Radoslaw Spiewak
Siemanko (hiya, Hallochen)!
Research interests
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InterestsAtopic Dermatitis, Urticaria, Contact Dermatitis, Allergy, Allergic Diseases, Allergens, Allergic Dermatological Disorders in Children, Skin Diseases, Pediatric Dermatology, Psoriasis, Acne, Skin Aging, Dermatitis, Skin Care, Skin Absorption, Skin, Skin Biology, Skin and Connective Tissue Diseases
Publications
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3.64Impact points
Current patch test results with the European baseline series and extensions to it from the 'European Surveillance System on Contact Allergy' network, 2007-2008.
Contact dermatitis. 04/2012;
Background. The pattern of contact sensitization to the supposedly most important allergens assembled in the baseline series differs between countries, presumably at least partly because of exposure differences. Objectives. To describe the prevalence of contact sensitization to allergens tested in c... [more] Background. The pattern of contact sensitization to the supposedly most important allergens assembled in the baseline series differs between countries, presumably at least partly because of exposure differences. Objectives. To describe the prevalence of contact sensitization to allergens tested in consecutive patients in the years 2007 and 2008, and to discuss possible differences. Methods. Data from the 39 departments in 11 European countries comprising the European Surveillance System on Contact Allergy network (www.essca-dc.org) in this period have been pooled and analysed according to common standards. Results. Patch test results with the European baseline series, and country-specific or department-specific additions to it, obtained in 25 181 patients, showed marked international variation. Metals and fragrances are still the most frequent allergens across Europe. Some allergens tested nationally may be useful future additions to the European baseline series, for example methylisothiazolinone, whereas a few long-term components of the European baseline series, namely primin and clioquinol, no longer warrant routine testing. Conclusions. The present analysis points to 'excess' prevalences of specific contact sensitization in some countries, although interpretation must be cautious if only few, and possibly specialized, centres are representing one country. A comparison as presented may help to target in-depth research into possible causes of 'excess' exposure, and/or consideration of methodological issues, including modifications to the baseline series.
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4.26Impact points
A European Multi-centre Photopatch Test Study (EMCPPTS).
The British journal of dermatology. 01/2012;
Background: The two most common agent groups currently responsible for photoallergic contact dermatitis (PACD) are organic ultraviolet (UV) absorbers in sunscreens and topical nonsteroidal anti-inflammatory drugs (NSAIDs). However, availability of information on the photoallergenic potential of the... [more] Background: The two most common agent groups currently responsible for photoallergic contact dermatitis (PACD) are organic ultraviolet (UV) absorbers in sunscreens and topical nonsteroidal anti-inflammatory drugs (NSAIDs). However, availability of information on the photoallergenic potential of these agents is scarce. Objectives: To obtain current information on the frequency of PACD to 19 organic UV absorbers and 5 topical NSAIDs, including newer agents, in common usage in Europe. Methods: A prospective, multi-centre photopatch test study of 1,031 patients attending for investigation of suspected PACD in 30 centres across 12 European countries. Results: A total of 346 PACD reactions in 200 (19.4%) subjects occurred. PACD was most commonly caused by the topical NSAIDs ketoprofen (128 subjects) and etofenamate (59 subjects). Of the organic UV absorbers, octocrylene, benzophenone-3 and butyl methoxydibenzoylmethane most frequently elicited PACD. The "newer" organic sunscreen absorbers rarely led to PACD. There appeared to be an association between the agents ketoprofen, octocrylene and benzophenone-3, with several subjects developing PACD to two or all three agents concomitantly. Allergic contact dermatitis (ACD) was less commonly observed than PACD, comprising 55 reactions in 47 (4.6%) subjects. Irritant reactions and photoaugmentation and photoinhibition of ACD occurred infrequently. Conclusions: The EMCPPTS has provided current information on the relative frequency of PACD to common photoallergens. Such data will be of value when deciding on which agents to include in future European "baseline" photopatch test series.
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[Patterns of drug consumption and the occurrence of adverse drug reactions among students of public health]
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego. 01/2012; 32(120):232-237.
