Hilde Lapeere

The dramatic increase in the rate of methylisothiazolinone contact allergy in Belgium: a multicentre study.

The rate of contact allergy and allergic contact dermatitis caused by methylisothiazolinone (MI) is dramatically increasing throughout Europe.

Prevalence of allergic sensitization versus allergic rhinitis symptoms in an unselected population

Background: Allergic rhinitis (AR) is the most common allergic disorder and its prevalence has significantly increased worldwide, nowadays affecting up to 40% of the population in young adults. The objective of the present survey was to evaluate the prevalence of allergic sensitization and the prevalence of clinically diagnosed AR in a sample of the Belgian population, and to estimate the effect of age and gender. Methods: We performed a cross-sectional population-based study at an annual public fair in Ghent. Participants underwent a skin prick test (SPT) to 3 aeroallergens: a mix of trees (hazel, alder, and birch), grass pollen, and house dust mite (HDM). The clinical relevance of sensitization was assessed by relating relevant symptoms of AR to the corresponding SPT. Results: A total of 2,320 participants (1,475 females, median age 44.7 years, range 3–86) were included in this study. The standardized prevalence rates of sensitization were 13.2% for tree mix, 25.9% for grass pollen, and 25.9% for HDM. Sensitization to at least one of the allergens was present in 40.3% of the subjects. Symptomatic sensitization related to trees was reported in 9.7% of cases, grass-related AR was 17.6%, and HDM-related AR was 17.1%. The overall prevalence of AR was 30.9%. Conclusion: In this study we demonstrated a 40.3% prevalence of a positive SPT to one or more common aeroallergens. A clinical diagnosis of AR was present in 30.9% of cases, peaking in the third and fourth decades of life. It is to be expected that in the next decades, when this generation grows older, the general AR prevalence will further increase.

Basophil activation tests: time for a reconsideration

Challenges in in vitro allergy diagnostics lie in the development of accessible and reliable assays allowing identification of all offending allergens and cross-reactive structures. Flow-assisted analysis and quantification of in vitro activated basophils serves as a diagnostic instrument with increasing applications developed over the years. From the earliest days it was clear that the test could constitute a diagnostic asset in basophil-mediated hypersensitivity. However, utility of the basophil activation test should be reassessed regarding difficulties with preparation, characterization and validation of allergen extracts; availability and the potential of more accessible diagnostics. Today, the added value mainly lies in diagnosis of immediate drug hypersensitivity. Other potential indications are monitoring venom-immunotherapy and follow-up of natural history of food allergies. However, results in these nondiagnostic applications are preliminary. We review the most relevant clinical applications of the basophil activation test. Some personal comments and views about perspectives and challenges about flow-assisted allergy diagnosis are made.

A case of anaphylaxis caused by macrogol 3350 after injection of a corticosteroid.

Conflicts of interest: The authors have declared no conflicts. Macrogols are polymers of ethylene glycol, and are widely used in food and food packaging, and also in cosmetics and pharmaceutical preparations as solvents, softening agents, and lubricants. There are different types of macrogols, according to their molecular weight (e.g. macrogol 400, 3350, 4000, and 6000). There have been reports of anaphylactic reactions to macrogol

Incidence of scabies in Belgium

A prospective survey on scabies in Ghent, Belgium was performed in 2004. Sixty-four individual cases were reported, corresponding to a crude incidence rate of 28/100,000 inhabitants. The incidence was higher in the elderly (51/100,000 in persons aged >75 years) and a higher incidence was also found in immigrants (88/100,000). More than 40% of the registered scabies patients had symptoms for more than 4 weeks at the time of presentation. In 54% of the consultations, the patient had already consulted a physician for his/her skin problem. Of this group, 44% had not yet received any scabicidal treatment, indicating that scabies was not yet diagnosed or that an inappropriate treatment was prescribed. The observations suggest that the diagnosis and/or treatment of scabies in this region can still be improved.

