Publications (62) View all
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Article: Kontaktdermatitis auf para-Phenylendiamin in Haarfärbemitteln bei vorausgegangener Sensibilisierung nach "Black-Henna-Tattoos"- ein aktuelles Problem.
Journal der Deutschen Dermatologischen Gesellschaft 08/2012; 10(8):572-8. · 1.47 Impact Factor -
Article: Contact dermatitis to para-phenylenediamine in hair dye following sensitization to black henna tattoos - an ongoing problem.
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ABSTRACT: The increased frequency of case reports of allergic contact dermatitis from non-permanent black henna tattoos in recent years shows the popularity of this form of body painting. Seven patients presented with allergic contact dermatitis after initial hair or eyelash dyeing. They all had a history of a previous reaction from a black henna tattoo. All were patch tested with the European standard patch test series and the standard supplemental series, as well as special series for dyes and hairdressers. All seven patients showed a positive reaction in patch testing with para-phenylenediamine (PPD) (0.3 % and/or 1.0 % in pet.). Five patients also had positive reactions to other dyes such as aminophenol, para-toluene diamine, disperse orange and yellow and four patients reacted to benzocaine. These were interpreted as cross-reactions. The time from sensitization by the black henna tattoo to the onset of allergic contact dermatitis after hair dyeing was an average of 6.2 years. The most common cause of allergic contact dermatitis after black henna tattoos is PPD. Both the long skin contact and the high concentrations of PPD increase the risk of sensitization. Allergic contact dermatitis may be followed by post-inflammatory hyper- or hypopigmentation, scarring and lifelong sensitization, which can have occupational impact, especially for hair dressers and cosmeticians.Journal der Deutschen Dermatologischen Gesellschaft 02/2012; 10(8):572-8. · 1.47 Impact Factor -
Article: Implementation of anaphylaxis management guidelines: a register-based study.
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ABSTRACT: Anaphylaxis management guidelines recommend the use of intramuscular adrenaline in severe reactions, complemented by antihistamines and corticoids; secondary prevention includes allergen avoidance and provision of self-applicable first aid drugs. Gaps between recommendations and their implementation have been reported, but only in confined settings. Hence, we analysed nation-wide data on the management of anaphylaxis, evaluating the implementation of guidelines. Within the anaphylaxis registry, allergy referral centres across Germany, Austria and Switzerland provided data on severe anaphylaxis cases. Based on patient records, details on reaction circumstances, diagnostic workup and treatment were collected via online questionnaire. Report of anaphylaxis through emergency physicians allowed for validation of registry data. 2114 severe anaphylaxis patients from 58 centres were included. 8% received adrenaline intravenously, 4% intramuscularly; 50% antihistamines, and 51% corticoids. Validation data indicated moderate underreporting of first aid drugs in the Registry. 20% received specific instructions at the time of the reaction; 81% were provided with prophylactic first aid drugs at any time. There is a distinct discrepancy between current anaphylaxis management guidelines and their implementation. To improve patient care, a revised approach for medical education and training on the management of severe anaphylaxis is warranted.PLoS ONE 01/2012; 7(5):e35778. · 4.09 Impact Factor -
Article: Failure of omalizumab (Xolair®) in the treatment of a case of solar urticaria caused by ultraviolet A and visible light.
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ABSTRACT: Solar urticaria is a rare photodermatosis probably caused by a chromophore, that - if activated by light of a specific spectrum - binds to mast cell-bound IgE and elicits degranulation. In our patient an action spectrum in ultraviolet A and visible light range was found, in the autologous serum test the presence of a serum chromophore for the same action spectra could be demonstrated, which may underline this pathogenetic hypothesis. Symptoms did not improve using antihistamines and sun protection. Photo hardening was denied from the patient, immunosuppression and plasmapheresis were discussed but not considered. So a treatment with Omalizumab was started that recently was successfully used in 4 case reports. After 3 doses of Xolair® there was no changing in the phototesting results and after 4 doses no subjective improvement.Photodermatology Photoimmunology and Photomedicine 12/2011; 27(6):336-7. · 1.30 Impact Factor -
Article: Allergic complications from orthopaedic joint implants: the role of delayed hypersensitivity to benzoyl peroxide in bone cement.
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ABSTRACT: Orthopaedic implants and osteosynthesis materials are increasingly being used. Complications include mainly physical-mechanical problems and infections. Uncommonly, an allergic reaction towards an alloy metal or a bone cement component has been implicated. Potential bone cement allergens include acrylates, benzoyl peroxide, N,N-dimethyl-p-toluidine, and gentamicin. Typical symptoms are pain, swelling, inflammatory skin reactions, implant loosening, and fistula formation. To report on 5 patients with complications from a knee or a shoulder joint implant in whom a relevant sensitization to benzoyl peroxide was shown. Patch tests were performed with the European baseline series, an extended metal series, and a bone cement series. Patch tests with benzoyl peroxide were performed twice in all patients. A bone cement-free replacement was chosen in sensitized patients. In 4 patients sensitized to benzoyl peroxide, a bone cement-free replacement resulted in a considerable decrease or disappearance of pain and swelling, and complete clearing of cutaneous symptoms. Components of bone cement, such as benzoyl peroxide, may rarely cause allergic complications. However, because of the irritant potential of these substances, careful performance, reading and interpretation of the patch tests is required.Contact Dermatitis 11/2011; 66(1):20-6. · 3.51 Impact Factor
