J.M. Fernández-Vozmediano

Current patch test results with the European baseline series and extensions to it from the 'European Surveillance System on Contact Allergy' network, 2007-2008

Background. The pattern of contact sensitization to the supposedly most important allergens assembled in the baseline series differs between countries, presumably at least partly because of exposure differences.

Epidemiología del eczema de contacto en España. Resultados de la Red Española de Vigilancia en Alergia de Contacto (REVAC) durante el año 2008

BACKGROUND The epidemiology of contact dermatitis can be analyzed using clinical data from skin allergy units. OBJECTIVES The aims of this study were to define the profile of patients attending a skin allergy unit and to determine the prevalence of the most common sensitizations in this population. MATERIAL AND METHODS Throughout 2008, a retrospective observational study was carried out in the 5 hospitals of the Spanish Surveillance System on Contact Allergies. All patients underwent skin patch tests with the Spanish standard series. The frequencies of sensitization were normalized for age and gender. RESULTS Data were gathered on 1161 patients. The 5 allergens that gave the most frequent positive reactions were nickel sulfate (25.88%), potassium dichromate (5.31%), cobalt chloride (5.10%), fragrance blends (4.64%), and balsam of Peru (4.44%). The least frequently detected reactions were to quinolone-clioquinol mix and sesquiterpene lactone mix. There was a 35% prevalence of sensitization to nickel among women. CONCLUSIONS The profile of sensitizations in Spain is similar to that of other Southern European countries. Nickel sulfate continues to be the most prevalent allergen, particularly in women. The low prevalence of sensitization to quinolone-clioquinol mix and sesquiterpene lactone mix supports their exclusion of the Spanish series.

Nickel allergy in Spain needs active intervention.

Juan Garcı́a-Gavı́n1 , José Carlos Armario-Hita2 , Virginia Fernández-Redondo1, José Manuel Fernández-Vozmediano3, Javier Sánchez-Pérez4, Juan Fco. Silvestre5, Wolfgang Uter6 and Ana M Giménez-Arnau7 1Faculty of Medicine, Department of Dermatology, University Hospital Complex, Santiago de Compostela, La Coruña 15706, Spain, 2Department of Dermatology, Hospital Punta de Europa (Algeciras), University of Cádiz, Cádiz 11207, Spain, 3Department of Dermatology, Hospital Universitario de Puerto Real, University of Cádiz, Cádiz 11510, Spain, 4Department of Dermatology, Hospital Universitario la Princesa, Madrid 28006, Spain, 5Department of Dermatology, Hospital General Universitario de Alicante, Alicante 03010, Spain, 6Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen-Nüremberg, Erlangen 91054, Germany, and 7Department of Dermatology, Hospital del Mar, Universitat Autónoma de Barcelona, Barcelona 08003, Spain

Benign symmetric lipomatosis (Launois–Bensaude syndrome)

A 37‐year‐old woman with a personal history of appendicectomy, cholecystectomy, left oophorectomy secondary to an ovarian cyst complication, nephritic colic with repeated episodes of pyelonephritis, alcoholic hepatopathy, Raynauds phenomenon and bilateral exophthalmos showed an increase in volume in the root of the upper limbs and in the base of the neck over a period of 4 years, painful to the touch and of a soft consistency. She presented with a pseudo‐athletic appearance ( Fig. 1 ) produced by an increase in the volume at the root of the upper limbs, upper back and the back of the neck ( Fig. 2 ). The lesions produced a pulling sensation and were associated with paresthesia, hyperesthesia, and a moderate loss of strength in both arms. A biopsy taken from the upper third of the right arm showed a diffuse proliferation of the subcutaneous adipose tissue, which appeared normal, and extended between the collagen fibers, reaching in some cases into the most superficial zones of the reticular dermis ( Fig. 3 ). Laboratory evaluation revealed a chronic anemia, leukopenia with moderate lymphopenia, increased erythrocyte sedimentation rate, elevation of enzymes of hepatic function, decrease in total proteins, and increase in ferritin, all in the context of hepatopathy. Antinuclear antibodies and the hormonal profile were normal. Abdominal and gynecologic echography revealed a right ovarian cyst of no clinical relevance. Cranial nuclear magnetic resonance (NMR) revealed an increase in the periorbital fat responsible for bilateral exophthalmos.

Epidemiology of contact dermatitis in Spain. Results of the Spanish Surveillance System on Contact Allergies for the year 2008

Abstract Background The epidemiology of contact dermatitis can be analyzed using clinical data from skin allergy units. Objectives The aims of this study were to define the profile of patients attending a skin allergy unit and to determine the prevalence of the most common sensitizations in this population. Material and methods Throughout 2008, a retrospective observational study was carried out in the 5 hospitals of the Spanish Surveillance System on Contact Allergies. All patients underwent skin patch tests with the Spanish standard series. The frequencies of sensitization were normalized for age and gender. Results Data were gathered on 1161 patients. The 5 allergens that gave the most frequent positive reactions were nickel sulfate (25.88%), potassium dichromate (5.31%), cobalt chloride (5.10%), fragrance blends (4.64%), and balsam of Peru (4.44%). The least frequently detected reactions were to quinolone-clioquinol mix and sesquiterpene lactone mix. There was a 35% prevalence of sensitization to nickel among women. Conclusions The profile of sensitizations in Spain is similar to that of other Southern European countries. Nickel sulfate continues to be the most prevalent allergen, particularly in women. The low prevalence of sensitization to quinolone-clioquinol mix and sesquiterpene lactone mix supports their exclusion of the Spanish series.

