Eczema Homeopathic Cure

Eczema Free Forever by Rachel Anderson

Rachel Anderson, the author, has created a inclusive program to help adults and children alike who suffer from this skin condition change their lifestyles and in turn create healthy, beautiful skin. As a mother to a 9 year old boy suffering from eczema, the author Rachel Anderson sure knows how hard it is to see her son, Samuel, deal with eczema. Using all her knowledge as a skin specialist with a medical background together with her interest in natural healing and herbal remedies, she created Eczema Free Forever to see if she could finally ease her son's skin irritation, itching and redness. The best point about Eczema Free Forever is that it does not involve any creams, lotions, pills, or any other drugs. Instead, it cures the eczema though natural remedies. Read more...

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Conditions That May Simulate Atopic Dermatitis

This eruption is partially eczematous and partially papulosquamous. Onset and distribution are similar to those for infantile atopic dermatitis. Differentiation is particularly difficult when the eczema component is predominant. Both conditions may exhibit heavy scale. While the scale of seborrhea is yellow and greasy, that of atopy is white and dry. The distinction is not always easy to make. Seborrhea lesions tend to have sharp margins, while those of atopic dermatitis are indistinct. In addition, involvement of the facial creases, crural folds, and diaper area favors seborrhea. Infantile or childhood atopic dermatitis with widespread papular morphology and excoriations is very similar in appearance to the papules and vesicular lesions of advanced scabies. In addition, the two diseases may coexist. It is fairly common for an atopic patient to acutely deteriorate during a concomitant scabies and or bacterial infection. The practitioner must maintain a high index of suspicion. Family...

Atopic Dermatitis

Clogged Tear Photos

Of these types 70 result from allergic contact dermatitis, and about 9 to 10 each from irritant contact dermatitis, atopic dermatitis, and seborrheic dermatitis. Atopic dermatitis is a chronically relapsing inflammatory skin disease. It is a genetically fixed disease that remains with the patient all their lives, whether they show symptoms or not. It occurs in approximately 2 of the population. In several large series 80 to 90 of patients with eyelid dermatitis were female. Distinct infantile, juvenile, and adult stages of the disease have been reported. Associated diffuse eczematous skin changes vary with the age of the patient and often disappear during puberty or adolescence. In the infantile stages associated manifestations include facial erythema and crusting. After age two to three years erosions, lichenification, and hyper or hypopigmentaton develop particularly on the face and flexural surface of the extremities. In adults the rash may be bright red, edematous and oozing or...


BIRCH leaves have always been used for treating skin complaints (Conway), and they can be treated with birch tar oil made up into a soothing ointment (Mitton) or can be used in medicated soaps (Gordon) to treat eczema. The complaint was treated in Dorset with NETTLE tea (Dacombe), which is a well-established East Anglian remedy for any skin complaint (Porter. 1974). The sap of the GRAPE VINE is collected in some country areas when growth starts in spring, to be used for eczema among other complaints (Shauenberg & Paris). Gypsies use an ointment made from the fresh leaves of FOXGLOVE to cure eczema (Vesey-Fitzgerald), and a compress made from MALLOW leaves or flowers is often used. A CHICKWEED poultice is used in Norfolk for quite severe dermatitis and eczema (V G Hatfield. 1994). A tea made from GROUND IVY used to be popular for this complaint in the north of Scotland. It was said that the fairies taught Donald Fraser, of Ross-shire, to use it (R M Robertson). A dozen or so BLACK...

Atopic eczema

A proportion of young children with atopic eczema show an improvement when selected foods are excluded from their diet.16 Common foods implicated in the causation of eczema are egg and milk, and in some cases wheat and peanut. A detailed history and skin prick tests or RAST are sometimes helpful in identifying the food, but a negative test does not exclude the possibility of benefit from a food exclusion diet. If the child is sensitised to one or more foods on skin test or RAST, a trial diet excluding these foods should be prescribed for 4-6 weeks. If the child is not sensitised to foods, a trial of cow's milk and egg may be of value in children with extensive eczema. Eczema is a chronic disease and improvement with exclusion diet may not occur immediately. An open challenge should always be undertaken if an improvement has been observed to confirm the causative relationship. Doubleblind challenge may not always be feasible in clinical practice. Once the food(s) are identified, a...

Dyshidrotic eczema

Dyshidrosis pompholyx vesicular pal-moplantar eczema vesicular eczema of palms and soles Dyshidrotic eczema. Multiple vesicles on the hands, with concentration along the sides of the digits Contact dermatitis vesicular tinea pedis tinea manus palmoplantar pustular psoriasis autosensitization reaction (id reaction)

Safety and Handling Issues

First and foremost, microbicides in general must be handled with caution and stored out of the reach of young children, particularly in the case of domestic products 6 . Reports of poisoning from ingestion of microbicides, and the serious consequences that can result 7 , are far outnumbered by the unpublished occurrences. While such dramatic events draw attention to the acute toxicity following microbicide ingestion, the majority of human exposures come from using microbicidal products on a regular basis. Occupational exposures can result in immune reactions including hypersensitivity 8-11 and contact dermatitis 12-16 . Data from California show that, between 1991 and 1995, four types of microbicidal chemicals (sodium hypochlorite, quats, chlorine gas, and glutaraldehyde) were responsible for the highest number of occupational illnesses 17 . This is not a trivial issue as many healthcare professionals can be affected 12,16,18 while such sensitivities are rarely life threatening, they...

Indicated Supporting Diagnostic Data

EM minor is readily diagnosed on clinical exam, and in the absence of systemic signs, supporting diagnostic data are seldom indicated. Vesiculobullous EM and EM major may at times enter into the differential of drug eruptions, lupus erythematosus, cutaneous vasculitis, dermatitis herpetiformis, pemphigoid, toxic epidermal necrolysis, and other toxic erythemas. On these rare occasions, the following laboratory studies may be helpful. Otherwise, lab data are indicated mainly for the management of the complications of EM major.

Clinical Application Questions

In the early spring, a 75-five-year-old woman visits your office with a complaint of generalized itching. The symptoms began in late December on local skin areas, and have progressed throughout the winter. You suspect an asteatotic eczema. 2. What are the primary lesions in areas of asteatotic eczema 3. What are the secondary lesions seen in asteatotic eczema

Pathology and Histopathology

Limited studies on patients with a fatal outcome have demonstrated focal necrosis of the hepatic cells, Councilman bodies, and hyaline necrosis of Kupffer cells in the liver. Changes in the kidney are suggestive of an immune complex type of glomerulonephritis. There is depression of bone marrow elements, which improve when the patient becomes afebrile. Biopsy studies of the skin rash

Clinical manifestation

Transient, superficial vesicles and bullae, transforming into crusted or scaly eroded plaques on an erythematous base, mainly in seborrhoic areas, with little or no involvement of mucous membranes pemphigus erythematosus (Senear-Usher) variant features of cutaneous lupus erythematosus and pemphigus foliaceus red scaly plaques on the bridge of the nose and malar area exfoliative erythroderma with extensive involvement pemphigus herpetiformis variant pruritic grouped papules and vesicles, suggestive of dermatitis herpetiformis occasional oral erosions drug-induced variant may occur with penicillamine or cap-topril therapy, usually after at least 2 months of use relatively mild signs and symptoms

Ethanediamine N[Ethenylphenyl MethylN [3Trimethoxysilyl Propyl Monohydrochloride

Heino T, Haapa K, Manelius F (1996) Contact sensitization to organo-silane solution in glass filament production. Contact Dermatitis 341294 Toffoletto F, Cortona G, Feltrin G, Baj A, Goggi E, Cecchetti R (1994) Occupational contact dermatitis from amine-functional methoxysilane in continuous-glass-filament production. Contact Dermatitis 31 320-321 Heino T, Haapa K, Manelius F (1996) Contact sensitization to organo-silane solution in glass filament production. Contact Dermatitis 34

Eyelid Lesions and Tissues of Origin

Sweat Gland Disease

All lesions that involve the eyelids or any other region of the body can be thought of as deriving from two basic sources. Those that arrive in the lids from other more remote sources are exogenous lesions. These include metastatic tumors from sites such as the breast or lung. Also included here are infiltrations in the dermis and epidermis of cellular or other materials that secondarily involve eyelid structures. Included here are diseases such as amyloidosis, sarcoidosis, infectious inflammations such as herpes and cellulitis, xanthelamas, acute atopic dermatitis, erythema multiforme, granuloma annulare, and lymphoid and myeloid infiltrates. All exogenous lesions disturb the normal eyelid architechture to some extent, and may be generalized or confined to specific eyelid tissue types.

