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Assessment – Nutrition-Focused Physical Exam to Detect Micronutrient Deficiencies
Published in Jennifer Doley, Mary J. Marian, Adult Malnutrition, 2023
Dermatitis appears as swollen, reddened skin that may blister or ooze. Potential micronutrient deficiencies include EFAs or zinc. Possible non-nutrient causes include allergic or medication reactions, rashes, cellulitis and psoriasis.4,9–11
Adnexal Diseases
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Hasan Aksoy, Jordan V. Wang, Ayşe Serap Karadağ
Management: Periorificial dermatitis is usually treated with topical medications, which can include metronidazole, erythromycin, clindamycin, tacrolimus, and pimecrolimus. Systemic tetracyclines (e.g., doxycycline, minocycline) can be used for initial improvement. Any topical steroid use should be stopped.
Monographs of fragrance chemicals and extracts that have caused contact allergy / allergic contact dermatitis
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
In a subsequent publication by this group of authors, the results of long-term dietary restrictions were reported (179). 64 patients participated in this study. 24 were patients who had positive patch tests to MP and in 40 individuals, the dermatitis had previously flared after oral challenge with MP. All 64 patients were asked to avoid food items suspected of containing balsams for 1 to 2 months and the dermatitis of 37 (58%) cleared or improved markedly. If an improvement had taken place, the patient was asked to continue to diet moderately; 6 months to 3 years later, 30 (47%) felt there was a long-term effect and 27 still followed the diet instructions to some degree. In the subgroup of the 24 patients with a positive patch test to MP, 15 (63%) reported benefit from the diet. Food items most commonly mentioned by patients as causes of flare of dermatitis were spices, cinnamon, curry, vanilla, liver paste, pickled herring, fruit, citrus fruit, cake, ice cream, vegetables, candy and wine (179).
Real-life experience with chlormethine gel for early-stage mycosis fungoides with emphasis on types and management of cutaneous side-effects#
Published in Journal of Dermatological Treatment, 2022
Hadas Prag Naveh, Iris Amitay-Laish, Omri Zidan, Yael A. Leshem, Shany Sherman, Yehonatan Noyman, Joseph Taieb, Elena Didkovsky, Emmilia Hodak
The most common cutaneous side effect was contact dermatitis, in 24 patients (36%). Median time to first appearance of dermatitis was 7 weeks (range, 1–42). Based on clinical judgment, primary irritation was diagnosed in 9 patients (more commonly in skin folds) (Figure 2(A)), and allergic contact dermatitis in 3 (Figure 2(B,C)). The nature of the contact dermatitis (whether primary irritation or allergic dermatitis) could not be determined with high certainty in the remaining 12 patients. Management of mild/moderate dermatitis (n = 16) consisted of TCS and/or reduction in CG application frequency or, less often, drug interruption/discontinuation. Re-initiation of treatment, when possible, was gradual, and if necessary, combined with TCS. Overall, treatment interruption/discontinuation occurred in 13 patients, all with moderate-severe dermatitis. In those 8 patients with severe dermatitis, rechallenge caused severe recurrence despite concomitant use of TCS, necessitating permanent discontinuation.
Framework for sensitization assessment of extractables and leachables in pharmaceuticals
Published in Critical Reviews in Toxicology, 2022
Patricia Parris, Geraldine Whelan, Anders Burild, Jessica Whritenour, Uma Bruen, Joel Bercu, Courtney Callis, Jessica Graham, Esther Johann, Troy Griffin, Martin Kohan, Elizabeth A. Martin, Melisa Masuda-Herrera, Brad Stanard, Eric Tien, Maureen Cruz, Lee Nagao
Sensitization occurs when exposure to an allergen results in the development of an adaptive immune response. The adaptive immune response can involve the generation of allergen-specific antibodies, allergen-specific T cells, or both (induction). Repeated exposure to the allergen manifests in a clinical reaction such as dermatitis or pneumonitis (elicitation). Importantly for risk assessment, induction of sensitization is threshold-based irrespective of the route of administration and therefore it is possible to determine a dose below which sensitization will not occur (Kimber et al. 1999). As concluded by the World Health Organization International Programme on Chemical Safety project on the Harmonization of Approaches to the Assessment of Risk from Exposure to Chemicals, “the most effective strategy to control the elicitation of allergic contact dermatitis is to prevent the induction of skin sensitization in the first place” (World Health Organization Inter-Organization Programme for the Sound Management of Chemicals 2008).
Efficacy of topical epigallocatechin gallate (EGCG) 1% on the healing of chronic plantar ulcers in leprosy
Published in Journal of Dermatological Treatment, 2021
C. R. S. Prakoeswa, R. N. Oktaviyanti, D. M. Indramaya, E. Hendradri, S. Sawitri, L. Astari, D. Damayanti, M. Y. Listiawan
No adverse events were encountered in either of the study groups, but a complication occurred in 1 patient (4.5%) in the FGD group when the size of the ulcer became wider. During the clinical examination of this patient, neither any clinical signs of allergic contact dermatitis nor any clinical signs of infection (no erythema on the skin around the ulcer, no swelling, no warmth on palpation, odorless and no exudation) were found. The ulcer had enlarged in the 3rd week of treatment. Consequently, the FGD treatment was discontinued in the 3rd week and the wound care was replaced with normal saline. Follow-up was continued until the 8th week. In the 4th and the 5th week, the size and the depth of the ulcer remained the same. In the 6th, the 7th and the 8th week, the size of the ulcer increased, but the depth remained the same. This patient had a clawfoot and the ulcer was positioned at the head of the first metatarsal. The worsening of the ulcer in this patient was not caused directly by the treatment with FGD but was caused by the clawfoot. This patient required a pressure reducing measure such as an appropriate shoe or sandal for reducing the pressure on the ulcer.