Elise M. Herro

Systemic contact dermatitis--kids and ketchup.

Abstract:  Systemic manifestations of allergic contact dermatitis due to consumption of foods containing balsam of Peru (Myroxylon pereirae)‐associated chemicals have recently been reported in children. We present seven children with widespread, recalcitrant dermatitis who experienced 60–80% clearance after initiating a diet low in balsam of Peru, specifically the tomato product ketchup. Furthermore, because we have observed a high prevalence of ketchup in our pediatric patients’ diets, we recommend consideration of moderate consumption of this product in patients with recalcitrant widespread dermatitis.

Recommendations for a screening series for allergic contact eyelid dermatitis.

BackgroundAlthough allergic contact dermatitis of the eyelids is a common condition, limited information is available regarding the selection of patch-testing chemicals for proper evaluation. ObjectiveThe purpose of this analysis was to evaluate the relevance of allergens responsible for allergic eyelid dermatitis among a series of patch-tested patients attending our clinic at the University of Miami and compare these results to published studies in the literature. MethodsData were retrospectively reviewed for eyelid-only dermatitis from clinically relevant patch-test evaluations performed between December 2004 and January 2007. ResultsFormaldehyde was the most frequently encountered antigen, accounting for 45.83% (11/24) of the cases, followed by nickel 33.33% (8/24) and balsam of Peru (Myroxylon pereirae) 29.17% (7/24). In addition, not only did we find a higher prevalence of certain allergens when compared with other studies, but we identified several relevant allergens not previously reported at other referral centers. ConclusionsThe allergens found to be relevant in eyelid dermatitis vary among different regions. These data may help contribute to generating a standard screening tool to improve the detection and management of these cases.

Bra-associated allergic contact dermatitis: p-tert-butylphenol formaldehyde resin as the culprit.

Abstract:  P‐tert‐butylphenol formaldehyde resin (PTBPFR) is recognized as a significant source of allergic contact dermatitis in adults and children in association with athletic gear, shoes, and neoprene. To our knowledge, this is the first case report of allergic contact dermatitis with PTBPFR associated with padded foam bras.

Practical patch testing and chemical allergens in contact dermatitis

Practical patch testing and chemical allergens in contact dermatitis / , Practical patch testing and chemical allergens in contact dermatitis / , کتابخانه دیجیتال جندی شاپور اهواز

p-tert-Butylphenol formaldehyde resin and its impact on children.

: p-tert-Butylphenol formaldehyde resin (PTBPFR) is widely used as an adhesive owing to its rapid onset of action, durability, flexibility, and heat resistance. Moreover, because of its tackiness, it is particularly useful as a glue component on both leather and rubber products. Sensitization to this resin has been increasing since the first cases of PTBPFR contact allergy in the late 1950s, and pediatric contact allergy to this resin is a significant problem. p-tert-Butylphenol formaldehyde resin has been reported as a leading cause of shoe-associated dermatitis internationally, as well as a cause of allergic contact dermatitis from its use in neoprene wet suits and sports equipment such as shin guards. In summary, patch test screening of both adults and children with PTBPFR is important, given the ubiquitous use of this chemical.

Nickel exposure from household items: potential method of protection.

production of rubber tires and inner tubes as well as asphalt. When patients with foot dermatitis patch tested positive to DTDM, it was speculated they had been sensitized through rubber exposure in footwear, leading investigators to recommend addition of DTDM as a screening allergen in evaluating foot dermatitis. In a recent Mayo review of patch testing with rubber allergens, however, the majority of patients who tested positive to DTDM had hand (46.4%) rather than foot (10.7%) or generalized (25.0%) dermatitis. The authors acknowledged the potential for irritation from this allergen, but the reactions they observed conformed to the pattern of allergic patch test responses. They did not discuss possible sources of DTDM exposure in their hand dermatitis patients. In our patients, we would have failed to confirm the relationship of rubber accelerator allergy to occupational hand dermatitis had we not added DTDM to our screening series 2 years ago. With its use, we have observed the expected occasional early irritant reactions but also rare persisting or increasing pink papular responses characteristic of allergic response. It is difficult to discover exactly which chemicals may have been used during production of synthetic rubber gloves. Many manufacturers closely guard such data as proprietary. Furthermore, the manufacturing process undergoes frequent modification, and steps may be outsourced to factories in far-flung international sites, making accurate details unobtainable. Information from several product safety spokespersons for our manufacturer failed to include or specifically exclude DTDM as an accelerator used during the production of the lavender gloves. Our cases suggest that patch testing with DTDM may help identify allergy to rubber gloves in some patients with hand dermatitis who show no reaction to other commonly screened rubber accelerators. Future studies should investigate further the significance of this allergen in both hand and foot dermatitis.

