Sait Yesillik

A case of textile dermatitis due to disperse blue on the surgical wound

Disperse blue (DB) 106 and DB 124 are the most frequent fabric dye allergens inducing textile dermatitis, but contact allergy to them may easily undiagnosed because the clinical picture usually needs high index of suspicion. We present the case of a 35-year-old woman who was referred for a recurred lesion over the incision scar of right total hip replacement surgery, which did not respond to treatment with povidone–iodine, mupirocin, and rifampicin. Patch testing, conducted with a European standard series and therapeutics that were used in the treatment of the lesion, revealed a positive reaction to dispersion mix blue 106/124. The patient was questioned in detail and reported that she has been wearing dark-colored synthetic panties for long years. The correlation was done between the positive antigen in the patch test and the clinical findings. The patient was treated with a corticosteroid cream for 2 weeks. She did not wear any dark-colored synthetic panties afterward and no flare-up was seen in the follow-up period. In this report, we emphasize the importance of detailed questioning of patients and that contact dermatitis should be considered potential cause of dermatitis at skin sites where the barrier function is compromised.

Erratum to: Killer-cell immunoglobulin-like receptor and human leukocyte antigen-C genes in common variable immunodeficiency

SummaryBackgroundWe aimed herein to investigate the killer-cell immunoglobulin-like receptor (KIR) genes and human leukocyte antigen (HLA)-C alleles in patients with common variable immunodeficiency (CVID), and to reveal their differences from those in healthy population.MethodsIn all, 18 patients who have been diagnosed with CVID and 15 living donors of kidney transplant recipients were enrolled in the study. Polymerase chain reaction-sequence-specific primer (PCR-SSP) typing method was used in molecular genetic analysis. The frequencies of the genes in the study groups were statistically compared with each other using chi-square or Fisher exact tests, whichever were appropriate.ResultsAlthough there was no significant difference between both study groups with respect to distribution of KIR and HLA-C2 group genes, HLA-Cw7 allele frequency in patients with CVID was significantly lower than that in healthy population (P = 0.008).ConclusionThis present study results support that HLA-Cw7 allele, an inhibitor of KIR ligand, may play a role in the pathogenesis of CVID.

An unexpected allergic reaction with Saccharomyces boulardii: a case report

Saccharomyces boulardii (S.boulardii), known as a nonpathogenic yeast probiotic shows its efficacy in inflammatory and infectious diseases of the gastrointestinal tract safely. This report presents an allergic reaction and positive skin test in a patient who takes S.boulardii as an antidiarrheal therapy.

Multifocal fixed drug eruption due to ornidazole

Ornidazole, a synthetic nitroimidazole derivative, is widely used in clinical practice. Ornidazol has low rate of side effects, but sometimes may cause significant allergic reactions such as fixed drug eruption (FDE). We describe a case of multifocal FDE caused by ornidazole.

Vitamin B12 allergy and successful desensitisation with cyanocobalamin: A case report

Vitamin B12, as it is not biosynthesised without certain bacteria and algae must be taken with a diet. The most important natural source of vitamin B12 is animal products and deficiency of vitamin B12 most commonly appears as pernicious anaemia. However vitamin B12 deficiency is not only associated with pernicious anaemia but is also linked with neurological conditions. Therefore, patients with low serum concentrations of vitamin B12 are given vitamin B12 supplements at regular intervals. Vitamin B12 deficiency is a common condition, although hypersensitivity reaction against vitamin B12 is rare. In this paper, vitamin B12 allergy developed in a patient who does not eat meat and a successful desensitisation procedure with cyanocobalamin is presented. The 39-year-old vegetarian woman with vitamin B12 deficiency (pernicious anaemia) who was taking monthly injections of 10 mg cyanocobalamin, referred to allergy clinic, and commonly presented with itchy, exanthematous skin rashes about 30 min after the tenth dose. The physical examination revealed widely distributed urticarial plaques all of the skin. The patient had no history of allergic disease. Skin prick tests (SPT) were performed with cyanocobalamin and a possible cross-reaction to the hydroxycobalamin (1 mg/ml dilutions). Both Drug allergies and treatmethe preparations did not contain any dyes or preservatives. Histamine and saline were used as positive and negative controls, respectively. SPT were positive for both preparations: cyanocobalamin; wheal 4 mm × 5 mm and flare 30 mm × 30 mm, hydroxycobalamin; wheal 4 mm × 3 mm and flare 20 mm × 30 mm, histamine (positive control); wheal 3 mm × 3 mm and flare 20 mm × 20 mm. Any wheal and flare reaction were not induced by saline (negative control). We desensitised the patient in our clinic as described in the literature (Table 1). After written consent was obtained, the desensitisation procedure began with 15min intervals, and the desensitisation process started with increasing doses, one, two and four-week intervals, were similar to literature. The patient did not receive any premedication before the desensitisation procedure. The desensitisation procedure was completed without any adverse events. At the end of the desensitisation procedure, SPT was performed with cyanocobalamin (1 mg/ml) and resulted negative. Drug allergies and treatment are the troublesome situations for the physicians in daily clinically practices. The patient who developed any adverse events after the drug treatment, the IgE-mediated allergic reactions should be confirmed with skin tests or specific IgE assays. Afterwards, desensitisation is performed in these cases if there are no suitable alternative drugs. Nowadays, desensitisation application is carried out successfully with antibiotics, aspirin, and even many different chemotherapeutic drugs. Unfortunately there is no standardised protocol for vitamin B12 desensitisation such as at antibiotics and aspirin. Therefore we used the same desensitisation protocol which Table 1 Desensitisation protocol with cyanocobalamin.

Anti- IgE treatment in asthma: is atopy essential?

Methods Case 1, a fifty one-year old woman who has been treated for 11 years diagnosis of asthma, went to emergency service four times last year in spite of taking high dose inhaler corticosteroid. In her physical examination widespread rhonchi was oscultated. FEV1: %76, total IgE: 897 IU/mL inhalant skin prick tests and mites spesific IgE were negative. Visual Analog Score(VAS) was 2, asthma symptom score (ASS) was determined as 6. Omalizumab was started 450mg/month as diagnosis of nonallergic asthma. One week after the first injection of omalizumab, patient’s complaints got better. The patient is taking omalizumab for ten months and VAS is 8, ASS is 2, can use salbutamol if necessary. Case 2, a sixty nine-year old woman patient has hypertension, epilepsy, anxiety disorder as well as 12 years of asthma. She consulted the emergency countless times and stayed in hospital twice last year. The patient is still using high dose of inhaler corticosteroid and using oral corticosteroid constantly. FEV1: %73, inhalant skin prick tests were negative. Total IgE: 116 IU/mL mite and mold spesific IgE were negative. At the begginning, the patient whose VAS 3, ASS 8, is taking 300 mg of Omalizumab every month. The patient’s symptoms got better after the second dose of treatment and the VAS was 8, ASS was 3 in the 9th month of omalizumab. The patient is still using one dose of budesonid/formoterol and the other disease is under control. In both of the cases, there wasn’t any emergency consult or hospitilization. Results The text does not involve results.