intradermal test with vitamin K1 might be done, although caution Background: KRAK Study is a Polish multi-centre patch test study
is warranted not to sensitize the patient.
utilizing the new Polish Baseline Series (introduced in June 2010),which basically consists of European Baseline Series supplemented Conflicts of interest: The authors have declared no conflicts.
with two frequent and relevant sensitizers palladium and propolis.
Objectives: To analyse KRAK Study patch test results with the new
Polish Baseline Series.
Methods: Eleven participating dermatology and allergy centres
Allergic contact dermatitis to benzoyl peroxide
submitted data of patients tested to the Polish Baseline Series within topical acne treatments
(Chemotechnique Diagnostics) from June 2010 until October JDL Williams1, S Felton1, A Weidmann1 and D Orton2 Results: Altogether, 624 patients (475 women and 149 men aged
Salford Royal NHS Foundation Trust, Manchester, UK and 0 to 85, median 36 years) were patch tested in participating centres.
Buckinghamshire Healthcare NHS Trust, Amersham, UK At least one positive reaction was recorded in 370 patients (59.3%).
Benzoyl peroxide (BPO) is a recognized cause of allergic contact In 255 patients (40.9%), at least one positive test was deemed dermatitis (ACD). We report two patients presenting with florid clinically relevant (higher rates in children and adolescents: 65.4% facial dermatitis secondary to BPO in topical acne treatments.Case 1.
and 46.5%, respectively). The top 16 sensitizers were nickel (33.5% A 20-year old patient was admitted to hospital with acute onset facial positive; 24.7% deemed clinically relevant), cobalt (16.2% and 8.3%, erythema and oedema 2 weeks after commencing topical treatment respectively), chromium (14.7%; 7.1%), palladium (11.4%; 4.2%), with Duac gel (5% BPO and 1% clindamycin phosphate) for facial paraphenylenediamine (7.4%; 3.8%), balsam of Peru (6.6%; 2.7%), acne. Patch testing was performed to our hospital standard battery, fragrance mix I (6.3%; 3.4%), propolis (4.6%; 1.4%), fragrance mix II the face series, parts of the plant series and other relevant allergens (3.4%; 1.6%), neomycin (3.4%; 1.0%), wool alcohols (2.6%; 1.4%), appropriately applied in Finn chambers on Scanpor (Epitest).
colophonium (2.4%; 1.6%), lyral (2.4%; 1.1%) MI/MCI 0.01% (2.1%; There were positive reactions to BPO (++,D4) and Duac 10% 1.6%), paraben mix and primin (each 1.9%; 1.1%). Noteworthy, the in aqueous solution (+++,D4). (Preliminary testing to Duac 5% two additions to the Polish Baseline Series – palladium and propolis occupied ranks 4 and 8, respectively. Also interestingly, 10 patients Case 2. A 42-year old lady developed intense irritation, erythema (1.6%) reacted to palladium, but not nickel, suggesting that under and scaling whilst using Duac gel and Quinoderm cream (10% modern environmental exposures palladium is not just a mere BPO) topically for facial acne. Prior to dermatological assessment cross-reactivity to nickel, as commonly believed.
she had performed ‘home patch testing’ to Quinoderm on her Conclusions: Polish patients are most frequently sensitized to
forearm which was ‘positive’. She reported similar reactions metals and cosmetic ingredients. Natural remedies containing previously to sunscreen products, certain cosmetics and fabric balsam of Peru and propolis should be avoided because of high sticking plasters. Patch testing was performed to the standard sensitization rates. Our results confirm that palladium and propolis series, cosmetic series, sunscreens with photopatch testing, BPO are frequent sensitizers and are important additions to the baseline (1% pet) and to both Duac gel and Quinoderm cream. There were positive reactions to BPO (++,D4), Duac (++,D4) and Conflicts of interest: The authors have declared no conflicts.
Quinoderm (++,D4) in addition to colophonium (+,D4) andphenyl salicylate (+,D4). There are few reports of BPO in topical acnepreparations causing ACD. Given the increased use of such acne treatments and the availability of Quinoderm over-the-counter,we seek to highlight this source of exposure and the severity of Evaluation of a tertiary prevention program
reactions. Given that patients may be warned that such topical for occupational skin diseases
treatments can cause skin irritation, they may mistakenly believe R Brans1, SM John1, C Skudlik1, E Weisshaar2, R Scheidt2, that the early symptoms of ACD are attributable to an irritant P Elsner3, B Wulfhorst1, M Sch ¨onfeld4 and TL Diepgen2 effect and so continue their usage until reactions becomes more 1University of Osnabrueck, Osnabrueck, Germany, 2University of Heidelberg, Heidelberg, Germany, 3Friedrich Schiller University, Conflicts of interest: The authors have declared no conflicts.
Jena, Germany, and 4Clinic for Occupational Diseases of the VBG,Bad Reichenhall, Germany Background: Occupational skin diseases (OSD) have been leading
Krak: first multi-centre study of the new polish
among occupational diseases in industrialized countries for years.
Contact dermatitis (CD) is the most common OSD. In Germany, baseline series
an interdisciplinary integrated (inpatient/outpatient) rehabilitation R Spiewak1, A Gregorius1, E Grubska-Suchanek2, A Cisowska3, program consisting of an intensified dermatological treatment, K Jedrzejewska-Jurga4, M Pasnicki5, A Krakowski5, health education and psychological intervention is offered for severe M Cendrowska-Pinkosz6, P Sznelewski7 and R Olszanski8 cases of OSD as a tertiary individual prevention measure since 1994 1Faculty of Pharmacy, Jagiellonian University Medical College, Krakow, Poland, 2Medical University, Gdansk, Poland, Objectives: Evaluation of this interdisciplinary tertiary prevention
3Dermatology Practice, Kamienna Gora, Poland, 4Regional Centre program in a large cohort of patients with severe OSD.
of Occupational Medicine, Wroclaw, Poland, 5NZOZ Methods: In 2005 a prospective cohort multicentre study was
Allergicus-Dent, Zary, Poland, 6Medical Centre ‘Alergologia’, initiated. 1788 patients with severe OSD (93.4% CD) were recruited Lublin, Poland, 7Military Medical Institute, Warszawa, Poland, and until 2009 in five participating centres. Regular follow-ups of these 8Dermatology and Allergy Practice, Gdynia, Poland patients for up to 5 years have been scheduled.
 2012 The Authors
Contact Dermatitis  2012 John Wiley & Sons A/S, 66 (Suppl. 2), 54–65

Source: http://radoslawspiewak.net/a12-01.pdf

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