteroids. However, these treatments were not effective.</p><p>Emergency physicians also suggested bradykinin-induced angioedema. Diagnostic laboratory examinations for angioedema (serum levels of C3, C4 and C1INH) were normal.</p><p>In the emergency room, tryptase was also normal with a value of 3.26 μg/L, excluding anaphylaxis.</p><p>The reaction finally resolved in 1 week, with a desquamative rash.</p><p>She was then referred to allergy consulting in July 2024.</p><p>She mentioned she did not use any other topical treatments or cosmetics.</p><p>However, she had previously applied anti-acne creams, but could not remember which molecule she had used.</p><p>The patient applied Cutacnyl® all over her face, not just to the lesions as recommended by her general practioner. A prick-test to topical antiacne gel was performed and was negative at 20 min.</p><p>Patch testing was performed with the European and cosmetic series (Chemotechnique Diagnostics, Vellinge Sweden), BP 1% petrolatum and the Cutacnyl gel® (5% BP-containing) ‘as is’.</p><p>The haptens were applied on the back using IQ Ultra chambers (Chemotechnique Diagnostics), and following by an occlusion of 2 days, readings were performed on day (D)2 and D3.</p><p>Positive strong reactions were observed on D2 and D3 to BP 1% pet. (+++) and also, to topical antiacne cream as is (++) (Figure 2A,B).</p><p>A diagnostic of allergic contact dermatitis from BP was confirmed with an angioedema clinical aspect.</p><p>A positive patch test (+) reaction to nickel sulfate was found, relevant with reactions to costume jewellery in the past (Figure 2C).</p><p>ACD is a type IV hypersensitivity reaction which may also present as facial and eyelid edema.</p><p>Whereas anaphylaxis is a sudden IgE-mediated reaction occurring typically within 1–2 h, following contact with the allergen with several organ systems involved.<span><sup>1<","PeriodicalId":10527,"journal":{"name":"Contact Dermatitis","volume":"92 3","pages":"243-245"},"PeriodicalIF":4.8,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cod.14720","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marion Menanteau, Lynda Bensefa-Colas, Marie-Noëlle Crepy
<p>We present the first case of pustular eyelid eczema due to contact allergy to methacrylates in artificial nails.</p><p>A 36-year-old African woman with a past history of ACD (allergic contact dermatitis) to fragrances and thiuram mix, was referred for acute pustular lesions, erythema and mild oedema of the eyelids and periorbital skin. The lesions had started the week before on the eyelids and were slowly extending to the temples and cheeks (Figure 1). She also had erythema and squamous lesions of the hands with a few pustules (Figure 2). She had received a prescription for oral Pristinamycin and local Fucidin with no improvement.</p><p>The patient had not recently been using gloves. She avoided the use of fragrances in her personal products since she had received her first diagnosis of ACD to fragrances.</p><p>The patient reported she had recently been to see a beautician for an artificial nail application, but 3 days later, she decided to pull the false nails out herself.</p><p>Patch tests had been performed with EBS (European baseline series) and acrylates series using test preparations from D'Estaing (Grasse France) or SmartPractice Europe (Greven, Germany), using IQ ultra chambers® from Chemotechnique MB Diagnostics AB (Vellinge, Sweden) and Mepilex® border tape with an occlusion time of 48 h according to the ESCD guidelines. Positive results were found for 2-hydroxypropyl methacrylate 2% pet (+) and ethylene glycol dimethacrylate 2% pet (+) at D3 and D10; as well as 2-hydroxyethyl methacrylate 2% pet (+), thiuram mix 1% pet (++), fragrance mix I 8% pet (++) and fragrance mix II 14% pet (++), linalool 0.5% pet (++), limonene 0.2% pet (+).</p><p>She healed a few days later with a topical dermocorticoid treatment and the avoidance of artificial nails and nail products.</p><p>The eyelids are one of the most sensitive areas of skin: frequently exposed to potential allergens, histologically the thinnest skin area of the body, and with an occluded eyelid skin while the eye is open. Contamination of the fingers with small amounts of allergen can result in the transfer of sufficient material to the eyelids to produce dermatitis via hand-to-face contact.