UNASSIGNED: There are still some gaps in the summary and generalization of cosmetic-related adverse reaction reports.
UNASSIGNED: The aim of this study is to summarize and analyze the occurrence of cosmetic adverse reactions in Shanghai Han population by using available survey data.
UNASSIGNED: Collection, statistics and analysis of patients with cosmetic adverse reactions in Shanghai Huashan Hospital from 2017 to 2021.
UNASSIGNED: Among the 1004 patients, most of them (96.71%) were diagnosed as cosmetic contact dermatitis, which often occurred within 3 days of using cosmetics (51.79%). A total of 260 patients were tested with patch test, but the compliance rate was only 18.08%. Among them, 240 patients underwent additional European standard allergen tests, and positive allergens were detected in 210 cases (87.5%). Univariate analysis revealed that dosage form (emulsion and cream), age (≤25 years) and the allergic ingredients triethanolamine, rose oil, propylene glycol, thiomersal and musk ambrette are associated with the occurrence of cosmetic adverse reactions within seven days. A logit prediction model was also successfully constructed: Logit (P) = 1.710-0.796×1 + 1.185×2 -3.650X3-1.335X4.
UNASSIGNED: This study complements the data reported on cosmetic adverse reactions in the Chinese Han population and suggests that in future clinical diagnosis and data collection, emphasis should be placed on patch testing, combining the patch test with cosmetic protoplast with the European standard allergen test to improve the detection rate.

During the outbreak of Coronavirus disease 2019 (COVID-19), health care workers wore personal protective equipment including masks, gloves and goggles for a long time. In order to reduce the transmission routes of the virus, public places were sprayed with disinfectant. Moreover, the body, hands and clothing were frequently disinfected and washed for hygiene purposes. Studies have shown that these practices could easily irritate the skin and damage the skin barrier. Long-term irritation or exposure to allergens may lead to the occurrence of contact dermatitis (CD).
Subject headings were searched via the National Library of Medicine (PubMed) and web of science databases: COVID-19; contact dermatitis; adverse skin reaction; PPE; dermatitis; mask; glory; hand hygiene, disinfection; face shield; goggle; protect cloth. A total of 246 and 646 articles were retrieved from the two databases, respectively. 402 articles remained after removing duplicates. Reviews, non-English articles, articles that could not be accessed to read or did not conform to our topic were excluded. Finally, a total of 32 cross-sectional studies, 9 case reports and 2 randomized controlled trials were included.
This article reviews reports of CD caused by various prevention and hygiene measures during the COVID-19 pandemic. The amount of skin damage caused by COVID-19 prevention measures could be decreased by improved education about skin management.

OBJECTIVE: To study the expression of interleukin-1β (IL-1β), interleukin-4 (IL-4), interferon-γ (IFN-γ) and tumour necrosis factor α (TNF-α) in different tissue in a dinitrochlorobenzene (DNCB)-induced ear swelling test in mice and further evaluate the correlation between the cytokine expression in different tissues and the degree of ear swelling.
METHODS: The mice were sensitised with a 0.50% DNCB solution on their back for 3 days. After 7 days, the thickness of their ears was measured and grouped. Different concentrations of the DNCB solution were challenged in the left ear of each group of mice, and the right ear was used as the control. The thickness of both ears was measured every 24 h, and the mice were sacrificed 72 h after the challenge. The expressions of IL-1β, IL-4, IFN-γ and TNF-α in the mouse serum, lymph node and ear tissue were quantified by enzyme-linked immunosorbent assay, respectively.
RESULTS: There was a linear positive correlation between the swelling index of the mouse lateral ear and the challenge concentration of DNCB (r = 0.96, p < 0.01). The high expression of IL-1β and IL-4 in the lateral ear tissue of the mice was positively correlated with the ear swelling index 48 h after the challenge. The correlation coefficient was 0.78 (p < 0.01). Furthermore, IFN-γ and TNF-α had no significant correlation with the ear swelling index 48 h after the challenge.
CONCLUSIONS: There is a correlation between the degree of ear swelling in mice and the concentration of DNCB and the expression of IL-1β and IL-4 in the lateral ear tissue. There is a sub-clinical skin sensitivity state in contact allergy.

Kaposi varicelliform eruption (KVE) is a cutaneous dissemination of a viral infection, which is mostly caused by herpes simplex virus (HSV) in the setting of certain underlying skin diseases. KVE occurs mainly in infants and children, but very rarely in adults. Here, we report a case of KVE with contact dermatitis in a 36-year-old man with acquired immunodeficiency syndrome (AIDS), who was referred to our deparment with pruritic well-defined facial erythema and multiple vesicular lesions. A punch biopsy and immunohistochemical examination established the diagnosis of KVE with contact dermatitis. After treatment with valacyclovir and antihistamines, facial lesions achieved complete remission. With this case report, KVE has specific manifestation in clinic, histopathology and immunohistochemistry, which could guide the early diagnosis and improve prognosis.

BACKGROUND: Cosmetic contact dermatitis (CCD) is a very common cosmetic adverse reaction, but there are few reports of adverse reactions to breast enhancement cream.
METHODS: We reported a case of adverse skin reactions after applying a cosmetic cream and performed patch tests of cosmetic series and cosmetic product.
RESULTS: After drug treatment, the patient\'s symptoms improved significantly. The cosmetic series patch test showed that she was allergic to thimerosal, and the cosmetic product patch also showed positive.
CONCLUSIONS: The adverse reactions of dermatologists to cosmetics cannot be ignored, and it is suggested that in addition to common skin care products, the safety of other functional products should also be concerned.