The research of drug consumption is focused mainly upon the elderly, while the knowledge of drug consumption patterns among young people remains insufficient. Public health students (PHS) seem of particular interest as future opinion leaders and drug policy makers. The aim of the study was to analyz... [more] The research of drug consumption is focused mainly upon the elderly, while the knowledge of drug consumption patterns among young people remains insufficient. Public health students (PHS) seem of particular interest as future opinion leaders and drug policy makers. The aim of the study was to analyze opinions and patterns of drug consumption, and adverse drug reactions (ADR) in this group. Material and methods: 130 PHS took part in the anonymous questionnaire survey. Results: All students admitted to using some drug at least once in their lives. While purchasing over-the-counter (OTC) drugs, 51.6% students trusted their own knowledge and experience. Women more often relied on a pharmacist's recommendation (47.2% vs 21.7% men; p = 0.045), while men were more influenced by advertising (34.8% vs 12.3% women, p = 0.008). Strict adherence to recommended dosage of OTC and prescription drugs (Rx) was declared by 41.1% and 71.9% students, respectively. Every fourth student (24.8%) admitted to having purchased a Rx drug at least once without having the prescription. Past episodes of ADR to OTC were reported by 7.8% students and to Rx by 38.4% (p < 0.001). Respectively 27.2% and 34.4% students were never, or hardly ever asked about past ADR by prescribing physicians. According to 89.2% students, drug advertising should be subject to regulation and policing, and 66.1% considered it inaccurate and unreliable. Forty-five percent of students had an OTC drug on them while responding the questionnaire, 20.0% had a prescription drug. Conclusions: Students of public health seem to be notorious consumers of drugs and their attitude seems not fully rational.
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[Pitted keratolysis--how to treat?].
Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 08/2011; 31(182):127-9.
Pitted keratolysis is a common and problematic skin condition affecting the feet caused by the keratolytic activity of Corynebacterium, Micrococcus, Dermatophilus. Skin lesions are characterized by crater-like pits of the epidermis accompanied by a burning sensation, itching, pain and malodor. The p... [more] Pitted keratolysis is a common and problematic skin condition affecting the feet caused by the keratolytic activity of Corynebacterium, Micrococcus, Dermatophilus. Skin lesions are characterized by crater-like pits of the epidermis accompanied by a burning sensation, itching, pain and malodor. The purpose of the present paper was to characterise the disease's clinical features and possibilities for the therapy. Due to its interdisciplinary nature, not only dermatologists ought to be familiar with the disease, but also physicians, pediatricians, surgeons, orthopedists, military doctors and occupational health doctors.
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Immunotherapy of allergic contact dermatitis.
Immunotherapy. 08/2011; 3(8):979-96.
The term 'immunotherapy' refers to treating diseases by inducing, enhancing or suppressing immune responses. As allergy is an excessive, detrimental immune reaction to otherwise harmless environmental substances, immunotherapy of allergic disease is aimed at the induction of tolerance toward... [more] The term 'immunotherapy' refers to treating diseases by inducing, enhancing or suppressing immune responses. As allergy is an excessive, detrimental immune reaction to otherwise harmless environmental substances, immunotherapy of allergic disease is aimed at the induction of tolerance toward sensitizing antigens. This article focuses on the historical developments, present state and future outlook for immunotherapy with haptens as a therapeutic modality for allergic contact dermatitis. Inspired by the effectiveness of immunotherapy in respiratory allergies, attempts were undertaken at curing allergic contact dermatitis by means of controlled administration of the sensitizing haptens. Animal and human experiments confirmed that tolerance to haptens can be induced most effectively when the induction of tolerance precedes attempted sensitization. In real life, however, therapy is sought by people who are already sensitized and an effective reversal of hypersensitivity seems more difficult to achieve. Decades of research on Rhus hypersensitivity led to a conclusion that immunotherapy can suppress Rhus dermatitis, however, only to a limited degree, for a short period of time, and at a high risk of side effects, which makes this method therapeutically unprofitable. Methodological problems with most available studies of immunotherapy of contact allergy to nickel make any definite conclusions impossible at this stage.
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Laboratory markers of mast cell and basophil activation in monitoring rush immunotherapy in bee venom-allergic children.
Immunotherapy. 08/2011; 3(8):1013-7.