<span><sup>1, 2</sup></span></p><p>Contact allergy from acrylic compounds is well known and often described related to artificial nails in the occupational setting, but also concerns the non-occupational setting.<span><sup>3-6</sup></span></p><p>The pustular form of ACD to acrylates is unusual with no other case reported to our knowledge.</p><p>Pustular ACD is rare and has been reported with fragrances, colophonium, rubber additives, textile dyes, triethanolamine and benzoic acid.<span><sup>7-11</sup></span> Pustular lesions can mimic an infectious skin disease, and hamper the diagnosis of ACD.</p><p>In conclusion, this is the first case of pustular eyelid ACD associated with methacrylates in artificial nails. This report highlights the importance of considering unusual location and presentations i
{"title":"First case of pustular eyelid allergic contact dermatitis to methacrylates in artificial nails","authors":"Marion Menanteau, Lynda Bensefa-Colas, Marie-Noëlle Crepy","doi":"10.1111/cod.14717","DOIUrl":"10.1111/cod.14717","url":null,"abstract":"<p>We present the first case of pustular eyelid eczema due to contact allergy to methacrylates in artificial nails.</p><p>A 36-year-old African woman with a past history of ACD (allergic contact dermatitis) to fragrances and thiuram mix, was referred for acute pustular lesions, erythema and mild oedema of the eyelids and periorbital skin. The lesions had started the week before on the eyelids and were slowly extending to the temples and cheeks (Figure 1). She also had erythema and squamous lesions of the hands with a few pustules (Figure 2). She had received a prescription for oral Pristinamycin and local Fucidin with no improvement.</p><p>The patient had not recently been using gloves. She avoided the use of fragrances in her personal products since she had received her first diagnosis of ACD to fragrances.</p><p>The patient reported she had recently been to see a beautician for an artificial nail application, but 3 days later, she decided to pull the false nails out herself.</p><p>Patch tests had been performed with EBS (European baseline series) and acrylates series using test preparations from D'Estaing (Grasse France) or SmartPractice Europe (Greven, Germany), using IQ ultra chambers® from Chemotechnique MB Diagnostics AB (Vellinge, Sweden) and Mepilex® border tape with an occlusion time of 48 h according to the ESCD guidelines. Positive results were found for 2-hydroxypropyl methacrylate 2% pet (+) and ethylene glycol dimethacrylate 2% pet (+) at D3 and D10; as well as 2-hydroxyethyl methacrylate 2% pet (+), thiuram mix 1% pet (++), fragrance mix I 8% pet (++) and fragrance mix II 14% pet (++), linalool 0.5% pet (++), limonene 0.2% pet (+).</p><p>She healed a few days later with a topical dermocorticoid treatment and the avoidance of artificial nails and nail products.</p><p>The eyelids are one of the most sensitive areas of skin: frequently exposed to potential allergens, histologically the thinnest skin area of the body, and with an occluded eyelid skin while the eye is open. Contamination of the fingers with small amounts of allergen can result in the transfer of sufficient material to the eyelids to produce dermatitis via hand-to-face contact.<span><sup>1, 2</sup></span></p><p>Contact allergy from acrylic compounds is well known and often described related to artificial nails in the occupational setting, but also concerns the non-occupational setting.<span><sup>3-6</sup></span></p><p>The pustular form of ACD to acrylates is unusual with no other case reported to our knowledge.</p><p>Pustular ACD is rare and has been reported with fragrances, colophonium, rubber additives, textile dyes, triethanolamine and benzoic acid.<span><sup>7-11</sup></span> Pustular lesions can mimic an infectious skin disease, and hamper the diagnosis of ACD.