BACKGROUND: Occupational exposure to locusts induces a high prevalence of allergic sensitization. However, knowledge on occupational locust allergens remains unclear.
OBJECTIVE: This study aimed to identify the allergens from locusts causing occupational allergies.
METHODS: We conducted a survey of 57 persons exposed to locusts using questionnaires and immunological tests for occupational allergies in long-term locust laboratories. The major allergen was identified by immunoblotting and analysed by mass spectrometry. The allergenicity of the allergen was assessed by sIgE detection, immunoblotting and ELISA inhibition assays.
RESULTS: The survey indicated that the frequency of locust occupational allergies was 40.4% among subjects exposed to locust. The symptoms in most males were allergic rhinitis, while females showed higher prevalence of atopic dermatitis. Occupational exposure increased the allergy risk. The recombinant hexamerin-2 protein possesses high allergenicity in the allergic exposure group. Hexamerin-2 protein can inhibit IgE reactivity with locust protein extracts by approximately 60%. The potential for cross-reactivity with cockroaches was indicated by sequence alignment of hexamerin-2 protein and allergens of cockroaches.
CONCLUSIONS: The hexamerin-2 protein of locusts as an important allergen was identified. Therefore, occupational exposure is an important risk factor for locust allergy.

Contact dermatitis usually presents as erythematous macules, papules, and vesicles. Sometimes, unusual clinical presentations of contact dermatitis are reported, including pustular, lymphomatoid, lichenoid, and pigmented variants. We describe the first patient with bullous irritant contact dermatitis caused by perfume, mimicking impetigo lesions. We report this case to raise awareness concerning the possibility of serious cutaneous reactions, such as bullous impetigo-like irritant contact dermatitis due to perfumes which are ubiquitous, especially after direct contact with the solution. Perfume ingredients, such as fragrance, solvents, and preservatives all may cause or contribute to irritant contact dermatitis.

2, 4-dinitrofluorobenzene (DNFB) and 2, 4-dinitrochlorobenzene (DNCB) are well known as skin sensitizers that can cause dermatitis. DNFB has shown to more potently sensitize skin; however, how DNFB and DNCB cause skin inflammation at a molecular level and why this difference in their sensitization ability is observed remain unknown. In this study, we aimed to identify the molecular targets and mechanisms on which DNFB and DNCB act. We used a fluorescent calcium imaging plate reader in an initial screening assay before patch-clamp recordings for validation. Molecular docking in combination with site-directed mutagenesis was then carried out to investigate DNFB and DNCB binding sites in the TRPA1 ion channel that may be selectively activated by these tow sensitizers. We found that DNFB and DNCB selectively activated TRPA1 channel with EC50 values of 2.3 ± 0.7 μM and 42.4 ± 20.9 μM, respectively. Single-channel recordings revealed that DNFB and DNCB increase the probability of channel opening and act on three residues (C621, E625, and Y658) critical for TRPA1 activation. Our findings may not only help explain the molecular mechanism underlying the dermatitis and pruritus caused by chemicals such as DNFB and DNCB, but also provide a molecular tool 7.5-fold more potent than the current TRPA1 activator allyl isothiocyanate (AITC) used for investigating TRPA1 channel pharmacology and pathology.

Imidazolidinyl urea (IU) is used as an antimicrobial preservative in cosmetic and pharmaceutical products. IU induces allergic contact dermatitis, however, the mechanism has not yet been elucidated. Mas-related G protein-coupled receptor-X2 (MRGPRX2) triggers drug-induced pseudo-allergic reactions. The aims of this study were to determine whether IU activated mast cells through MRGPRX2 to further trigger contact dermatitis. Wild-type (WT) and KitW-sh/HNihrJaeBsmJNju (MUT) mice were treated with IU to observe its effects on local inflammation and mast cells degranulation in vivo. Laboratory of allergic disease 2 cells were used to detect calcium mobilization and release of inflammatory mediators in vitro. WT mice showed a severe local inflammatory response and contact dermatitis, whereas only slight inflammatory infiltration was observed in MUT mice. Thus, MRGPRX2 mediated the IU-induced activation of mast cells. However, histamine, a typical allergen, was not involved in this process. Tryptase expressed by mast cells was the major non-histaminergic inflammatory mediator of contact dermatitis. IU induced anaphylactic reaction via MRGPRX2 and further triggering non-histaminergic contact dermatitis, which explained why antihistamines are clinically ineffective against some chronic dermatitis.

The immunomodulatory effects of regulatory T cells (Tregs) and co-signaling receptors have gained much attention, as they help balance immunogenic and immunotolerant responses that may be disrupted in autoimmune and infectious diseases. Drug hypersensitivity has a myriad of manifestations, which ranges from the mild maculopapular exanthema to the severe Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms/drug-induced hypersensitivity syndrome (DRESS/DIHS). While studies have identified high-risk human leukocyte antigen (HLA) allotypes, the presence of the HLA allotype at risk is not sufficient to elicit drug hypersensitivity. Recent studies have suggested that insufficient regulation by Tregs may play a role in severe hypersensitivity reactions. Furthermore, immune checkpoint inhibitors, such as anti-CTLA-4 or anti-PD-1, in cancer treatment also induce hypersensitivity reactions including SJS/TEN and DRESS/DIHS. Taken together, mechanisms involving both Tregs as well as coinhibitory and costimulatory receptors may be crucial in the pathogenesis of drug hypersensitivity. In this review, we summarize the currently implicated roles of co-signaling receptors and Tregs in delayed-type drug hypersensitivity in the hope of identifying potential pharmacologic targets.