Herbal Remedies for Eczema

Eczema Free Forever Ebook

Rachel Anderson has written an educational ebook that allows readers to not only be extremely informed about the type of eczema they are experiencing, but also shows them simple straight forward steps that can be taken to promote an overall healthier life. The central part of this book is that it concentrates on the fundamental causes that behind eczema, as well as it shows how to heal the root reasons to get rid of this problem completely. The best point about Eczema Free Forever is that it does not involve any creams, lotions, pills, or any other drugs. Instead, it cures the eczema though natural remedies. Continue reading...

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Treatment of Eczema

In exogenous irritant or allergic contact dermatitis the mainstay of treatment is to identify the precipitating agent and to avoid it if at all possible. Otherwise the same general principles apply to the treatment of all forms of eczema. If there is a possibility that the eczema may be infected, skin swabs should be submitted for bacterial culture and sensitivity and, if appropriate, an antibiotic such as flucloxacillin should be prescribed. For acute, particularly wet and weeping eczema, astringent solutions such as potassium permanganate (1 10,000) are indicated. The involved area, such as hands or feet, can be placed in a bowl of the solution or, alternatively, wet gauze swabs may be applied directly to the skin. The majority of patients with eczema have a chronic, dry scaling, rash. These patients should be advised to use emollients frequently. They should also avoid soap and use soap substitutes, such as emulsifying ointment or Diprobase, wherever possible. Emollient bath oil...

Atopic Eczema Dermatitis

Rash From Figs Eaten

The etiology of atopic eczema is unknown. Patients have increased levels of serum IgE and some have precipitating antibodies to environmental allergens, including foods and inhaled materials. Many patients will have a positive response to intracutaneous challenge with pollen, house dust mite, cat fur, and fish antigens. However, the significance of these positive reactions is unclear. Patients with atopic eczema have reduced numbers of circulating T-suppressor cells which are responsible for modulating immunoglobulin-producing B lymphocytes. Low levels of the unsaturated fatty acids y-linoleic and dihomo-y-linolenic acid have been reported (8). In most patients there is a family history of eczema or of other atopic diseases, such as asthma or allergic rhinitis. Atopic eczema usually presents during infancy and, often, may resolve during childhood, whereas in others it may persist into adult life. Atopic eczema usually affects the face, wrists, and the flexural aspects of the elbows...

Atopic Dermatitis Atopic Eczema

Atopic Dermatitis (Atopic Eczema) (Continued) Etiology Cutaneous immune dysfunction IgE-mediated genetics. Strong association with personal and family history of atopy (eczema, asthma, hay fever). History Pruritus is a hallmark (the itch that rashes). Aggravating factors sweating, contact sensitivity, secondary infection, wool, food allergy, stress anxiety. Physical

Irritant Contact Dermatitis ICD

Hyperkeratotic Papules

History Regular exposure to common irritants water, soap, detergents, solvents, alcohol. Pain, burning, and stinging exceed pruritus early on. Those with history of atopic dermatitis are more susceptible. Allergic Contact Dermatitis (ACD) Misconceptions About Allergic Contact Dermatitis (ACD)

Lymphomatoid Contact Dermatitis

Contact Dermatitis Lymphomatoid

Lymphomatoid contact dermatitis has been reported as a reaction to various allergens including nickel (6,7), cobalt naphthenate (8), isopropyl-diphenylenediamine (9), and others. Genotyping has shown clonal rearrangement in some cases. Such cases may be closely related to clonal dermatitis some of which develop into overt CTCL (10). Histologically, epidermotropism of lymphocytes and accumulations of CDla-positive Langerhans cells may be found (Figs. 4 and 5). Evolution into cutaneous T-cell lymphoma was observed in four patients with long-standing chronic contact dermatitis (11) present for up to 15 years before clinically and histologically verified mycosis fungoides occurred. Contact allergy was confirmed in these cases by patch testing with sensitization against nickel, potassium dichromate, and formaldehyde. These observations may suggest that at least in some cases, CTCL may be caused by chronic antigenic immunostimulation (12).

Allergic Contact Dermatitis

Allergic contact dermatitis is a skin condition that occurs when your skin comes into contact with allergens, substances to which you are allergic but that are harmless to most people. This condition is not triggered by harsh soaps or acids, for example, because these substances are irritants that will produce a rash on anyone's skin, given enough exposure. Upon contact with an allergen, the skin reddens and swells and may blister. The blisters may burst, leaving scaly patches. The condition is sometimes difficult to distinguish from other skin conditions, such as atopic eczema (see previous page). Substances that can trigger allergic contact dermatitis include nickel or nickel-plated items, rubber, hair dyes, and cosmetics such as perfumes and lotions. (Some people are allergic to the chemicals used to preserve cosmetics, while others are allergic to the fragrances used in these products.) Rubber can cause a more serious allergic reaction that goes beyond a simple rash. Some people...

Conditions That May Simulate Atopic Dermatitis

This eruption is partially eczematous and partially papulosquamous. Onset and distribution are similar to those for infantile atopic dermatitis. Differentiation is particularly difficult when the eczema component is predominant. Both conditions may exhibit heavy scale. While the scale of seborrhea is yellow and greasy, that of atopy is white and dry. The distinction is not always easy to make. Seborrhea lesions tend to have sharp margins, while those of atopic dermatitis are indistinct. In addition, involvement of the facial creases, crural folds, and diaper area favors seborrhea. Infantile or childhood atopic dermatitis with widespread papular morphology and excoriations is very similar in appearance to the papules and vesicular lesions of advanced scabies. In addition, the two diseases may coexist. It is fairly common for an atopic patient to acutely deteriorate during a concomitant scabies and or bacterial infection. The practitioner must maintain a high index of suspicion. Family...

Classification of Eczema

Eczema may be considered as either endogenous or exogenous. The terms eczema and dermatitis are synonomous, although dermatitis is sometimes used to imply that the eczema has been caused by an external agent (exogenous). Endogenous eczemas include atopic eczema, seborrheic eczema, discoid eczema, pompholyx, and varicose eczema. Exogenous eczemas include both irritant and allergic contact dermatitis as Acute eczema presents as a pruritic erythematous confluent papular rash with an ill-defined border. There may be vesicles present, and if these rupture there may be exudation and weeping. Chronic eczema tends to be erythematous, scaly, and is less likely to be vesicular. There may also be some degree of lichenification and fissuring.

Contact Dermatitis

Irritant contact dermatitis is caused by (usually repeated) exposure to chemical or mechanical trauma. Some individuals seem more prone than others. In allergic contact dermatitis the sensitizing agent (antigen) crosses the stratum corneum to reach the epidermal Langerhans cells. The antigen is processed by the Langerhans cells and presented to circulating T lymphocytes with subsequent development of a clone of T lymphocytes with a specific memory for that particular antigen. In an individual sensitized to a particular antigen, repeat exposure to that antigen will result in migration of the sensitized T lymphocytes to the site of exposure, with initiation of the inflammatory eczematous process. Both irritant and allergic contact dermatitis usually start at the site(s) of initial or more frequent contact, but may spread to involve other areas.

Atopic Dermatitis

Parakeratosis And Atopic Dermatitis

Of these types 70 result from allergic contact dermatitis, and about 9 to 10 each from irritant contact dermatitis, atopic dermatitis, and seborrheic dermatitis. Atopic dermatitis is a chronically relapsing inflammatory skin disease. It is a genetically fixed disease that remains with the patient all their lives, whether they show symptoms or not. It occurs in approximately 2 of the population. In several large series 80 to 90 of patients with eyelid dermatitis were female. Distinct infantile, juvenile, and adult stages of the disease have been reported. Associated diffuse eczematous skin changes vary with the age of the patient and often disappear during puberty or adolescence. In the infantile stages associated manifestations include facial erythema and crusting. After age two to three years erosions, lichenification, and hyper or hypopigmentaton develop particularly on the face and flexural surface of the extremities. In adults the rash may be bright red, edematous and oozing or...

