Aneta Lazarov

Occupational contact dermatitis due to essential oils

Background:  Allergic contact dermatitis induced by the occupational use of products containing essential oils has not been studied comprehensively.

European Standard Series patch test results from a contact dermatitis clinic in Israel during the 7‐year period from 1998 to 2004

The results of a 7‐year retrospective study (1998–2004) from patch testing with the European Standard Series (ESS) establishing the frequency of sensitization in a contact dermatitis clinic in Israel are presented. 23 allergens were patch tested on 2156 patients, 1462 females (67.8%) and 694 males (32.2%). Atopy and asthma were present in 21.9% of the patients. One or more allergic reactions were observed in 937 patients (43.5%). The highest yield of patch test positives from the 1076 positive reactions were obtained from nickel sulfate (13.9%), fragrance mix (7.1%), potassium dichromate (3.8%), Balsam of Peru (3.6%), CL + Me‐isothiazolinone (3.4%) and cobalt chloride (3.4%). Allergens which produced the least amount of positive results were primin and clioquinol. Allergic contact dermatitis (ACD) was established in 32.8%, whereas occupationally related allergic (8.0) and irritant contact dermatitis (5.6%) affected a total of 13.6% of the cases studied. The most common clinical forms of dermatitis were chronic dermatitis (47.7%) followed by acute dermatitis (22.8%), and lichenification and hyperkeratosis (7.9%). The hands (30.7%), face and neck (23.9%) and extremities (11.3%) were the most frequently affected areas. Four allergens in our study differed from the top 10 allergens in Europe namely: Cl + Me‐isothiazolinone, formaldehyde, 4‐tert‐butylphenol formaldehyde resin and sesquiterpene lactone mix reflecting an existing difference in environmental exposure. Our study is the first to provide data on the frequency of sensitization and important allergens in the aetiology of ACD in Israel. In spite of the existing differences with Europe, we conclude that ESS is an appropriate screening system for the diagnosis of ACD in Israel.

Comparison of reactivity to allergens using the TRUE Test and IQ chamber system

The reproducibility of the patch test is of great importance to its diagnostic utility. The objective of this study was to quantitatively and qualitatively compare the reproducibility of patch test reactions between the manufacturer‐loaded TRUE Test® (TT) panel and the investigator‐loaded IQ® Chamber (IQC) system using the European Standard Series (ESS) (Chemotechnique Diagnostics, Malmö, Sweden). Consecutive patients were simultaneously patch tested with 21 allergens using the TT and IQC system. The concordance and discordance of the 2 methods were analysed. Testing was performed in 207 patients (85 men and 122 women) who yielded 317 positive reactions, 188 with the IQ system and 129 with the TT. A total of 204 tests were positive with both methods, showing a positive concordance rate of 64.4%, with IQC producing more positive results. A high concordance rate of positive results was achieved for Cl+ Me− isothiazolinone (81.5%), nickel sulfate (79%), formaldehyde (76.9%), and paraphenylenediamine (PPD) (72.7%); a moderate concordance was noted for quaternium 15 (66.7%), potassium dichromate (64.3%), and fragrance mix (58.1%); and a low concordance was noted for cobalt chloride (27.6%) and Balsam of Peru (18.2%). The IQC and the TT are similar in finding allergy to allergens with high concordance. The IQC system has an advantage in detecting clinically relevant reactions to allergens that have a moderate and a low concordance.

Self-reported skin disease in hydrotherapists working in swimming pools

The aim of our study was to investigate the risk and characteristics of self‐reported skin diseases among hydrotherapists. We attempted to contact 400 adults who participated in 1 of 2 training courses. 248 were reached and 190 of them (76.6%) completed the questionnaires. The data were collected by means of a telephone interview and a detailed questionnaire sent by mail. Statistical analysis included descriptive statistics, univariate and multifactorial analysis. Of those completing the questionnaire (75.8% females and 24.2% males), 44.4% of the hydrotherapists reported on the development of skin disease for the first time after the beginning of work at the swimming pool. The most common symptoms included pruritus and erythematous patches affecting mainly the extremities and trunk. Both smoking and increased exposure hours to pool water were independently associated with skin disease, suggesting a dose–response relationship. We conclude that contact dermatitis should be recognized as an occupational disease in hydrotherapists.