Patrón de sensibilización por contacto a parafenilendiamina y su detección en tintes capilares

BACKGROUND One of the greatest challenges in occupational dermatology is the identification of chemical substances used by patients in their work in order to determine their allergenic potential. Numerous techniques have been described for the identification of allergenic compounds. These tests must be sensitive, specific, and safe. We describe a study to detect the presence of paraphenylenediamine (PPD) in hair dyes that are commercially available in Spain. MATERIAL AND METHODS We undertook an experimental study involving qualitative and semiquantitative detection of PPD in hair dyes sold in Spain. The qualitative technique we used was a previously described colorimetric method involving dilution of the dye with isopropyl alcohol followed by addition of a reagent solution (1g of vanilla in 15 ml of isopropyl alcohol and 7.5 ml of hydrochloric acid). A quantitative study was then done in which the dye was extracted in 96% ethanol and subjected to 1-dimensional thin-layer chromatography. RESULTS A total of 15 brown and 12 blonde dyes were analyzed. PPD was identified in all of the brown dyes analyzed, irrespective of whether it was indicated (n = 12) or not (n = 3) in the composition. PPD was found in 6 of the 9 blonde dyes that indicated it in the composition and 2 of the 3 in which it was not indicated. Semiquantitative analysis by thin-layer chromatography revealed that the concentration of PPD in brown hair dyes (mean, 3%) was higher than in blonde dyes (mean, 0.1-0.3%). CONCLUSIONS The presence of PPD in hair dyes is related to the color of the dye. It is consistently present in darker dyes and at low levels in blonde dyes. This study highlights the clinical and epidemiological importance of identifying allergens in dermatology, particularly in occupational dermatology.

Frontal congenital lipoma.

Abstract:  Frontonasal dysplasia (FND) is a rare syndrome characterized by malformations of the central portion of the face, especially of the forehead, nose, and philtrum. FND is associated with hypertelorism, a hidden encephalocele, and a cleft of the nose. Occasionally, affected individuals also experience abnormalities of the brain and craniofacial bones. In such cases, a frontal lipoma or calcification of the falx cerebri suggest the existence of a lipoma of the corpus callosum. We present the case of a male newborn with a congenital lipoma 15 mm in size located in the medial frontal line. Magnetic resonance imaging confirmed complete agenesis of the corpus callosum. While there is controversy about the association of frontal lipoma and lipoma of the corpus callosum and FND, we believe our case supports the concept that the changes are due to the same underlying pathogenic mechanism. Therefore, we recommend imaging of the central nervous system in newborns with a congenital lipoma located in the craniofacial midline.

Importancia de la vigilancia epidemiológica en el eczema de contacto. La Red Española de Vigilancia de Alergia de Contacto

The high prevalence of contact dermatitis means that this common medical problem has considerable personal, societal, and economic impact. Clinical and epidemiologic research is needed if we are to shed light on the real situation of contact dermatitis in Spain. In this article we will look at epidemiologic research from a practical point of view and analyze the role of the dermatologist in planning and designing studies. The advantages of multicenter studies are discussed, along with the roles of national and international surveillance networks. We present the Spanish Surveillance System on Contact Allergies, which serves as a bridge between Spanish dermatologists and the European Surveillance System on Contact Allergies. The present and future aims of the Spanish network are described.

Etiopatogenia y tratamiento de la pitiriasis versicolor

La pitiriasis versicolor es una infeccion fungica superficial de la piel producida por hongos lipofilicos dimorficos pertenecientes al genero Malassezia spp., que forman parte de la flora normal de la piel. De las especies descritas, las responsables mas frecuentes de la clinica son M. globosa, M. sympodialis y M. furfur . En Espana, el agente patogeno mas frecuente es M. globosa . Se presenta en forma de maculas redondas u ovales de pequeno a mediano tamano y coloracion, eritematosas, hiperpigmentadas o hipopigmentadas. Su superficie suele estar cubierta por una fina descamacion. Son mas frecuentes en las areas de distribucion de las glandulas sebaceas, sobre todo en el tercio superior del tronco, de forma especial en la espalda, la raiz de los miembros superiores, el cuello y con menor frecuencia en la cara. En su tratamiento se han utilizado diferentes agentes terapeuticos topicos (ciclopiroxolamina, azoles, griseofulvina, terbinafina, succinato de litio) o sistemicos (ketoconazol, itraconazol, fluconazol).