Contact allergy to corticosteroids

This article describes a rare case of granuloma of the lacrimal sac, which was treated with dacryocistorhinostomy and glabellar flap. In addition, the possible etiologic factors, the differential diagnosis and reconstructive techniques indicated in such cases are described.     

Contact allergy to cocamidopropyl betaine

Cocamidopropyl betaine is an amphoteric surfactant used increasingly in cosmetic products. We describe 20 cases of cosmetic allergy to cocamidopropyl betaine; all were caused by shampoo or shower gel. 8 patients were hairdressers, who had occupational allergic contact dermatitis from shampoos. We recommend patch testing cocamidopropyl betaine 1% aq. routinely in hairdressers with dermatitis of the hands, and in all patients suspected of suffering from cosmetic allergy.     

Contact allergy to eyedrops containing beta-blockers]

In six patients (4 women aged 80, 62, 43 and 52 years and 2 men aged 58 and 51 years), who used eyedrops containing beta-blockers for the treatment of glaucoma, allergic contact dermatitis of the eyelids was diagnosed. Three were allergic to metipranolol, 2 to levobunolol and 1 to timolol. In literature, less than 50 cases of hypersensitivity to beta-blockers in eye medication have been reported. There are, however, reasons to assume that sensitization is more frequent: (a) not all patients are referred by the ophthalmologist to the dermatologist; (b) false-negative reactions to patch tests with the commercial preparations and with beta-blockers are not infrequent; (c) they are not routinely tested because beta-blockers are difficult to obtain in pure form; (d) cross-reactions with other beta-blockers are infrequent, and changing to another preparation therefore usually solves the clinical problem. Nevertheless it is advisable to test a battery of beta-blockers (befunolol, levobunolol, metipranolol, timolol) in allergic patients. A test preparation of 2% in water or 3%-10% in petrolatum may be suitable. Control testing in non-exposed individuals is necessary to exclude irritation reactions.     

Contact allergy to aluminium in 2 brothers

A 10-year-old boy reacted to aluminium Finn Chambers during routine patch testing. Further patch tests with aqueous aluminium chloride confirmed contact allergy to aluminium. The boy's 8-year-old brother also reacted to aluminium Finn Chambers. Both boys had suffered from a scaling eruption on their face and limbs since infancy.     

Contact allergy in children

We examined the genomic status of the p16INK4A (inhibitor of cyclin-dependent kinase 4 A) and cyclin-dependent kinase 4 (CDK4) genes in 62 human hepatocellular carcinomas (HCCs), 5 cholangiocellular carcinomas and 6 cell lines derived from human liver cancers. Although no samples showed the homozygous deletion of the p16INK4A gene, we detected intragenic mutations of the p16INK4A gene in 3 HCCs and one HCC cell line, which led to an amino-acid substitution or a frameshift. In 2 HCC samples with mis-sense mutations of the p16INK4A gene, loss of heterozygosity on 9p22 was also detected, suggesting that the loss of function of p16 was induced during hepatocarcinogenesis. On the other hand, amplification or rearrangement of the CDK4 gene was not detected in any samples examined in this study. These results indicated that the mutations or deletions of the p16INK4A gene are not frequent, but may play a role in a sub-set of human HCC.     

Contact allergy to 2,4,6-tris(dimethylaminomethyl)phenol

The use of saliva samples is an alternative to blood samples when a large number of control samples are to be compared by DNA investigations. The most convenient and safe method is by using cotton wool swabs. In this investigation the average DNA content of saliva samples taken by three different sampling techniques (i. e. cotton wool swab, filter paper, liquid saliva) was compared. In addition the possibility of a DNA mixture of saliva samples after intensive kissing was investigated by taking samples from voluntary pairs. Mixed STR patterns were found in five samples but restricted to the first sampling after kissing within max. 60 s.     

Contact allergy to gold and gold therapy in patients with rheumatoid arthritis

Patients with rheumatoid arthritis were investigated for contact allergy to gold in connection with treatment with gold preparations. There were 57 patients with rheumatoid arthritis previously treated with gold, with or without cutaneous side-effects, as well as 20 patients intended for such treatment; all were exposed to patch and intradermal tests with gold sodium thiosulfate, gold sodium thiomalate and auranofin. Contact allergy to gold was demonstrated in 8 out of 77 patients (10.4%). In the retrospective material, gold allergy was found in 1.8%, in the prospective material in 35.0%. Contact allergy to gold is very frequent among patients with rheumatoid arthritis before gold therapy. In order to avoid early hypersensitivity reactions skin tests should be carried out before gold therapy is instituted.     