Asteatotic eczema

Asteatotic dermatitis eczema craquel eczema craquelatum xerotic eczema eczema hiemalis eczema fendille etat craquel Physiologic process with aging seen more often in the winter, with cold air outside and heated air inside causing a decrease in humidity loss of water by stratum cor-neum causing cells to shrink and creating fine fissures eczematous changes resulting from patients rubbing and scratching these pruritic areas Ichthyosis atopic dermatitis nummular eczema stasis dermatitis contact dermatitis mycosis fungoides other causes of generalized pruritus scabies atopic dermatitis drug reaction obstructive hepatobil-iary disease end-stage renal disease polycythemia vera Hodgkin's disease thyroid disease hyperparathyroidism psycho-genic pruritus

Dyshidrotic eczema

Dyshidrosis pompholyx vesicular pal-moplantar eczema vesicular eczema of palms and soles Dyshidrotic eczema. Multiple vesicles on the hands, with concentration along the sides of the digits Contact dermatitis vesicular tinea pedis tinea manus palmoplantar pustular psoriasis autosensitization reaction (id reaction)

Atopic Eczema

Atopic eczema is a recurrent inflammatory skin condition that produces redness, itching, and scaly patches. People who have atopic eczema also often have other allergic conditions, such as allergic rhinitis (see page 379) or asthma (see page 245), or are allergic to penicillin or sulfa. Atopic eczema is a very common condition that affects about 3 percent of Americans. The disorder can occur at any age but typically appears between infancy and young adulthood. The condition often improves on its own before puberty but also can persist throughout life. Most people have dry skin at some point, but people with atopic eczema have periodic eruptions of red, scaly patches of skin. In adolescents and young adults the patches usually appear inside the elbows and behind the knees and at the ankles and wrists in children they appear on the face and neck. But the eruptions can occur anywhere on the body and may not follow a pattern. The itching produced by the eruptions can be severe and...

Seborrheic Eczema

In infants, seborrheic eczema may present as greasy adherent scale on the scalp (cradle cap). Seborrheic eczema in adults principally affects the greasier areas of the body, including the scalp, eyebrows, eyelids, nasal-labial areas, and chin. In young men, it may also affect the presternal area and upper back and, in the elderly, may involve the flexures and may become generalized. Individuals who are immunosup-pressed (including those with human immunodeficiency virus HIV) are more prone to develop seborrheic eczema. It is possible that, in affected individuals, the commensal yeast-like microorganism Pityrosporum ovale has become pathogenic and provokes an inflammatory response (10). Cradle cap in infants may be treated with olive oil or arachis (peanut) oil. In adults, weak topical steroids, with or without azoles such as miconazole, clotrimazole, or ketoconazole, may be used. Ketoconazole shampoo, used two or three times weekly as a liquid soap to wash the affected areas, can also...

Dictionary of Contact Allergens Chemical Structures Sources and References

Bisphenol Epoxy Diacrylate

This chapter has been written in order to familiarize the reader with the chemical structure of chemicals implicated in contact dermatitis, mainly as haptens responsible for allergic contact dermatitis. For each molecule, the principal name is used for classification. We have also listed the most important synonym(s), the Chemical Abstract Service (CAS) Registry Number that characterizes the substance, and its chemical structure. The reader will find one or more relevant literature references. As it was not possible to be exhaustive, some allergens have been omitted since they were obsolete, extremely rarely implicated in contact dermatitis, their case reports were too imprecise, or they are extensively treated in other chapters of the textbook. From a practical chemical point of view, acrylates, cyanoacrylates and (meth)acrylates, cephalosporins, and parabens have been grouped together. Bergh M, Menne T, Karlberg AT (1994) Colophony in paper-based surgical clothing. Contact...

Cocamide DEA Coconut Oil Fatty Acids Diethanolamide NNbis2Hydroxyethyl Coco Fatty Acid Diethanolamide Cocoyl

Fowler JF Jr (1998) Allergy to cocamide DEA.Am J Contact Dermat 9 40-41 Kanerva L, Jolanki R, Estlander T (1993) Dentist's occupational allergic contact dermatitis caused by coconut diethanolamide, N-ethyl-4-toluene sulfonamide and 4-tolydietahnolamine. Acta Derm Venereol (Stockh) 73 126-129 Pinola A, Estlander T, Jolanki R, Tarvainen K, Kanerva L (1993) Occupational allergic contact dermatitis due to coconut diethanolamide (Cocamide DEA). Contact Dermatitis 29 262-265

R34Dimethoxy Dalbergione

Chieregato C,Vincenzi C, Guerra L, Rapacchiale S (1993) Occupational airborne contact dermatitis from Machaerium scleroxylum (Santos rosewood). Contact Dermatitis 29 164-165 Lamminp A, Estlander T, Jolanki R, Kanerva L (1996) Occupational allergic contact dermatitis caused by decorative plants. Contact Dermatitis 34 330-335

Polyvinylpyrrolidone Iodine PVPIodine

Povidone-iodine is iodophor, used as a topical antiseptic. A 10 povidone-iodine solution contains 1 available iodine, but free-iodine is at 0.1 concentration. Skin exposure causes irritant rather than allergic contact dermatitis. In such a situation however, iodine seems to be the true hapten. Lachapelle JM (2005) Allergic contact dermatitis from povidone-iodine a re-evaluation study. Contact Dermatitis 52 9-10 Tosti A, Vincenzi C, Bardazzi F, Mariani R (1990) Allergic contact dermatitis due to povidoneiodine. Contact Dermatitis 23 197-198

Acrylates And Chalazion

Kanerva L, Lauerma A, Estlander T, Alanko K, Henriks-Eckerman ML, Jolanki R (1996) Occupational allergic contact dermatitis caused by photobonded sculptured nails and a review of (meth) acrylates in nail cosmetics. Am J Contact Dermat 7 109-115 Kiec-Swierczynska MK (1996) Occupational allergic contact dermatitis due to acrylates in Lodz. Contact Dermatitis 34 419-422 Rustemeyer T, Frosch PJ (1996) Occupational skin diseases in dental laboratory technicians. (I). Clinical picture and causative factors. Contact Dermatitis 34 125-133 Trimethylolpropane triacrylate (TMPTA) is a multifunctional acrylic monomer. It reacts with propyleneimine to form polyfunc-tional aziridine. Sensitization was observed in a textile fabric printer. Patch tests were positive with the polyfunctional aziridine hardener, but were negative to TMPTA. TMPTA caused contact dermatitis in an optic fibre manufacturing worker and was reported as a sensitizer in a floor top coat or in photopolymerizable inks. Kanerva L,...

Caffeic Acid Dimethyl Allylic Ester

Lamminpaa A, Estlander T, Jolanki R, Kanerva L (1996) Occupational allergic contact dermatitis caused by decorative plants. Contact Dermatitis 34 330-335 Oliwiecki S, Beck MH, Hausen BM (1992) Occupational contact dermatitis from caffeates in poplar bud resin in a tree surgeon. Contact Dermatitis 27 127-128

Captane NTrichloromethylmercaptotetrahydrophtalimide

It is used as a fungicide and a bacteriostatic agent in cosmetics and toiletries, particularly in shampoos. Cases of contact dermatitis were reported in painters, polishers, and varnishers. allergy to captan in a hairdresser. Contact Dermatitis 31 46 Moura C, Dias M, Vale T (1994) Contact dermatitis in painters, polishers and varnishers. Contact Dermatitis 31 51-53 O'Malley M, Rodriguez P, Maibach HI (1995) Pesticide patch testing California nursery workers and controls. Contact Dermatitis 32 61-62 Peluso AM, Tardio M, Adamo F, Venturo N (1991) Multiple sensitization due to bis-dithiocarbamate and thiophthalimide pesticides. Contact Dermatitis 25 327 Vilaplana J, Romaguera C (1993) Captan, a rare contact sensitizer in hair-dressing. Contact Dermatitis 29 107

Cincaine Cinchocaine Percaine Sovcaine

Dibucaine hydrochloride is an amide group local anesthetic that can induce allergic contact dermatitis. Erdmann SM, Sachs B, Merk HF (2001) Systemic contact dermatitis from cinchocaine. Contact Dermatitis 44 260-261 Nakada T, Iijima M (2000) Allergic contact dermatitis from dibucaine hydrochloride. Contact Dermatitis 42 283

DihydroxyN3Hydroxypropyl33Dimethylbutanamide Pantothenylol NPantoyl3Propanolamine Panthenol Pantothenyl Alcohol

Pan(to)thenol is the alcohol corresponding to pantothenic acid, of the vitamin B5 group. It is used as a food additive, and in skin and hair products as a conditioning agent. Contact dermatitis and urticaria have been reported. nol in hair conditioner. Contact Dermatitis 43 223 Stables GI, Wilkinson SM (1998) Allergic contact dermatitis due to panthenol. Contact Dermatitis 38 236-237

