Sabine Sommer

Eczema: quality of life by body site and the effect of patch testing.

Summary Background Patients with dermatitis are known to have impaired quality of life. Whether this varies according to body site has not been evaluated. Patch tests have previously been shown to influence quality of life, although no previous studies have shown if this is dependent on the results of the patch tests.

Type IV hypersensitivity reactions to natural rubber latex: results of a multicentre study

Summary Background  Positive patch test reactions to natural rubber latex (NRL) have been interpreted as allergic or irritant by different groups. Additives to the NRL test solution have also caused positive reactions in previous studies.

Sweet’s syndrome presenting as palmoplantar pustulosis

Sweets syndrome was initially described as a reactive dermatosis characterized by sudden onset of fever, leucocytosis, and raised erythematous plaques infiltrated with neutrophils, and therefore called acute febrile neutrophilic dermatosis. However, later it became obvious that fever and neutrophilia are variable features, and a number of other characteristics have been described. Although the dorsa of the hands are frequently affected, the palmoplantar involvement mimicking pustulosis observed in our case appears to be unusual.

Facial hirsutism treated with the normal-mode ruby laser : Results of a 12-month follow-up study

Fifty-one patients of skin type I to IV with facial hirsutism received treatment with the normal-mode ruby laser (950-micros pulse; 4-mm spot; mean fluence, 49 J/cm(2); maximum fluence, 66 J/cm(2)). For each patient, one site was treated once only, and a second site was treated 4 times at 4-week intervals. After 48 weeks, 46 patients were available for assessment. After a single treatment, hair counts were reduced to a mean of 45% at 4 weeks (pretreatment median of 63 hairs down to 26), increased to 80% (median, 51 hairs) at 12 weeks, were 65% (median, 41 hairs) at 24 weeks, and were 59% (median, 35 hairs) at 48 weeks. Four weeks after 3 treatments, the hair counts had reduced to a mean of 30% (pretreatment median of 68 hairs down to 15). Twelve weeks after 4 treatments, the hair counts had increased to 45% (median, 24 hairs) and were 39% after 36 weeks (median, 22.5 hairs). No anesthesia was needed. Treatment tolerance improved with consecutive visits, allowing higher fluences to be used. Hyperpigmentation developed in 9 patients, which had faded completely in 8 patients at the end of the study. One patient showed hypopigmentation. Depressions in the skin below the jaw line developed in 5 patients, which resolved completely within 4 to 32 weeks. We conclude that normal-mode ruby laser treatment is well tolerated and leads to significant improvement of facial hirsutism, which is maintained for at least 48 weeks. Repeated treatments result in greater clinical effects.

The relationship between pityriasis rubra pilaris and inflammatory arthritis: case report and response of the arthritis to anti-tumor necrosis factor immunotherapy.

Pityriasis rubra pilaris (PRP) refers to a group of erythematous, scaling dermatologic conditions that have been associated with seronegative arthritis. We report a case of polyarthritis in a young man with PRP in which magnetic resonance imaging suggested an entheseal-based pathology for the joint disease. The arthritis, but not the skin condition, demonstrated dramatic response to anti-tumor necrosis factor immunotherapy.

Atrophie blanche–like scarring after pulsed dye laser treatment

Pulsed dye laser treatment is well established for the treatment of port-wine stains and other vascular skin lesions. Although hyperpigmentation is quite common, other side effects such as hypopigmentation and atrophic scarring occur infrequently, and hypertrophic scarring is rare.

Photoallergic contact dermatitis from the sunscreen octyl triazone

In January 2000, the British Photodermatology Group in conjunction with the British Contact Dermatitis Group started an investigation into topical sunscreens. In addition to already known photo-sensitizers, consecutive patients attending for photopatch testing were tested to a series of newer sunscreens (Hermal Kurt Hermann, Hamburg, Germany). We report the first case of a positive photopatch test to octyl triazone.

Contact dermatitis due to urea-formaldehyde resin in shin-pads

8. Forström L, Hannuksela M, Kousa M, Lehmuskallio E. Merthiolate hypersensitivity and vaccination. Contact Dermatitis 1980: 6: 241–245. 9. Tosti A, Melino M, Bardazzi F. Systemic reactions due to thimerosal. Contact Dermatitis 1986: 15: 187–188. 10. Lohiya G. Asthma and urticaria after hepatitis B vaccination. West J Med 1987: 147: 341. 11. Maibach H. Acute laryngeal obstruction presumed secondary to thimerosal (merthiolate) delayed hypersensitivity. Contact Dermatitis 1975: 1: 221. 12. Möller H. Merthiolate allergy: a nationwide iatrogenic sensitization. Acta Dermato-venereologica 1977: 57: 509–517. 13. Sato M. Patch test of mercury compounds and disinfectant solutions on clinical picture of mercury contact dermatitis. Jpn J Dermatol 1989: 99: 15–23. 14. Osawa J, Kitamura K, Ikezawa Z, Nakajima H. A prob-

Prediction of outcome in the treatment of onychomycosis

Summary Patients with toenail onychomycosis remain a therapeutic challenge despite the introduction of new systemic therapies. Around 20% of patients remain uncured even with optimal oral therapy, but the reasons for treatment failure are unclear. Thus far there are no data to suggest that treatment failures can be identified on the basis of their presenting features or progress during treatment. In a series of patients, we have attempted to identify clinical parameters that determine the patient response to 12 weeks of oral terbinafine for confirmed dermatophyte onychomycosis. As part of a dose‐defining randomized multicentre study, 35 patients were followed for 48 weeks. The unaffected nail length, growth rate, hyperkeratosis, onycholysis and presence of a dermatophytoma were assessed prospectively. To confirm our findings, at the end of the study period we analysed retrospectively photographs that had been taken regularly throughout the trial. The average degree of hyperkeratosis was less severe in the group achieving a disease‐free nail, meaning clinical and mycological cure. For mycological cure alone, no predictive factors could be identified.

Airborne contact dermatitis caused by microscopy immersion fluid containing epoxy resin

Case Reports Case no. 1 A 33-year-old medical genetics laboratory technician presented with an exposure-pattern eczema, which had been present for 1 month. This improved when she was off work and recurred within 4 h of her returning. She had no other skin diseases and was not atopic. She had already been tested to the European standard series, topical corticosteroids and her own cosmetics, with strong positive reactions to epoxy resin, nickel and cobalt. Subsequently tested to cycloaliphatic epoxy resin, bisphenol A and the epoxy hardeners, phenyl glycidyl ether and cresyl glycidyl ether, she reacted π at D 2 and 4 to all of these. She also reacted π at D 2 to the immersion oil 50%, 10% and 5% pet. Patch tests in 20 controls were negative.