Contact allergy to the monomers of p-tert-butylphenol-formaldehyde resin in the guinea pig

Bacterial products are thought to induce labor by stimulating the production of pro-inflammatory cytokines and prostaglandins in gestational tissues, leading to the onset of preterm parturition. Progesterone withdrawal is a prerequisite of parturition in many species. Yet a role for progesterone in the mechanisms responsible for preterm parturition, in the setting of infection, is unclear. The current studies were conducted to determine if a fall in serum progesterone concentrations occurs before the onset of bacterial product-induced preterm parturition in animals. Accordingly, pregnant mice at day 15 (70% gestation) were injected i.p. with Escherichia coli lipopolysaccharide (LPS; 50 microg/mouse) and timed-pregnant rabbits were inoculated transcervically with a suspension of E. coli to cause an ascending intrauterine infection. Control animals in both groups received equal volumes of sterile phosphate-buffered saline (PBS) solution. Blood specimens were collected at regular intervals and serum progesterone levels were determined by RIA. Within 14 h of LPS administration, mice delivered their pups. The median concentrations of serum progesterone were significantly lower at 1 h, 4 h, 10 h, and at the onset of preterm parturition (11-12 h) after LPS injection, compared to that in animals given PBS. Similarly, E. coli-inoculated rabbits delivered 1-2 days posttranscervical inoculation and demonstrated 60% decrease in serum progesterone within 12-24 h of inoculation compared to those given PBS. Parturition in both control groups occurred at term, following typical progesterone withdrawal. It is concluded that LPS administration to pregnant mice and ascending intrauterine infection in pregnant rabbits is associated with a dramatic fall in serum progesterone concentrations prior to the onset of parturition.     

Contact allergy to topical corticosteroids and systemic contact dermatitis from prednisolone with tolerance of triamcinolone

We report the case of a 27-year-old female who had an allergic contact dermatitis to topical corticosteroids belonging to the corticosteroid groups A and D. Upon oral treatment with prednisolone a disseminated exanthema began within 24 h. Patch tests revealed sensitization to corticosteroids of group A, C and D, including prednisolone-21-acetate and betamethasone valerate, but not of group B corticosteroids such as triamcinolone. After intradermal testing of corticosteroids the exanthema flared again and the patient was treated with oral triamcinolone, with rapid improvement of her symptoms. A literature review revealed that exanthematous reactions after systemic treatment with corticosteroids have been rarely reported. Since corticosteroids are essential emergency drugs, a safe corticosteroid should be identified for such patients. Patch and intradermal tests may be used for that purpose.     

Approaches to otolaryngic allergy emergencies

The otolaryngic allergist should take every measure possible to prevent reactions during testing and treatment of the allergic patient. Because the risk of this rare complication cannot be completely eliminated, however, it is essential to be prepared for prompt recognition and proper treatment of an anaphylactic emergency. An emergency set, including airway management tools, oxygen, intravenous materials, and proper medication, is essential. The entire office staff should be educated to cope with the emergency. Finally, a medication history must be repeated at intervals to detect patients who are receiving beta blockers to either remove them from the patients' treatment regimen or to prepare for the special treatment of the patients on beta blockers.     

Severe allergy to sorbolene cream

One of the principles of primary health care is intersectoral co-ordination. A cross sectional study done at the primary health center revealed existence of unsatisfactory co-ordination between health and education department.     

Allergy to nuts and allergy to birch

Among 527 children and young in age from 2 months to 19 years of life it has been separated the group 70 with increased specific IgE levels to hazelnuts or/and to peanuts. In them it has been determined specific IgE to pollen birch and it has been make correlation the results with the symptoms. Specific IgE has been determined immunoenzymatic Visagnost Tosse Diagnostika method. The control group stand 34 children in the same age with the infections symptoms. In the infants group--13 (59.1%) had sIgE to birch, in children 2-3 age group--15 (75%), in 406 age--8 (72.7%), in the school age--7 (87.5%) and in young > 16 age--8 (88.9%). In the control group found absence sIgE to each of examination allergens. In 5 infants in the time of the pollen birch (April 1993) it has been manifestation dyspnoea. In group 2-3 age--in 10 (45.5%) found pollinosis symptoms, 12 (60%) had asthmatic dyspnoea, 7 (35%) atopic dermatitis, 2 (10%) allergic rhinoconjunctivitis and 5 (25%) abdominal pain with concomitant dyspnoea. It has been characteristic, that never found one of clinical allergic symptoms. In group 5-6 age and 7-15 age it has been dominated atopic dermatitis (63.3% and 87.5%), pollen asthma (45.4% and 62.5%) and pollinosis (45.4% and 25%). While in young 16 age--8 (88.8%) had pollinosis, 5 (55.5%) had atopic dermatitis and pollinosis. The conclusion: 1. In children which had specific IgE to nuts increased together with age specific IgE to birch. 2. The gravely pollinosis symptoms appear in small children in 1-2 age of life, already.(ABSTRACT TRUNCATED AT 250 WORDS)     

Toxicity and allergy to local anesthesia

Considering the amount of local anesthetic administered on a daily basis, dental professionals must be familiar with the factors that influence the dose and type of local anesthetic that induces a toxic or allergic reaction. In addition to the route and rate of administration, the patient's physical condition and health may also influence the dose of local anesthetic that could be safely administered. This article reviews the different causes of local anesthesia toxicity and allergy. With prevention and early recognition of the warning signs, poor prognosis can be avoided.