delayed hypersensitivity

迟发性超敏反应
  • 文章类型: Case Reports
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  • 文章类型: Case Reports
    手术诱发的坏死性巩膜炎(SINS)是眼手术后罕见的迟发型超敏反应,以手术部位疼痛和发红为特征。虽然通常在各种眼部手术中报道,其在玻璃体视网膜手术后的发生仍然很少。我们介绍了一例61岁的糖尿病男性,他在23号玻璃体切除术治疗视网膜脱离后两个月出现了进行性巩膜融化和葡萄膜暴露。感染和免疫谱均为阴性。尽管采取了积极的医疗和手术干预措施,患者表现出巩膜融化的进展。诊断挑战在于确定创伤的相对贡献,上皮破裂,免疫激活,以及这些患者的感染。我们的病人不受控制的糖尿病可能加重血管破坏,导致伤口愈合延迟和免疫复合物沉积。治疗涉及局部类固醇和广谱抗生素,其次是结膜瓣和口服皮质类固醇。这个病例强调了早期诊断的重要性,谨慎的免疫抑制,和彻底的感染评估在管理术后巩膜炎。限制包括单一培养测试和患者失去随访。
    Surgically induced necrotizing scleritis (SINS) is a rare delayed hypersensitivity reaction following ocular surgeries, characterized by pain and redness at the surgical site. While commonly reported in various ocular surgeries, its occurrence after vitreoretinal procedures remains infrequent. We present a case of a 61-year-old diabetic male who developed progressive scleral melting and uveal exposure two months after an uneventful 23-gauge vitrectomy for retinal detachment. The infectious and immunologic profile was negative. Despite aggressive medical and surgical interventions, the patient exhibited advancing scleral melting. The diagnostic challenge lies in determining the relative contributions of trauma, epithelial breakdown, immune activation, and infection in these patients. Our patient\'s uncontrolled diabetes potentially aggravated vascular disruption, contributing to delayed wound healing and immune complex deposition. The treatment involved topical steroids with broad-spectrum antibiotics, followed by conjunctival flap and oral corticosteroids. This case underscores the importance of early diagnosis, cautious immunosuppression, and thorough infection evaluation in managing postoperative scleritis. The limitations include a single culture test and the patient being lost to follow-up.
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  • 文章类型: Case Reports
    戊二醛(GA),一种广泛用于医疗机构的有效消毒剂和灭菌剂,因其与接触性皮炎的关系而受到关注。这种职业性皮肤状况,通常由反复暴露于GA引起,对医疗保健专业人员和患者的福祉提出了重大挑战。了解原因,症状,针对GA引起的接触性皮炎的预防措施对于在医疗机构中促进安全和健康的工作环境至关重要。一名28岁的女性表现出严重的灼烧感和下下巴区域的深棕色斑点,根管治疗后一天。根据斑块的特征性外观和与过敏反应相关的典型烧灼感,诊断为急性接触性皮炎。专家皮肤科医生的贴片测试证实患者对GA过敏。GA,一种流行的商业杀菌产品,广泛用作手术牙科器械的冷消毒剂。当在根管手术过程中使用的牙髓文件用2%GA冷灭菌时,患者出现了反应。在施用皮质类固醇和抗组胺剂后,病变经历显著改善并最终愈合。本报告涉及一例GA诱发的接触性皮炎。随着GA的使用越来越广泛,特别是在牙科诊所,该病例引起了人们的关注,并报告了患者和临床医生的安全性.
    Glutaraldehyde (GA), a potent disinfectant and sterilizing agent extensively used in healthcare settings, has garnered attention for its association with contact dermatitis. This occupational skin condition, often induced by repeated exposure to GA, poses significant challenges to the well-being of healthcare professionals and patients alike. Understanding the causes, symptoms, and preventive measures against GA-induced contact dermatitis is essential for promoting a safe and healthy working environment in healthcare facilities. A 28-year-old female presented with a severe burning sensation and dark brown patches in the lower chin region, one day following root canal treatment. Based on the characteristic appearance of patches and the typical burning sensation associated with an allergic reaction, a diagnosis of acute contact dermatitis was made. Patch testing by an expert dermatologist confirmed that the patient was allergic to GA. GA, a popular commercial germicidal product, is widely used as a cold sterilizing agent for operative dental instruments. The patient developed a reaction as the endodontic files used during the root canal procedure were cold sterilized with 2% GA. The lesion experienced significant improvement and ultimately healed following the administration of corticosteroids and antihistamines. This report concerns a case of GA-induced contact dermatitis. As GA is being used more widely, particularly in dental clinics, this case was of interest and is reported in the safety interest of patients and clinicians.