Tixocortol 21Pivalate Tixocortol 21Trimethylacetate CAS Registry Number [55560968

Tixocortol 21-pivalate is a 21-ester of tixocortol, widely used in topical treatments. It can induce severe allergic contact dermatitis. This corticosteroid is a marker of the allergenic A group that includes molecules without major substitution on the D cycle (no C16 methylation, no C17 side chain). A short-chain C21 ester is possible. Molecules are cloprednol, cortisone, fludrocortisone, fluoro-metholone, hydrocortisone, methylprednisolone, methylpred-nisone, prednisolone, prednisone, tixocortol, and their C21 esters (acetate, caproate or hexanoate, phosphate, pivalate or trimethyl-acetate, succinate or hemisuccinate, m-sulfobenzoate).

Evaluation of Eyelid Lesions

Lesions Definition

Eyelid lesions are classified according to the anatomic structures from which they arise. These include the epidermis, dermis, and various cells and adnexal structures within these layers. Eyelid inflammations may present as a localized or diffuse erythematous area. They can be associated with ulceration, induration, eczematous changes, necrosis, edema, or loss of eyelashes. If skin contraction occurs the eyelid margins may be malpositioned manifesting as an ectropion or canthal angle dystopia. Inflammatory lesions may be painful and at times can be associated with lymphadenopathy. Infectious conditions of the eyelid result from viral, bacterial, fungal or parasitic processes and may be primary or secondary. The latter can result as extensions from head and neck foci such as the sinuses or lacrimal sac, or from hematoge-nous spread from distant sites. The cause of the infection on the eyelid is often evident, such as in a site of trauma or recent surgery. However, when the infection...

Molluscum Contagiosum Dimple Warts

Medical Dermatology Human Figure

In children, and occasionally in young adults, eczematous patches will develop within the regions of activity. The eczema is identical to patches of atopic dermatitis and, if left untreated, the resultant excoriations can lead to dissemination of the MC infection. Whether this represents an exacerbation of latent atopic disease or a delayed immune response to the virus is uncertain. Atopic dermatitis patients do seem to have an increased incidence of MC. As lesions evolve, some will enlarge rapidly, become edematous and dusky red, and form a yellow or dark crust. In patients with associated eczema, excoriations are usually present and may cause mild scarring, as can overly exuberant treatment. Solitary large lesions are rare and may simulate a keratoacanthoma, squamous cell carcinoma, or basal cell carcinoma. These are more common in HIV disease. In HIV-positive patients, lesions of disseminated cryptococcosis, histoplasmosis, or cutaneous coccidioidomycosis can resemble MC lesions,...

Usnic Acid dUsnic Acid lUsnic Acid

Usnic acid is a component of lichens, also used as a topical antibiotic. Allergic contact dermatitis from lichens occurs mainly occupa-tionally in forestry and horticultural workers, and in lichen pickers. Aalto-Korte K, Lauerma A, Alanko K (2005) Occupational allergic contact dermatitis from lichens in present-day Finland. Contact Dermatitis 52 36-38 Hahn M, Lischka G, Pfeifle J, Wirth V (1995) A case of contact dermatitis from lichens in southern Germany. Contact Dermatitis 32 55-56

Dictionary of Contact Allergens Chemical Structures Sources and References

This chapter has been written in order to familiarize the reader with the chemical structure of chemicals implicated in contact dermatitis, mainly as haptens responsible for allergic contact dermatitis. For each molecule, the principal name is used for classification. We have also listed the most important synonym(s), the Chemical Abstract Service (CAS) Registry Number that characterizes the substance, and its chemical structure. The reader will find one or more relevant literature references. As it was not possible to be exhaustive, some allergens have been omitted since they were obsolete, extremely rarely implicated in contact dermatitis, their case reports were too imprecise, or they are extensively treated in other chapters of the textbook. From a practical chemical point of view, acrylates, cyanoacrylates and (meth)acrylates, cephalosporins, and parabens have been grouped together. Bergh M, Menne T, Karlberg AT (1994) Colophony in paper-based surgical clothing. Contact...


Angelini G, Foti C, Rigano L, Vena GA (1995) 3-Dimethylaminopropyl-amine a key substance in contact allergy to cocamidopropylbetaine Contact Dermatitis 32 96-99 Kanerva L, Estlander T, Jolanki R (1996) Occupational allergic contact dermatitis from 3-dimethylaminopropylamine in shampoos. Contact Dermatitis 35 122-123 Speight EL, Beck MH, Lawrence CM (1993) Occupational allergic contact dermatitis due to 3-dimethylaminopropylamine. Contact Dermatitis 28 49-50

Cicatricial Pemphigoid

DIFFERENTIAL DIAGNOSIS The differential diagnosis includes porphyria, bullous pemphigoid, sebaceous gland carcinoma, dermatitis herpetiformis, pemphigus vulgaris, Sjogren's disease, beta-hemolytic strep-tococcal infections, diphtheria, adenoviral and herpes simplex infections, trachoma, prolonged use of oral practolol, and reactions to epinephrine, pilocarpine, and or phospholidine iodide eye drops.

PVPHexadecene Copolymer

Eczema Arch

PVP hexadecene copolymer, another PVP copolymer used for identical applications as PVP eicosene copolymer, has been rarely implicated in contact dermatitis. De Groot AC, Bruynzeel DP, Bos JD, van der Meeren HL, van Joost T, Jagtman BA, Weyland JW (1988) The allergens in cosmetics. Arch Dermatol 124 1525-1529 Scheman A, Cummins R (1998) Contact allergy to PVP hexadecene copolymer. Contact Dermatitis 39 201

PVPEicosene Copolymer

Gallo R, dal Sacco D, Ghigliotti G (2004) Allergic contact dermatitis from VP eisosene copolymer (Ganex V-220) in an emollient cream. Contact Dermatitis 50 261 Le Coz CJ, Lefebvre C, Ludmann F, Grosshans E (2000) Polyvinylpyrrolidone (PVP) eicosene copolymer an emerging cosmetic allergen. Contact Dermatitis 43 61-62

Squamous Cell Carcinoma

Squamous Follicular Keratosis

CLINICAL PRESENTATION The most common site of eyelid involvement is the lower lid. Initial changes can look like a chronic eczema-like lesion. The tumor often originates in an actinic keratosis, but tends to be thicker, larger and have a more heaped-up keratinization. These lesions have a

Nonylphenol Ethoxylates PEGn Nonyl Phenyl Ether Polyoxyethylene n Nonyl Phenyl Ether

Ly used, as a preservative in topical antiseptics or in spermicides, acting as a iodophor in PVP-iodine solutions. Nonoxynol-10 was reported as a UVB-photosensitizer. Nonoxynol-12 caused contact dermatitis in a domestic cleaner who used a polish containing it. Dooms-Goossens A, Deveylder H, de Alam AG, Lachapelle JM, Tennstedt D, Degreef H (1989) Contact sensitivity to nonoxynols as a cause of intolerance to antiseptic preparations. J Am Acad Dermatol 21 723-727 Meding B (1985) Occupational contact dermatitis from nonylphenolpoly- glycolether. Contact Dermatitis 13 122-123 Nethercott JR, Lawrence MJ (1984) Allergic contact dermatitis due to nonylphenol ethoxylate (nonoxynol-6). Contact Dermatitis 10 35-239 Wilkinson SM, Beck MH, August PJ (1995) Allergic contact dermatitis from nonoxynol-12 in a polish. Contact Dermatitis 33 128-129

Hexamethylene Diacrylate

2-EHA was contained in a surgical tape and caused allergic contact dermatitis in a patient. Daecke C, Schaller J, Goos M (1994) Acrylates as potent allergens in occupational and domestic exposures. Contact Dermatitis 30 190-191 Kanerva L, Estlander T, Jolanki R, Tarvainen K (1993) Occupational allergic contact dermatitis caused by exposure to acrylates during work with dental prostheses. Contact Dermatitis 28 268-275 Kanerva L, Lauerma A, Estlander T, Alanko K, Henriks-Eckerman ML, Jolanki R (1996) Occupational allergic contact dermatitis caused by photobonded sculptured nails and a review of (meth) acrylates in nail cosmetics. Am J Contact Dermat 7 109-115 Rustemeyer T, Frosch PJ (1996) Occupational skin diseases in dental laboratory technicians. (I). Clinical picture and causative factors. Contact Dermatitis 34 125-133 Botella-Estrada R, Mora E, de La Cuadra J (1992) Hexanediol diacrylate sensitization after accidental occupational exposure. Contact Dermatitis 26 50-51 2-HEA is...