To evaluate markers of mast cell and basophil activation in children undergoing the initial phase of honeybee venom immunotherapy (VIT). Five children (four boys and one girl) aged 9.5-18 years with severe systemic bee sting reactions and confirmed IgE-mediated allergy were enrolled. Plasma and urin... [more] To evaluate markers of mast cell and basophil activation in children undergoing the initial phase of honeybee venom immunotherapy (VIT). Five children (four boys and one girl) aged 9.5-18 years with severe systemic bee sting reactions and confirmed IgE-mediated allergy were enrolled. Plasma and urine concentrations of 9α,11β-PGF2 and serum tryptase levels were measured at four time points and peripheral blood basophil count and CD63 expression were measured at three time points in the course of VIT, including 5-day rush initial immunotherapy (cumulative dose of 223 µg of bee venom allergen) and two subsequent maintenance doses of 100 µg. In the first 40 days of VIT, there was a decrease in mean plasma levels of 9α,11β-PGF2 (from 41.5 to 27.9 pg/ml; p < 0.05), accompanied by an increase in baseline basophil activation (from 2 to 15%; p < 0.05). The median serum tryptase levels increased from 3.45 to 4.40 ng/ml during rush phase and subsequently returned to initial values (statistically not significant). In four patients, the basophil activation test in response to bee venom allergens remained positive throughout the study. The fifth patient was basophil activation test-negative at all three measurements, and a post hoc analysis revealed clinical peculiarities that are discussed in the paper. Our preliminary results indicate that plasma levels of 9α,11β-PGF2 decrease while numbers of activated basophils increase during the initial phase of bee venom rush immunotherapy in children.
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2.79Impact points
Not all that looks like eczema is atopic eczema.
Journal of the European Academy of Dermatology and Venereology : JEADV. 05/2011;
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3.64Impact points
The EU Nickel Directive revisited--future steps towards better protection against nickel allergy.
Contact dermatitis. 03/2011; 64(3):121-5.
In July 2001, the EU Nickel Directive came into full force to protect European citizens against nickel allergy and dermatitis. Prior to this intervention, Northern European governments had already begun to regulate consumer nickel exposure. According to part 2 of the EU Nickel Directive and the Dani... [more] In July 2001, the EU Nickel Directive came into full force to protect European citizens against nickel allergy and dermatitis. Prior to this intervention, Northern European governments had already begun to regulate consumer nickel exposure. According to part 2 of the EU Nickel Directive and the Danish nickel regulation, consumer items intended to be in direct and prolonged contact with the skin were not allowed to release more than 0.5 µg nickel/cm2/week. It was considered unlikely that nickel allergy would disappear altogether as a proportion of individuals reacted below the level defined by the EU Nickel Directive. Despite this, the EU Nickel Directive part 2 was expected to work as an operational limit that would sufficiently protect European consumers against nickel allergy and dermatitis. This review presents the accumulation of epidemiological studies that evaluated the possible effect of this major public health intervention. Also, it evaluates recent exposure assessment studies that have been performed using the dimethyl glyoxime test. It is concluded that the EU Nickel Directive has started to change the epidemiology of nickel allergy in Europe but it should be revisited to better protect consumers and workers since nickel allergy and dermatitis remain very frequent.
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Food-provoked eczema: A hypothesis on the possible role of systemic contact allergy to haptens present in both cosmetics and foods.
Estetol Med Kosmetol. 01/2011; 1(1):35-40.
Patients with eczema frequently associate relapses of their disease with ingestion of particular foods, however, actual causation by food allergens can be confirmed only in a minority of them. In the present paper, a hypothesis is proposed on the possible causal link between eczema and food in cases... [more] Patients with eczema frequently associate relapses of their disease with ingestion of particular foods, however, actual causation by food allergens can be confirmed only in a minority of them. In the present paper, a hypothesis is proposed on the possible causal link between eczema and food in cases not explainable by type I allergy to "classical" protein food allergens like those of egg, milk or peanut. It is proposed that eczema in such cases may be due to delayed-type allergy to haptens present in food - either natural components, contaminants, or food additives. A wide range of haptens are used in the production of both food and cosmetics. It is proposed that initial sensitization of the skin to a hapten may follow external exposure (e.g. from skin care products), while relapses in the course of eczema may be due to subsequent oral exposures to the same hapten from food (systemic contact dermatitis). Furthermore, this hypothesis also offers an explanation for cases of photoaggravated eczema by indicating on food haptens with photosensitizing properties. The proposed hypothesis is unifying recent scientific discoveries and clinical observations in the attempt at explaining cases of food-provoked eczema that could not be explained by the present mainstream views on food allergy. Nevertheless, it requires a thorough verification through dedicated research aimed specifically at testing the proposed causal relationship between food-provoked eczema and haptens occurring in both cosmetics and foods. If confirmed, appropriate diagnostic methods (e.g. patch test panels with food haptens or specially devised in vitro tests) should be introduced into routine diagnosis of eczema. Furthermore, results of such studies will provide scientific evidence for possible restrictions on the use of food additives identified as potent sensitizers within the legal scheme of consumer protection policy.