A nickel for your thoughts: determining relative nickel content using an analog color scale.

counter preparations, such as cold remedies and liniments. In European and Latin American countries, it also may be found in topical NSAIDs. It may also be present in shoes, floor and furniture polishes, adhesives, varnishes, lacquers, sealing wax, and printer ink. Turpentine was included in the Standard European Series for patch testing until 1979, when it was withdrawn because of a decrease in sensitization. Different sources of turpentine, mechanization in industry, replacement with cheaper substitutes, and relocation of factories out of Western Europe may all contribute to the decrease in occupational sensitization to turpentine. However, over recent years, increased rates of turpentine sensitization have been reported in users of the products cited previously. Because of its widespread use, Chemotechnique Diagnostics included 0.03% pet turpentine peroxides in its latest cosmetics series in 2009. Turpentine appears to be associated with a high frequency of concomitant sensitizations, especially to MCI/MI1. Our patient presented with both types of sensitization, and this finding suggests a possible common exposure to both haptens.

Ultraviolet Protective Eyewear for Wood’s Light Use

Abstract:  When interpreting delayed patch test reads for children suspected of having contact dermatitis, we use the Wood’s light to illuminate the highlighter outlines we made at the first read. Our pediatric patients wear single‐use ultraviolet protective goggles to shield their retinas, because children have a propensity to attempt to look into the Wood’s lamp.

Butylhydroxytoluene--from jet fuels to cosmetics?

A patient with a 1.5-year history of recalcitrant hand dermatitis, presented to the VA Medical Center contact dermatitis clinic. The dermatitis had started on both his dorsal feet and hands, spreading to affect the whole body, within 1 week of daily using Up and Up over-the-counter antifungal liquid spray containing tolnaftate 1% to self-treat presumed tinea pedis. Initially, the patient had been treated in urgent care with a prednisone taper. He promptly ceased using the spray, but his hand dermatitis persisted and worsened, despite the use of high-potency topical steroids (eg, clobetasol; Fig. 1). When he arrived for consultation, he brought his personal hygiene products, along with the antifungal spray can. Given his history of jet fuel exposure, butylhydroxytoluene (BHT) was questioned as the causative allergen in the fungal spray. Butylhydroxytoluene was also present in his deodorant (Degree Invisible Stick) and shave gel (Nivea For Men Y Sensitive). Patch testing demonstrated a 2+ reaction to BHTas well as a 1+ reaction to both the deodorant and antifungal spray. Avoidance of products containing BHT was recommended, and the patient’s hand dermatitis eventually resolved. Our patient had reported a near daily handling of F-76 and JP-5 aviation fuels, both of which can contain BHT, often without personal protective equipment while on active duty. Butylhydroxytoluene, or 2,6-di-tert-butyl-4-methylphenol, is a common antioxidant in a wide range of products from cosmetics to jet fuel (JP-4, JP-5, JP-8, Jet A, F-76). Fuel samples are transported, analyzed, and used on a daily basis to keep military operations running smoothly; this transport often occurs without gloves or other personal protective equipment when performing routine checks. Figure 1. Examples of several wood species and plants that are known to contain SLs. The characteristic tulip-shaped green-yellow flowers of L. tulipifera and the white flowers of Magnolia grandiflora trees are shown at the upper left and right, respectively. The foliage and flowers of L. nobilis are displayed at the bottom left, whereas the liverwort Frullania dilatata is shown at the bottom right.

Allergic Contact Dermatitis in Children: Prevention, Diagnosis, and Management

ABSTRACT Allergic contact dermatitis among children is more common than previously thought. This is why it is imperative for providers to become educated on preventative strategies, presenting signs and symptoms, diagnostic methods, and treatment.