Food Intolerance and Allergy

Mast Cell Diagram

Usually, individuals prone to food allergies suffer only a few symptoms. Symptoms can vary among individuals, ranging from the common gastrointestinal symptoms to severe anaphylaxis. Table 10.4 summarizes the symptoms experienced during allergic reactions to foods. Rhinitis is runny nose, asthma is difficulty breathing, laryngeal edema is constriction of the throat, angioedema is swelling, urticaria is hives, and eczema atopic dermatitis is skin rash. The potentially fatal form of food- Laryngeal edema Eczema atopic dermatitis Nausea

Cocamide DEA Coconut Oil Fatty Acids Diethanolamide NNbis2Hydroxyethyl Coco Fatty Acid Diethanolamide Cocoyl

Fowler JF Jr (1998) Allergy to cocamide DEA.Am J Contact Dermat 9 40-41 Kanerva L, Jolanki R, Estlander T (1993) Dentist's occupational allergic contact dermatitis caused by coconut diethanolamide, N-ethyl-4-toluene sulfonamide and 4-tolydietahnolamine. Acta Derm Venereol (Stockh) 73 126-129 Pinola A, Estlander T, Jolanki R, Tarvainen K, Kanerva L (1993) Occupational allergic contact dermatitis due to coconut diethanolamide (Cocamide DEA). Contact Dermatitis 29 262-265

MethamNa Carbathion SodiumNMethyldithiocarbamate

Koch P (1996) Occupational allergic contact dermatitis and airborne contact dermatitis from 5 fungicides in a vineyard worker. Cross-reactions between fungicides of the dithiocarbamate group Contact Dermatitis Schubert H (1978) Contact dermatitis to sodium-N-methyldithiocarba- mate. Contact Dermatitis 4 370-371 Wolf F, Jung HD (1970) Akute Kontaktdermatitiden nach Umgang mit Nematin. Z Ges Hyg 16 423-426

Advantages of breastfeeding

Enteromammary Pathway

There are a number of reports that show lower incidences of atopic illness such as eczema and asthma in breastfed babies. This effect is particularly important when there is a family history of atopic illnesses 22 . When the atopic illness is present, it is commonly associated with raised levels of immunoglobulin E, especially cow's milk protein.

Polyvinylpyrrolidone Iodine PVPIodine

Povidone-iodine is iodophor, used as a topical antiseptic. A 10 povidone-iodine solution contains 1 available iodine, but free-iodine is at 0.1 concentration. Skin exposure causes irritant rather than allergic contact dermatitis. In such a situation however, iodine seems to be the true hapten. Lachapelle JM (2005) Allergic contact dermatitis from povidone-iodine a re-evaluation study. Contact Dermatitis 52 9-10 Tosti A, Vincenzi C, Bardazzi F, Mariani R (1990) Allergic contact dermatitis due to povidoneiodine. Contact Dermatitis 23 197-198

Effects on Particular Organs or Organ Systems

The skin suffers toxic effects itself, including cancer, primary irritation, allergic reactions, hair loss, pigment disturbances, ulceration, and chloracne. Dermatitis is an inflammation of the dermis. Irritant contact dermatitis and allergic dermatitis can both be caused by exposure to chemicals and produce similar symptoms, including hives, rashes, blistering, eczema, or skin thickening. The difference between them is that a true allergy takes time to develop, typically at least two weeks whereas irritation does not require a previous exposure. For example, no one reacts to poison ivy when first exposed. Only after a second or subsequent exposure does the itchy rash develop. Common causes of ulceration include acids and burns. In addition, contact with cement and chromium-containing materials are well known to cause skin ulcers. The latter includes leathers that have been tanned with chromium compounds. Chloracne is an disease characterized by acute formation of an acnelike skin...

Clinical Features Lassa fever

Lassa fever begins after 7-18 days of incubation, with fever, headache and malaise. Aching in the large joints, pain in the lower back, a nonproductive cough, severe headache and sore throat are common. Many patients also develop severe retrosternal or epigastric pain. Vomiting and diarrhea occurs in between a half and two-thirds of patients. In more severely ill patients complete prostration may occur by the 6th to 8th day of illness. Patients with Lassa fever appear toxic and anxious, and in the absence of shock, the skin is usually moist from diapheresis. There is an elevated respiratory rate and pulse. The systolic blood pressure may be low. There is no characteristic skin rash petechiae and ecchymoses are rare, nor is jaundice a feature of Lassa fever. Conjunctivitis is common, but rare conjunctival hemorrhages portend a poor prognosis. Seventy percent of patients have pharyngitis, often exudative, but few if any petechiae, and ulcers are rare. Mucosal bleeding occurs in 15-20 of...

Answers To Clinical Application Questions

A 68-year-old retired bank executive seeks your help regarding a progressively disabling and intensely pruritic rash that has generalized over the past 6 months. Examination reveals a widespread inflammatory dermatitis with excoriations and impetiginization. Heavily involved areas include the face, neck, upper back, scalp, and the dorsum of the hands. The margins of the eruption are indistinct and the neck and flexures are more heavily involved with secondary changes of lichenification. You consider a diagnosis of late-onset atopic dermatitis. a. Family history of other blood relatives with asthma, hay fever (seasonal conjunctivitis), or chronic eczema. b. Personal history of asthma, hay fever, or infantile childhood eczema that went into remission. 2. Are there any ancillary physical findings that support your diagnosis Answer The following physical findings support a diagnosis of atopic dermatitis. Starred items are most helpful in adult cases. 3. What is the most important...

Clinical Features of Infection

Most (70-90 ) childhood HSV-1 infections are asymptomatic, but they may be followed by subsequent recurrent episodes of symptomatic disease. In children 1-3 years of age, the major manifestion of HSV-1 infection is gingivostomatitis, a serious infection of the gums, tongue, mouth, lip, facial area and pharynx, often accompanied by high fever, malaise, myalgias, swollen gums, irritability, inability to cat and cervical lymphadenopathy. Later in life the major clinical manifestation of HSV-1 infection is an upper respiratory tract infection, generally pharyngitis. Reactivated HSV-1 is associated with mucosal ulcerations or lesions at the mucocutaneous junction of the lip, presenting as small vesicles that last 4-7 days and are known as herpes labialis, cold sores or fever blisters. Other HSV-1 skin diseases include primary herpes dermatitis (a generalized vesicular eruption), eczema herpeticum (usually a manifestation of a primary infection in which the skin is the portal of entry), and...

Dermatologic Physical Examination

Apocrine Gland Distribution

Learn to internalize what you are observing. It is easy to look at a skin rash but not really see it. Look for and think about each of the distinguishing characteristics of the lesion. An epidermal thickening with a surface pattern of accentuated skin lines. Lichenification is caused by chronic repeated low-grade rubbing or scratching and implies the presence of severe pruritus or dysesthesia. It is characteristically, but not exclusively, found in cases of atopic dermatitis (see Photo 22). 1. Skin surface temperature by feel gives a clue as to the degree of blood flow. An inflammatory skin condition such as an eczema is red due to vasodilation but is not warm like 5. Stroking the skin surface firmly with either a fingernail or a blunt instrument will reveal features such as the exaggerated triple response of Lewis seen in immediate dermo-graphism or white dermographism, which is characteristic of atopic dermatitis. The same maneuver applied to most lesions of cutaneous mastocytosis...

Conditions That May Simulate Tinea

Patches of nummular eczema, early lesions of psoriasis, patches of impetigo, pityriasis alba in its early inflammatory phase, and the herald patch of pityriasis rosea can all be confused with TC. When other diagnostic features of these conditions are absent, a simple KOH exam should distinguish them. Eczema, although common on the feet, rarely affects the toe webs. Dry scaling fungal infections of the palms and soles are difficult to confuse with other conditions. A simple KOH exam should establish the diagnosis because the surface is usually teeming with hyphae. Dyshidrosis or contact dermatitis may be easily confused with vesicular fungal infections of the palms and soles. A KOH exam of an inverted blister roof is almost always positive if it is a dermatophytosis. Remember, active TP can cause a sympathetic id reaction (see Photo 19) on the hands, and those vesicles are KOH negative. Both areas should be tested.