Dimethylaminopropylamine

Angelini G, Foti C, Rigano L, Vena GA (1995) 3-Dimethylaminopropyl-amine a key substance in contact allergy to cocamidopropylbetaine Contact Dermatitis 32 96-99 Kanerva L, Estlander T, Jolanki R (1996) Occupational allergic contact dermatitis from 3-dimethylaminopropylamine in shampoos. Contact Dermatitis 35 122-123 Speight EL, Beck MH, Lawrence CM (1993) Occupational allergic contact dermatitis due to 3-dimethylaminopropylamine. Contact Dermatitis 28 49-50

Dipentamethylenethiuram Disulfide

Conde-Salazar L, Del-Rio E, Guimaraens D, Gonzalez Domingo A (1993) Type IV allergy to rubber additives a 10-year study of 686 cases. J Am Acad Dermatol 29 176-180 Conde-Salazar L, Guimaraens D, Villegas C, Romero A, Gonzalez MA (1995) Occupational allergic contact dermatitis in construction workers. Contact Dermatitis 35 226-230 Kiec-Swierczynska M (1995) Occupational sensitivity to rubber. Contact Dermatitis 32 171-172 Von Hintzenstern J, Heese A, Koch HU, Peters KP, Hornstein OP (1991) Frequency, spectrum and occupational relevance of type IV allergies to rubber chemicals. Contact Dermatitis 24 244-252

Ethanediamine N[Ethenylphenyl MethylN [3Trimethoxysilyl Propyl Monohydrochloride

Heino T, Haapa K, Manelius F (1996) Contact sensitization to organo-silane solution in glass filament production. Contact Dermatitis 34 294 Toffoletto F, Cortona G, Feltrin G, Baj A, Goggi E, Cecchetti R (1994) Occupational contact dermatitis from amine-functional methoxysilane in continuous-glass-filament production. Contact Dermatitis 31 320-321

Glyceryl Trinitrate Glycerol Trinitrate

Aquilina S, Felice H, Boffa MJ (2002) Allergic reactions to glyceryl trini-trate and isosorbide dinitrate demonstrating cross-sensitivity. Clin Exp Dermatol 27 700-702 Kanerva L, Laine R, Jolanki R, Tarvainen K, Estlander T, Helander I (1991) Occupational allergic contact dermatitis caused by nitroglycerin. Contact Dermatitis 24 356-362 Machet L, Martin L, Toledano C, Jan V, Lorette G,Vaillant L (1999) Allergic contact dermatitis from nitroglycerin contained in 2 transdermal systems. Dermatology 198 106-107

MethamNa Carbathion SodiumNMethyldithiocarbamate

Koch P (1996) Occupational allergic contact dermatitis and airborne contact dermatitis from 5 fungicides in a vineyard worker. Cross-reactions between fungicides of the dithiocarbamate group Contact Dermatitis Schubert H (1978) Contact dermatitis to sodium-N-methyldithiocarba- mate. Contact Dermatitis 4 370-371 Wolf F, Jung HD (1970) Akute Kontaktdermatitiden nach Umgang mit Nematin. Z Ges Hyg 16 423-426

Nonylphenol Ethoxylates PEGn Nonyl Phenyl Ether Polyoxyethylene n Nonyl Phenyl Ether

Ly used, as a preservative in topical antiseptics or in spermicides, acting as a iodophor in PVP-iodine solutions. Nonoxynol-io was reported as a UVB-photosensitizer. Nonoxynol-12 caused contact dermatitis in a domestic cleaner who used a polish containing it. Dooms-Goossens A, Deveylder H, de Alam AG, Lachapelle JM, Tennstedt D, Degreef H (1989) Contact sensitivity to nonoxynols as a cause of intolerance to antiseptic preparations. J Am Acad Dermatol 21 723-727 Meding B (1985) Occupational contact dermatitis from nonylphenolpoly- glycolether. Contact Dermatitis 13 122-123 Nethercott JR, Lawrence MJ (1984) Allergic contact dermatitis due to nonylphenol ethoxylate (nonoxynol-6). Contact Dermatitis 10 35-239 Wilkinson SM, Beck MH, August PJ (1995) Allergic contact dermatitis from nonoxynol-12 in a polish. Contact Dermatitis 33 128-129

ONitrop Phenylenediamine Onpd Ci 76070 CAS Registry Number [5307142 NH2

Frosch PJ, Burrows D, Camarasa JG, Dooms-Goossens A, Ducombs G, Lahti A, Menne T, Rycroft RJG, Shaw S, White IR, Wilkinson JD (1993) Allergic reactions to a hairdresser's series results from 9 European centres. Contact Dermatitis 28 180-183 Guerra L, Tosti A, Bardazzi F, Pigatto P, Lisi P, Santucci B, Valsecchi R, Schena D,Angelini G, Sertoli A,Ayala F, Kokelj F (1992) Contact dermatitis in hairdressers the Italian experience. Gruppo Italiano Ricerca Dermatiti da Contatto e Ambientali. Contact Dermatitis 26 101-107 Van der Walle HB, Brunsveld VM (1994) Dermatitis in hairdressers (I). The experience of the past 4 years. Contact Dermatitis 30 217-220

Polyvinylpyrrolidone Polyvidone Povidone 2Pyrrolidinone 1Ethenyl Homopolymer

Adachi A, Fukunaga A, Hayashi K, Kunisada M, Horikawa T (2003) Anaphylaxis to polyvinylpyrrolidone after vaginal application of povidone-iodine. Contact Dermatitis 48 133-136 Ronnau AC, Wulferink M, Gleichmann E, Unver E, Ruzicka T, Krutmann J, Grewe M (2000) Anaphylaxis to polyvinylpyrrolidone in an analgesic preparation. Br J Dermatol 143 1055-1058

Prilocaine Hydrochloride

Prilocaine in a local anesthetic of the amide group. It can induce allergic contact dermatitis, particularly from EMLA cream. Le Coz CJ, Cribier BJ, Heid E (1996) Patch testing in suspected allergic contact dermatitis due to Emla cream in haemodialyzed patients. Contact Dermatitis 35 316-317

PVPEicosene Copolymer

Gallo R, dal Sacco D, Ghigliotti G (2004) Allergic contact dermatitis from VP eisosene copolymer (Ganex V-220) in an emollient cream. Contact Dermatitis 50 261 Le Coz CJ, Lefebvre C, Ludmann F, Grosshans E (2000) Polyvinylpyrrolidone (PVP) eicosene copolymer an emerging cosmetic allergen. Contact Dermatitis 43 61-62

PVPHexadecene Copolymer

PVP hexadecene copolymer, another PVP copolymer used for identical applications as PVP eicosene copolymer, has been rarely implicated in contact dermatitis. De Groot AC, Bruynzeel DP, Bos JD, van der Meeren HL, van Joost T, Jagtman BA, Weyland JW (1988) The allergens in cosmetics. Arch Dermatol 124 1525-1529 Scheman A, Cummins R (1998) Contact allergy to PVP hexadecene copolymer. Contact Dermatitis 39 201

Sodium Pyrosulfite Disodium Disulfite E223 CAS Registry Number [7681574O O

This agent is frequently used as a preservative in pharmaceutical products, in the bread-making industry as an antioxidant, and it can induce contact dermatitis. It can be used as a reducing agent in photography and caused dermatitis in a photographic technician, probably acting as an aggravating irritative factor. Sodium metabisulfite contains a certain amount of sodium sulfite and sodium sulfate. Acciai MC, Brusi C, Francalanci Giorgini S, Sertoli A (1993) Allergic contact dermatitis in caterers. Contact Dermatitis 28 48 Jacobs MC, Rycroft RJG (1995) Contact dermatitis and asthma from sodium metabisulfite in a photographic technician. Contact Dermatitis 33 65-66 Riemersma WA, Schuttelaar ML, Coenraads PJ (2004) Type IV hyper-sensitivity to sodium metabisulfite in local anaesthetic. Contact Dermatitis 51 148 Vena GA, Foti C, Angelini G (1994) Sulfite contact allergy. Contact Dermatitis 31 172-175

Tixocortol 21Pivalate Tixocortol 21Trimethylacetate CAS Registry Number [55560968

Tixocortol 21-pivalate is a 21-ester of tixocortol, widely used in topical treatments. It can induce severe allergic contact dermatitis. This corticosteroid is a marker of the allergenic A group that includes molecules without major substitution on the D cycle (no C16 methylation, no C17 side chain). A short-chain C21 ester is possible. Molecules are cloprednol, cortisone, fludrocortisone, fluoro-metholone, hydrocortisone, methylprednisolone, methylpred-nisone, prednisolone, prednisone, tixocortol, and their C21 esters (acetate, caproate or hexanoate, phosphate, pivalate or trimethyl-acetate, succinate or hemisuccinate, m-sulfobenzoate).