Illness perception and quality of life in patients with contact dermatitis

Background. Peoples subjective perceptions of illness are important determinants of their ways of coping with health threats and the ensuing physical and mental outcomes, including quality of life (QoL), which has been consistently reported to be impaired by contact dermatitis.

Paediatric Behçet disease manifested as recurrent myositis: from an incomplete to a full-blown form.

Abstract A 12-year-old boy presented with a limp and findings suggesting localised myositis of his right calf and a working diagnosis of Behçet disease was made. During 3 years of follow-up, he had another three episodes of calf myositis, all responsive to corticosteroids within days. Conclusion A case of recurrent localised myositis as a main manifestation of Behçet disease is reported. The evolution of incomplete Behçet disease, which is common in children, to the full blown form, with the emphasis on muscle involvement and the importance of early diagnosis of Behçet disease, is discussed.

Frequency of textile dye and resin sensitization in patients with contact dermatitis in Israel

1. Disperse Yellow 3 0 2. Disperse Orange 3 0 3. Disperse Red 1 0 4. Disperse Red 17 1 5. Disperse Blue 153 0 6. Disperse Blue 3 0 7. Disperse Blue 35 2 8. dimethylol dihydroxyethylene urea 2 9. dimethylol propylene urea 6 10. tetramethylol acetylene diurea 6 11. Disperse Blue 106 12 12. ethylene urea melamine formaldehyde 9 13. urea formaldehyde 7 14. melamine formaldehyde 7 15. Disperse Blue 85 5 16. Disperse Orange 1 1 17. Disperse Orange 13 0 18. Disperse Brown 1 0 19. Disperse Yellow 9 1 20. Disperse Blue 124 21 21. Basic Red 46 0 otechnique Diagnostics (Malmö, Sweden). The allergens were placed on unaffected skin of the upper back, removed at 2 days and read at day (D) 2 and 3 according to standard patch test definitions (2).

The purpuric patch test in patients with allergic contact dermatitis from azo dyes.

The histopathological features of the purpuric patch test have been described in individual cases only. We report a series of patients with allergic contact dermatitis, who developed purpuric patch tests at the sites of allergens from the azo dye group. 105 patients were clinically evaluated and tested with the TRUE Test and the textile color & finish series (Chemotechnique Diagnostics) because of suspected clothing dermatitis. Positive results to the latter were found in 31 patients (29.5%). In 9 of these, purpuric patch tests were observed at the sites of the allergens Disperse Blue 124, 106 and 85. 10 biopsies were performed and studied. The histopathological changes of the purpuric patch test included: spongiosis (in 90% of cases), exocytosis (70%), and dilated blood vessels (100%) without signs of vasculitis, surrounded by an inflammatory infiltrate composed mainly of T lymphocytes. Extravasated erythrocytes were seen perivascularly, but also in the interstitium, surrounding the acrosyringium, at the dermoepidermal junction, and in the epidermis. Increased number of mast cells were found in 22.2% of cases. Disperse Blue 124, 106, and 85 are potent allergens that can elicit purpuric patch test reactions. The purpuric patch test in our cases was a manifestation of an allergic reaction, based not only on histopathological changes, but also on evolution and relevance of the patch tests.

Anxiety and depression in patients with allergic and non-allergic cutaneous disorders.

Background  Numerous studies have shown that anxiety and depression are more prevalent among patients suffering from chronic skin disorders.

Airborne irritant contact dermatitis from phosphates in a fertilizer factory

Case Report A 46-year-old non-atopic man presented with a 5-year history of a work-related burning, itchy rash on the face and hands. He had been working in a dusty factory making mineral fertilizers for 23 years as a plant operator. Raw materials used in production included rough, dry, wet and baked phosphates (Table 1). The patient wore protective clothing and sometimes gloves, but never any facial protection. There was marked erythema, edema and scaling of the cheeks, nasolabial folds, eyelids, retroauricular areas and neck to be seen, as well as erythema and scaling of the wrists and finger webs. He was patch tested with the TRUE Test standard series and with a series comprising 1% and 2% pet. of rough, dry, wet and baked phosphates, applied in Square Chambers with Micropore, according to US guidelines (1). There was a π reaction to epoxy resin in the standard series at both D2 and D3, which was of past rather