Cincaine Cinchocaine Percaine Sovcaine

Dibucaine hydrochloride is an amide group local anesthetic that can induce allergic contact dermatitis. Erdmann SM, Sachs B, Merk HF (2001) Systemic contact dermatitis from cinchocaine. Contact Dermatitis 44 260-261 Nakada T, Iijima M (2000) Allergic contact dermatitis from dibucaine hydrochloride. Contact Dermatitis 42 283

Medicinal Lauraceae

P. thunbergii (Sieb. & Zucc.) Kosterm. (Machilus thunbergii Sieb.& Zucc.), or common machilus, tabunoki (Japanese), is a tree native to Korea and Japan and is also found in Taiwan. The bark is smooth, fawn, and lenticelled. The leaves are spiral, simple, exstipulate-elliptic, glossy, and somewhat fleshy. In Japan and Korea, the plant affords a remedy for eczema, diseases of the spleen and stomach, and asthma.

Appendix A Table of Primary Lesions and Related Disorders

Acne (with or without comedones) Part VI Atopic dermatitis Part IV Atypical nevi Part V Actinic keratosis (erythematous) Part V Asteatosis Part IV Atopic dermatitis Part IV Erythrasma Part III Malignant melanoma Part V Rosacea (erythematous) Part VI Seborrheic keratosis Part V Senile purpura (purple) Part IV Striae distensae (linear) Part IV Tinea Part III Atopic dermatitis Part IV

Immunological markers

Puzzlingly also showed that an elevated cord blood total IgE was a significant protective factor for early-onset atopic eczema (Edenharter et al. 1998). Thus, cord blood total IgE is an unhelpful marker in predicting the development of food allergy and in planning appropriate prevention strategies.

Idiopathic Scrotal Edema

Acute idiopathic scrotal edema (AISE) is a fairly common, yet underreported cause of the acute scrotum in children, accounting for as many as 30 of patients who undergo assessment (Najmaldin and Burge 1987). It is characterized by the rapid onset of nontender, frequently unilateral scrotal and penile erythema and edema. The patient is usually afebrile and is otherwise asymptomatic, apart from the distressing appearance of the genitalia. It is usually found in prepubertal children from 5 to 11 years of age. As the name implies, the cause of AISE is unknown however, some children present with a history of asthma or allergic conditions such as eczema or dermatitis (Klin et al. 2002). Laboratory investigations are usually normal, with occasional

Clinical Description of Infection

These viruses are ubiquitous and frequently reactivate. Proof that viral replication is causal in specific disease associations is usually lacking. The greatest attention has focused on links between HHV-6A and multiple sclerosis and HHV-7 and the skin rash pityriasis rosea. Links between HHV-6 HHV-7 and chronic fatigue syndrome have not been substantiated by molecular techniques.

Antimicrobial C3a Biology Biophysics and Evolution

Candida is a dimorphous fungi colonizing the mucous membranes of the mouth and vagina in a saprophytic manner. However, Candida is also known to be involved in several diseases such as cutaneous infections, atopic eczema, oroesophageal candidiasis, candida vaginosis, and septicaemia (Odds 1988 Savolainen, Lammintausta, Kalimo and Viander 1993). In animal models it has been shown that Candida activates the complement system and C3 fragments are deposited at the cell surface of Candida (Kozel 1996 Kozel, Weinhold and Lupan 1996 Sohnle and Kirkpatrick 1976). In humans, generation of C3a has been implicated in the pathogenesis of skin diseases, such as atopic dermatitis (Kawamoto, Yalcindag, Laouini, Brodeur, Bryce, Lu, Humbles, Oettgen, Gerard and Geha 2004 Werfel, Kirchhoff, Wittmann, Begemann, Kapp, Heidenreich, Gotze and Zwirner 2000). In a recent report, it was shown that the anaphylatoxin peptide C3a exerts antifungal activity (Sonesson et al. 2006). Notably, C3a was active against...

Other symptomatic treatment

Ketotifen with antihistaminic and anti-inflammatory properties has been used in food allergic reactions such as urticaria and bronchospasm. It may be useful as an additional therapy in some patients. Beta-2 agonists such as salbutamol or terbutalin may be used when bronchospasm is a prominent feature in an allergic reaction. These drugs can be delivered by inhalation through a metered dose inhaler, in an aerosol form through a nebuliser, or by intravenous route. Food-related eczema and rhinitis should be treated along the standard line with topical steroids and antihistamine in addition to allergen avoidance.

Occupation and smoking

Respiratory diseases have known associations with those working in the food and food-related industries. These include occupational asthma, occupational rhinitis and hypersensitivity pneumonitis. Skin diseases such as contact dermatitis and contact urticaria are also associated with work in these industries. These diseases are not all Type I, IgE-mediated reactions. Some cases of occupational asthma and some of contact dermatitis occur as a result of irritation.12 Hypersensitivity pneumonitis occurs as a result of a Type III or possibly a Type IV hypersensitivity reaction.13 As with non-industrial food allergy or intolerance, the pathophysiological mechanism affects the choice of diagnostic tests.

Novel and uncommon food allergies

Table 10.12 makes the point that uncommon food allergens are important causes of food allergy in specific countries. In an Israel allergy clinic population, sunflower seed was responsible for 22.3 of 112 positive food challenges in subjects between 10 and 48 years of age (Kivity et al. 1994). In Singapore, out of 124 consecutive admissions with anaphylaxis, the commonest cause was bird's nest soup (Goh et al. 1999), a food not implicated in allergy elsewhere in the world. In Japan rice appears to be a relatively common cause of allergy causing atopic eczema, although more severe acute reactions to rice are rare (Ikezawa et al. 1992). Rice is also a common cause of food allergy in Thailand (Hill et al. 1997). Adverse reaction to buckwheat is a common problem in Japan. In a population of 92,680 schoolchildren in Japan, the incidence of adverse reaction to buckwheat on questionnaire was 0.22 (Takahashi et al. 1998). The risk of anaphylaxis to buckwheat was higher than for egg and milk....

Maternal intervention

Less eczema in Eczema Using eczema as the endpoint, which of course may or may not be associated with adverse food reactions, a number of studies in atopic populations using maternal dietary restriction during lactation alone (Chandra et al. 1989, Lovegrove et al. 1994, Hattevig et al. 1996) or during the last trimester of pregnancy and lactation (Chandra et al. 1986) have shown a reduction in eczema. The protective effect lasts for between 18 months and four years, with no effect being seen on ten-year follow-up (Hattevig et al. 1996). Not all the studies are randomised, and two of the studies have an unusually high prevalence of eczema in the control (no dietary restriction) population (Chandra et al. 1986, Lovegrove et al. 1994). In conclusion there is no consistent evidence to support maternal pregnancy dietary restriction in an attempt to reduce the risk of adverse food reactions. This is not surprising given the studies showing an absence of specific IgE to foods in cord blood...

Intervention strategies aimed at preventing adverse food reactions

Most of the work in this area has been directed at preventing allergic sensitisation (primary prevention), rather than the prevention or suppression of clinical disease once sensitisation has occurred (secondary and tertiary prevention respectively). Up to now, no therapy has been shown to be of value in secondary or tertiary prevention of adverse food reactions. Furthermore, whilst some studies show that pharmacological intervention may alter the incidence and natural history of asthma, there are no comparable data regarding adverse food reactions (Bustos et al. 1995, Warner 1997). This section therefore concentrates on the dietary intervention studies set up with the aim of preventing or reducing the occurrence of adverse food reactions. Some of the studies look at children with a high risk of atopy (usually defined as those children with at least one first-degree relative with documented atopic disease), others at unselected children from the general population. Most do not focus...

Implications of study design

Cohort studies are important in identifying risk factors for food allergy. This risk is usually quantified using odds ratios or relative risks. Confounding can still occur where a third factor may account for a perceived association between a particular exposure and an allergic outcome. Where such confounding variables are suspected and identified, their effects can be eliminated by the application of statistical methods such as logistic regression analysis. An example is the association seen between prolonged breast feeding and food allergy. This is not a real association as it is confounded by eczema infants with eczema are deliberately breast fed for longer periods and eczema is a known risk factor for food allergy.

