Marcella Aquino

Winthrop University Hospital, Mineola, New York, United States

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Publications (15)63.8 Total impact

  • Marcella Aquino, Luz Fonacier
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    ABSTRACT: Because both atopic dermatitis (AD) and contact dermatitis (CD) are characterized by a similar morphologic appearance and similar distribution of skin involvement, the diagnosis of CD in AD has been difficult. Historically, it was thought that patients with AD were unable or less likely to develop CD due to various studies in which patients with AD stimulated with strong allergens failed to develop sensitization at rates similar to patients without AD. However, more recent evidence from the United States and Europe has shown that patients with AD have similar if not higher rates of positive patch test results to common contact allergens, including metals and fragrance, than those patients without AD. In this review, we highlight evidence for and against the role of contact allergy in patients with AD and seek to give clinically relevant management recommendations for the evaluation of CD in the patient with AD.
    08/2014; 2(4):382–387. DOI:10.1016/j.jaip.2014.05.004
  • Journal of Allergy and Clinical Immunology 02/2014; 133(2):AB122. DOI:10.1016/j.jaci.2013.12.454 · 11.25 Impact Factor
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    ABSTRACT: The use of cellular phones has risen exponentially with over 300 million subscribers. Nickel has been detected in cell phones and reports of contact dermatitis attributable to metals are present in the literature. We determined nickel and cobalt content in popular cell phones in the United States. Adults (>18 years) who owned a flip phone, Blackberry(®), or iPhone(®) were eligible. Seventy-two cell phones were tested using SmartPractice's(®) commercially available nickel and cobalt spot tests. Test areas included buttons, keypad, speakers, camera, and metal panels. Of the 72 cell phones tested, no iPhones or Droids(®) tested positive for nickel or cobalt. About 29.4% of Blackberrys [95% confidence interval (CI), 13%-53%] tested positive for nickel; none were positive for cobalt. About 90.5% of flip phones (95% CI, 70%-99%) tested positive for nickel and 52.4% of flip phones (95% CI, 32%-72%) tested positive for cobalt. Our study indicates that nickel and cobalt are present in popular cell phones. Patients with known nickel or cobalt allergy may consider their cellular phones as a potential source of exposure. Further studies are needed to examine whether there is a direct association with metal content in cell phones and the manifestation of metal allergy.
    Pediatric Allergy, Immunology, and Pulmonology 12/2013; 26(4):181-186. DOI:10.1089/ped.2013.0280 · 0.56 Impact Factor
  • Marcella Rita Aquino, Janelle Sher, Luz Fonacier
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    ABSTRACT: Adverse drug reactions occur commonly and primarily manifest in a myriad of cutaneous eruptions. The use of drug patch testing in the diagnosis of specific drug eruptions is increasing; however, a standardized approach to this methodology is currently lacking. A review of current literature was performed on the available evidence of patch testing for drugs. This review addresses the use of patch testing for specific cutaneous adverse drug reactions and for specific classes of drugs including antimicrobials, anticonvulsants, antiretrovirals, glucocorticoids, and nonsteroidal anti-inflammatory drugs. In addition, the approach to performing patch testing to drugs in the clinical arena as well as current contraindications for drug patch testing is reviewed.
    Dermatitis 09/2013; 24(5). DOI:10.1097/DER.0b013e3182a0d38a · 1.36 Impact Factor
  • Marcella Aquino, Tania Mucci
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    ABSTRACT: Systemic contact dermatitis (SCD) refers to a skin condition where an individual who is cutaneously sensitized to an allergen will subsequently react to that same allergen or a cross-reacting allergen via the systemic route. It occurs to allergens including metals, medications, and foods. There has been recent interest in metal allergy as it relates to the implantation of devices such as orthopedic, dental, cardiac, and gynecologic implants. This review will briefly address all causes of systemic contact dermatitis with a special and expanded focus on metal implant allergy. We present literature on SCD to various metal biomedical devices, patch testing for diagnosis of metal allergy pre and post implantation and treatment.
