Roland Tomb

Ectopic contact dermatitis from ethyl cyanoacrylate instant adhesives

Although allergic reactions to cyanoacrylate adhesives are extremely rare, they should not be considered impossible. We report a young hairdresser who developed an occupational allergic‐contact dermatitis to 2 “instant glues” used to attach false hair. The eczematous eruption involved the fingers and face slightly but mainly the eyelids. Patch test reactions were strongly positive to ethyl cyanoacrylate adhesives.

Systemic contact dermatitis from pseudoephedrine

A patient with rhinitis developed systemic contact dermatitis when starting oral treatment with Rhinalair®, Containing pseudoephedrine hydrochloride. A few months later, another oral treatment Rinutan®, containing norephedrine hydrochloride, provoked a more severe generalized eczema. Patch test reactions were strongly positive to ephedrine and pseudoephedrine, slightly positive to phenylephrine and negative to epinephrine. Norephedrine was not tested.

Allergic contact dermatitis from topical corticosteroids

22 casts of allergic contact dermatitis from topical corticosteroids were observed in Strasbourg and previously published. 7 further cases are reported here and the vehicle and concentration of corticosteroids for patch tests are discussed. A 0.1% concentration in petrolatum seemed adequate for testing the 4 molecules (triamcinolone acetonide, dexamethasone, desonide and amcinonide) responsible for the 7 new cases. In 1 case, several cross‐reactions were seen. A corticosteroid screening series permits patch testing of the suspected molecule(s) in a selective way. Without this series, long delays are required to make the correct diagnosis by patch testing. We have reviewed more than 60 papers on corticosteroid allergy published up to now.

Fractional laser for vitiligo treated by 10,600 nm ablative fractional carbon dioxide laser followed by sun exposure.

Vitiligo is an acquired disorder of the skin and mucous membranes. Many patients with vitiligo remain in the refractory state despite the availability of numerous potential treatments. To the best of our knowledge, only one trial considers ablative fractional CO2 laser in the treatment of vitiligo.

Patch testing with frullania during a 10‐year period: hazards and complications

Contact dermatitis from frullania mainly affects people living in the country. The 2 most frequent species in Europe, Frullania dilatata and Frullania tamarisci, do not cross‐react: both species must be patch tested when frullania intolerance is suspected. Yet patch testing with Frullania may be hazardous 9 out of 37 cases recorded in Strasbourg correspond to active sensitization by the tests. Since routine testing is risky, only aimed testing can be recommended.

Bullous Pemphigoid Associated With Linagliptin Treatment

and dysgeusia than the continuous regimen. Similarly, the muscle cramps and dysgeusia in the present patients resolved within 1 month after interrupting the vismodegib regimen. Although pharmacokinetic studies have shown suboptimal efficacy and similar incidence and severity of adverse effects when vismodegib, 150 mg, was used once weekly or 3 times weekly, no studies to our knowledge have investigated the efficacy of continuous daily doses with drug breaks in between.3 We found a mean of 1.4 new surgically eligible BCCs per year per patient undergoing intermittent therapy, which is comparable to the 2.0 new surgically eligible BCCs per year per patient found by Tang et al1 in patients undergoing a standard continuous daily regimen. Vismodegib resistance occurs in patients who undergo continuous vismodegib dosing.4 The frequency of resistance in patients who undergo an intermittent form of treatment is largely unknown. Combination therapy with hedgehog pathway inhibitors downstream of smoothened, such as itraconazole and arsenic trioxide, provide opportunities to increase efficacy and possibly reduce the incidence of resistance.5,6

Allergic contact dermatitis from eosin.

Before 1960, eosin sensitivity was not rare and lipstick cheilitis was very common. We report 4 patients soon in 1988 and 1989 who were sensitized to eosin from topical bacteriostatic preparations. All 4 patients had positive patch tests to eosin. The allergen is probably an impurity rather than eosin itself.

Contact dermatitis after ultrasonography and electrocardiography.

We report 4 patients who developed allergic contact dermatitis after ultrasound investigations. Patch testing was positive with conducting gels, and in 2 cases with propylene glycol. Contact dermatitis to gels is also seen in electrographic practice and after transcutaneous electrical analgesia.

Clinical resistance to three types of botulinum toxin type A in aesthetic medicine

Botulinum toxin injections have become the most frequent noninvasive cosmetic procedure carried out worldwide. Botulinum toxin has also multiple other indications in different medical fields. However, with the repetition of injections, a new concern has emerged: clinical resistance and loss of effectiveness of the treatment. After reporting a case of primary nonresponsiveness to three types of botulinum toxin type A injections, we conducted a review about all factors leading to the primary or secondary nonresponsiveness, as well as the factors affecting the immunogenicity of this neurotoxin. Most of the reports and studies focused on secondary resistance to botulinum toxin (BT) and the neurotoxin immunogenicity; primary nonresponsiveness was rarely reported. Factors leading to primary or secondary resistance to BT injections were numerous. In the majority of the studies, development of neutralizing antibodies to botulinum toxin was considered responsible of the induced clinical resistance. Patients should be aware of this rising concern as well as clinicians who should learn how to minimize the risk of resistance development, sparing the patients more invasive treatment modalities. Further studies related to botulinum toxin resistance are needed.

Pediatric pyoderma gangrenosum: a systematic review and update

Pyoderma gangrenosum (PG) is a sterile neutrophilic disorder that rarely affects children. Clinical, epidemiological, and therapeutic data on pediatric PG is poor as there are many newly reported associated diseases and drugs. This paper aims to review all recent available data on pediatric PG. A systematic review of the literature was conducted using Embase, Medline, and Cochrane databases. A total of 132 articles were included in the review. The most commonly reported underlying diseases in pediatric PG are inflammatory bowel diseases followed by hematologic disorders, vasculitis, immune deficiencies and Pyogenic Arthritis, Pyoderma gangrenosum and Acne (PAPA) syndrome. More than half of the cases occur with no underlying disease. The most frequently reported clinical presentation is multiple disseminated ulcers. Treatment should be tailored according to the underlying etiology. It includes systemic steroids, corticosteroid sparing agents such as dapsone and cyclosporine, and TNF‐alpha inhibitors such as adalimumab and infliximab. Response to treatment is high with cure rates reaching 90%. A high index of suspicion and a thorough workup are mandatory in the management of pediatric PG.