Jørgen Serup

European Society of Contact Dermatitis guideline for diagnostic patch testing – recommendations on best practice

The present guideline summarizes all aspects of patch testing for the diagnosis of contact allergy in patients suspected of suffering, or having been suffering, from allergic contact dermatitis or other delayed‐type hypersensitivity skin and mucosal conditions. Sections with brief descriptions and discussions of different pertinent topics are followed by a highlighted short practical recommendation. Topics comprise, after an introduction with important definitions, materials, technique, modifications of epicutaneous testing, individual factors influencing the patch test outcome or necessitating special considerations, children, patients with occupational contact dermatitis and drug eruptions as special groups, patch testing of materials brought in by the patient, adverse effects of patch testing, and the final evaluation and patient counselling based on this judgement. Finally, short reference is made to aspects of (continuing) medical education and to electronic collection of data for epidemiological surveillance.

Handbook of non-invasive methods and the skin, second edition

Firmly established as the leading international reference in this field, Non-Invasive Methods and the Skin broke new ground with its comprehensive coverage of methods used in both clinical and expe ...

Guidelines for measurement skin colour and erythema A report from the Standardization Group of the European Society of Contact Dermatitis

This report reviews individual‐related variables (age, sex, race, anatomical site. skin surface properties), intra‐ and interindividual variation (temporal, physical and mental activity, orthostatic effect, menstrual cycle/menopause), environment‐related variables (light conditions, temperature) and various instrument‐related variables that influence skin colour. CIE colorimetry (Minolta Chroma Meter) and spectrophotometric measurement (Derma Spectrometer) are considered. The guidelines give recommendations for measuring conditions and procedures.

Guidelines for measurement of cutaneous blood flow by laser Doppler flowmetry : a report from the standardization group of the European Society of Contact Dermatitis

The report reviews individual‐related variables (age, sex. race, anatomical site), intra‐ and inter‐individual variation (temporal, physical and mental activity, food and drugs), and environment‐related variables (air convection, temperature). Technical variation, instrument validation including a standard reactive hyperemia experiment, and a standard operating procedure are discussed and included in the guidelines.

Treatment of lichen planus with acitretin: A double-blind, placebo-controlled study in 65 patients

Sixty-five patients with lichen planus were included in a multicenter trial of acitretin. At the end of an 8-week placebo-controlled, double-blind phase, a significantly higher number of patients treated with 30 mg/day acitretin (64%) showed remission or marked improvement compared with placebo (13%). Furthermore, during the subsequent 8-week open phase, 83% of previously placebo-treated patients responded favorably to acitretin therapy. Typical retinoid adverse reactions were present in all patients on active drug. Laboratory studies did not show any clinically significant changes. This study shows that acitretin is an effective and acceptable therapy for severe cases of lichen planus.

Skin reactions to irritants assessed by non‐invasive bioengineering methods

Pathophysiological components of irritant contact dermatitis caused by 3 chemically‐different irritants were investigated. 20 healthy volunteers were patch tested with sodium lauryl sulphate, nonanoic acid and hydrochloric acid on the flexor side of the upper arm. The skin response was evaluated after 24, 48 and 96 h by visual scoring and measured by the following bioengineering methods: transepidermal water loss measurement, electrical conductance for measurement of skin hydration, laser Doppler flowmetry for measurement of cutaneous blood flow and 20 MHz ultrasound A‐scan for measurement of skin thickness. In spite of homogeneous inflammatory responses, significant differences in the severity of the injury to the skin barrier function caused by the different irritants were found. Also significant differences between irritants were found in the time course of development of maximum irritant reactions. Bioengineering methods indicating inflammatory responses (measurement of blood flow and skin thickness) were helpful in quantifying the irritant response in general, while bioengineering methods indicating epidermal damage (measurement of TEWL and electrical conductance) were helpful in classifying the individual irritants.

EEMCO guidance for the assessment of dry skin (xerosis) and ichthyosis: clinical scoring systems

Background/aims: Visual and tactile assessment of dry skin and ichthyosis is difficult and may vary. There is a need for standardized assessment according to universal scoring schemes.

Comparison of Narrow-Band Reflectance Spectrophotometric and Tristimulus Colorimetric Measurements of Skin Color

Two types of portable reflectance instruments, tristimulus colorimeters (Chroma Meter CR-200) and narrow-band spectrophotometers (Dermaspectrometer), have recently become available for the quantification of skin color. In order to know the difference and the relationship between the different color systems, the CIE L*a*b* system and the erythema melanin (E/M) indices, respectively, adopted by the two, the variations in skin color were measured at 23 different anatomical sites of 10 healthy Caucasian male subjects. The reddish tint of the skin color of the face, palm and sole was readily detected by either of them in the increase in the a* value or in the E index, and a strong linear correlation (r = 0.92, p < 0.001) was noted between the two values. The fair color appearance of the trunk was detected in the high L* value and in the low M index, but the correlation between the two was much less significant (r = -0.56, p < 0.001). Although the mean b* values were highest in the trunk, they are significantly lower on the non-light-exposed side than those on the light-exposed side of the arm. The correlation between the b* value and the M index was weak.

Age‐related diurnal changes of dermal oedema: evaluation by high‐frequency ultrasound

Using high‐frequency ultrasound, we measured the influence of gravitational stress on skin echogenicity in 22 young (age range 17–27; median 19) and 22 elderly (age range 75–100; median 87) healthy adults. B‐mode ultrasound images were obtained from the medial malleolus, lateral calf, anterior thigh, volar forearm and the medial aspect of the arm three times daily; in the morning, immediately before rising, and 2 and 12 h later. The echogenicity was measured by counting the number of low echogenic pixels in the image. Pronounced changes of low echogenic pixel numbers were seen in the areas exposed to high gravitational stress, i.e, the ankle and calf. In the young age‐group echogenicity of the skin increased steadily during the day, whereas in the elderly population echogenicity decreased 2 h after getting up in the morning, and subsequently returned to the baseline level. In a control group of 10 people (aged 17–83; median 18), who remained in the supine position throughout the day, the echogenicity of the skin remained unchanged. As the echogenicity of the dermis is inversely related to the amount of fluid it contains, our results indicate that young skin responds to gravitational stress by fluid depletion. In the skin of the elderly, the mechanism of fluid removal appears to be defective. The impaired protection against the development of intradermal oedema in the elderly may predispose to the development of lipodermatosclerosis and leg ulceration.

Experimental itch in sodium lauryl sulphate-inflamed and normal skin in humans: a randomized, double-blind, placebo-controlled study of histamine and other inducers of itch.

Summary Background Investigations of pruritogenic substances in humans have involved intradermal injections in normal skin; itching of inflamed skin has been little studied.