Foods commonly associated with allergy Table

Yunginger et al.3 and Sampson et al.4 showed the most common cause of severe food-related allergic reactions in adults and older children to be peanuts, crustaceans, shellfish, tree nuts and fish. In selected American children with atopic dermatitis (eczema), Burks et al.5 showed that skin prick testing with eight foods identified 99 of subjects who reacted to a food in DBPCFC, even if the food causing the reaction in the challenge had not been one of the foods used for skin testing. Or, put another way, subjects who reacted to an unusual food nearly always had a positive skin prick test (SPT) to one of the eight foods used for screening with or without associated symptoms on exposure to that food. Such studies need to be repeated in different populations of subjects. There are clearly geographical variations regarding these foods because the lists involved in reactions in Britain6 are like American lists but European studies give slightly different figures regarding allergic...

Approach to food avoidance

Unconfirmed food intolerance (food known or suspected) If the food is known or suspected either from the history or from skin test or RAST, a trial exclusion diet is recommended. The period of exclusion depends, to some extent, on the type and frequency of reaction. If the subject is having frequent symptoms, for example urticarial episodes several times a week or diarrhoea, exclusion for a couple of weeks might be sufficient to gauge the response. For atopic eczema or chronic recurrent urticaria, a longer period, i.e. 2-3 months, may be required to assess improvement, allowing for spontaneous fluctuation in the disease severity. If significant improvement is observed on a trial exclusion diet, then open or DBPCFC should be performed.6 An open challenge or reintroduction of the food in the diet may be sufficient if an objective improvement has been observed, for example if the frequency and severity of urticaria or severity of eczema assessed objectively with a standardised score has...

Possible Implications Of Observations In Rat In Human Behavior

Attention-deficit hyperactive disorder (ADHD) is known to be typical among atopic patients (Stevens, 1995, 1996). Atopic dermatitis is treated effectively with steroidal anti-inflammatory drugs and other antiallergic drugs that exert their effects mainly by inhibiting the cascade of LA ARA lipid mediators of allergic, inflammatory reactions receptors (LA cascade). Clinically, decreasing the intake of LA and increasing the intake of n-3 fatty acids that are competitive effectors of the LA cascade and partial agonists for the lipid mediator receptors were shown to be effective for the prevention of atopic dermatitis (Kato, 2000) and other allergic hyperreactivities (Ashida, 1997). In rodents suffering from n-3 fatty acid deficiency, the observed decrease in the feedback suppression of negative responses in the brightness-discrimination learning test (Fig. 3) and the increase in anxiety in the elevated plus-maze test (Nakashima, 1993) appear to have characteristics common to ADHD in...

Differential diagnosis

Plaque and guttate variants pityriasis rubra pilaris seborrheic dermatitis tinea cor-poris lupus erythematosus pityriasis rosea syphilis lichen planus parapsoria-sis pityriasis lichenoides cutaneous T-cell lymphoma nummular eczema Pustular variant subcorneal pustular dermatosis acute generalized exanthematous pustulosis septicemia generalized atopic and or seborrheic dermatitis dyshidrotic eczema contact dermatitis autosensitiza-tion reaction vesicular dermatophyte infection

Microdistribution None

Figurines Desnudos

Scabies must be considered in the differential diagnosis of any generalized pruritic skin disorder especially with a history of nocturnal itching that interrupts sleep. Atopic dermatitis, generalized drug reactions, and widespread impetigo all show common features. A high index of suspicion that leads to a search for primary lesions is important to maintain. Crusted scabies can simulate eczema, psoriasis, or on rare occasions, an ery-throderma.

Conditions That May Simulate Toxicodendron Dermatitis

Many other plants, reaction including house plants, trees, and ornamental garden covers, can cause a delayed hypersensitivity. Depending on the plant and mode of contact, the pattern may show streaks of acute vesicular eczema indistinguishable from toxicodendron dermatitis. The source must be sought from the history and confirmed with a patch test.

Conditions That May Simulate Psoriasis Vulgaris

Nummular Eczema The resemblance is usually superficial. Lesions of PV tend to be more profuse and more symmetrical than those of nummular eczema. Scale of PV is also more prominent, loose, and silvery. Eczema lesions are often moist and the scale has a crackled or fissured pattern. Itching can occur in both diseases but is usually intense with nummular eczema.

Conditions That May Simulate Asteatosis

Nummular Eczema This common condition produces coin-like circular lesions, and in elderly patients may begin initially in an area of asteatosis. Lesions are discrete and much more inflammatory than those of asteatosis. Excoriation of the lesions is prominent, the surface is moist and eczematous, and the surface lacks the canal-like or craquel pattern. Initially, itching is confined to individual lesions.

Vitamin E Acetate dlVitamin E Acetate d

Tocopherol and tocopheryl acetate are used mainly as antioxidants. Tocopheryl acetate, an ester of tocopherol (vitamin E), can induce allergic contact dermatitis. De Groot AC, Berretty PJ, van Ginkel CJ, den Hengst CW, van Ulsen J, Weyland JW (1991) Allergic contact dermatitis from tocopheryl acetate in cosmetic creams. Contact Dermatitis 25 302-304 Matsumura T, Nakada T, Iijima M (2004) Widespread contact dermatitis from tocopherol acetate. Contact Dermatitis 51 211-212

Sodium Pyrosulfite Disodium Disulfite E223 CAS Registry Number [7681574O O

This agent is frequently used as a preservative in pharmaceutical products, in the bread-making industry as an antioxidant, and it can induce contact dermatitis. It can be used as a reducing agent in photography and caused dermatitis in a photographic technician, probably acting as an aggravating irritative factor. Sodium metabisulfite contains a certain amount of sodium sulfite and sodium sulfate. Acciai MC, Brusi C, Francalanci Giorgini S, Sertoli A (1993) Allergic contact dermatitis in caterers. Contact Dermatitis 28 48 Jacobs MC, Rycroft RJG (1995) Contact dermatitis and asthma from sodium metabisulfite in a photographic technician. Contact Dermatitis 33 65-66 Riemersma WA, Schuttelaar ML, Coenraads PJ (2004) Type IV hyper-sensitivity to sodium metabisulfite in local anaesthetic. Contact Dermatitis 51 148 Vena GA, Foti C, Angelini G (1994) Sulfite contact allergy. Contact Dermatitis 31 172-175

Prilocaine Hydrochloride

Prilocaine in a local anesthetic of the amide group. It can induce allergic contact dermatitis, particularly from EMLA cream. Le Coz CJ, Cribier BJ, Heid E (1996) Patch testing in suspected allergic contact dermatitis due to Emla cream in haemodialyzed patients. Contact Dermatitis 35 316-317

Glyceryl Trinitrate Glycerol Trinitrate

Aquilina S, Felice H, Boffa MJ (2002) Allergic reactions to glyceryl trinitrate and isosorbide dinitrate demonstrating cross-sensitivity. Clin Exp Dermatol 27 700-702 Kanerva L, Laine R, Jolanki R, Tarvainen K, Estlander T, Helander I (1991) Occupational allergic contact dermatitis caused by nitroglycerin. Contact Dermatitis 24 356-362 Machet L, Martin L, Toledano C, Jan V, Lorette G,Vaillant L (1999) Allergic contact dermatitis from nitroglycerin contained in 2 transdermal systems. Dermatology 198 106-107

Dipentamethylenethiuram Disulfide

Conde-Salazar L, Del-Rio E, Guimaraens D, Gonzalez Domingo A (1993) Type IV allergy to rubber additives a 10-year study of 686 cases. J Am Acad Dermatol 29 176-180 Conde-Salazar L, Guimaraens D, Villegas C, Romero A, Gonzalez MA (1995) Occupational allergic contact dermatitis in construction workers. Contact Dermatitis 35 226-230 Kiec-Swierczynska M (1995) Occupational sensitivity to rubber. Contact Dermatitis 32 171-172 Von Hintzenstern J, Heese A, Koch HU, Peters KP, Hornstein OP (1991) Frequency, spectrum and occupational relevance of type IV allergies to rubber chemicals. Contact Dermatitis 24 244-252

