Marta Elena Sánchez Morán

Comparative Spanish multicenter study: TRUE TestTM versus allergens in petrolatum

Epiquick (EPI) is a new ready-to-use patch test system with a set of 5 Finn Chambers on Scanpor tape (FCS), filled with a standardized volume of the test material in pet. (18 ,ul/chamber). The EECDRG performed a multicenter trial comparing this system with the conventional one (Finn Chambers filled with the test materials shortly before use). 19 substances of the European standard series were evaluated in a total of 963 unselected patients at 10 centers. 378 patients (39.2%) had neither irritant nor allergic reactions in both test systems. Irritant reactions were recorded 81 times with EPI and 92 times with FCS. 578 patients (60%) showed at least 1 allergic reaction resulting in a total of 1130 paired skin reactions. Analyzing clearly positive allergic reactions at different reading times, the overall correspondence was good: Epi + /CFS + or Epi/FCS83% (48 h), 73% (72 h) and 82% (96 h). Different patterns of test-reactions (Epi/FCS + or Epi + / FCS-) were seen in 7% to 13%, depending on type of allergen and reading time. There was a tendency for a slightly higher positivity rate with EPI than with FCS. For major allergens, the concordance was excellent (nickel: EPI 87.4%, FCS 83.6%; fragrancemix: EPI 70.4%, FCS 70.4% 96 h readings). In conclusion, EPI is a suitable system for patch testing and yields comparable results to self-filled FCS. Major advantages are standardization of the filling volume and saving of time in the application procedure.

Mucormicosis diseminada en una paciente con leucemia mieloblástica aguda

Resumen —Una paciente de 63 anos afecta de leucemia aguda mieloblastica, tras 5 dias de infeccion de las vias respiratorias altas, presento una placa necrotica en ala nasal derecha; posteriormente, una lesion satelite en la pierna derecha y empeoramiento del estado general. Se aislo Mucor spp. En el cultivo de una de las dos biopsias efectuadas. En ambas habia trombos formados por hifas no septadas. A pesar de un tratamiento precoz con anfotericina B intravenosa y desbridamiento quirurgico la paciente fallecio. La mucormicosis es una infeccion por hongos saprofitos de la clase de los zigomicetos que afecta a pacientes inmunodeprimidos. Las manifestaciones cutaneas en la mucormicosis diseminada son raras; sus formas de presentacion varian: nodulos con centros equimoticos, placas eritematosas con centro purpurico y lesiones similares al ectima gangrenoso. Dada su ubicuidad, para su diagnostico se necesitan criterios microbiologicos e histopatologicos estrictos. El tratamiento mas eficaz es el empleo de anfotericina B intravenosa a dosis altas y el desbridamiento quirurgico, a pesar de lo cual la mortalidad es elevada.