Virginia Fernández-Redondo

Current patch test results with the European baseline series and extensions to it from the 'European Surveillance System on Contact Allergy' network, 2007-2008

Background. The pattern of contact sensitization to the supposedly most important allergens assembled in the baseline series differs between countries, presumably at least partly because of exposure differences.

Pigmented contact dermatitis due to kojic acid. A paradoxical side effect of a skin lightener.

Kojic acid (5-hydroxy-2-(hydroxymethyl)-4-pyrone; CAS 501-30-4) has been increasingly used as a skinlightening agent in cosmetic products. Despite it being considered to have high sensitizing potential (1), few cases of contact allergy have been reported in the literature (2, 3). We report a case of pigmented contact dermatitis to kojic acid. The clinical diagnosis and the histopathology of the lesions are briefly discussed. Case Report

Allergic contact dermatitis to plants in a Spanish dermatology department: a 7-year review

To investigate the incidence of allergic contact dermatitis (ACD) to plants in our area, we reviewed the records of the patients that were studied in the Allergic Contact Unity of our hospital in the last 7 years (2248 patients). We found 69 cases of positive patch tests to plant allergens, representing 3% of all the patients in that period. Diallyl disulfide was the most frequent allergen (47 cases), involving mainly middle‐aged housewives with chronic hand eczema. Positive tests to sesquiterpene lactone mix (SL mix) were found in 11 patients, mostly middle‐aged rural workmen with an airborne clinical pattern. Other allergens detected were lichens, primin, tulipalin A and wood. These results show a high incidence of ACD to diallyl disulfide that, in our opinion, should be tested in all housewives or cooks with chronic hand eczema. The predominance of the classical airborne pattern of allergy to SL in our study may be because the airborne way of allergen exposure in our area, with a high percentage of rural population, is the most frequent, and it makes it important to remember this possibility in the differential diagnosis of photosensitivity.

Expression of growth hormone receptor in benign and malignant cutaneous proliferative entities

The skin has the necessary elements to respond to growth hormone (GH) and suffers clinical changes in the pathological circumstances of excess and deficiency of GH. The GH has been involved in the development of different types of human neoplasms. Based on these data, we have studied the GH receptor (GHR) expression in acrochordons, seborrheic keratosis, melanocytic nevi, histiocytomas, squamous cell carcinomas, basal cell carcinomas, and malignant melanomas by means of the immunohistochemistry with the monoclonal antibody MAb 263. All the entities showed immunoreactivity for GHR. In the histiocytomas, the expression of GHR in the keratinocytes of the hyperplastic epidermis coating the lesion showed a strong nuclear pattern, but the non‐hyperplastic epidermis of the edges of the histiocytomas expressed GHR with a cytoplasmic pattern. In the basal cell carcinoma and squamous cell carcinoma, the immunoreactivity was weaker than in normal skin. In the squamous cell carcinoma, the intensity of immunostaining correlated directly with the grade of cellular differentation. In conclusion, the GH may be involved in the development of different kinds of cutaneous neoplasms, and the intracellular localization of GHR may imply a functional significance, at least in the histiocytomas.

Epidemiología del eczema de contacto en España. Resultados de la Red Española de Vigilancia en Alergia de Contacto (REVAC) durante el año 2008

BACKGROUND The epidemiology of contact dermatitis can be analyzed using clinical data from skin allergy units. OBJECTIVES The aims of this study were to define the profile of patients attending a skin allergy unit and to determine the prevalence of the most common sensitizations in this population. MATERIAL AND METHODS Throughout 2008, a retrospective observational study was carried out in the 5 hospitals of the Spanish Surveillance System on Contact Allergies. All patients underwent skin patch tests with the Spanish standard series. The frequencies of sensitization were normalized for age and gender. RESULTS Data were gathered on 1161 patients. The 5 allergens that gave the most frequent positive reactions were nickel sulfate (25.88%), potassium dichromate (5.31%), cobalt chloride (5.10%), fragrance blends (4.64%), and balsam of Peru (4.44%). The least frequently detected reactions were to quinolone-clioquinol mix and sesquiterpene lactone mix. There was a 35% prevalence of sensitization to nickel among women. CONCLUSIONS The profile of sensitizations in Spain is similar to that of other Southern European countries. Nickel sulfate continues to be the most prevalent allergen, particularly in women. The low prevalence of sensitization to quinolone-clioquinol mix and sesquiterpene lactone mix supports their exclusion of the Spanish series.