Usnic Acid dUsnic Acid lUsnic Acid

Usnic acid is a component of lichens, also used as a topical antibiotic. Allergic contact dermatitis from lichens occurs mainly occupa-tionally in forestry and horticultural workers, and in lichen pickers. Aalto-Korte K, Lauerma A, Alanko K (2005) Occupational allergic contact dermatitis from lichens in present-day Finland. Contact Dermatitis 52 36-38 Hahn M, Lischka G, Pfeifle J, Wirth V (1995) A case of contact dermatitis from lichens in southern Germany. Contact Dermatitis 32 55-56

Vitamin E Acetate dlVitamin E Acetate d

Tocopherol and tocopheryl acetate are used mainly as antioxidants. Tocopheryl acetate, an ester of tocopherol (vitamin E), can induce allergic contact dermatitis. De Groot AC, Berretty PJ, van Ginkel CJ, den Hengst CW, van Ulsen J, Weyland JW (1991) Allergic contact dermatitis from tocopheryl acetate in cosmetic creams. Contact Dermatitis 25 302-304 Matsumura T, Nakada T, Iijima M (2004) Widespread contact dermatitis from tocopherol acetate. Contact Dermatitis 51 211-212

With the Patients Own Products

Commercially available patch test kits (standard series and various supplementary series) are the basis of a diagnostic work-up if an allergic contact dermatitis is to be confirmed. However, various investigators have shown that this way of testing is not sufficient. Menn et al. 20 found in a multicenter study that the European Standard Series detects only 37-73 of the responsible allergens in patients with contact dermatitis. The additional and or separately tested allergens were positive in 5-23 the authors emphasize the necessity of testing with the products actually used by the patient. In Italy, an analysis of 230 patients referred to a contact clinic because of suspected occupational contact dermatitis showed that the standard series alone detected 69.9 of all cases considered to be of an allergic nature 22 26.3 of all allergic cases were positive only to supplementary series. The agents most commonly responsible for allergic contact dermatitis were metals and...

Zinc NNDibutyldithiocarbamate CAS Registry Number [136232 SS

Conde-Salazar L, Del-Rio E, Guimaraens D, Gonzalez Domingo A (1993) Type IV allergy to rubber additives a 10-year study of 686 cases. J Am Acad Dermatol 29 176-180 Conde-Salazar L, Guimaraens D, Villegas C, Romero A, Gonzalez MA (1995) Occupational allergic contact dermatitis in construction workers. Contact Dermatitis 35 226-230 Kiec-Swierczynska M (19959 Occupational sensitivity to rubber. Contact Dermatitis 32 171-172

Diethylenetriamine

Holness DL, Nethercott JR (1993) The performance of specialized collections of bisphenol A epoxy resin system components in the evaluation of workers in an occupational health clinic population. Contact Dermatitis 28 216-219 Jolanki R, Kanerva L, Estlander T, Tarvainen K, Keskinen H, Henriks-Eckerman ML (1990) Occupational dermatoses from epoxy resin compounds. Contact Dermatitis 23 172-183 Kanerva L, Estlander T, Jolanki R (1990) Occupational allergic contact dermatitis due to diethylenetriamine (DETA) from carbonless copy paper and from an epoxy compound. Contact Dermatitis 23 272-273

Dibutylthiourea

Kanerva L, Estlander T, Jolanki R (1994) Occupational allergic contact dermatitis caused by thiourea compounds. Contact Dermatitis 31 242-248 Kiec-Swierczynska M (1995) Occupational sensitivity to rubber. Contact Dermatitis 32 171-172 Schmid-Grendelmeier P, Elsner P (1995) Contact dermatitis due to occupational dibutylthiourea exposure a case of phonecard dermatitis. Contact Dermatitis 32 308-309

Alpha Pinene

Lear JT, Heagerty AHM, Tan BB, Smith AG, English JSC (1996) Transient re-emergence of oil turpentine allergy in the pottery industry. Contact Dermatitis 35 169-172 Moura C, Dias M, Vale T (1994) Contact dermatitis in painters, polishers and varnishers. Contact Dermatitis 31 51-53

Octocrilene

Octocrylene is an anti-UVB filter used in cosmetics that may induce photoallergic contact dermatitis. Carrotte-Lefebvre I, Bonnevalle A, Segard M, Delaporte E, Thomas P (2003) Contact allergy to octocrylene. Contact Dermatitis 48 46-47 De Groot AC, Gerkens F (1990) Occupational airborne contact dermatitis from octyl gallate. Contact Dermatitis 23 184-186 Giordano-Labadie F, Schwarze HP, Bazex J (2000) Allergic contact dermatitis from octyl gallate in lipstick. Contact Dermatitis 42 51

Bardac22

This quaternary ammonium compound is used as a detergent-disinfectant in hospitals, as an algaecide in swimming pools, as a fungicide, and against termites in wood. We recently observed severe contact dermatitis in a slaughterhouse worker using a liquid soap containing this product (personal observation). Dejobert Y, Martin P, Piette F, Thomas P, Bergoend H (1997) Contact dermatitis from didecyldimethylammonium chloride and bis-(amino-propyl)-laurylamine in a detergent-disinfectant used in hospital. Contact Dermatitis 37 95-96

Captafol

Captafol is a pesticide, belonging to thiophthalimide group. Occupational contact dermatitis was reported in an agricultural worker who had multiple sensitizations. Peluso AM, Tardio M, Adamo F, Venturo N (1991) Multiple sensitization due to bis-dithiocarbamate and thiophthalimide pesticides. Contact Dermatitis 25 327

Chloroatranol

Bernard G, Gimenez-Arnau E, Rastogi SC et al (2003) Contact allergy to oak moss search for sensitizing molecules using combined bioassay-guided chemical fractionation, GC-MS and structure-activity relationship analysis (part 1). Arch Dermatol Res 295 229-235 Johansen JD, Andersen KE, Svedman C, Bruze M, Bernard G, Gimenez-Arnau E, Rastogi SC, Lepoittevin JP, Menne T (2003) Chloroatranol, an extremely potent allergen hidden in perfumes a dose response elicita-tion study. Contact Dermatitis 49 180-184

Chlorpromazine

This phenothiazine with sedative properties is used in human medicine and induced contact dermatitis in nurses or those working in the pharmaceutical industry. It is also in veterinary medicine, to avoid mortality of pigs during transportation. It is a sensi-tizer and a photosensitizer. Brasch J, Hessler HJ, Christophers E (1991) Occupational (photo)allergic contact dermatitis from azaperone in a piglet dealer. Contact Dermatitis 25 258-259

Cooh

Cloxacillin is a semi-synthetic penicillin close to oxacillin. It induced contact dermatitis in a pharmaceutical factory worker with positive reactions to ampicillin but not to penicillin. In cutaneous drug reactions such as acute generalized exanthematous pustul-osis due to amoxicillin, cross-reactivity is frequent to cloxacillin (personal observations). Rudzki E, Rebandel P (1991) Hypersensitivity to semisynthetic penicillins but not to natural penicillin. Contact Dermatitis 25 192

Cyclohexanone

Used as a polyvinyl chloride solvent, cyclohexanone caused contact dermatitis in a woman manufacturing PVC fluidotherapy bags.Cyclohexanone probably does not cross-react with cyclohexanone resin. A cyclohexanone-derived resin used in paints and varnishes, caused contact dermatitis in painters. Bruze M, Boman A, Bergquist-Karlson A, Bjorkner B, Wahlberg JE, Woog E (1988) Contact allergy to cyclohexanone resin in humans and guinea pigs. Contact Dermatitis 18 46-49 Sanmartin O, de la Cuadra J (1992) Occupational contact dermatitis from cyclohexanone as a PVC adhesive. Contact Dermatitis 27 189-190