Captane NTrichloromethylmercaptotetrahydrophtalimide

It is used as a fungicide and a bacteriostatic agent in cosmetics and toiletries, particularly in shampoos. Cases of contact dermatitis were reported in painters, polishers, and varnishers. allergy to captan in a hairdresser. Contact Dermatitis 31 46 Moura C, Dias M, Vale T (1994) Contact dermatitis in painters, polishers and varnishers. Contact Dermatitis 31 51-53 O'Malley M, Rodriguez P, Maibach HI (1995) Pesticide patch testing California nursery workers and controls. Contact Dermatitis 32 61-62 Peluso AM, Tardio M, Adamo F, Venturo N (1991) Multiple sensitization due to bis-dithiocarbamate and thiophthalimide pesticides. Contact Dermatitis 25 327 Vilaplana J, Romaguera C (1993) Captan, a rare contact sensitizer in hair-dressing. Contact Dermatitis 29 107

Caffeic Acid Dimethyl Allylic Ester

Lamminpaa A, Estlander T, Jolanki R, Kanerva L (1996) Occupational allergic contact dermatitis caused by decorative plants. Contact Dermatitis 34 330-335 Oliwiecki S, Beck MH, Hausen BM (1992) Occupational contact dermatitis from caffeates in poplar bud resin in a tree surgeon. Contact Dermatitis 27 127-128

Recognition of Microbial Components

Forward View Summary

Inflammatory mechanism - perhaps combined with direct strengthening of epithelial integrity (Fig. 3.10). Notably, the most promising results have been reported for atopic eczema 209 . This skin disease is often seen in patients with IgE-mediated food allergy (20-40 ) and is particularly associated with loss-of-function mutations in the fillagrin gene, which is involved in the epidermal barrier function 214 . Similar mutations appear to predispose for the combination of atopic eczema and asthma 215 . These findings apparently reflect that a leaky surface epithelium anywhere in the body may be a predisposing condition for allergen penetration, and that food allergy could be a consequence rather than a cause of atopic eczema 12 . Therefore, the use of this disorder as a clinical read-out of intervention effects on food allergy may not be scientifically acceptable.

Clinical Presentations

At least two clinical presentations of ATIN due to diuretics occur. An insidious form in which renal failure appears to develop over a several-month period of time and an acute form which develops over days to a few weeks. In the first form the onset of renal failure from the time of initiation of diuretic therapy varies from 3 to 12 months. Gradual onset of renal failure often is associated with skin rash and peripheral eosinophilia occur in this form of ATIN. In addition, many of these patients have underlying glomerulonephropathy with nephrotic syndrome. A clue to the diagnosis of ATIN in such cases is an accelerated rate of deterioration in renal function. The second form occurs shortly after initiation of therapy ranging from a few days up to 1 month. In many of these cases thiazides and triamterene were administered concomitantly. Both forms may present with systemic manifestations including fever, myalgia skin rash, and eosinophilia. Importantly, discontinuation of the diuretic...

Characteristics of patients with food intolerance

Briefly, intolerance reactions are more common in adults and a wide range of responsible foods and symptoms induced are demonstrated.11,12 It must be remembered that not all IgE-mediated disease occurs immediately. There is a well-described phenomenon of late-phase IgE reactions with late urticaria (itchy hives) and oedema (swelling) within the first 24 hours of exposure to the foods. It can be difficult to distinguish clinically this 24-48 hour reaction from that which is caused by non-IgE-mediated immunological reactions such as those that cause an exacerbation of eczema. Often the temporal association with a dietary exposure to allergen is the only clue.

Zinc NNDibutyldithiocarbamate CAS Registry Number [136232 SS

Conde-Salazar L, Del-Rio E, Guimaraens D, Gonzalez Domingo A (1993) Type IV allergy to rubber additives a 10-year study of 686 cases. J Am Acad Dermatol 29 176-180 Conde-Salazar L, Guimaraens D, Villegas C, Romero A, Gonzalez MA (1995) Occupational allergic contact dermatitis in construction workers. Contact Dermatitis 35 226-230 Kiec-Swierczynska M (19959 Occupational sensitivity to rubber. Contact Dermatitis 32 171-172

ONitrop Phenylenediamine Onpd Ci 76070 CAS Registry Number [5307142 NH2

Frosch PJ, Burrows D, Camarasa JG, Dooms-Goossens A, Ducombs G, Lahti A, Menne T, Rycroft RJG, Shaw S, White IR, Wilkinson JD (1993) Allergic reactions to a hairdresser's series results from 9 European centres. Contact Dermatitis 28 180-183 Guerra L, Tosti A, Bardazzi F, Pigatto P, Lisi P, Santucci B, Valsecchi R, Schena D,Angelini G, Sertoli A,Ayala F, Kokelj F (1992) Contact dermatitis in hairdressers the Italian experience. Gruppo Italiano Ricerca Dermatiti da Contatto e Ambientali. Contact Dermatitis 26 101-107 Van der Walle HB, Brunsveld VM (1994) Dermatitis in hairdressers (I). The experience of the past 4 years. Contact Dermatitis 30 217-220

DihydroxyN3Hydroxypropyl33Dimethylbutanamide Pantothenylol NPantoyl3Propanolamine Panthenol Pantothenyl Alcohol

Pan(to)thenol is the alcohol corresponding to pantothenic acid,of the vitamin B5 group. It is used as a food additive, and in skin and hair products as a conditioning agent. Contact dermatitis and urticaria have been reported. nol in hair conditioner. Contact Dermatitis 43 223 Stables GI, Wilkinson SM (1998) Allergic contact dermatitis due to panthenol. Contact Dermatitis 38 236-237

Polyvinylpyrrolidone Polyvidone Povidone 2Pyrrolidinone 1Ethenyl Homopolymer

Adachi A, Fukunaga A, Hayashi K, Kunisada M, Horikawa T (2003) Anaphylaxis to polyvinylpyrrolidone after vaginal application of povidone-iodine. Contact Dermatitis 48 133-136 Ronnau AC, Wulferink M, Gleichmann E, Unver E, Ruzicka T, Krutmann J, Grewe M (2000) Anaphylaxis to polyvinylpyrrolidone in an analgesic preparation. Br J Dermatol 143 1055-1058

With the Patients Own Products

Commercially available patch test kits (standard series and various supplementary series) are the basis of a diagnostic work-up if an allergic contact dermatitis is to be confirmed. However, various investigators have shown that this way of testing is not sufficient. Menn et al. 20 found in a multicenter study that the European Standard Series detects only 37-73 of the responsible allergens in patients with contact dermatitis. The additional and or separately tested allergens were positive in 5-23 the authors emphasize the necessity of testing with the products actually used by the patient. In Italy, an analysis of 230 patients referred to a contact clinic because of suspected occupational contact dermatitis showed that the standard series alone detected 69.9 of all cases considered to be of an allergic nature 22 26.3 of all allergic cases were positive only to supplementary series. The agents most commonly responsible for allergic contact dermatitis were metals and...

Application to the diagnosis of food allergy

Foodstuffs are an uncommon cause of immunologically mediated contact dermatitis, although regular contact with vegetables and meat can certainly irritate intact or eczematous skin. Plant-derived saps such as from poison ivy and poison oak can cause a characteristic contact dermatitis. There exists cross-reactivity with these saps and mango skin and the oil from cashew nut shells. Some clinicians claim an exacerbation of eczema atopic dermatitis in patients who are patch test positive to nickel, cobalt and balsam of Peru, following oral ingestion of foods containing these substances. They similarly claim an improvement in these patients' conditions when they manipulate their diet to reduce the amount of these substances. There is some double-blind placebo-controlled evidence to support this, although there are some problems with the study design, in particular with the amount, source and form in which the salts are ingested. An exacerbation of eczema following oral ingestion of foods...

R34Dimethoxy Dalbergione

Chieregato C,Vincenzi C, Guerra L, Rapacchiale S (1993) Occupational airborne contact dermatitis from Machaerium scleroxylum (Santos rosewood). Contact Dermatitis 29 164-165 Lamminp A, Estlander T, Jolanki R, Kanerva L (1996) Occupational allergic contact dermatitis caused by decorative plants. Contact Dermatitis 34 330-335

Specific History

A simple scratch or nick can trigger an episode. On the face and head, infection may be secondary to fissuring of chronic eczema or may complicate trauma to the auditory meatus as patients manipulate the canal while relieving the itch of a chronic dermatitis. In children, periorbital cellulitis has been associated with middle-ear infections, and orbital cellulitis has been associated with chronic sinusitis in older children and in adults. On the lower extremities, Assuring from dermatophytosis or chronic stasis ulceration is a predisposing factor. These conditions often act in concert with long-standing lymphatic injury from old trauma or chronic phlebitis. A recently defined syndrome of recurrent cellulitis of the lower extremities has been reported in cardiac bypass patients where vessel harvesting in the lower extremities has disrupted the normal venous and lymphatic return. Diabetes mellitus, neutropenia, IV drug abuse, and immunosuppression predispose patients to the more severe...