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[Basic dermoscopy of melanocytic lesions for beginners].
Postȩpy higieny i medycyny doświadczalnej (Online). 01/2011; 65:501-8.
Dermoscopy is a safe, easy-to-repeat diagnostic method used especially in the diagnosis of melanocytic lesions and others. Performing dermoscopy for skin lesions on the whole body takes only one minute more than standard clinical examination. Therefore the knowledge of basic dermoscopy among multi-s... [more] Dermoscopy is a safe, easy-to-repeat diagnostic method used especially in the diagnosis of melanocytic lesions and others. Performing dermoscopy for skin lesions on the whole body takes only one minute more than standard clinical examination. Therefore the knowledge of basic dermoscopy among multi-specialization doctors - from general practitioners, surgeons, oncologists to dermatologists - increases the possibility of detection of potential melanoma. To describe the basic aspects of dermoscopy of melanocytic lesions. Review of medical databases PubMed and Medline from the last 8 years and a retrospective analysis of own experience. We report the fundamental principles of performing dermoscopy, basic dermoscopic features and diagnostic algorithms of selected melanocytic lesions. Conclusions. The knowledge base of dermoscopy is very important among doctors of many specializations. It increases melanoma detection in very early stages.
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3.64Impact points
Cutaneous adverse drug reaction to heparins with hypereosinophilia and high IgE level.
Contact dermatitis. 01/2011; 64(1):61-2.
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2.79Impact points
Excessive nickel release from earrings purchased from independent shops and street markets--a field study from Warsaw and London.
Journal of the European Academy of Dermatology and Venereology : JEADV. 11/2010; 25(9):1021-6.
Nickel allergy is frequent and cause morbidity and increased health care costs. The aim of this study was to determine the proportion of inexpensive earrings randomly purchased from stores and street markets in two capitals that gave positive dimethylglyoxime (DMG) test reactions and to determine wh... [more] Nickel allergy is frequent and cause morbidity and increased health care costs. The aim of this study was to determine the proportion of inexpensive earrings randomly purchased from stores and street markets in two capitals that gave positive dimethylglyoxime (DMG) test reactions and to determine whether the degree of nickel release was related to shop category. Random inexpensive metallic earrings were purchased from stores and vendors in London and Warsaw. A qualitative investigation of nickel release by using the DMG test was performed. DMG testing revealed that respectively 15.1% (n=205) and 18.4% (n=206) of earrings purchased in London and Warsaw released nickel as indicated by positive test outcomes. Stratification by store category showed that DMG test-positive jewellery were mainly purchased from street markets and from stores that were not part of national or international chains. Despite the EU Nickel Directive having resulted in decreasing prevalence of nickel allergy, a large proportion of inexpensive earrings still release nickel in concentrations that may result in nickel allergy and dermatitis. Authorities should prioritize information campaigns and random inspections as a legislation that is not followed is of limited value.
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2.79Impact points
A half of schoolchildren with 'ISAAC eczema' are ill with allergic contact dermatitis.
Journal of the European Academy of Dermatology and Venereology : JEADV. 11/2010; 25(9):1104-7.