Cyclohexen1one

Goossens A, Deschutter A (2003) Acute irritation followed by primary sensitization to 2-cyclohenen-1-one in a chemistry student. Contact Dermatitis 48 163-164 Dermatitis 32 171-172 Von Hintzenstern J, Heese A, Koch HU, Peters KP, Hornstein OP (1991) Frequency, spectrum and occupational relevance of type IV allergies to rubber chemicals. Contact Dermatitis 24 244-252

Dehydrocostuslactone

Ducombs G, Benezra C, Talaga P, Andersen KE, Burrows D, Camarasa JG, Dooms-Goossens A, Frosch PJ, Lachapelle JM, Menne T, Rycroft RJG, White IR, Shaw S, Wilkinson JD (1990) Patch testing with the sesquiterpene lactone mix a marker for contact allergy to Compositae and other sesquiterpene-lactone-containing plants. Contact Dermatitis 22 249-252

Diallyl Disulfide

Contact Dermatitis 37 70-77 Lamminpaa A, Estlander T, Jolanki R, Kanerva L (1996) Occupational allergic contact dermatitis caused by decorative plants. Contact Dermatitis 34 330-335 McFadden JP, White IR, Rycroft RJG (1992) Allergic contact dermatitis from garlic. Contact Dermatitis 27 333-334 Bruynzeel DP, van der Wegen-Keijser MH (1993) Contact dermatitis in a cast technician. Contact Dermatitis 28 193-194 Conde-Salazar L, Gonzalez de Domingo MA, Guimaraens D (1994) Sensitization to epoxy resin systems in special flooring workers. Contact Dermatitis 31 157-160 Holness DL, Nethercott JR (1993) The performance of specialized collections of bisphenol A epoxy resin system components in the evaluation of workers in an occupational health clinic population. Contact Dermatitis 28 216-219 Jolanki R, Kanerva L, Estlander T, Tarvainen K, Keskinen H, Henriks-Eckerman ML (1990) Occupational dermatoses from epoxy resin compounds. Contact Dermatitis 23 172-183 Jolanki R,...

Dibutyl Phthalate

Capon F, Cambie MP, Clinard F, Bernardeau K, Kalis B (1996) Occupational contact dermatitis caused by computer mice. Contact Dermatitis 35 57-58 Chieregato C, Vincenzi C, Guerra L, Farina P (1994) Occupational allergic contact dermatitis due to ethylenediamine dihydrochloride and cresyl glycidyl ether in epoxy resin systems. Contact Dermatitis 30 120

Dimethoate

This organophosphorus compound is used as a contact and systemic insecticide and acaricide. It induced an erythema-multiform-like contact dermatitis in a warehouseman in an agricultural consortium. Haenen C, de Moor A, Dooms-Goossens A (1996) Contact dermatitis caused by the insecticides omethoate and dimethoate. Contact Dermatitis 35 54-55 Schena D, Barba A (1992) Erythema-multiforme-like contact dermatitis from dimethoate. Contact Dermatitis 27 116-117

Dimethylol Phenol

Bruze M, Zimerson E (1997) Cross-reaction patterns in patients with contact allergy to simple methylol phenols. Contact Dermatitis 37 82-86 Bruze M, Zimerson E (1985) Contact allergy to 3-methylol phenol, 2,4-dimethylol phenol and 2,6-dimethylol phenol. Acta Derm Venereol (Stockh) 65 548-551

Dipentene

Dipentene corresponds to a racemic mixture of D-limonene and L-limonene. Dipentene can be prepared from wood turpentine or by synthesis. It is used as a solvent for waxes, rosin and gums, in printing inks, perfumes, rubber compounds, paints, enamels, and lacquers. An irritant and sensitizer, dipentene caused contact dermatitis mainly in painters, polishers, and varnishers. Martins C, Gon alo M, Gon alo S (1995) Allergic contact dermatitis from dipentene in wax polish. Contact Dermatitis 33 126-127 Moura C, Dias M, Vale T (1994) Contact dermatitis in painters, polishers and varnishers. Contact Dermatitis 31 51-53

Diphencyprone

Diphencyprone is a potent contact allergen used in topical immunotherapy, to treat some severe alopecia areata. It is responsible for occupational contact dermatitis in chemists and dermatology department staff. diphencyprone in a chemist. Contact Dermatitis 32 363 Temesv ri E, Gonz lez R, Marschalk M, Horv th A (2004) Age dependence of diphenylcyclopropenone sensitization in patients with alopecia areata. Contact Dermatitis 50 381-382 Dermatitis 32 171-172 Von Hintzenstern J, Heese A, Koch HU, Peters KP, Hornstein OP (1991) Frequency, spectrum and occupational relevance of type IV allergies to rubber chemicals. Contact Dermatitis 24 244-252 Bruze M, Kestrup L (1994) Occupational allergic contact dermatitis from diphenylguanidine in a gas mask. Contact Dermatitis 31 125-126 Conde-Salazar L, Del-Rio E, Guimaraens D, Gonzalez Domingo A (1993) Type IV allergy to rubber additives a 10-year study of 686 cases. J Am Acad Dermatol 29 176-180 Kiec-Swierczynska M (1995) Occupational...

Disperse Blue 106

This clothing dye used in synthetic fibers is one of the most potent sensitizers in clothes. Allergic contact dermatitis is relatively frequent in consumers. Occupational textile dye dermatitis was reported in a ready-to-wear shop. Constant concomitant reactions with Disperse Blue 124 are due to their chemical similarities, as with photograph developers CD1, CD2, CD3, and CD4. Menezes-Brandao F, Altermatt C, Pecegueiro M, Bordalo O, Foussereau J (1985) Contact dermatitis to Disperse Blue 106. Contact Dermatitis 13 80-84 Mota F, Silva E, Varela P, Azenha A, Massa A (2000) An outbreak of occupational textile dye dermatitis from Disperse Blue 106. Contact Dermatitis 43 235-236 This clothing dye used in synthetic fibers is one of the most potent sensitizers in clothes. It is a textile dye responsible for occupational contact dermatitis in the textile industry. A positive patch test reaction was observed in a painter sensitized to phthalo-cyanine dyes, with no occupational relevance....

Doxepin

This benzoxepin tricylcic drug has antidepressant, anticholin-ergic, anti-itching, and antihistamine properties. After oral use, it has been developed as a topical anti-itching agent. Allergic contact dermatitis is not infrequent. Buckley DA (2000) Contact allergy to doxepin. Contact Dermatitis 43 231-232 Taylor JS, Praditsuwan P, Handel D, Kuffner G (1996) Allergic contact dermatitis from doxepin cream. One-year patch test clinic experience. Arch Dermatol 132 515-518 Holness DL, Nethercott JR (1993) The performance of specialized collections of bisphenol A epoxy resin system components in the evaluation of workers in an occupational health clinic population. Contact Dermatitis 28 216-219 Rebandel P, Rudzki E (1990) Dermatitis caused by epichlorhydrin, oxpren-olol hydrochloride and propranolol hydrochloride. Contact Dermatitis Van Jost T, Roesyanto ID, Satyawan I (1990) Occupational sensitization to epichlorhydrin (ECH) and bisphenol-A during the manufacture of epoxy resin. Contact...