Grape Vine

It is said in Iowa that a vine leaf in the hat will prevent sunstroke (Stout), and in Kentucky, they say that rubbing the sap from a grape vine on the hair will make it grow (Thomas & Thomas). Sap collected when growth starts in the spring is used for eczema in some country areas, and drops of it are also used for eye infections (Shauenberg & Paris).


This benzoxepin tricylcic drug has antidepressant, anticholin-ergic, anti-itching, and antihistamine properties. After oral use, it has been developed as a topical anti-itching agent. Allergic contact dermatitis is not infrequent. Buckley DA (2000) Contact allergy to doxepin. Contact Dermatitis 43 231-232 Taylor JS, Praditsuwan P, Handel D, Kuffner G (1996) Allergic contact dermatitis from doxepin cream. One-year patch test clinic experience. Arch Dermatol 132 515-518 Holness DL, Nethercott JR (1993) The performance of specialized collections of bisphenol A epoxy resin system components in the evaluation of workers in an occupational health clinic population. Contact Dermatitis 28 216-219 Rebandel P, Rudzki E (1990) Dermatitis caused by epichlorhydrin, oxpren-olol hydrochloride and propranolol hydrochloride. Contact Dermatitis Van Jost T, Roesyanto ID, Satyawan I (1990) Occupational sensitization to epichlorhydrin (ECH) and bisphenol-A during the manufacture of epoxy resin. Contact...


Toluene-2,5-diamine is a permanent hair dye involved in contact dermatitis in hairdressers and consumers. It does not cross-react with PPD, but co-sensitization is frequent. Frosch PJ, Burrows D, Camarasa JG, Dooms-Goossens A, Ducombs G, Lahti A, Menne T, Rycroft RJG, Shaw S, White IR, Wilkinson JD (1993) Allergic reactions to a hairdresser's series results from 9 European centres. Contact Dermatitis 28 180-183 Guerra L, Tosti A, Bardazzi F, Pigatto P, Lisi P, Santucci B, Valsecchi R, Schena D,Angelini G, Sertoli A,Ayala F, Kokelj F (1992) Contact dermatitis in hairdressers the Italian experience. Gruppo Italiano Ricerca Dermatiti da Contatto e Ambientali. Contact Dermatitis 26 101-107 Le Coz CJ, Lefebvre C, Keller F, Grosshans E (2000) Allergic contact dermatitis caused by skin painting (pseudotattooing) with black henna, a mixture of henna and p-phenylenediamine and its derivatives. Arch Dermatol 136 1515-1517


Rotacion Lateral Medial Rodilla

An 11-month-old infant presents at your office with an intensely pruritic generalized atopic dermatitis with multiple areas of excoriation and lichenification in some flexor locations. The eruption spares only the diaper area, the palms, and the soles. Most skin regions are dry and fissured. Because the epidermis is the major barrier, abraded or damaged skin will be more susceptible to the effects and side effects of topically applied substances. Atopic dermatitis, exfoliative eruptions, and skin that is fissured or ulcerated exhibit enhanced absorption of applied substances because of alterations and breaks in the barrier. Typical plaque psoriasis has an absorptive capacity similar to normal skin however, thick scale or crusting will markedly decrease the absorptive capacity. 3. Systemic steroids can result in severe withdrawal flares in some cases of psoriasis and atopic dermatitis. In psoriasis, these can, on rare occasion, be life-threatening. Because both diseases are chronic and...


Bullous Impetigo Eyelid

INTRODUCTION Impetigo represents a superficial invasion of the skin by pathogenic streptococci, staphylococci, or sometimes a mixture of both. Infections tend to occur in areas of previously compromised or diseased skin, such as skin affected by dermatitis, especially eczema, or in a recently lasered resurfaced skin. Owing to the superficial location there is rarely any systemic reaction of consequence. However, in rare instances the bacterial infection may result in the formation of antigen-antibody complexes that can lead to a life-threatening nephritis.

Mycosis Fungoides

Mycosis Fungoides Bilder

The disease typically progresses through three characteristic phases. The first is a pruritic, disseminated, eczematous dermatitis that ultimately progresses to infiltrating and plaque forming lesions and terminates in a tumor phase. Eyelid lesions are usually seen in the later tumor phase. However, the disease may start with skin tumors without a preceding dermatitis. The Sezary syndrome with skin involvement, adenopathy and hepatosplenomegaly represents a leukemic form of mycosis fungoides. In all types, this disease is characterized by a slowly progressive indolent course with episodes of remissions and exacerbations. Ultimately the disease can prove fatal due to involvement of lymph nodes, bone marrow, and visceral organs. Survival ranges from seven months to two years. Death usually results from sepsis or from systemic involvement with lymphoma. CLINICAL PRESENTATION The disease begins as a chronic, pruritic, scaling dermatitis. This premycotic stage is represented by an...


The causes of vulvovaginitis in children are shown in Table 37.1 The vast majority of cases are due to nonspecific bacterial contamination, although the other causes should be remembered. Candidal infection in children is extremely rare, although because it is a common cause of vulvovaginitis in the adult it is a common misdiagno-sis in children. Candida in children is usually associated with diabetes mellitus or immunodeficiency and almost entirely related to these two medical disorders. The presence of viral infections, for example, herpes simplex or condyloma acuminata, should alert the clinician to the possibility of sexual abuse. Vulval skin disease is not uncommon in children, particularly atopic dermatitis in those children who also have eczema. Referral to a dermatologist is appropriate in these circumstances. Lichen sclerosis is also seen in children and may cause persistent vulval itching. The skin undergoes atrophy and fissuring and is very susceptible to secondary...


The signs of systemic sepsis are non-specific. Infants may present with apnoea, bradycardia or cyanotic episodes poor feeding is a common association. They may be lethargic and hypotonic and they are hyper or hypother-mic. Sepsis frequently presents as a metabolic acidosis or shock and occasionally causes petechial skin rash or severe jaundice.



Diphencyprone is a potent contact allergen used in topical immunotherapy, to treat some severe alopecia areata. It is responsible for occupational contact dermatitis in chemists and dermatology department staff. diphencyprone in a chemist. Contact Dermatitis 32 363 Temesv ri E, Gonz lez R, Marschalk M, Horv th A (2004) Age dependence of diphenylcyclopropenone sensitization in patients with alopecia areata. Contact Dermatitis 50 381-382 Dermatitis 32 171-172 Von Hintzenstern J, Heese A, Koch HU, Peters KP, Hornstein OP (1991) Frequency, spectrum and occupational relevance of type IV allergies to rubber chemicals. Contact Dermatitis 24 244-252 Bruze M, Kestrup L (1994) Occupational allergic contact dermatitis from diphenylguanidine in a gas mask. Contact Dermatitis 31 125-126 Conde-Salazar L, Del-Rio E, Guimaraens D, Gonzalez Domingo A (1993) Type IV allergy to rubber additives a 10-year study of 686 cases. J Am Acad Dermatol 29 176-180 Kiec-Swierczynska M (1995) Occupational...

Basal Cell Carcinoma

Basal Cell Carcinoma Nodule

DIFFERENTIAL DIAGNOSIS The differential diagnosis includes malignant melanoma, sebaceous cell carcinoma, squamous cell carcinoma, actinic keratosis, radiation dermatitis, keratoacanthoma, cutaneous horns, dermoid and sebaceous cysts, eccrine and apocrine cysts, papillomatous lesions, seborrheic kertosis, blepharitis, chalazion, eczema, psoriasis, and seborrheic dermatitis.


