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Contact Dermatitis
Published in Pudupakkam K Vedanthan, Harold S Nelson, Shripad N Agashe, PA Mahesh, Rohit Katial, Textbook of Allergy for the Clinician, 2021
Irritant Contact Dermatitis (ICD) is caused by non-immunologic direct tissue activation. T-cells are stimulated to release inflammatory Th1 cytokines such as TNF-a, IL-1, IL-8 and GM-SCF via non-immune mechanisms (Pedersen et al. 2004), thus no immunologic memory or sensitization period is necessary for these reactions. In these irritant reactions there tends to be a higher concentration of the agent needed to provoke a response; it may also produce burning and stinging sensation in the patient as opposed to itching. The area of involvement is usually limited to the area that comes into contact with the involved agent and is a dose dependent response. Common agents that produce ICD include water, soap, detergents, acids/bases and bodily fluids including urine, saliva and stool.
Nasal problems in the athlete
Published in John W. Dickinson, James H. Hull, Complete Guide to Respiratory Care in Athletes, 2020
Seasonal, outdoor allergens can be avoided by foreign travel, but this is impractical and expensive. Air filtration systems by the bedside have shown positive results, as have nasal filters, albeit only in small trials. With regards to athletes, major championships may cause problems depending on the time of year they are scheduled. Spring and early summer are perhaps the worst times given the high levels of tree and grass pollens. Avoidance of airway irritants, such as cigarette smoke and diesel pollution is also advisable. Simple nasal douching with saline or saline-bicarbonate can be very beneficial both for removal of residual allergen and clearance of excess mucous.
The skin
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
An irritant is any exogenous agent, physical or chemical, that in significant concentrations and duration of exposure can cause cellular damage. This process is independent of prior sensitization and immunological memory. The nature of the damage is dependent upon the physiochemical structure of the irritant. The disease manifests where the barrier or repair function of the skin is exceeded, or if penetrating chemicals elicit an inflammatory response. For example, detergents result in destruction of lysosomes in the stratum corneum. More caustic substances have been shown to physically denature keratinocytes subsequently stimulating inflammatory pathways. Once initiated, T cell mediated inflammation may persist despite withdrawal of the allergen.
Emerging drugs for the treatment of acne: a review of phase 2 & 3 trials
Published in Expert Opinion on Emerging Drugs, 2022
Siddharth Bhatt, Rohit Kothari, Durga Madhab Tripathy, Sunmeet Sandhu, Mahsa Babaei, Mohamad Goldust
Benzoyl Peroxide is an organic peroxide derived from coal tar. It is one of the drugs to which no resistance has been detected despite decades of usage. It has antibacterial, oxidative, anti-inflammatory, and keratolytic actions which make it an ideal drug for acne management. Its combination with other drugs is more efficacious than individual use. It helps to prevent resistance to clindamycin when used in combination with it. Combination with retinoids like adapalene provides a synergistic effect. It can cause irritant dermatitis that presents with burning, erythema, peeling, and dryness. This irritation increases with adapalene benzoyl peroxide combination as compared to benzoyl peroxide alone. The chances of true allergy to benzoyl peroxide are rare with an incidence of 0.2 − 1%. It can also bleach the fabric and hair [4].
Occupational chronic obstructive pulmonary disorder: prevalence and prevention
Published in Expert Review of Respiratory Medicine, 2022
Further work of the subjects with occupational chronic obstructive pulmonary disorder depends on type of the disease. Existing evidence indicates that early, complete and definitive avoidance of exposure to the causal agent and pharmacological treatment that follows clinical-practice guidelines is the preferable approach to the management of immunologic OA. Reduction of exposure to the causal agent may be an alternative to the complete avoidance of exposure, but it seems that reduced exposure is less beneficial than exposure cessation. In the contrast of immunologic OA, stop exposure to causal or aggravating occupational agents in the working patients with IIA, WEA or occupational COPD is not necessary. Reduction of exposure to respiratory irritants, e.g. by changes in ventilation system or in work processes, move to a different work area, use of appropriate masks for short-term exposure, etc., obtains sufficient protection of triggering symptoms in the working patient. If measures for reduction of exposure are not successful, the working patient should be removed to a workplace with fewer triggers [61–64].
Methyl methacrylate and respiratory sensitisation: a comprehensive review
Published in Critical Reviews in Toxicology, 2022
Regarding the second sub-question; the evidence in favour of the involvement of an immune-specific mechanism associated with allergic sensitisation is both weak and insufficient since no cases of “respiratory sensitisation” due to MMA have been documented. The only evidence suggestive of involvement of an immune mechanism comes in the form of a small number of OA cases with positive SIC from the dental sector. However, irritant provocation is the more likely explanation since a) exposure levels used were not sufficiently established to be below levels that cause irritation and, b) the profile of LAR in these few cases does not indicate with any confidence immune involvement. Furthermore, considering workers in the dental sector are known to have mixed exposures to other chemicals including dusts, both in their workplace and during the SIC tests, it is not possible to infer that MMA is an asthmagen, i.e. based upon causation of OA in the workplace or, indeed, that MMA is a respiratory allergen, i.e. based upon “specificity” of the asthma response in SIC.