H2so4h2o

Contact Dermatitis 27 340-341 Galindo PA, Garcia R, Garrido JA, Feo F, Fernandez F (1994) Allergic contact dermatitis from colour developers absence of cross-sensitivity to para-amino compounds. Contact Dermatitis 30 301 Hansson C, Ahlfors S, Bergendorff O (1997) Concomitant contact dermatitis due to textile dyes and to colour film developers can be explained by the formation of the same hapten. Contact Dermatitis 37 27-31 Liden C, Brehmer-Andersson E (1988) Occupational dermatoses from colour developing agents. Clinical and histopathological observations. Acta Derm Venereol (Stockh) 68 514-522 Rustemeyer T, Frosch PJ (1995) Allergic contact dermatitis from colour developers. Contact Dermatitis 32 59-60 Scheman AJ, Katta R (1997) Photographic allergens an update. Contact Dermatitis 37 130

Methylmorphine

Conde-Salazar L, Guimaraens D, Gonzalez M, Fuente C (1991) Occupational allergic contact dermatitis from opium alkaloids. Contact Dermatitis 25 202-203 Estrada JL, Alvarez Puebla MJ, Ortiz de Urbina JJ, Matilla B, Rodriguez Prieto MA, Gozalo F (2001) Generalized eczema due to codeine. Contact Dermatitis 44 185 Waclawski ER, Aldridge R (1995) Occupational dermatitis from thebaine and codeine. Contact Dermatitis 33 51

Paratert Butylphenol

Handley J, Todd D, Bingham A, Corbett R, Burrows D (1993) Allergic contact dermatitis from para-terti'ary-butylphenol-formaldehyde resin (PTBP-F-R) in Northern Ireland. Contact Dermatitis 29 144-146 Mancuso G, Reggiani M, Berdondini RM (1996) Occupational dermatitis in shoemakers. Contact Dermatitis 34 17-22 Shono M, Ezoe K, Kaniwa MA, Ikarashi Y, Kohma S, Nakamura A (1991) Allergic contact dermatitis from para-tertiary-butylphenol-formalde-hyde resin (PTBP-FR) in athletic tape and leather adhesive. Contact Dermatitis 24 281-288 Tarvainen K (1995) Analysis of patients with allergic patch test reactions to a plastics and glue series. Contact Dermatitis 32 346-351

Parthenolide

Hausen BM, Osmundsen PE (1983) Contact allergy to parthenolide in Tanacetum parthenium (L.) Schultz-Bip. (feverfew, Asteraceae) and cross-reactions to related sesquiterpene lactone containing Compositae spe-cies.Acta Derm Venereol (Stockh) 63 308-314 Lamminpaa A, Estlander T, Jolanki R, Kanerva L (1996) Occupational allergic contact dermatitis caused by decorative plants. Contact Dermatitis 34 330-335 Paulsen E, Andersen KE, Hausen BM (1993) Compositae dermatitis in a Danish dermatology department in one year (I). Results of routine patch testing with the sesquiterpene lactone mix supplemented with aimed patch testing with extracts and sesquiterpene lactones of Com-positae plants. Contact Dermatitis 29 6-10

Phenylethyl Caffeate

Lamminpaa A, Estlander T, Jolanki R, Kanerva L (1996) Occupational allergic contact dermatitis caused by decorative plants. Contact Dermatitis Oliwiecki S, Beck MH, Hausen BM (1992) Occupational contact dermatitis from caffeates in poplar bud resin in a tree surgeon. Contact Dermatitis 27 127-128

Phthalic Anhydride

Sensitization among ceramics workers. Contact Dermatitis 22 45-49 Tarvainen K, Jolanki R, Estlander T, Tupasela O, Pf ffli P, Kanerva L (1995) Immunologic contact urticaria due to airborne methylhexahydroph-thalic and methyltetrahydrophthalic anhydrides. Contact Dermatitis 32 204-209

Piroxicam

This nonsteroidal anti-inflammatory drug belongs to the oxicam class. It induces photo-allergic contact dermatitis rather than contact allergy. Systemic photosensitivity is frequent, in patients prev Arevalo A, Blancas R, Ancona A (1995) Occupational contact dermatitis from piroxicam. Am J Contact Dermat 6 113-114 De la Cuadra J, Pujol C, Aliaga A (1989) Clinical evidence of cross-sensitivity between thiosalicylic acid, a contact allergen, and piroxicam, a photoallergen. Contact Dermatitis 21 349-351

Pivampicillin

Pivampicillin is a prodrug of ampicillin. It caused sensitization in 56 workers at a penicillin factory. Pivampicillin and pivmecillinam were responsible for contact dermatitis in pharmaceutical production workers. Ampicillin, mecillinam or amdinocillin, penicillin V and penicillin G were also implicated in cross-reactions. Moller NE, von W rden K (1992) Hypersensitivity to semisynthetic penicillins and cross-reactivity with penicillin. Contact Dermatitis 26 351-352 Moller NE, Nielsen B, von W rden K (1990) Changes in penicillin contamination and allergy in factory workers. Contact Dermatitis 22 106-107

Primin

Primin is the major allergen of Primula obconica Hance (Primula-ceae family). Allergic contact dermatitis is mainly occupational, occurring in florists and horticulturists. from intact Primula obconica plants. Contact Dermatitis 42 149-153 Lamminpaa A, Estlander T, Jolanki R, Kanerva L (1996) Occupational allergic contact dermatitis caused by decorative plants. Contact Dermatitis 34 330-335 Barbaud A, Trechot P, Weber-Muller F, Ulrich G, Commun N, Schmutz JL (2004) Drug skin tests in cutaneous adverse drug reactions to pristi-namycin 29 cases with a study of cross-reactions between synergis-tins. Contact Dermatitis 50 22-26

Propranolol

Pereira F, Dias M, Pacheco FA (1996) Occupational contact dermatitis from propranolol, hydralazine and bendroflumethiazide. Contact Dermatitis 35 303-304 Rebandel P, Rudzki E (1990) Dermatitis caused by epichlorhydrin, Oxprenolol hydrochloride and propranolol hydrochloride. Contact Dermatitis 23 199

Propyl Gallate

This gallate ester (E 311) is an antioxidant frequently used in the food, cosmetic, and pharmaceutical industries to prevent the oxidation of unsaturated fatty acids into rancid-smelling compounds. It causes cosmetic dermatitis mainly from lipsticks and induced contact dermatitis in a baker, and in a female confectioner, primarily sensitized by her night cream, who fried doughnuts -the margarine probably containing gallates. Bojs G, Niklasson B, Svensson A (1987) Allergic contact dermatitis to propyl gallate. Contact Dermatitis 17 294-298 Marston S (1992) Propyl gallate on liposomes. Contact Dermatitis 27 74-76 Serra-Baldrich E, Puig LL, Gimenez Arnau A, Camarasa JG (1995) Lipstick allergic contact dermatitis from gallates. Contact Dermatitis 32

Pyrethrosin

Mitchell JC, Dupuis G, Towers GHN (1972) Allergic contact dermatitis from pyrethrum (Chrysanthemum spp.). The roles of pyrethrosin, a sesquiterpene lactone, and of pyrethrin II. Br J Dermatol 86 568-573 Paulsen E, Andersen KE, Hausen BM (1993) Compositae dermatitis in a Danish dermatology department in one year (I). Results of routine patch testing with the sesquiterpene lactone mix supplemented with aimed patch testing with extracts and sesquiterpene lactones of Compositae plants. Contact Dermatitis 29 6-10

Pyridine

Pyridine (unsubstituted pyridine) and its derivative (substituted pyridines) are widely used in chemistry. Pyridine is a solvent used for many organic compounds and anhydrous metallic salt chemicals. Contained in Karl Fischer reagent, it induced contact dermatitis in a laboratory technician. No cross-sensitivity is observed between those different substances. Knegt-Junk C, Geursen-Reitsma L, van Joost T (1993) Allergic contact dermatitis from pyridine in Karl Fischer reagent. Contact Dermatitis 28 252

Quaternium22

Le Coz CJ, Leclere JM, Arnoult E, Raison-Peyron N, Pons-Guiraud A, Vigan M, Members of Revidal-GERDA (2002) Allergic contact dermatitis from shellac in mascara. Contact Dermatitis 46 149-152 Scheman AJ (1998) Contact allergy to quaternium-22 and shellac in mascara. Contact Dermatitis 38 342-343

Ranitidine

Ranitidine, an H2-receptor antagonist, can cause contact dermatitis within the pharmaceutical industry and in healthcare workers, or may induce systemic drug reactions in patients. Martinez MB, Salvador JF, Aguilera GV, Mas IB, Ramirez JC (2003) Acute generalized exanthematous pustulosis induced by ranitidine hydrochloride. Contact Dermatitis 49 47 Romaguerra C, Grimalt F, Vilaplana J (1988) Epidemic of occupational contact dermatitis from ranitidine. Contact Dermatitis 18 177-178

Rubber Chemicals

Strong allergic patch test reactions to a fresh dilution series of a metalworking fluid brought in by a patient with chronic occupational hand eczema (use concentration at the work place was 6 in water). He also showed positive reactions to colophony (2+), abietic acid (3+), mono-ethanolamine (1+), and 2-(2-aminoethoxy)ethanol (diglycolamine) (1+). These materials are often present in metalworking fluids and may cause relevant sensitizations