Efficacy of Products to Remove Eggs of Pediculus humanus capitis (Phthiraptera: Pediculidae) From the Human Hair

ABSTRACT Head lice infestations are very common in children aged between 3 and 12 yr old. The eggs of the head louse are difficult to remove and remain firmly attached to the hair even after any head louse treatment. Solid in vitro and in vivo evidence to support the use of any of the proposed products to facilitate nit removal is scarce. The objective of the current study was to determine the efficacy of several products to remove eggshells from human hair using an objective measurement procedure. Water and ordinary hair conditioner significantly facilitated the removal of nits in vitro. We found no difference between ordinary conditioner and products specifically marketed for the purpose of nit removal. Other products such as formic acid solution and almond oil did not have a beneficial effect.

Method to Measure Force Required to Remove Pediculus humanus capitis (Phthiraptera: Pediculidae) Eggs from Human Hair

Abstract Head lice are very common and mainly affect children between 3 and 12 yr old. Little is known about the way nits, the eggs of the head louse, are attached to the hair. In this report, an objective measurement procedure for the ease with which nits can be removed is presented. The first peak force, associated with the start of nit movement, and the average and maximal force during the sliding of the nit were measured. The three force variables correlated with the length of the cylinder by which the nit was attached to the hair. A negative correlation was found between the maximum force exerted and the distance of the nit from the scalp. The method described in this report can be used to determine the in vitro efficacy of various products to remove nits.

Occupational contact allergy caused by pao ferro (Santos rosewood): a report of two cases.

A 50-year-old Caucasian male experienced severe vesicular dermatitis of the hands, arms, face, chest and genitals several hours after using pao ferro to build a guitar (Fig. 1). There were no respiratory symptoms. Topical treatment was insufficient to clear the eruption, and a course of oral methylprednisolone was needed. The patient was participating in a guitar-building workshop, and had been exposed to pao ferro on two previous occasions, without any skin complaints. He also worked with glues and other woods (maple, walnut, spruce, and ebony), which caused him no problems. The patient has played the guitar himself since childhood, and had never experienced any complaints previously. Patch tests were performed with the Belgian baseline series and different woods provided by the patient: East Indian rosewood, African blackwood, Bubinga, black walnut, Honduras rosewood, African ebony, Honduras mahogany, Amazon rosewood, and santos rosewood (pao ferro). Scrapings of the woods as such were tested at 10% pet. The patch tests were placed on the upper back, and occluded for 2 days with Van der Bend chambers® (Van der Bend, Brielle, The Netherlands) fixed with Hypafix® (BSN Medical, Hamburg, Germany). Readings

Contact dermatitis caused by lovage (Levisticum officinalis) essential oil

A 31-year-old female presented with sharply demarcated, erythematous and slightly scaling patches on the flexural side of both underarms and the right shoulder (Fig. 1). The lesions started 2 weeks after application of two undiluted essential oils: fifth Chakra (mixture of Geranium spp., Boswellia carterii, Jasminum grandiflorum absolute, Pogostemon cablin, and Citrus aurantium ssp. bergamia) and Lavas (Levisticum officinalis) (both obtained from Sjankara, Belgium). The lesions healed after treatment with topical and systemic steroids. Because the lesions were suggestive of allergic contact dermatitis, patch tests were performed with the Belgian baseline series, cosmetic, fragrance and plant series, and the patient’s own products (fifth Chakra and Lavas, both diluted 5% in ethanol). The patch tests were placed on the upper back, and occluded for 2 days with van der Bend® square chambers (Van der Bend, Brielle, The Netherlands) fixed with Hypafix® (BSN Medical, Hamburg, Germany). Readings were performed after D2 and D4, according to International Contact Dermatitis Research Group guidelines. Patch tests were positive for p-phenylenediamine (+), Myroxylon pereirae (++), sesquiterpene lactone mix (+), eugenol (+), isoeugenol (++), cananga oil (+), jasmine absolute (+), fifth Chakra (+), and Lavas (+++) (Fig. 2).

Contact dermatitis in patients undergoing serial intravitreal injections

Anti‐vascular endothelial growth factor (VEGF) medication, injected intravitreally, is currently the standard of care in patients with different retinal pathologies. Since its introduction in 2006, an increasing number of patients have undergone this procedure in Ghent University Hospital. Strikingly, more patients were diagnosed with contact dermatitis caused by ophthalmic products used during intravitreal injection procedure.