Octocrylene is an anti-UVB filter used in cosmetics that may induce photoallergic contact dermatitis. Carrotte-Lefebvre I, Bonnevalle A, Segard M, Delaporte E, Thomas P (2003) Contact allergy to octocrylene. Contact Dermatitis 48 46-47 De Groot AC, Gerkens F (1990) Occupational airborne contact dermatitis from octyl gallate. Contact Dermatitis 23 184-186 Giordano-Labadie F, Schwarze HP, Bazex J (2000) Allergic contact dermatitis from octyl gallate in lipstick. Contact Dermatitis 42 51


This quaternary ammonium compound is used as a detergent-disinfectant in hospitals, as an algaecide in swimming pools, as a fungicide, and against termites in wood. We recently observed severe contact dermatitis in a slaughterhouse worker using a liquid soap containing this product (personal observation). Dejobert Y, Martin P, Piette F, Thomas P, Bergoend H (1997) Contact dermatitis from didecyldimethylammonium chloride and bis-(amino-propyl)-laurylamine in a detergent-disinfectant used in hospital. Contact Dermatitis 37 95-96


Used as a polyvinyl chloride solvent, cyclohexanone caused contact dermatitis in a woman manufacturing PVC fluidotherapy bags.Cyclohexanone probably does not cross-react with cyclohexanone resin. A cyclohexanone-derived resin used in paints and varnishes, caused contact dermatitis in painters. Bruze M, Boman A, Bergquist-Karlson A, Bjorkner B, Wahlberg JE, Woog E (1988) Contact allergy to cyclohexanone resin in humans and guinea pigs. Contact Dermatitis 18 46-49 Sanmartin O, de la Cuadra J (1992) Occupational contact dermatitis from cyclohexanone as a PVC adhesive. Contact Dermatitis 27 189-190


Of SCENTED MAYWEED is another possibility (Fluck). Thomas Hill, in 1577 was of opinion that PURSLANE helpeth the shingles , so, he claimed, does CHICORY. WHITE HOREHOUND was made up in Wales as an infusion, to be used both externally and internally, for eczema and shingles (Conway), and MARIGOLD is still used by herbalists for both chickenpox and shingles (Warren-Davis).


Nicotine is an alkaloid found in tobacco, and is responsible for its pharmacological effects and addiction. Contact dermatitis from nicotine, considered as rare, has been more frequent since its use in transdermal systems. Irritant dermatitis is mainly encountered, as contact urticaria seems to be rare. Allergic contact dermatitis, sometimes generalized, has been reported, with positive patch testing to nicotine base (10 ethanol or petrolatum). No consequences have been reported in patients who start smoking again after skin sensitization. a transdermal therapeutic system. Contact Dermatitis 25 230-236 Vincenzi C, Tosti A, Cirone M, Guarrera M, Cusano F (1993) Allergic contact dermatitis from transdermal nicotine systems. Contact Dermatitis 29 104-105

Clinical Features

It is probable that all PPVs are able to infect humans, although a human case of the PPV of red deer has not been reported. Transmission to humans occurs readily although there is little evidence of human to human transmission. Progression of the lesions is essentially as seen in sheep and cattle such that the infection is benign and confined to pustular lesions on the skin at the points of infection. More severe progressive disease can occur in immune-compromised individuals. Severe reactions have also been recorded in otherwise normal individuals in cases of burns and in cases of atopic dermatitis. Erythema multiformae reactions in the form of rashes on the backs of the hands and on the legs and ankles are common.


The use of yarrow for various skin complaints was quite widespread. Its fresh tops were made into a poultice for eczema by some of the American Indian peoples (Corlett). Irish country people have a herb poultice with which to dress a whitlow - yarrow leaves, fresh grass and a herb called finabawn, whatever that is. Equal parts of the herbs are ground up thoroughly, and then beaten up with white of egg. This is put on the inflamed finger, and it must not be changed for 48 hours (Logan).

Dibutyl Phthalate

Capon F, Cambie MP, Clinard F, Bernardeau K, Kalis B (1996) Occupational contact dermatitis caused by computer mice. Contact Dermatitis 35 57-58 Chieregato C, Vincenzi C, Guerra L, Farina P (1994) Occupational allergic contact dermatitis due to ethylenediamine dihydrochloride and cresyl glycidyl ether in epoxy resin systems. Contact Dermatitis 30 120


Herbalists still prescribe it as a diuretic and sedative, hence as a painkiller (Le Strange). Drinking the infusion can help aching joints, and sciatica can be treated with it the practice in the Highlands (Beith) and in Ireland (Moloney) was to make a poultice of the crushed herb. Eczema can be cured by drinking daily a half pint of the tea (A W Hatfield), and in East Anglia, the juice was squeezed on warts (V G Hatfield).

Paratert Butylphenol

Handley J, Todd D, Bingham A, Corbett R, Burrows D (1993) Allergic contact dermatitis from para-ferfi'ary-butylphenol-formaldehyde resin (PTBP-F-R) in Northern Ireland. Contact Dermatitis 29 144-146 Mancuso G, Reggiani M, Berdondini RM (1996) Occupational dermatitis in shoemakers. Contact Dermatitis 34 17-22 Shono M, Ezoe K, Kaniwa MA, Ikarashi Y, Kohma S, Nakamura A (1991) Allergic contact dermatitis from para-tertiary-butylphenol-formalde-hyde resin (PTBP-FR) in athletic tape and leather adhesive. Contact Dermatitis 24 281-288 Tarvainen K (1995) Analysis of patients with allergic patch test reactions to a plastics and glue series. Contact Dermatitis 32 346-351

Food additives

The commonest food additives thought to cause adverse reactions are tartrazine (E102), sunset yellow (E110), annatto, aspartame, benzoic acid and sulphites (Fuglsang et al. 1993). Key epidemiological studies are shown in Table 10.9. Adverse reactions to food additives can occur at any age. A UK study showed a higher reporting of adverse reactions to food additives in the first ten years of life, and more often occurring in females (Young et al. 1987). The mechanism of the reaction is often unknown, and IgE-mediated reactions are rare. Questionnaire-based studies give a high 6.6-7.4 prevalence of self-reported adverse reactions to food additives in the general population. However, when food challenges are used to make the diagnosis, the prevalence falls to about 0.23 . One study shows the risk to be greatest in the atopic population, with no reactions observed in non-atopic individuals (Fuglsang et al. 1994). Virtually all reactions are minor and limited to the skin (worsening of...


The signs of eczema and atopic dermatitis have proved difficult to define.17 The acute signs include erythematous (red) and vesicular (blistered) skin. More chronically one finds lichenified (thickened), oedematous (swollen) and cracked areas of skin. The picture and distribution is slightly different depending upon the age of the patient.


Oral sodium cromoglycate may be useful in some patients with multiple food allergies.12 It is a less effective but safer alternative to steroids in the management of chronic food allergy not responding adequately to food allergen avoidance. However, it should not be used in place of allergen avoidance. Acute symptoms such as bronchospasm, rash, nausea and diarrhoea respond better than do chronic food-related diseases such as atopic eczema. Side effects are minimal, although nausea, rashes and joint pain have been reported.

The Coeliac Society

The Coeliac Society was founded in 1968 as a national support group for people with coeliac disease and dermatitis herpetiformis. Coeliac disease is a lifelong inflammatory condition of the intestinal tract which affects the small intestine in genetically susceptible individuals. This is caused by gluten, a protein in wheat, and similar proteins in rye, barley and oats.

Prickpuncture tests

Small drops of each allergen extract are placed at least 2 cm apart on the skin. A hypodermic needle is placed at an angle through the drop of liquid and the needle tip is gently inserted to lift the top layer of epidermis, without causing bleeding. A separate needle is used for each allergen extract to reduce the risk of cross-contamination. Positive and negative controls are also used. The negative control identifies the patient with significant dermographism (non-specific skin sensitivity), reducing the chance of false positive reactions. This is commonly allergen diluent, or normal saline. The positive control commonly used is histamine phosphate (1 mg ml of histamine base).

Patch testing

Patch testing is a diagnostic tool commonly employed in the diagnosis of contact dermatitis. This may be irritant or allergic in origin. It may be difficult and even artificial to distinguish between these two. Irritants make up about 80 of the problem, and an allergic cause can be attributed to about 20 of patients with contact dermatitis. It is rarely used in the investigation of systemically induced food allergies.12 Patch testing infants suffering from eczema with cow's milk may hold some diagnostic promise.1 Patch testing is commonly used to identify substances to which the patient may have become sensitised and that are either causing their dermatitis or aggravating their eczema atopic dermatitis. These substances are derived from many sources - environmental, domestic or cosmetic, or the topical applications actually being used to treat the patient's skin. Food substances can cause contact dermatitis.

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