Skin Tests

Lipstick Irritant Dermatitis

Severe cheilitis with eczema-tous pruritic lesions in the perioral region after long-term use of a lipstick for dry lips (a). The patch test with the lipstick as is in a large Finn chamber showed a weak doubtful reaction (b). Breakdown testing with the ingredients provided by the manufacturer revealed a contact allergy to dexpan-thenol. The dermatitis cleared rapidly after discontinuance of the lipstick

Solvent

Solvent Red 23 is an oil-soluble red azo-dye used in cosmetic products in Japan. Cases were reported in hairdressers, who also reacted to PPD (the molecule is likely to be hydrolyzed into PPD) and to p-aminoazobenzene. One case of contact dermatitis was reported in the metal industry. Fregert S (1967) Allergic contact dermatitis due to fumes from burning alcohol containing an azo-dye. Contact Dermatitis Newslett 1 11 Matsunaga K, Hayakawa R, Yoshimura K, Okada J (1990) Patch-testpositive reactions to Solvent Red 23 in hairdressers. Contact Dermatitis 23 266

Spectinomycin

Dal Monte A, Laffi G, Mancini G (1994) Occupational contact dermatitis due to spectinomycin. Contact Dermatitis 31 204-205 Vilaplana J, Romaguera C, Grimalt F (1991) Contact dermatitis from linco-mycin and spectinomycin in chicken vaccinators. Contact Dermatitis 24 225-226

Tetrazepam

Tetrazepam is a benzodiazepine compound used systemically as a myorelaxant. It may induce skin rashes such as maculo-papular eruption, Stevens-Johnson syndrome or photosensitivity. Occupational sensitization can be observed in pharmaceutical plants. Sensitization generally does not concern other benzodiazepines (personal observations). Barbaud A, Trechot P, Reichert-Penetrat S, Granel F, Schmutz JL (2001) The usefulness of patch testing on the previously most severely affected site in a cutaneous adverse drug reaction to tetrazepam. Contact Dermatitis 44 259-260 Choquet-Kastylevsky G, Testud F, Chalmet P, Lecuyer-Kudela S, Descotes J (2001) Occupational contact allergy to tetrazepam. Contact Dermatitis 44 372

Thebaine

It is used in the manufacture of other opiate pharmaceuticals, such as buprenorphine and morphine, and caused contact dermatitis in a laboratory worker at an opiates manufacturing pharmaceutical company, also sensitive to codeine. Waclawski ER, Aldridge R (1995) Occupational dermatitis from thebaine and codeine. Contact Dermatitis 33 51

Thiabendazole

Izu R, Aguirre A, Goicoechea A, Gardeazabal J, Diaz Perez JL (1993) Photo-aggravated allergic contact dermatitis due to topical thiabendazole. Contact Dermatitis 28 243-244 Mancuso G, Staffa M, Errani A, Berdondini RM, Fabri P (1990) Occupational dermatitis in animal feed mill workers. Contact Dermatitis 22

Thiocarbamide

Thiourea is used as a cleaner agent for silver and copper, and as an antioxidant in diazo copy paper. It can induce (photo-)contact dermatitis. Dooms-Goossens A, Debusschere K, Morren M, Roelandts R, Coopman S (1988) Silver polish another source of contact dermatitis reactions to thiourea. Contact Dermatitis 19 133-135 Geier J, Fuchs T (1993) Contact allergy due to 4-N,W-dimethylamino-benzene diazonium chloride and thiourea in diazo copy paper. Contact Dermatitis 28 304-305 Kanerva L, Estlander T, Jolanki R (1994) Occupational allergic contact dermatitis caused by thiourea compounds. Contact Dermatitis 31 242-248

Toluene25Diamine

Toluene-2,5-diamine is a permanent hair dye involved in contact dermatitis in hairdressers and consumers. It does not cross-react with PPD, but co-sensitization is frequent. Frosch PJ, Burrows D, Camarasa JG, Dooms-Goossens A, Ducombs G, Lahti A, Menne T, Rycroft RJG, Shaw S, White IR, Wilkinson JD (1993) Allergic reactions to a hairdresser's series results from 9 European centres. Contact Dermatitis 28 180-183 Guerra L, Tosti A, Bardazzi F, Pigatto P, Lisi P, Santucci B, Valsecchi R, Schena D,Angelini G, Sertoli A,Ayala F, Kokelj F (1992) Contact dermatitis in hairdressers the Italian experience. Gruppo Italiano Ricerca Dermatiti da Contatto e Ambientali. Contact Dermatitis 26 101-107 Le Coz CJ, Lefebvre C, Keller F, Grosshans E (2000) Allergic contact dermatitis caused by skin painting (pseudotattooing) with black henna, a mixture of henna and p-phenylenediamine and its derivatives. Arch Dermatol 136 1515-1517

Trolamine

Blum A, Lischka G (1997) Allergic contact dermatitis from mono-, di- and triethanolamine. Contact Dermatitis 36 166 Le Coz CJ, Scrivener Y, Santinelli F, Heid E (1998) Sensibilisation de contact au cours des ulc res de jambe. Ann Dermatol Venereol 125 694-699 Scheman AJ, Katta R (1997) Photographic allergens an update. Contact Dermatitis 37 130

Tuliposide A

Christensen LP, Kristiansen K (1995) A simple HPLC method for the isolation and quantification of the allergens tuliposide A and tulipalin A in Alstroemeria. Contact Dermatitis 32 199-203 Gette MT, Marks JE (1990) Tulip fingers.Arch Dermatol 126 203-205 Lamminp A, Estlander T, Jolanki R, Kanerva L (1996) Occupational allergic contact dermatitis caused by decorative plants. Contact Dermatitis 34 330-335

Tylosin

Contact Dermatitis 20 308-309 Carafini S, Assalve D, Stingeni L, Lisi P (1994) Tylosin, an airborne contact allergen in veterinarians. Contact Dermatitis 31 327-328 Guerra L,Venturo N, Tardio M, Tosti A (1991) Airborne contact dermatitis from animal feed antibiotics. Contact Dermatitis 25 333-334 Tuomi ML, Rasanen L (1995) Contact allergy to tylosin and cobalt in a pig-farmer. Contact Dermatitis 33 285

Urushiol

Kawai K, Nakagawa M, Kawai K, Konishi K, Liew FM, Yasuno H, Shimode Y, Shimode Y (1991) Hyposensitization to urushiol among Japanese lacquer craftsmen. Contact Dermatitis 24 146-147 Kullavanijaya P, Ophaswongse S (1997) A study of dermatitis in the lacquer-ware industry. Contact Dermatitis 36 244-246

Vinylpyridine

4-Vinyl pyridine was used as a monomer in polymer chemistry and induced nonimmunological contact urticaria, and allergic contact dermatitis. No cross-reactivity is observed between pyri-dine derivatives. in a laboratory worker. Contact Dermatitis 40 280-281 Foussereau J, Lantz JP, Grosshans E (1972) Allergic eczema from vinyl-4- pyridine. Contact Dermatitis Newslett 11 261 Sasseville D, Balbul A, Kwong P,Yu K (1996) Contact sensitization to pyridine derivatives. Contact Dermatitis 35 101-102 Dermatitis 11 41-42 Tennstedt D, Dumont-Fruytier M, Lachapelle JM (1978) Occupational allergic contact dermatitis to virginiamycin, an antibiotic used as a food additive for pigs and poultry. Contact Dermatitis 4 133-134

Nicotine

Nicotine is an alkaloid found in tobacco, and is responsible for its pharmacological effects and addiction. Contact dermatitis from nicotine, considered as rare, has been more frequent since its use in transdermal systems. Irritant dermatitis is mainly encountered, as contact urticaria seems to be rare. Allergic contact dermatitis, sometimes generalized, has been reported, with positive patch testing to nicotine base (10 ethanol or petrolatum). No consequences have been reported in patients who start smoking again after skin sensitization. a transdermal therapeutic system. Contact Dermatitis 25 230-236 Vincenzi C, Tosti A, Cirone M, Guarrera M, Cusano F (1993) Allergic contact dermatitis from transdermal nicotine systems. Contact Dermatitis 29 104-105

Evaluation of Eyelid Lesions

Fluid Filled Cyst Eyelid

Eyelid lesions are classified according to the anatomic structures from which they arise. These include the epidermis, dermis, and various cells and adnexal structures within these layers. Eyelid inflammations may present as a localized or diffuse erythematous area. They can be associated with ulceration, induration, eczematous changes, necrosis, edema, or loss of eyelashes. If skin contraction occurs the eyelid margins may be malpositioned manifesting as an ectropion or canthal angle dystopia. Inflammatory lesions may be painful and at times can be associated with lymphadenopathy. Infectious conditions of the eyelid result from viral, bacterial, fungal or parasitic processes and may be primary or secondary. The latter can result as extensions from head and neck foci such as the sinuses or lacrimal sac, or from hematoge-nous spread from distant sites. The cause of the infection on the eyelid is often evident, such as in a site of trauma or recent surgery. However, when the infection...