</p><p>In conclusion, this is the first case of pustular eyelid ACD associated with methacrylates in artificial nails. This report highlights the importance of considering unusual location and presentations i","PeriodicalId":10527,"journal":{"name":"Contact Dermatitis","volume":"92 3","pages":"241-243"},"PeriodicalIF":4.8,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cod.14717","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Allergic contact cheilitis/stomatitis due to beverages and food, an underreported diagnosis","authors":"Stefan Kerre, An Goossens","doi":"10.1111/cod.14725","DOIUrl":"10.1111/cod.14725","url":null,"abstract":"","PeriodicalId":10527,"journal":{"name":"Contact Dermatitis","volume":"92 3","pages":"248-250"},"PeriodicalIF":4.8,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A case of contact dermatitis caused by a cell phone grip ring","authors":"Saki Ueda, Kanako Akashi, Ken Washio","doi":"10.1111/cod.14719","DOIUrl":"10.1111/cod.14719","url":null,"abstract":"","PeriodicalId":10527,"journal":{"name":"Contact Dermatitis","volume":"92 2","pages":"155-156"},"PeriodicalIF":4.8,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142602934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nadia Raison-Peyron, Marwa El Gana, Cecilia Svedman, Jakob Dahlin
{"title":"Pulpitis of the fingers, it is not always acrylates!","authors":"Nadia Raison-Peyron, Marwa El Gana, Cecilia Svedman, Jakob Dahlin","doi":"10.1111/cod.14716","DOIUrl":"10.1111/cod.14716","url":null,"abstract":"","PeriodicalId":10527,"journal":{"name":"Contact Dermatitis","volume":"92 2","pages":"159-160"},"PeriodicalIF":4.8,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dicyclohexylcarbodiimide (DCC) is known to cause occupational allergic contact dermatitis in biotechnology laboratory workers.
Objectives
This study aimed to assess the prevalence of DCC sensitization among workers of one biosynthesis laboratory and to determine the optimal DCC concentration for patch testing.
Materials and methods
23 laboratory workers frequently exposed to DCC of whom 21 suffered from dermatitis and 11 controls were enrolled into the study. All participants underwent skin patch testing with different concentrations of DCC and other substances used in the work environment. Statistical analysis was conducted to compare results between active and control groups.
Results
Of the 23 workers tested, 56.5% showed positive reactions to DCC. All of them had dermatitis. Morpholine also elicited positive reactions in 26.1% of workers who were all sensitized to DCC. Dimethylformamide and chloroform yielded negative results.
Conclusion
Dicyclohexylcarbodiimide was a major cause of contact dermatitis in the active group indicating an outbreak of contact allergy to DCC in the company necessitating preventive measures. Both DCC 0.1% ac. and DCC 0.05% pet. should both be used for patch testing.
{"title":"Outbreak of contact allergy to dicyclohexylcarbodiimide in a biotechnology laboratory","authors":"Linas Griguola, Kestutis Cerniauskas, Laura Malinauskiene, Kotryna Linauskiene, Justina Rudyte, Anzelika Chomiciene","doi":"10.1111/cod.14715","DOIUrl":"10.1111/cod.14715","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Dicyclohexylcarbodiimide (DCC) is known to cause occupational allergic contact dermatitis in biotechnology laboratory workers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to assess the prevalence of DCC sensitization among workers of one biosynthesis laboratory and to determine the optimal DCC concentration for patch testing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and methods</h3>\u0000 \u0000 <p>23 laboratory workers frequently exposed to DCC of whom 21 suffered from dermatitis and 11 controls were enrolled into the study. All participants underwent skin patch testing with different concentrations of DCC and other substances used in the work environment. Statistical analysis was conducted to compare results between active and control groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 23 workers tested, 56.5% showed positive reactions to DCC. All of them had dermatitis. Morpholine also elicited positive reactions in 26.1% of workers who were all sensitized to DCC. Dimethylformamide and chloroform yielded negative results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Dicyclohexylcarbodiimide was a major cause of contact dermatitis in the active group indicating an outbreak of contact allergy to DCC in the company necessitating preventive measures. Both DCC 0.1% ac. and DCC 0.05% pet. should both be used for patch testing.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10527,"journal":{"name":"Contact Dermatitis","volume":"92 2","pages":"145-151"},"PeriodicalIF":4.8,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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