Similarity in clinical symptoms between atopic eczema (AE) and allergic contact dermatitis (ACD) may lead to misdiagnoses in both clinical practice and epidemiological studies. As patch testing for contact allergy does not seem popular among paediatric allergists, the resulting bias leads mainly to ... [more] Similarity in clinical symptoms between atopic eczema (AE) and allergic contact dermatitis (ACD) may lead to misdiagnoses in both clinical practice and epidemiological studies. As patch testing for contact allergy does not seem popular among paediatric allergists, the resulting bias leads mainly to under diagnosing of ACD and over diagnosing of AE in children and adolescents. To assess the frequency of AE and ACD among children and adolescents who answered affirmatively the eczema module of ISAAC questionnaire. Of 9320 schoolchildren involved in an allergy screening programme, 143 consecutive participants were recruited for the present study. The inclusion criterion was affirmative answers to questions from the eczema module of the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. The children were examined by two allergists: a paediatrician and a dermatologist, and the children underwent patch testing. We diagnosed AE in 46 (55.4%) children and 18 (30.0%) adolescents, whereas 32 (38.6%) children and 31 (51.7%) adolescents were diagnosed with ACD, with a considerable overlap of both diseases. Nine of 46 (19.6%) children and 13 of 25 (52.0%) adolescents with affirmative answers to the question about flexural eczema were diagnosed with ACD, while lacking features sufficient for the diagnosis of AE according to Hanifin and Rajka. Based on the indices from the whole population tested (9320 pupils), a rough estimate of the general ACD prevalence was 5.8% for adolescents, and 8.5% for children, which is close to the figure of 7.2% observed previously in Danish schoolchildren. Our data demonstrate that 'ISAAC eczema' is an epidemiological entity that embraces comparable portions of cases of atopic eczema and allergic contact dermatitis, and possibly also other less frequent pruritic dermatoses. Each case of chronic recurrent dermatitis in children requires differential diagnosis aimed at allergic contact dermatitis and inflammatory dermatoses other than atopic eczema, even when predominantly localized in flexural areas.
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2.68Impact points
The most important contact sensitizers in Polish children and adolescents with atopy and chronic recurrent eczema as detected with the extended European Baseline Series.
Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology. 10/2010; 22(2):252-6.
The differential diagnostic work-up of children with chronic eczema should involve patch testing, also in cases with confirmed atopy. In our previous study, contact allergy was detected in every second child with chronic eczema. The aim of the present study was to identify the most important sensiti... [more] The differential diagnostic work-up of children with chronic eczema should involve patch testing, also in cases with confirmed atopy. In our previous study, contact allergy was detected in every second child with chronic eczema. The aim of the present study was to identify the most important sensitizers in atopic children with eczema. During an allergy screening program, 103 consecutive children aged 7-8 and 93 adolescents aged 16-17 were enrolled. The inclusion criterion was chronic recurrent eczema as detected with the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire and atopy, defined as positive skin prick test to one or more common airborne or food allergens. The children were patch-tested with the newly extended European Baseline Series (EBS, 28 test substances) supplemented with propolis, thimerosal, benzalkonium chloride, and 2-phenoxyethanol. In total, 67.0% children and 58.1% adolescents were found patch test positive. Among children, 35.9% reacted to nickel, 16.5% propolis, 11.7% thimerosal, 9.7% cobalt, each 6.8% fragrance mix (FM) I and chromium, and 5.8% to FM II. Among adolescents, 37.6% reacted to thimerosal, 19.4% to nickel, 6.5% to cobalt, and 5.4% to propolis. We demonstrate the advantage of using FM II - a new addition to the EBS that detects a relatively high proportion of contact hypersensitivity among children. An important sensitizer from outside EBS is propolis, which according to the frequency of sensitization occupies rank 2 in children and rank 4 in adolescents. These data show that propolis should be included into routine patch testing in children.
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6.38Impact points
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Detection of contact allergy: using more extensive test series increases the diagnostic efficacy of patch tests.
Przegla̧d lekarski. 01/2010; 67(2):103-6.
Contact allergy is the most frequent type of allergy, affecting 26-40% of all adults and 21-36% children. The gold standard in the diagnosis of contact allergy is patch test. To study the influence of the range and composition of patch test series on the efficacy of the diagnostic procedure. Retrosp... [more] Contact allergy is the most frequent type of allergy, affecting 26-40% of all adults and 21-36% children. The gold standard in the diagnosis of contact allergy is patch test. To study the influence of the range and composition of patch test series on the efficacy of the diagnostic procedure. Retrospective analysis of the frequency of positive reactions among patients diagnosed with patch tests at our Department during 2 periods: From December 2003 to March 2005, patients were tested with a series of 9 substances plus white petrolatum as the negative control. From April 2005 to July 2008, the series was expanded to 21 substances, while petrolatum was removed. In the analyzed period, 1379 patients were tested with 9 substances plus petrolatum (group referred to as "G9") and 682 patients with 21 substances ("G21"). In G9, at least one positive reaction was observed in 343 (24.9%, 95% CI: 22.6-27.2%) patients, as compared to 376 (55.1%; 95% CI: 51.4-58.7%) in G21 (p < 0.0001). The increase in the number of tested substances from 9 to 21 led to significant increase in the mean number of positive reactions per one patient (0.34 in G9 versus 0.90 in G21; p < 0.0001). We have not observed any positive reaction to white petrolatum. Patch testing with more extensive test series increases the chance for the detection of patient's sensitizations. As we have not observed any positive reaction to white petrolatum, using the vehicle as negative control does not seem to offer any advantage.
