BACKGROUND: Chronic actinic dermatitis (CAD) is an immunologically mediated photodermatosis that has been effectively treated with azathioprine and mycophenolate mofetil (MMF) in uncontrolled studies. We conducted a prospective randomized controlled trial to compare the efficacy and safety of azathioprine and MMF in CAD treatment, aiming to address existing evidence gaps.
METHODS: Consecutive CAD patients were randomized into two groups: azathioprine (Group A) or MMF (Group B) for 12 weeks. Primary outcomes included Eczema Area and Severity Index (EASI) and Dermatology Life Quality Index (DLQI) at baseline and Week 12. Secondary outcomes included various clinicodemographic factors predictive of treatment response, defined at least a 75% reduction in EASI score (EASI75) by Week 12.
RESULTS: The median (IQR) percentage reduction in EASI at 12 weeks was higher in Group B than in Group A [78.3% (75.0-83.30%) vs. 68.3% (31.2-80.10%), P = 0.034]. Baseline DLQI scores indicated a moderate impact on quality of life, with significant reductions by Week 12 in both groups and no intergroup differences at baseline (P = 0.291) or Week 12 (P = 0.599). Overall, 23 patients were classified as non-responders, with more extended illness duration (P = 0.026) and outdoor occupations (P = 0.042) associated with poorer responses. Adverse effects were consistent with known profiles, with one patient discontinuing azathioprine due to hypersensitivity.
CONCLUSIONS: Our study highlights the efficacy and safety of azathioprine and MMF in CAD treatment, with MMF showing superior outcomes. However, further research is warranted to explore emerging therapies and prognostic factors in CAD management.

BACKGROUND: Neomycin is an aminoglycoside antibiotic that may cause contact allergy. It was withdrawn as a medicine for human use in Denmark in October 2009 but is still found in some vaccines.
OBJECTIVE: To identify time trends in contact allergy to neomycin in the period from 2000 to 2023.
METHODS: A cross-section study of patients ≥18 years consecutively patch-tested with neomycin sulfate (20% in pet.) at Gentofte Hospital, Denmark, during the period 2000-2023 was conducted.
RESULTS: The overall prevalence of contact allergy to neomycin was 1.4%. The prevalence was significantly lower in the period \'2010-2023\' (1.2%) than in \'2000-2009\' (1.8%) (p < 0.005). Contact allergy to neomycin was significantly positively associated with facial dermatitis and age >40 years, and significantly negatively associated with occupational dermatitis and hand dermatitis. No changes in sex, occupational dermatitis, atopic dermatitis, hand dermatitis, leg dermatitis, facial dermatitis, or age > 40/≤40 (the MOAHLFA-index) were identified when comparing neomycin contact allergic-patients in the two periods \'2010-2023\' and \'2001-2009\'.
CONCLUSIONS: Neomycin is a rare cause of contact allergy in Denmark with a significantly lower prevalence following its withdrawal as a medicinal product for human use in Denmark in 2009.

We present a case of deep surgical site infection (SSI) at a spinal cord stimulator (SCS) trial implantation site, resulting from an allergic reaction to an unknown agent. A 38-year-old female with complex regional pain syndrome began an SCS trial, noting 100% pain relief for 5 days. Fluid drainage from the surgical site was reported on POD6 and trial leads were removed the following day. The patient was hospitalized with sepsis. Blood cultures revealed Staphylococcus aureus. MRIs showed skin breakdown and cellulitis of the paraspinal musculature extending into the epidural space. The patient was maintained with antibiotics and rigorous wound care for 9 days and the surgical site infection resolved. The patient proceeded to SCS implantation, and reported good pain relief with the implanted device.
This case report describes the treatment of an infection developed during a spinal cord stimulator (SCS) trial period. SCS are medical devices used to treat pain, they work by applying electrical current to the areas of the spinal cord that cause patients’ pain. Before patients get an SCS device implanted, they often undergo a trial period first. During a trial, the stimulator device stays outside the body, and only the wires carrying electricity to the spinal cord are implanted. Typically, SCS trial and implantation procedures are safe and result in effective pain relief. However, infections are a dangerous potential complication that can result from these procedures. In our case, the patient developed an infection during an SCS trial period, likely resulting from an allergic reaction to their surgical dressings. The infection traveled down the wires and nearly reached the spinal cord. Since the infection was quickly identified and managed, devastating complications were avoided. The patient was able to get a permanent SCS after the infection was resolved, and had effective pain relief. Our report emphasizes the importance of using strict infection prevention techniques, and monitoring patients for signs of infection throughout SCS trials.

暂无摘要。

BACKGROUND: Eczema and contact dermatitis are relatively common, non-life-threatening disease, but can reduce the patient\'s quality-of-life when it becomes chronic. This study describes two cases of bee venom acupuncture (BVA) and herbal medicine (San Wu Huangqin decoction; SWH) co-treatment for hand eczema and contact dermatitis, then confirms the effect of the combination therapy in an in vivo model of eczema.
METHODS: A 56-year-old female (case 1) and a 33-year-old male (case 2) presented to the clinic with symptoms of itching and erythema (case 1), and scaliness (case 2) on both hands. Both were diagnosed with hand eczema and contact dermatitis based on examination of the erythema and scaliness. They were treated with BVA and SWH for three months. The lesions were healed and had not recurred after 1 and 3 years of follow-up. A mouse study was conducted by repeated application of 2,4-dinitrochlorobenzene (DNCB) to induce eczema-like contact dermatitis in Balb/c mice. In a DNCB-induced eczema-like contact dermatitis model, BVA and SWH co-administration synergistically improved clinical symptoms seen in eczema. Also, they improved histological changes of the skin, suppressed immune cell infiltration, and decreased inflammatory cytokines and immunoglobulin E in the serum.
CONCLUSIONS: This study suggests BVA and SWH could be an alternative treatment for eczema and contact dermatitis.