Multinucleate cell angiohistiocytoma. Report of five cases

Background:  Multinucleate cell angiohistiocytoma is an infrequent and most likely non‐neoplastic disorder usually seen in acral regions in elderly women. It presents clinically as asymptomatic red‐to‐brown tumors, with a tendency to confluence. It must be distinguished from other diverse cutaneous lesions, notably dermatofibroma, Kaposi sarcoma, and angiofibroma.

Nickel allergy in Spain needs active intervention.

Juan Garcı́a-Gavı́n1 , José Carlos Armario-Hita2 , Virginia Fernández-Redondo1, José Manuel Fernández-Vozmediano3, Javier Sánchez-Pérez4, Juan Fco. Silvestre5, Wolfgang Uter6 and Ana M Giménez-Arnau7 1Faculty of Medicine, Department of Dermatology, University Hospital Complex, Santiago de Compostela, La Coruña 15706, Spain, 2Department of Dermatology, Hospital Punta de Europa (Algeciras), University of Cádiz, Cádiz 11207, Spain, 3Department of Dermatology, Hospital Universitario de Puerto Real, University of Cádiz, Cádiz 11510, Spain, 4Department of Dermatology, Hospital Universitario la Princesa, Madrid 28006, Spain, 5Department of Dermatology, Hospital General Universitario de Alicante, Alicante 03010, Spain, 6Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen-Nüremberg, Erlangen 91054, Germany, and 7Department of Dermatology, Hospital del Mar, Universitat Autónoma de Barcelona, Barcelona 08003, Spain

Resultados y evaluación del fotoparche en España: hacia una nueva batería estándar de fotoalergenos

Resumen Introduccion Mientras que la estandarizacion de la exploracion con pruebas de fotoalergia o fotoparche (FTP) sigue su curso en Europa, hemos realizado un estudio epidemiologico sobre la situacion actual de la fotoalergia en nuestro pais. Material y metodos Hemos recogido los resultados del FTP en 7 centros hospitalarios de Madrid, Cataluna, Galicia y Comunidad Valenciana, durante los anos 2004 y 2005. La exploracion ha incluido, al menos, la bateria estandar del Grupo Espanol de Fotobiologia (GEF), con 16 (foto)alergenos, que se han irradiado con 10 julios/ cm 2 . Hemos valorado el numero total de pacientes explorados, su sexo, la relevancia presente, pasada o desconocida de los fotoparches positivos, las reacciones cruzadas y los alergenos responsables de la fotosensibilizacion. Resultados El 39,3 % de los 224 pacientes explorados mediante FTP presentaron uno o mas fotoparches positivos. Ciento tres (71 %) se consideraron relevantes respecto a la historia clinica, 14 (9,6 %) fueron reacciones cruzadas y 28 (19,3 %) se consideraron de relevancia desconocida. Los alergenos mas prevalentes fueron los antiinflamatorios no esteroideos, particularmente el ketoprofeno (43 pacientes), seguido a distancia de la bencidamina (7 pacientes) y el etofenamato (5 pacientes). La mezcla de 4 filtros solares de la bateria estandar del GEF solo detecto 10/16 pacientes con fotoalergia a filtros solares. Los fotoparches de relevancia desconocida fueron sobre todo por antisepticos (fenticlor) y antihistaminicos topicos. Conclusiones Proponemos modificar la bateria estandar de fotoalergenos del GEF, que deberia contemplar la mayoria de los antiinflamatorios no esteroideos y filtros solares que hay en el mercado espanol. El ketoprofeno sigue siendo el fotoalergeno mas frecuente en nuestro pais. Su importancia deriva tambien de las sensibilizaciones cruzadas que puede presentar. Los filtros solares deben explorarse por separado, y no en forma de una mezcla.

Patch testing in children with hand eczema. A 5‐year multicentre study in Spain

Background. Hand eczema is common in children, but affected children are seldom patch tested. Relatively few studies have assessed patch testing in the paediatric population, and none has specifically evaluated its use in hand eczema in children.

Contact sensitization to limonene and linalool hydroperoxides in Spain: a GEIDAC(*) prospective study.

Limonene and linalool are common fragrance terpenes widely used in cosmetic, household and hygiene products. Their primary oxidation products formed after air exposure, the hydroperoxides, have been recognized as important contact haptens.