R. Brans

Association between TNFA-308 G/A polymorphism and sensitization to para-phenylenediamine: a case–control study

Background:  Para‐phenylenediamine (PPD) and related chemicals are common contact sensitizers, frequently causing allergic contact dermatitis (ACD). The cytokine tumor necrosis factor‐alpha (TNF‐α) plays a key role in contact sensitization.

Pilot study: optical coherence tomography as a non-invasive diagnostic perspective for real time visualisation of onychomycosis

The objective of this study was to compare optical coherence tomography (OCT) with conventional techniques such as KOH‐preparation, culture and histology in the identification of the fungal elements in the nail. A total of 18 patients were examined; 10 with clinically evident onychomycosis in toe nails, two with psoriatic nail lesions, one with nail affection caused by lichen planus and five healthy controls. Serial in vivo OCT analyses of onychomycosis was performed prior to KOH‐preparation, culture and punch biopsy of the nail plate for consecutive histology. Fungal elements were detected non‐invasively in vivo using OCT in all 10 patients with histologically proven onychomycosis. Fungal elements were detectable as highly scattering elongated structures inside the nail plate, in the middle of the areas of homogeneous decrease in signal intensity. KOH‐preparations and culture did reveal a positive result in 5/6 out of 10 patients. In patients with psoriasis, lichen planus as well as in the healthy controls, no fungal infection could be detected by either method used. OCT is a reliable, easy to use, non‐invasive and non‐destructive method to visualise fungal elements in vivo in onychomycosis, even in cases of false negative KOH‐preparation and culture. Furthermore, OCT offers the opportunity to screen several areas of the same nail plate and to detect fungal elements during local or systemic therapy.

Para-phenylenediamine and allergic sensitization: risk modification by N-acetyltransferase 1 and 2 genotypes.

Background  Para‐phenylenediamine (PPD) is a common contact sensitizer causing allergic contact dermatitis, a major skin problem. As PPD may need activation to become immunogenic, the balance between activation and/or detoxification processes may influence an individual’s susceptibility. PPD is acetylated and the metabolites do not activate dendritic‐like cells and T cells of PPD‐sensitized individuals.

Microarray-based detection of specific IgE against recombinant ω-5-gliadin in suspected wheat-dependent exercise-induced anaphylaxis.

Wheat-dependent exercise-induced anaphylaxis (WDEIA) is a rare IgE-mediated food allergy. Component-resolved measurement of specific IgE (sIgE) against ω-5-gliadin by fluorescence enzyme immunoassay (FEIA) has been postulated as a good predictive decision criterion in the diagnosis of WDEIA. More recently, microarray technology has been introduced into component-resolved diagnostics. The aim of this study was to evaluate the performance of an allergen microarray in the detection of sIgE against ω-5-gliadin in 10 patients with suspected WDEIA and high levels of sIgE against ω-5-gliadin (mean: 9.31±7.53 kU/L, range: 4.24-25.8) as measured by FEIA. Using an old version of the microarray assay (ImmunoCAP ISAC™, Phadia), sIgE against ω-5-gliadin was detected in only 3 of the first 6 patients. The same samples and those of another 4 patients were then analysed with an improved version of the microarray system, yielding elevated levels of sIgE against ω-5-gliadin in all patients. In conclusion, the old version of the microarray was not reliable for the detection of sIgE against ω-5-gliadin in the examined individuals with suspected WDEIA. In contrast, the improved version of the microarray seems to be as adequate as FEIA in the detection of sIgE against ω-5-gliadin. However, further large-scale studies are warranted to confirm these results.

