Mariana Cravo

Fixed drug eruption to cetirizine with positive lesional patch tests to the three piperazine derivatives

Background  The H1‐antihistamine cetirizine, a piperazine derivative widely used in daily practice, is rarely the cause of cutaneous drug reaction. Nevertheless, four cases of fixed drug eruption (FDE) as a result of this drug have been described recently. We present the case of a 45‐year‐old woman with a multilocalized FDE following oral intake of cetirizine for allergic rhinitis.

Cutaneous sarcoidosis: a histopathological study

Background  Sarcoidosis is a granulomatous disease of uncertain aetiology in which the skin is frequently involved. Naked sarcoidal granulomas are the characteristic histological feature in specific lesions of sarcoidosis.

Allergic contact dermatitis from photobonded acrylic gel nails: a review of four cases

Artificial photobonded acrylic gel nails, used to improve the cosmetic appearance of natural nails, have gained popularity over recent years. They can cause allergic contact dermatitis both in occupational and in non-occupational settings. It affects not only the nail area but also the elsewhere on the hands, and occasionally involves the face, including the eyelids, mainly due to an occupational airborne dermatitis. Case Reports

Recurrent impetigo herpetiformis successfully treated with methotrexate

© 2008 The Authors JEADV 2009, 23, 317–368 Journal compilation

Combined carbon dioxide laser and bipolar electrocoagulation: Another option to treat rhinophyma

Rhinophyma is a progressive and disfiguring disorder of the nose characterized by hyperplasia of the sebaceous glands and dermal tissue, representing the end-stage of rosacea. Four male patients affected by a moderate–severe rhinophyma were treated using a combined therapy with carbon dioxide laser and bipolar electrocoagulation. All patients achieved marked cosmetic results with minimal scarring. Various surgical approaches have been described to treat this condition but as yet there is no agreement in the literature on the ideal treatment. This combined method provides a bloodless operative field which allows the sculpting of the hypertrophic areas, leading to a good cosmetic outcome and a pain-free postoperative recovery.

Allergic contact dermatitis to rubber-containing bandages in patients with leg ulcers.

We investigated 7 patients, 4 men and 3 women (ages 47–75 years, mean 66.5 years), with venous insufficiency and associated leg ulcers lasting for more than one year. They all presented with acute or subacute eczema of the lower limbs, extending from the dorsum of the foot to the upper leg or thigh, with a sharp upper limit (Fig. 1). The area around their ulcers, where additional gauze protection was being applied, was relatively free of eczema. Patch testing was undertaken with the Portuguese baseline series of contact allergens, topical medicament series, and leg ulcer dressings used by the patients. Allergens were applied in Finn Chambers , Epitest Ltd, and readings were performed at D2 and D3 or D4 according to the International Contact Dermatitis Research Group (ICDRG) guidelines. All patients reacted to rubber components – carba mix (5), thiuram mix (6), and/or mercapto mix (1) and to its constituents and 6 of them to other allergens as well (Table 1). As all patients were sensitized to rubber components and their leg dermatitis had an upper limit coinciding with the bandages they had been using, we performed further patch tests with samples of the high compression bandages and the elastic tubular net Bend-a-Rete (3M Company, Minnesota, USA) they had been using, with positive results (þ/þþ) in all of them (Table 1). After modification of topical medicaments according to the patch test results, an improvement of their dermatitis was seen. However, some areas of eczema, namely those localized to the upper leg and thigh, only resolved when the rubber-containing bandages and tubular net were avoided or thicker cotton gauze was applied under the compressive bandages. Ulcer healing improved thereafter. There was no apparent other explanation for rubber dermatitis in these patients.