    Current Allergy and Asthma Reports 07/2013; 13(5). DOI:10.1007/s11882-013-0365-9 · 2.45 Impact Factor
  • Annals of allergy, asthma & immunology: official publication of the American College of Allergy, Asthma, & Immunology 02/2013; 110(2):128-9. DOI:10.1016/j.anai.2012.11.015 · 2.75 Impact Factor
  • Journal of Allergy and Clinical Immunology 02/2013; 131(2):AB175. DOI:10.1016/j.jaci.2012.12.1287 · 11.25 Impact Factor
  • Luz S Fonacier, Marcella R Aquino, Tania Mucci
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    ABSTRACT: Allergic contact dermatitis in children is underdiagnosed and undertreated, and its incidence is increasing. Appropriate history taking and the suspicion for allergic contact dermatitis is essential, and patch testing remains the gold standard in diagnosis. Avoidance of the offending allergen, once identified, is the first goal of treatment. Medical therapies include topical corticosteroid and topical immunomodulators. In severe cases, oral corticosteroids or immunomodulators are utilized, although prospective randomized trials for the treatment of this disease in children are lacking. A PubMed literature search was performed to identify publications on allergic contact dermatitis in the pediatric population with the keywords: dermatitis, children, allergic contact dermatitis, pediatrics, contact hypersensitivity, contact allergy, treatment, and management. This review will address the major principles behind the diagnosis and management of this disease in the pediatric population, and highlight useful strategies that may result in improved treatment of this condition.
    Current Allergy and Asthma Reports 09/2012; DOI:10.1007/s11882-012-0305-0 · 2.45 Impact Factor
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    ABSTRACT: Although the identification and management of anaphylaxis in an emergency department setting has been well studied, our understanding of the risk factors for admission in a community-based hospital is lacking. To determine the demographics and the predictors of hospitalization, in patients presenting with anaphylaxis to a community-based emergency department (ED). We performed a five-year retrospective chart review of all patients seen in the ED of Winthrop University Hospital, a community-based institution, with an International Classification of Diseases, 9(th)Edition code related to anaphylaxis. Fifty-eight visits met inclusion criteria, of which 34% resulted in hospital admission (95% CI: 22-48%). Univariate predictors for admission included (1) the involvement of 2, 3, and 4 organ systems (26%, 55%, and 75%, respectively; P < .02); (2) gastrointestinal symptoms vs no symptoms (59% vs 24%, P < .02); (3) non-sting (ingested and other allergens) vs insect sting allergen (50% vs 12.5%, P < .005); and (4) a history of an ED visit for anaphylaxis vs none (67% vs 30%, P < .05). Multivariate analysis (logistic regression) confirmed non-sting allergens (p < 0.02) and number of organ systems involved (P < .05) as independent predictors of hospitalization. In our study population, the involvement of multiple organ systems, particularly gastrointestinal involvement, a history of ED visits for anaphylaxis, and involvement of ingested or other allergens (non-sting) demonstrated higher admission rates.
    Annals of allergy, asthma & immunology: official publication of the American College of Allergy, Asthma, & Immunology 08/2012; 109(2):133-6. DOI:10.1016/j.anai.2012.06.003 · 2.75 Impact Factor
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    ABSTRACT: Background Contact Dermatitis (CD) is a frequently encountered skin disease by allergists and dermatologists that results from contact with external allergens. Patch Testing (PT) remains the gold standard in the diagnosis of allergic CD. Studies evaluating PT from allergy practices are lacking. Methods A multi-center, retrospective chart review of PT within the last 5 years at allergy practices in 3 institutions. We report PT results using allergens in the Thin-Layer Rapid-Use Epicutaneous Test (TT) and additional supplemental allergens [North American Contact Dermatitis (NACD) Panel, Dormer Cosmetic Panel, hairdresser's panel, corticosteroid panel and personal products]. Additionally, patient characteristics including age, gender, occupation, dermatitis site, history of atopic disease and final diagnosis were also obtained. Results A total of 427 patients (mean age = 49.8 years) were patch tested, 82% were female, 54% reported an atopic history (history of asthma, atopic dermatitis, allergic rhinitis or food allergy), 30% were tested with TT, 60% with NACD panel, 30% with cosmetic series, 15% with corticosteroid series and 35% with personal products. The 5 most common positive PT allergens were nickel sulfate, fragrance mix I, P-phenylenediamine, thimerosal and cobalt chloride. The most common dermatitis sites were eyelid/periorbital (31%), facial (25%) and trunk (21%). 56.9% of patients were positive to at least one TT allergen. 25.6% of patients were positive to both a TT and a supplemental allergen (these patients would have been “partially evaluated” with TT allergens alone as they are positive to at least 1 TT allergen and 1 supplemental allergen). 12.5% of patients were negative to a TT allergen and positive to at least 1 supplemental allergen only (these patients would have been “missed” as they are negative to all TT allergens, but positive to at least 1 supplemental allergen). Conclusions Nickel remains the most common allergen. When evaluating patients with CD, testing with TT allergens alone would miss 12.5% of patients while 25.6% of patients would be only partially evaluated. As half of our patients were positive to at least 1 TT allergen, the TT remains an adequate screening tool but a more comprehensive panel may be needed to fully evaluate contact dermatitis.