Eyelid Lesions and Tissues of Origin

Lymphatic Endothelial Cells Dermis

All lesions that involve the eyelids or any other region of the body can be thought of as deriving from two basic sources. Those that arrive in the lids from other more remote sources are exogenous lesions. These include metastatic tumors from sites such as the breast or lung. Also included here are infiltrations in the dermis and epidermis of cellular or other materials that secondarily involve eyelid structures. Included here are diseases such as amyloidosis, sarcoidosis, infectious inflammations such as herpes and cellulitis, xanthelamas, acute atopic dermatitis, erythema multiforme, granuloma annulare, and lymphoid and myeloid infiltrates. All exogenous lesions disturb the normal eyelid architechture to some extent, and may be generalized or confined to specific eyelid tissue types.

Background Information

In the normal murine (and human) epidermis, MHC class Il-expressing Langerhans cells are critical in both the afferent (sensitiza-tion) and efferent (elicitation) phases of contact hypersensitivity. Langerhans cells are derived from bone marrow stem cells and are critical cells in antigen presentation. The epicutaneous application of hapten is thought to chemically modify cell-surface molecules of Langerhans cells, which then migrate to regional lymph nodes and initiate a primary response to the hapten in an MHC-restricted manner. A second epicutaneous application of the hapten again modifies the surface of epidermal Langerhans cells, which then present the hapten in association with self-class II MHC molecules and recruit and activate antigen-specific T cells to the involved skin. These activated T cells produce a variety of cytokines and are thought to be responsible for the efferent phase of contact hypersensitivity ear swelling response (in mice) and allergic contact dermatitis...

Dermatologic Physical Examination

Example Physical Exam Form

Learn to internalize what you are observing. It is easy to look at a skin rash but not really see it. Look for and think about each of the distinguishing characteristics of the lesion. An epidermal thickening with a surface pattern of accentuated skin lines. Lichenification is caused by chronic repeated low-grade rubbing or scratching and implies the presence of severe pruritus or dysesthesia. It is characteristically, but not exclusively, found in cases of atopic dermatitis (see Photo 22). 1. Skin surface temperature by feel gives a clue as to the degree of blood flow. An inflammatory skin condition such as an eczema is red due to vasodilation but is not warm like 5. Stroking the skin surface firmly with either a fingernail or a blunt instrument will reveal features such as the exaggerated triple response of Lewis seen in immediate dermo-graphism or white dermographism, which is characteristic of atopic dermatitis. The same maneuver applied to most lesions of cutaneous mastocytosis...

Otoscopy Facial Nerve

Exostosis Ear Otoscopy

Pathologies 20 Eczema Eczema is a dermo-epidermal process of reactive nature resulting from local or general factors. Local factors include allergy, topical medical preparations, or cosmetics, whereas general factors include hepatic or gastrointestinal dysfunction. It manifests by itching, a bur-ning sensation, vesication, and sometimes serous otorrhea. Treatment consists of discontinuation the suspected causative irritant, correction of the systemic disturbances, as well as lavage with boric acid with alcohol and steroid lotion. Figure 3.25 Right ear. Chronic eczema of the external auditory canal. Squamous debris covering the skin of the external auditory canal can be noted. Successfully treated by the use of local steroid lotion. Figure 3.25 Right ear. Chronic eczema of the external auditory canal. Squamous debris covering the skin of the external auditory canal can be noted. Successfully treated by the use of local steroid lotion.

Safety Precautions For Using Vaccinia

To prevent laboratory infections, the Centers for Disease Control (CDC) and the National Institutes of Health (NIH) recommend that individuals who come into contact with vaccinia virus receive vaccinations at 10-year intervals (Richmond and McKinney, 1993). The CDC has supplied vaccine for such purposes when requested by qualified health workers. Eczema or an immunodeficiency disorder in the laboratory worker or a close contact, however, may be a contraindication to vaccination, which should only be given under medical supervision. The benefits of routine vaccination for healthy investigators have also been questioned (Baxby, 1989 Wenzel and Nettelman, 1989). Vaccinia virus is very stable and parenteral inoculation, ingestion, and droplet or aerosol exposure of mucous membranes are the primary hazards to laboratory or animal care personnel. Standard biosafety level 2 (BL-2) practices and class I or II biological safety cabinets should be employed (Richmond and McKin-ney, 1993). The...

Molluscum Contagiosum Dimple Warts

Warts Pubic Area

In children, and occasionally in young adults, eczematous patches will develop within the regions of activity. The eczema is identical to patches of atopic dermatitis and, if left untreated, the resultant excoriations can lead to dissemination of the MC infection. Whether this represents an exacerbation of latent atopic disease or a delayed immune response to the virus is uncertain. Atopic dermatitis patients do seem to have an increased incidence of MC. As lesions evolve, some will enlarge rapidly, become edematous and dusky red, and form a yellow or dark crust. In patients with associated eczema, excoriations are usually present and may cause mild scarring, as can overly exuberant treatment. Solitary large lesions are rare and may simulate a keratoacanthoma, squamous cell carcinoma, or basal cell carcinoma. These are more common in HIV disease. In HIV-positive patients, lesions of disseminated cryptococcosis, histoplasmosis, or cutaneous coccidioidomycosis can resemble MC lesions,...

Bullous Lesions in Lupus Erythematosus

Lupus Tumidus

Bullous pemphigoid or may resemble the vesiculobullous lesions of dermatitis herpetiformis. If the bullous lesions rupture, they leave erosions, crusts, and pigmentary changes, and when they regress, scars, milium cysts, or calcinosis cutis can remain (Eckman and Mutasim 2002). In this form of bullous skin lesions, the activity of blistering may or may not coincide with the activity of the patient's systemic disease, and occasionally, mild and serious cases associated with organ-threatening disease have been reported (Gammon and Briggaman 1993, Sontheimer 1997). An important and interesting feature of these patients is also the dramatic response to treatment with dapsone even with very small doses (Hall et al. 1982, Yung and Oakley 2000). However, the drug could not be tapered and discontinued without rapid recurrence of the lesions. In a recent study, the efficacy of methotrexate in bullous SLE has also been reported in one patient (Malcangi et al. 2003). Histologically, the...

Microdistribution None

Scabies must be considered in the differential diagnosis of any generalized pruritic skin disorder especially with a history of nocturnal itching that interrupts sleep. Atopic dermatitis, generalized drug reactions, and widespread impetigo all show common features. A high index of suspicion that leads to a search for primary lesions is important to maintain. Crusted scabies can simulate eczema, psoriasis, or on rare occasions, an ery-throderma.

Linear Iga Bullous Disease And Chronic Bullous Disease Of Childhood

Linear IgA bullous disease is an acquired autoimmune blistering disease that may be idiopathic or drug induced. In children the disease is referred to as chronic bullous disease of childhood. Cutaneous lesions of linear IgA bullous disease (LABD) are usually nonscarring blisters, often extensive on trunk and extremities. They are characterized by the cluster of jewels sign, with vesicles and bullae at edges of polycylic lesions (Fig. 7A). Linear IgA bullous disease resembles dermatitis herpetiformis or bullous pem-phigoid, but is usually not symmetric. Patients with LABD may occasionally have ocular involvement that can be indistinguishable from mucous membrane pemphigoid. Chronic bullous disease of childhood has a predilection for vesicles and blisters in the diaper area. Bullous lupus erythematosus bullous pemphigoid dermatitis herpetiformis

Curing Eczema Naturally

Curing Eczema Naturally

Do You Suffer From the Itching, Redness and Scaling of Chronic Eczema? If so you are not ALONE! It strikes men and women young and old! It is not just

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