Contact dermatitis.

Contact dermatitis (CD) is among the most common inflammatory dermatological conditions and includes allergic CD, photoallergic CD, irritant CD, photoirritant CD (also called phototoxic CD) and protein CD. Occupational CD can be of any type and is the most prevalent occupational skin disease. Each CD type is characterized by different immunological mechanisms and/or requisite exposures.

Comparison of Nickel Sulfate 2.5% and Nickel Sulfate 5% for Detecting Nickel Contact Allergy.

Background: Nickel is among the most common contact allergens found on patch testing worldwide and, because of its ubiquitous nature in our environment, often has important implications for allergen avoidance strategies. In both North America and Europe, nickel positivity is found in approximately 20% of patients who undergo patch testing. Whereas in North America, nickel sulfate is typically tested at a concentration of 2.

A case series of dupilumab-treated allergic contact dermatitis patients.

Atopic dermatitis is characterized by skin barrier abnormalities and immune dysregulation with increased T 2 signaling playing a central role. Investigations of allergic contact dermatitis suggest that certain allergens may also activate particular T cell signatures such as T 2-dominant responses to fragrance and rubber. We present a case series of patients with allergic contact dermatitis who were successfully treated with dupilumab, a biologic developed for atopic dermatitis that dampens T 2 signaling.

Benzalkonium Chloride: An Irritant and Sensitizer.

Background: Benzalkonium chloride (BAK) is a known irritant, and potentially cross-reacting quaternary ammonium compounds are commonly used as preservatives in personal care products.

Objective: The aim of the study was to review positive reactions to BAK in 615 patients patch tested for suspected allergic contact dermatitis.

Methods: A retrospective chart review was performed in 615 patients patch tested from June 2015 to October 2016.

Patch Testing for Evaluation of Hypersensitivity to Implanted Metal Devices: A Perspective From the American Contact Dermatitis Society.

The American Contact Dermatitis Society recognizes the interest in the evaluation and management of metal hypersensitivity reactions. Given the paucity of robust evidence with which to guide our practices, we provide reasonable evidence and expert opinion-based guidelines for clinicians with regard to metal hypersensitivity reaction testing and patient management. Routine preoperative evaluation in individuals with no history of adverse cutaneous reactions to metals or history of previous implant-related adverse events is not necessary.

Patch test results in psoriasis patients on biologics.

Objectives: The objective of this study was to determine the prevalence of positive patch tests in patients with psoriasis receiving biologics and whether these results differ from those of patients with psoriasis not on biologics.

Methods: An institutional review board-approved retrospective chart review was conducted for patients with psoriasis patch tested January 2002-2012 at Tufts Medical Center. Patients had a history of psoriasis, psoriatic arthritis, and patch testing as identified by International Classification of Diseases, Ninth Revision codes 696.

Contact allergy to sorbitans: a follow-up study.

Background: Sorbitan sesquioleate (SSO), an emulsifier in many corticosteroids, was previously found positive in 8.9% of 112 dermatitis patients.

Objective: The objective of this study was to present data on 24 of 591 dermatitis patients with reactions to SSO and/or sorbitan monooleate (SMO) on patch testing.

The role of contact allergens in chronic idiopathic urticaria.

Objective: The objective of this study was to determine whether contact allergens play a role in chronic idiopathic urticaria (CIU).

Methods: We conducted a longitudinal prospective study of 23 patients with CIU. Patients were patch tested to a modified North American Contact Dermatitis Group standard, fragrance, and cosmetic series; other series were tested as warranted by relevant history and physical examination.

Patch-testing while on systemic immunosuppressants.

Background: Occasionally, the need arises to patch-test patients while they are on immunomodulators. Little is known about how these systemic agents affect the results of patch testing.

Objective: To present data on 11 patients who underwent patch testing while under the effects of immunosuppressants.

Lichen planus-like eruptions: an emerging side effect of tumor necrosis factor-alpha antagonists.

As tumor necrosis factor (TNF)-alpha inhibitors gain wider use in clinical practice, it is becoming increasingly evident that these potent immunosuppressants can also induce inflammatory reactions. We present two cases of lichen planus-like eruptions after infliximab and adalimumab therapy for psoriasis, and review the literature on this phenomenon. Eleven cases of lichen planus or lichenoid drug eruptions have been previously reported in patients taking TNF-alpha inhibitors, in addition to several cases of psoriasiform eruptions with a lichenoid histology.

Sorbitan sesquioleate: an emerging contact allergen.

Sorbitol-based emulsifiers such as sorbitan sesquioleate (SSO) are commonly used in topical corticosteroids, topical antibiotics, topical antifungals, moisturizing creams and lotions, and topical retinoids. Contact dermatitis from sorbitol derivatives appears to be increasingly prevalent. Patch-testing with SSO can be useful in the work-up of patients with presumptive cosmetic allergic contact dermatitis.