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  • 文章类型: Case Reports
    超敏反应可能是任何疫苗的副作用,但它们通常很少见。COVID-19疫苗接种可能导致超敏反应,并且已经记录了几例对透明质酸(HA)真皮填充物的迟发性超敏反应(DH)。本报告介绍了一名36岁女性患者在接受辉瑞-BioNTechCOVID-19疫苗后,将DH改为HA皮肤填充物。症状,包括干燥,肿胀,一个无痛的结节,出现在第一剂和第二剂疫苗之后。该患者在门诊接受了病灶内透明质酸酶和曲安奈德治疗。虽然HA是相对安全和常规用于美容医学,必须考虑DH反应。因此,应该获得适当的病史,医生应就潜在的反应提供咨询,以避免这些不利影响。
    Hypersensitivity reactions can be a side effect to any vaccine, but they are usually rare. The COVID-19 vaccination may cause hypersensitivity, and several cases of delayed hypersensitivity (DH) to hyaluronic acid (HA) dermal filler have been documented. The current report presents a case of a 36-year-old female patient with DH to HA dermal filler after receiving the Pfizer-BioNTech COVID-19 vaccine. Symptoms, including dryness, swelling, and a painless nodule, appeared after the first and second doses of the vaccine. The patient was treated with intralesional hyaluronidase and triamcinolone in the outpatient clinic. Although HA is relatively safe and routinely used in aesthetic medicine, DH reactions must be considered. Therefore, an appropriate patient history should be obtained, and physicians should provide counselling on the potential reactions to avoid these adverse effects.
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  • 文章类型: Case Reports
    作者提出了一种罕见的病例,即对静脉内铁的激素性药物反应。出血性药疹,也称为麻疹病毒状或斑丘疹,可发生在首次药物暴露中,并代表迟发性IV型超敏反应的亚型。该患者是一名49岁的女性,有缺铁性贫血和甲状腺功能减退症的病史,在出现前两天静脉注射阿魏酚510mg后出现弥漫性全身斑丘疹皮疹后出现在急诊科。临床检查可疑为发疹性药疹。患者每天两次静脉注射甲基强的松龙40mg,连续三天,然后口服泼尼松40mg,每天两次,连续两天,并在出院时逐渐减少类固醇。患者的皮疹在类固醇治疗五天内消退。缺铁性贫血的全球患病率很高,因此可能需要静脉补铁。然而,针对其不利影响的研究有限,特别是那些包括迟发性超敏反应的。本文旨在提醒医疗保健专业人员对静脉铁剂的罕见类型的迟发性超敏反应,以更好地指导临床管理。
    The authors present a rare case of an exanthematous drug reaction to intravenous iron. Exanthematous drug eruptions, also called morbilliform or maculopapular drug rashes, can occur in first-time drug exposures and represent a subtype of delayed-type IV hypersensitivity reactions.  This patient is a 49-year-old female with a history of iron deficiency anemia and hypothyroidism who presented to the emergency department after experiencing a diffuse whole-body maculopapular rash following ferumoxytol 510 mg intravenously received once two days prior to her presentation. A clinical examination was suspicious of an exanthematous drug eruption. The patient was treated with methylprednisolone 40 mg intravenously twice a day for three days, followed by prednisone 40 mg orally twice a day for two days with a steroid taper upon discharge. The patient\'s rash resolved within five days of steroid treatment. There is a high global prevalence of iron deficiency anemia for which intravenous iron replacement may be required. However, there is limited research addressing its adverse effects, particularly those that include delayed hypersensitivity reactions. This paper aims to alert healthcare professionals of a rare type of delayed hypersensitivity reaction to intravenous iron to better guide management in the clinical setting.
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  • 文章类型: Case Reports
    Desloratadine is a second-generation H1-type antihistamine that is widely prescribed for multiple indications including allergic rhinitis and urticaria. It is well-tolerated and is not known to cause cutaneous side effects including fixed drug eruption (FDE). In this report, a case of recurrent fixed drug eruption induced by desloratadine is reported.
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  • 文章类型: Case Reports
    Tattoos have become increasingly popular worldwide making adverse effects from tattoos a growing concern. In our report, we present a 51-year-old man who developed an unusual allergic reaction to the red ink portions of his tattoos that coincided with the initiation of ledipasvir/sofosbuvir treatment for his hepatitis C. Clinical and histological features were consistent with a delayed-type hypersensitivity reaction to red ink.
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  • 文章类型: Journal Article
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    文章类型: Case Reports
    Contact dermatitis caused by the sap of plants from the Anacardiaceae family, including poison ivy, oak, and sumac, is among the most common skin conditions in the United States. The author reports the case of a 50-year-old man who presented with numerous vesicles and flaccid bullae on erythematous bases on his right volar wrist; smaller areas of vesiculation on his trunk and legs, several of which displayed a linear configuration; and erythema and swelling on and around his penis. The patient was diagnosed with Toxicodendron contact dermatitis caused by exposure to poison ivy. The author describes symptoms, assessment methods, and differential diagnoses, as well as provides a brief review of pathologic and etiologic factors, epidemiology, and treatment approaches for cutaneous dermatitis caused by contact with poison ivy and related plants. The author also provides an brief history, recommended therapies, and notable physical characteristics of poison ivy, with the final takeaway point-Clinicians should educate their patients on how to identify, and, thus, avoid, contact with these highly irritating plants.
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