BACKGROUND: Nickel is the leading cause of contact allergy in Europe, with 14.5% of the adult population being sensitized. Despite regulations limiting nickel release from consumer items, the incidence and prevalence of nickel allergy remain high.
OBJECTIVE: To investigate the clinical and subclinical immune response to low-dose nickel exposure on nickel pre-exposed skin to assess the adequacy of current regulatory limits.
METHODS: Nickel-allergic and healthy controls were patch tested with nickel twice with a 3-4 weeks interval. The first exposure used the diagnostic concentration of 2000 μg/cm2 nickel sulphate, and the same skin areas were then re-exposed to 0.2, 0.5, 12.8 and 370 μg/cm2 nickel sulphate. After 48 h, the patch reactions were examined for clinical signs of eczema, and skin biopsies were collected. The transcriptomic immune profile was analysed with Nanostring nCounter and quantitative polymerase chain reaction.
RESULTS: Two nickel-allergic participants (15%) had clinical reactions to the regulatory limiting doses for nickel (0.2/0.5 μg/cm2) following re-exposure. There was immune activation in all skin areas following re-exposure to nickel, predominantly mediated by up-regulation of cytokines and chemokines. In all nickel re-exposed skin areas, 81 genes were up-regulated independent from the clinical response. In skin areas exposed to 0.2 μg/cm2, 101 immune-related genes were differentially expressed, even when no clinical response was observed. Healthy controls showed up-regulation of three genes in response to nickel re-exposures without any clinical reactions.
CONCLUSIONS: Immune activation can be induced in skin with local memory to nickel upon challenge with nickel doses within the regulatory limits. Our findings suggest that the regulatory limits in the European nickel regulation may not provide sufficient protection for consumers against low-dose exposures.

BACKGROUND: Daily usage of facial masks during coronavirus disease 2019 pandemic influenced on facial dermatoses.
OBJECTIVE: This study investigated the impact of mask-wearing habits on facial dermatoses.
METHODS: A nationwide, observational, questionnaire-based survey was conducted from July through August 2021, involving 20 hospitals in Korea.
RESULTS: Among 1,958 facial dermatoses, 75.9% of patients experienced aggravation or development of new-onset facial dermatoses after wearing masks. In aggravated or newly developed acne patients (543 out of 743), associated factors were healthcare provider, female gender, and a long duration of mask-wearing. Irritating symptoms, xerosis, and hyperpigmentation were more frequently observed in this group. Aggravated or newly developed rosacea patients (515 out of 660) were likely to be female, young, and have a long duration of mask-wearing per day. Seborrheic dermatitis patients who experienced aggravation or de novo development (132 out of 184) were younger, and they more frequently involved the chin and jaw in addition to the nasolabial folds and both cheeks. Contact dermatitis patients (132 out of 147) with aggravation or de novo development tended to be female, involve both cheeks, and complain of pruritus. Aggravated or newly developed atopic dermatitis patients (165 out of 224) were more likely to be female, and had a higher baseline investigator global assessment score before mask-wearing.
CONCLUSIONS: Clinical features and factors related to aggravation were different according to the types of facial dermatoses.

UNASSIGNED: Facial contact dermatitis is an emerging skin disorder due to the use of a large array of materials over the face. It leads to psychological distress in patients, impacting their quality of life. Most of the allergens applied over the face vary as per cosmetic or herbal products\' availability, usage, or religious practices. Identifying and discontinuing the implicated allergens will lead to a better prognosis and reduced morbidity in clinical practice.
UNASSIGNED: To determine the frequency of different allergens responsible for causing facial contact dermatitis, in an urban part of central India, using patch test with the help of Indian standard and cosmetic series.
UNASSIGNED: All suspected patients (>18 years) of facial contact dermatitis visiting the outpatient department of dermatology were patch tested with both Indian standard and cosmetic series.
UNASSIGNED: Out of 38/58 patch-test-positive patients, 71.06% were females, and 28.94% were males. Most patch-test-positive females were housewives. The most common allergens implicated were thiomersal (17.24%), followed by fragrance mix (15.51%), and paraphenylene diamine (12.06%).
UNASSIGNED: In our study, forehead and malar areas were most commonly involved indicating fairness creams and perfumes as the important contributors to facial contact dermatitis. Antigen batteries need to be updated with changing social and cultural trends, as many with a consistent history of aggravation with some products tested negative in patch tests.

暂无摘要。

Background and Objectives: Allergic contact dermatitis (ACD) is a serious health and socio-economic problem. Accurate and reliable assessment of exposure to ACD factors in the work environment would increase quality of life and work of employees. The aim of this study was to assess the level of exposure of workers of a multidisciplinary hospital to the factors causing ACD. Material and Methods: The proprietary OSDES-16 questionnaire was used. The effectiveness of the OSDES-16 was confirmed statistically. The study included 230 employees of the medical center in Polanica Zdrój, divided into groups. Results: The differences in the overall assessment of exposure between the individual groups in the OSDES-16 scale were statistically insignificant (p > 0.05). There was no significant correlation between the current workplace and the level of exposure to ACD (p > 0.05). The level of exposure to ACD in the group of employees with work experience in the current position for more than 10 years was significantly higher than those working less than 6 years (p < 0.05). Conclusions: Nurses, midwives and paramedics are the occupational group most exposed to the development of contact allergy related to exposure to factors present in the work environment. The seniority of more than 10 years in the current position was linked with a higher level of occupational exposure.