    World Allergy Organization Journal 02/2012; 5(Suppl 2):S116. DOI:10.1097/01.WOX.0000412128.79639.80
  • Journal of Allergy and Clinical Immunology 02/2012; 129(2):AB35. DOI:10.1016/j.jaci.2011.12.794 · 11.25 Impact Factor
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    ABSTRACT: Studies assessing patch testing (PT) in allergy practices are limited. To determine whether PT results using a limited panel of allergens such as in the Thin-Layer Rapid-Use Epicutaneous Test (TT) as compared with an expanded panel, such as the addition of supplemental allergens (North American Contact Dermatitis [NACD] Panel, Dormer Cosmetics, hairdressing series, corticosteroid series, and personal products) will miss a significant number of positive PTs. To compare our PT results with published data from dermatology practices. This is a 5-year multicenter retrospective chart review of PT at 3 separate allergy practices. Four hundred twenty-seven patients (mean age, 49.8 years) were patch tested. Eighty-two percent were female; 54% reported an atopic history. Of the standardized allergens, the 5 most common positives were nickel sulfate, fragrance mix I, p-phenylenediamine (PPD), thimerosal, and cobalt chloride. Two hundred eighteen (56.9%; 95% CI = 51.9-61.8%) patients were positive to at least 1 TT allergen. Ninety-eight (25.6%; 95% CI = 21.5-30.2%) patients were positive to both a TT and a supplemental allergen. Forty-eight (12.5%; 95% CI = 9.6-16.2%) patients were negative to a TT allergen but positive to a supplemental allergen. Positive allergens would have been missed in 12.5% of patients when evaluating with TT allergens alone, whereas 25.6% would be partially evaluated. Patch test performance characteristics for these allergy practices appear to parallel that seen for dermatology. The TT remains an adequate screening tool in an allergy practice, but a more comprehensive panel may be needed to fully evaluate contact dermatitis.
    Annals of allergy, asthma & immunology: official publication of the American College of Allergy, Asthma, & Immunology 12/2011; 107(6):487-92. DOI:10.1016/j.anai.2011.09.004 · 2.75 Impact Factor
  • Journal of Allergy and Clinical Immunology 02/2011; 127(2). DOI:10.1016/j.jaci.2010.12.314 · 11.25 Impact Factor
  • Luz S Fonacier, Marcella R Aquino
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    ABSTRACT: Although allergic contact dermatitis (CD) was previously thought to occur less frequently in patients with atopic dermatitis (AD), more recent studies show that it is at least as common in patients with AD as in the general population, if not more so. Thus, patients with AD should be considered for patch testing (PT). Although conflicting data exist, the severity of the AD may impact the PT results. Furthermore, younger patients may yield more positive PT results. Hand eczema and compositae allergy are more common in atopic patients. Reassuringly, PT is positive for topical antiseptic and corticosteroids in only a small subset of patients. When personal products are patch tested, emollients should be included in the series.
    Immunology and allergy clinics of North America 08/2010; 30(3):337-50. DOI:10.1016/j.iac.2010.06.001 · 2.22 Impact Factor
  • Luz Fonacier, Marcella Aquino, Bora Kim
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    ABSTRACT: Chronic urticaria is a common disease characterized by recurrent pruritic wheals with surrounding erythema for >6 weeks. It is associated with a significant health care burden and affects patient quality of life. The etiology of chronic urticaria is often difficult to elucidate; however, known etiologies include autoimmune urticaria, physical urticarias (eg, cold, cholinergic, and delayed pressure urticaria), and idiopathic urticaria. The etiology is unknown in many patients, leading to a diagnosis of chronic idiopathic urticaria. The diagnosis of chronic idiopathic urticaria can be challenging for the primary care physician because of the disease's chronic symptoms. Diagnosis requires a detailed patient history and comprehensive physical examination, with additional testing tailored to the patient's history. Effective treatments include antihistamines, leukotriene receptor antagonists in combination with antihistamines, and oral immunomodulatory drugs, including corticosteroids, cyclosporine, dapsone, hydroxychloroquine, and sulfasalazine. Newer experimental therapies include intravenous immunoglobulin and omalizumab. This article reviews the pathophysiology, diagnosis, and treatment of chronic urticaria.
    Postgraduate Medicine 03/2010; 122(2):148-56. DOI:10.3810/pgm.2010.03.2132 · 1.54 Impact Factor