Earl J. Rudner

A five-year study of cosmetic reactions***

During 64 months (1977 to 1983), twelve dermatologists from various sections of the United States studied a total of 713 patients with cosmetic dermatitis out of an estimated total of 13,216 patients with contact dermatitis. The number of patients seen for all causes during this period was 281,100. An important finding was that half of the patients or physicians were unaware that a cosmetic was responsible for their dermatitis. Skin care products, hair preparations (including colors), and facial makeup were responsible for the majority of the reactions. The most important objective was identification of causative ingredients. Eighty-seven percent of the subjects had patch tests. Fragrance, preservatives (Quaternium-15, formaldehyde, imidazolidinyl urea, and parabens), p-phenylenediamine, and glyceryl monothioglycolate were the most frequently identified allergic sensitizers, in that order. In addition to the clinical data, the study permitted assessment of the frequency of cosmetic reactions, although the data may not be entirely representative of the country at large because of the special interests of the dermatologists involved.

Prospective study of cosmetic reactions: 1977-1980

This prospective study (1977-1980) of cosmetic adverse reactions by eleven dermatologists identified 487 cases of cosmetic-induced dermatitis. Approximately half of the cases were covert in nature. Eighty percent were due to allergic contact dermatitis; the face, eye, and upper arm were the most involved sites. Skin care products, hair preparations (including colors), and facial makeup products were the most commonly involved product categories. Fragrances, preservatives, lanolin and lanolin derivatives, p -phenylenediamine, and propylene glycol were the most commonly identified causative agents. The data may not be representative of the country at large because of the special interests of the dermatologists involved.

Implantation dermatosis. Wood splinter with fungus contamination.

Ilistopathologically, a solid fragment of wood was found embedded in deep dermis (Eig. 1) and the fat tissue was surrounded by areas of foreign body granuloma and fibrosis. An interesting finding was the presence in the wood splinter of many dark brown septated and branching fungus mycelia (Fig. 2). The fungus elements must have been in the wood splinter at the time it penetrated into the skin and seem to have remained viable for the following 3 years.

How We Treat Granuloma Pyogenicum

Granuloma pyogenicum is a benign growth that may appear anywhere on the skin or mucous membranes following trauma. It must be removed or destroyed completely or it is likely to recur. A feeder vessel lies deep in the dermis.