Occupational dermatoses in health care workers evaluated for suspected allergic contact dermatitis.

Background: Occupational skin diseases, including allergic contact dermatitis (ACD), irritant contact dermatitis, and allergic contact urticaria (ACU), occur commonly among health care workers (HCWs).

Purpose: To evaluate the aetiology of the various skin diseases afflicting HCWs evaluated for suspicion of ACD and/or ACU and to identify the most common allergens among HCWs found to have ACD and/or ACU.

Methods: A total of 1434 patients underwent patch testing.

Blue-jean button nickel: prevalence and prevention of its release from buttons.

Background: Nickel is a common cause of allergic contact dermatitis and is associated with metal buttons and snaps on blue jeans.

Objective: To determine the prevalence of nickel-positive metal buttons on blue jeans and the efficacy of nail polish in the prevention of nickel release.

Methods: We collected 62 pairs of new and preworn blue jeans.

Elastosis perforans serpiginosa.

A 41-year-old white man with Down syndrome presented with a slightly pruritic, papular eruption on bilateral forearms of several years' duration. Physical examination revealed multiple 2- to 3-mm keratotic, umbilicated pink papules in an annular configuration distributed symmetrically on the flexural surfaces of the forearms (Figure 1). The skin surrounding these papules was noted to be hyperpigmented and somewhat atrophic.

Efalizumab-induced autoimmune pancytopenia.

Efalizumab is a recombinant, humanized monoclonal anti-CD11a antibody used for the treatment of moderate to severe plaque psoriasis. Immune-mediated thrombocytopenia and anaemia have previously been reported with this therapy. We describe the first case of immune-mediated pancytopenia in a patient treated with efalizumab.

Comparative study of Finn Chambers and T.R.U.E. test methodologies in detecting the relevant allergens inducing contact dermatitis.

T.R.U.

Waiting times to see a dermatologist are perceived as too long by dermatologists: implications for the dermatology workforce.

Background: The issue of workforce requirements in dermatology has come to attention in recent years because it affects the delivery of dermatologic care in the United States.

Objective: To determine the waiting times for appointments with dermatologists in order to assess the adequacy of the current level of dermatology workforce.

Methods: Waiting times were determined for new and return patient appointments by telephone survey of a random sample of American Academy of Dermatology members.

Thimerosal in the detection of clinically relevant allergic contact reactions.

Thimerosal, a mercuric derivative of thiosalicylic acid, is a preservative used in several types of consumer products, including cosmetics, ophthalmic and otolaryngologic medications, and vaccines. As a result of allergic reactions and environmental concerns, its use has declined significantly during the past 2 decades. During a 5-year study at the University of Kansas Medical Center, 574 patients were patch tested to the North American Contact Dermatitis Group's standard allergen tray, which included thimerosal.