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1.54Impact points
Cathelicidin LL-37, granzymes, TGF-beta1 and cytokines levels in induced sputum from farmers with and without COPD.
Annals of agricultural and environmental medicine : AAEM. 12/2009; 16(2):289-97.
The cathelicidin LL-37 is an antimicrobial and lipopolysaccharide neutralizing peptide, possessing pro-inflammatory, tissue repair and remodeling activities. Recent reports indicate that the progression of COPD might be connected with increased levels of LL-37. The numerous experimental data show th... [more] The cathelicidin LL-37 is an antimicrobial and lipopolysaccharide neutralizing peptide, possessing pro-inflammatory, tissue repair and remodeling activities. Recent reports indicate that the progression of COPD might be connected with increased levels of LL-37. The numerous experimental data show the potential role of LL-37 in the response to the exposure to organic dust (containing lipopolysaccharide and microorganisms) which is one of the major COPD causative factors. This work strives to further prove the role of LL-37 in the development of COPD. A cross-sectional study was conducted in 30 farmers in the early stages of COPD according to GOLD, 36 healthy farmers and 16 healthy urban dwellers. Collection of induced-sputum samples and lung function testing were conducted before and after work. The quantification of the LL-37 in sputum samples was performed by mass spectrometry and radioisotope techniques. Levels of granzymes A and B, IL-8, IFN-gamma and TGF-beta1 in sputum were measured by ELISA technique. Statistical analysis was conducted by Kruskal-Wallis and Mann-Whitney U tests. Significantly higher levels of LL-37 were observed in sputum samples from farmers with COPD compared to healthy individuals. The concentration of LL-37 in sputum from farmers was significantly higher compared to urban dwellers. The same was true for both granzymes A and B. The results of this study suggest that LL-37 and granzymes A and B may add to the development of COPD. The results suggest also their role in an organism's response to organic dust exposure.
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1.54Impact points
Contact allergy to nickel: Patch test score correlates with IL-5, but not with IFN-gamma nickel-specific secretion by peripheral blood lymphocytes.
Annals of agricultural and environmental medicine : AAEM. 07/2009; 16(1):37-41.
Traditionally, allergic contact dermatitis (ACD) has been associated with the activity of Th1 lymphocytes that secrete interferon gamma. Recent evidence indicates that other cells, e.g. interleukin 5 (IL-5)-secreting Th2 or Tc2 cells may be among the key effectors of ACD. The aim of the present stud... [more] Traditionally, allergic contact dermatitis (ACD) has been associated with the activity of Th1 lymphocytes that secrete interferon gamma. Recent evidence indicates that other cells, e.g. interleukin 5 (IL-5)-secreting Th2 or Tc2 cells may be among the key effectors of ACD. The aim of the present study was to assess the influence of nickel-specific IFN-gamma secretion (marker of Th1 and Tc1 activity) and IL-5 secretion (Th2 and Tc2) on the clinical outcome (patch test score) in nickel-allergic patients. 40 women with suspicion of ACD were involved, aged from 14-54 (median 31.5) years. They were patch tested with NiSO(4). Peripheral blood mononuclear cells (PBMC) from the patients were cultured and analysed for IFN-gamma and IL-5 secretion in response to NiSO(4). A series of statistical models (classical logit or cloglog link function) were used. We demonstrate that nickel-specific IL-5 secretion by PBMC is correlated with the intensity of patch test reaction (p=0.05), with no significant effect of IFN-gamma. An increase in the nickelspecific IL-5 secretion from PBMC by 10 pg/ml is associated with a 10-20% increase (depending on statistical model) in the odds ratio of the patient to have a higher patch test score. These findings support the assumption that cells secreting IL-5 (e.g. Th2, Tc2) play a more important role in the pathogenesis of ACD than previously thought.
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3.64Impact points
Contact hypersensitivity and allergic contact dermatitis among school children and teenagers with eczema.
Contact dermatitis. 06/2009; 60(5):264-9.