Kontaktsensibilisierung gegen Azol-Antimykotika

Contact sensitization to azole antimycotics is rare, even though they are widely used. We present the case of a man who developed allergic contact dermatitis due to topical application of a variety of antimycotics. Patch testing revealed positive reactions to clotrimazole, croconazole, oxiconazole and tioconazole. Cross-sensitivity was possible, but multiple sensitizations could not be excluded.ZusammenfassungKontaktsensibilisierungen gegen Azol-Antimykotika sind trotz ihrer weiten Verbreitung sehr selten. Wir berichten über einen Patienten mit allergischer Kontaktdermatitis nach lokaler Anwendung verschiedener Antimykotika. In der Epikutantestung zeigten sich positive Reaktionen auf Clotrimazol, Croconazol, Oxiconazol und Tioconazol. Hierbei handelt es sich möglicherweise um Kreuzreaktionen. Multiple Sensibilisierungen konnte anamnestisch jedoch nicht ausgeschlossen werden.AbstractContact sensitization to azole antimycotics is rare, even though they are widely used. We present the case of a man who developed allergic contact dermatitis due to topical application of a variety of antimycotics. Patch testing revealed positive reactions to clotrimazole, croconazole, oxiconazole and tioconazole. Cross-sensitivity was possible, but multiple sensitizations could not be excluded.

[Sensitisation to p-Phenylenediamine. Effects of metabolism and individual susceptibility].

Due to its constant exposure to small molecular weight compounds, the skin is a major target for allergic reactions. Para-phenylenediamine (PPD) is a common and strong contact allergen. Recent studies have revealed new aspects of steps involved in sensitization and allergic contact dermatitis to PPD, giving insight into the cutaneous metabolism of small molecular compounds and its effect on activation and deactivation of immunogenic substances. Molecular epidemiological studies have suggested that polymorphisms in genes encoding cytokines (e.g. TNF-alpha) or metabolizing enzymes (e.g. N-acetyltransferase) may have influence on these mechanisms and the individual susceptibility for sensitization.ZusammenfassungDie Haut ist Zielorgan allergischer Reaktionen auf kleinmolekulare Stoffe. Ein häufiges und starkes Kontaktallergen stellt para-Phenylendiamin (PPD) dar. Die Untersuchungen der letzten Jahre haben neue Erkenntnisse über die Abläufe bei der Sensibilisierung und allergischen Kontaktdermatitis auf PPD erbracht. Hierbei konnten wichtige Informationen über die Metabolisierung kleinmolekularer Stoffe in der Haut und deren Beteiligung bei der Aktivierung bzw. Deaktivierung immunogener Substanzen gewonnen werden. Molekularepidemiologische Studien weisen darauf hin, dass genetische Polymorphismen möglicherweise diese Vorgänge und damit das individuelle Sensibilisierungsrisiko beeinflussen.AbstractDue to its constant exposure to small molecular weight compounds, the skin is a major target for allergic reactions. Para-phenylenediamine (PPD) is a common and strong contact allergen. Recent studies have revealed new aspects of steps involved in sensitization and allergic contact dermatitis to PPD, giving insight into the cutaneous metabolism of small molecular compounds and its effect on activation and deactivation of immunogenic substances. Molecular epidemiological studies have suggested that polymorphisms in genes encoding cytokines (e.g. TNF-alpha) or metabolizing enzymes (e.g. N-acetyltransferase) may have influence on these mechanisms and the individual susceptibility for sensitization.

