RESUMO
Brazilian peppertree (Schinus terebinthifolia), a member of the Anacardiaceae family, has invaded territory throughout the world, including the southeastern and western United States. Similar to fellow family members poison ivy and poison oak, Brazilian peppertree causes allergic contact dermatitis (ACD) in susceptible individuals. As this pest increases its range, dermatologists living in endemic areas should familiarize themselves with Brazilian peppertree, its effects on the skin, and how to treat any associated ACD.
Assuntos
Dermatite Alérgica de Contato , Humanos , Dermatite Alérgica de Contato/etiologia , Dermatite Alérgica de Contato/diagnóstico , Brasil , SchinusRESUMO
INTRODUCTION: Atopic dermatitis (AD) is a chronic and relapsing inflammatory skin disease mainly affecting children. Similarly, Allergic contact dermatitis (ACD) is an inflammatory skin disease, but unlike AD it results from direct exposure to an external agent. Theoretically, the impaired skin barrier facilitates the penetration of potential allergens. Therefore, AD patients are at risk for an associated ACD, exacerbating their skin condition. Because eczema is similar, performing a patch test (PT) for the differential diagnosis is essential. METHODS: In this cross-sectional transversal study, we performed a PT with 30 sensitizers in 26 children with AD, selected according to established criteria for suspected ACD, and treated at an AD center of a pediatric university hospital in Rio de Janeiro. Clinical presentation, patient profile, main sensitizers, and frequency of ACD caused by therapeutic skincare products were evaluated. RESULTS: In all, 23 (88.5%) patients reacted to at least one allergen, 21 (80.7%) had a relevant positive patch test, and 15 (57.7%) were polysensitized. The main positive sensitizers were nickel (38.5%), blue disperse (30.8%), fragrance mix (30.8%), and neomycin (23.1%). Nineteen (73%) patients reacted to substances present in therapeutic or skincare products. CONCLUSION: Our data underscore the importance of performing a PT in AD children whose eczema has atypical distribution. The expressive percentage of positive tests, especially of allergens in skincare products, indicates the constant need to review the proposed treatments. Therefore, we recommend a specific and expanded PT battery for pediatric AD patients, including a negative control, to increase sensitivity for diagnosing ACD.
Assuntos
Alérgenos , Dermatite Atópica , Testes do Emplastro , Humanos , Testes do Emplastro/métodos , Estudos Transversais , Dermatite Atópica/diagnóstico , Dermatite Atópica/imunologia , Criança , Feminino , Masculino , Brasil , Alérgenos/imunologia , Pré-Escolar , Adolescente , Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/imunologia , Lactente , Diagnóstico DiferencialRESUMO
BACKGROUND: Hand eczema (HE) is a highly prevalent, recurrent, and multifactorial disease. It encompasses a group of eczematous diseases that affect the hands, etiologically classified into irritant contact dermatitis (ICD), allergic contact dermatitis (ACD) and atopic dermatitis (AD). Few epidemiological studies in Latin America have investigated the characteristics of patients with this condition and the origin of the disease. OBJECTIVES: To analyze the profile of patients diagnosed with HE submitted to patch tests aiming to determine its etiology. METHODS: A retrospective descriptive study was carried out on epidemiological data and patch tests of patients with HE treated at a tertiary hospital in the city of São Paulo from January 2013 to December 2020. RESULTS: A total of 173 patients were studied, whose final diagnosis was 61.8% of ICD, 23.1% of ACD and 5.2% of AD, with diagnostic overlap in 42.8% of the cases. The main positive and relevant patch tests were: Kathon CG (42%), nickel sulfate (33%), and thiuram mix (18%). STUDY LIMITATIONS: The number of treated cases and socioeconomic profile was limited to a vulnerable population group. CONCLUSION: HE is a diagnosis in which overlapping etiologies are frequent, with the main sensitizers identified in ACD being Kathon CG, nickel sulfate and thiuram mix.
Assuntos
Dermatite Alérgica de Contato , Dermatite Atópica , Dermatite Irritante , Eczema , Humanos , Estudos Retrospectivos , Tiram , Testes do Emplastro , Brasil/epidemiologia , Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/epidemiologia , Dermatite Alérgica de Contato/etiologia , Eczema/diagnóstico , Eczema/epidemiologia , Eczema/induzido quimicamente , Dermatite Atópica/diagnóstico , Dermatite Atópica/epidemiologia , Dermatite Irritante/diagnóstico , Dermatite Irritante/epidemiologia , Dermatite Irritante/etiologia , Alérgenos/efeitos adversosRESUMO
Propolis is a lipophilic resin extracted from plants by bees. The purpose of this case report was to show the importance of this substance as cause of allergic contact cheilitis. A 21-year-old female patient complained of pruritic perioral eczema for 5 years. In the past months it also affected the neck. After diagnosing contact dermatitis, she was submitted to a patch test with a Latin American baseline series. The result was strongly positive for propolis (++) and weakly positive for perfume mix I (+). After the test, the patient revealed she had been using propolis drops, per oris, for 10 years. The worsening of the condition was due to increased dose, aiming "to improve immunity", during the coronavirus disease 2019 (COVID-19) pandemic. The contact allergy to propolis might be increasing due to the widespread use of natural products. Propolis is a sensitizer to be considered in patients with long-lasting cheilitis.
Assuntos
COVID-19 , Queilite , Dermatite Alérgica de Contato , Própole , Queilite/induzido quimicamente , Queilite/complicações , Queilite/diagnóstico , Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/etiologia , Feminino , Humanos , Própole/efeitos adversos , SARS-CoV-2RESUMO
ABSTRACT Propolis is a lipophilic resin extracted from plants by bees. The purpose of this case report was to show the importance of this substance as cause of allergic contact cheilitis. A 21-year-old female patient complained of pruritic perioral eczema for 5 years. In the past months it also affected the neck. After diagnosing contact dermatitis, she was submitted to a patch test with a Latin American baseline series. The result was strongly positive for propolis (++) and weakly positive for perfume mix I (+). After the test, the patient revealed she had been using propolis drops, per oris, for 10 years. The worsening of the condition was due to increased dose, aiming "to improve immunity", during the coronavirus disease 2019 (COVID-19) pandemic. The contact allergy to propolis might be increasing due to the widespread use of natural products. Propolis is a sensitizer to be considered in patients with long-lasting cheilitis.
Assuntos
Humanos , Feminino , Própole/efeitos adversos , Queilite/complicações , Queilite/diagnóstico , Queilite/induzido quimicamente , Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/etiologia , COVID-19 , SARS-CoV-2RESUMO
Surfactants, many of which are used as detergents, can be found in many common household items, such as shampoos, conditioners, soaps, and cosmetics. One should recognize the multitude of surfactants that are used in today's products to identify any potential allergic contact dermatitis (ACD) or irritant contact dermatitis (ICD). Given their abundance in everyday products, it is understandable that many cases of occupational contact dermatitis that arise can be attributed to surfactants. The products most connected with ACD are cocamidopropyl betaine, oleamidopropyl dimethylamine, decyl glucoside, 3-dimethylaminopropylamine, amidoamine, and cocamide diethanolamine. Similarly, the most common surfactant-related causes of ICD are sodium lauryl sulfate and benzalkonium chloride. It is important for dermatologists to identify the causes and differentiate between the two, to adjust treatments and products accordingly. Here, the most frequently used surfactants, as well as their correlation between ACD and ICD, will be reviewed.