BACKGROUND: Patch testing is an essential procedure in the investigation of eczema in children. OBJECTIVES: To analyse the frequency of contact hypersensitivity and allergic contact dermatitis among Polish children with eczema. PATIENTS/METHODS: During an allergy screening programme involving 9320 c... [more] BACKGROUND: Patch testing is an essential procedure in the investigation of eczema in children. OBJECTIVES: To analyse the frequency of contact hypersensitivity and allergic contact dermatitis among Polish children with eczema. PATIENTS/METHODS: During an allergy screening programme involving 9320 children aged 7 and 16 years, 12.6% reported symptoms of chronic/recurrent eczema. From this group, a representative sample of 229 eczema children underwent patch testing: 96 children aged 7 years and 133 teenagers aged 16 years. Patch testing was with 10 allergens: methylchloroisothiazolinone/methylisothiazolinone (MCI/MI), nickel sulfate, mercury ammonium chloride, thimerosal, cobalt chloride, potassium dichromate, lanolin, fragrance mix I, Myroxylon pereirae (balsam of Peru), and colophonium. RESULTS: 49.4% tested children were found patch test (PT) positive. 43.8% of 7 year olds with eczema were PT positive, with sensitization to nickel sulfate (30.2%), thimerosal (10.4%), cobalt chloride (8.3%), fragrance mix I (7.3%), MCI/MI (6.3%), potassium dichromate (6.3%), M. pereirae (3.1%), mercury ammonium chloride (2.3%), and colophonium (1.0%). 52.6% teenagers were PT positive, with sensitization to nickel sulfate (23.3%), thimerosal (27.8%), cobalt chloride (10.5%), potassium dichromate (6.0%), mercury ammonium chloride (2.3%), M. pereirae (1.5%), and MCI/MI (0.8%). The final diagnosis of allergic contact dermatitis was confirmed in 36% of 7 year olds and 26% of 16 year olds. CONCLUSIONS: Every second child with eczema is PT positive, whereas every third child is finally diagnosed with allergic contact dermatitis.
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Spiewak R. [Photoallergies]. Post Dermatol Alergol 2009; 26(5): 347-349.
Post Dermatol Alergol. 05/2009; 26(5-5):347.
Photoallergic diseases – solar urticaria and photoallergic contact dermatitis – are encountered in every allergist's practice. Unfortunately, most such cases are treated non-specifically as "sun allergy" and remain undiagnosed. Focused diagnostic procedures – photoprovocation and photo... [more] Photoallergic diseases – solar urticaria and photoallergic contact dermatitis – are encountered in every allergist's practice. Unfortunately, most such cases are treated non-specifically as "sun allergy" and remain undiagnosed. Focused diagnostic procedures – photoprovocation and photopatch testing – would enable the managing physician to find the actual cause and select the most adequate treatment. Solar urticaria (SU) is an IgE-dependent photoallergic disease. The suspicion of SU should always be taken into account when the following features are observed:1) development of pruritus, erythema and wheals on the sun-exposed skin, 2) appearance of the symptoms within minutes after sun exposure, 3) spontaneous resolution within a few hours. The diagnostics is based on photoprovocation with suspected allergens and autologous serum. The treatment of SU includes: avoidance of the allergen in exogenous variant of SU, avoidance of the provoking radiation type, and antihistamines (effective in 2/3 cases). Photoallergic contact dermatitis (PhotoACD) belongs to the Gell & Coombs type IV allergic reactions. Inflammatory skin diseases appear 24-48 h after exposure, and are limited to skin areas exposed to both the sensitizing photohapten and the irradiation. The final diagnosis requires photopatch testing, in which series of test substances are applied in double. After 48 h, one of the series is irradiated, typically with 5 J/cm2 UVA. Therapy of PhotoACD comprises avoiding the responsible photohaptens. Photoprotection may be very helpful, but some patients may be photosensitized to sunscreens. Therefore, photopatch testing is recommended with ingredients of sunscreens while selecting the proper photoprotection. Pharmacological therapy of PhotoACD follows the same rules as "classical" allergic contact dermatitis, and is mainly based on topical corticosteroids, calcineurin inhibitors, and barrier creams. Antihistamines are ineffective in photoallergic eczema.
Following (10)
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Torsten Zuberbier
Charité Universitätsmedizin Berlin -
Marta Lemieszek
Institute of Agricultural Medicine -
Thomas Rustemeyer
VU medisch centrum -
Marcus Maurer
Charité Universitätsmedizin Berlin
Topics (3)