Sensibilisierung auf p-Phenylendiamin

Due to its constant exposure to small molecular weight compounds, the skin is a major target for allergic reactions. Para-phenylenediamine (PPD) is a common and strong contact allergen. Recent studies have revealed new aspects of steps involved in sensitization and allergic contact dermatitis to PPD, giving insight into the cutaneous metabolism of small molecular compounds and its effect on activation and deactivation of immunogenic substances. Molecular epidemiological studies have suggested that polymorphisms in genes encoding cytokines (e.g. TNF-alpha) or metabolizing enzymes (e.g. N-acetyltransferase) may have influence on these mechanisms and the individual susceptibility for sensitization.ZusammenfassungDie Haut ist Zielorgan allergischer Reaktionen auf kleinmolekulare Stoffe. Ein häufiges und starkes Kontaktallergen stellt para-Phenylendiamin (PPD) dar. Die Untersuchungen der letzten Jahre haben neue Erkenntnisse über die Abläufe bei der Sensibilisierung und allergischen Kontaktdermatitis auf PPD erbracht. Hierbei konnten wichtige Informationen über die Metabolisierung kleinmolekularer Stoffe in der Haut und deren Beteiligung bei der Aktivierung bzw. Deaktivierung immunogener Substanzen gewonnen werden. Molekularepidemiologische Studien weisen darauf hin, dass genetische Polymorphismen möglicherweise diese Vorgänge und damit das individuelle Sensibilisierungsrisiko beeinflussen.AbstractDue to its constant exposure to small molecular weight compounds, the skin is a major target for allergic reactions. Para-phenylenediamine (PPD) is a common and strong contact allergen. Recent studies have revealed new aspects of steps involved in sensitization and allergic contact dermatitis to PPD, giving insight into the cutaneous metabolism of small molecular compounds and its effect on activation and deactivation of immunogenic substances. Molecular epidemiological studies have suggested that polymorphisms in genes encoding cytokines (e.g. TNF-alpha) or metabolizing enzymes (e.g. N-acetyltransferase) may have influence on these mechanisms and the individual susceptibility for sensitization.

Berufsdermatologische Aspekte des Friseurberufes

ZusammenfassungBeschäftigte im Friseurberuf sind während ihrer Tätigkeit im besonderen Maße potenziellen Allergenen und Irritanzien ausgesetzt. Vor allem durch den hohen Anteil an Feuchtarbeit und den Kontakt zu Friseurprodukten gehört das Friseurhandwerk zu den Berufsgruppen mit dem höchsten Risiko für die Entstehung einer Berufsdermatose. In den letzten Jahren konnte durch gesetzliche Regelungen zum Einsatz von gefährdenden Substanzen und Tätigkeiten sowie verbesserten Hautschutz die Prävalenz von beruflich bedingten Hauterkrankungen im Friseurberuf deutlich reduziert werden. Eine konsequente Umsetzung und kontinuierliche Optimierung dieser Maßnahmen ist notwendig, um auch zukünftig das Auftreten von Berufsdermatosen im Friseurberuf zu minimieren.AbstractHairdressers are exposed to a broad variety of substances known for their strong sensitizing and irritant capacities. Especially wet work and handling of hair-care products causes a high risk for occupational skin disease. Lately, due to new regulations regarding substances and techniques used as well as improved skin protection, the prevalence of occupational skin disease in hairdressers has significantly declined. It is of great importance to fulfill and extent these requirements to further minimize the risk of occupational skin disease in this profession.Hairdressers are exposed to a broad variety of substances known for their strong sensitizing and irritant capacities. Especially wet work and handling of hair-care products causes a high risk for occupational skin disease. Lately, due to new regulations regarding substances and techniques used as well as improved skin protection, the prevalence of occupational skin disease in hairdressers has significantly declined. It is of great importance to fulfill and extent these requirements to further minimize the risk of occupational skin disease in this profession.

[Wheat-dependent, exercise-induced anaphylaxis].

Wheat-dependent exercise-induced anaphylaxis (WDEIA) is a rare IgE-dependent anaphylaxis to wheat, which occurs in sensitized people after ingestion of wheat followed by physical exercise. The major allergen associated with WDEIA is the wheat protein Omega (omega)-5-Gliadin (Tri a 19). We present three cases of WDEIA, demonstrating that this disease might be more frequent than anticipated and that neither prick test nor specific IgE to allergen extracts but rather detection of specific IgE against the recombinant protein Tri a 19 leads to diagnosis.

Weizenabhängige anstrengungsinduzierte Anaphylaxie

Wheat-dependent exercise-induced anaphylaxis (WDEIA) is a rare IgE-dependent anaphylaxis to wheat, which occurs in sensitized people after ingestion of wheat followed by physical exercise. The major allergen associated with WDEIA is the wheat protein Omega (omega)-5-Gliadin (Tri a 19). We present three cases of WDEIA, demonstrating that this disease might be more frequent than anticipated and that neither prick test nor specific IgE to allergen extracts but rather detection of specific IgE against the recombinant protein Tri a 19 leads to diagnosis.