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Wolfgang Uter,
Werner Aberer,
José Carlos Armario-Hita,
José M Fernandez-Vozmediano,
Fabio Ayala,
Anna Balato,
Andrea Bauer,
Barbara Ballmer-Weber,
Aiste Beliauskiene,
Anna Belloni Fortina, [......],
Thomas Rustemeyer,
Javier Sánchez-Pérez,
Jane E Sansom,
Juan Fco Silvestre,
Dagmar Simon,
Radoslaw Spiewak,
Barry N Statham,
Natalie Stone,
Mark Wilkinson,
Axel Schnuch
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ABSTRACT: 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.
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.
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.
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.
Contact Dermatitis 04/2012; 67(1):9-19. · 3.51 Impact Factor
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ABSTRACT: In a recent paper by Schaarschmidt et al., patients with moderate-to-severe psoriasis completed a conjoint analysis survey (discrete choice experiment) to determine which factors had influenced their choice of treatment, and the relative importance of each factor. They also assessed how socioeconomic and demographic factors affected patient choice. Using relative importance scores, treatment location was found to be the more important attribute to patients, followed by probability of benefit and method of delivery.
Expert Review of Pharmacoeconomics & Outcomes Research 04/2012; 12(2):145-7.
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ABSTRACT: The acne drug isotretinoin has 13-cis retinoic acid as its active agent. Adverse effects that have been described include severe depression. Animal studies indicate that the hippocampus is particularly sensitive to retinoic acid. Changes induced by isotretinoin to hippocampal function could contribute to depression but may be more evident in altered visuospatial learning and memory, the primary function of the hippocampus.
We aimed to test the hypothesis that a course of oral isotretinoin therapy would result in declining visuospatial learning and memory.
CANTAB tasks designed to assess visuospatial memory were performed repeatedly on 14 males and 3 females in an open prospective observational study of patients with severe acne undergoing isotretinoin therapy. Beck's Depression Inventory and Global Acne Grade were also administered.
Performance stayed unchanged for DMS, SRM and PRM tasks, while surprisingly participants improved their speed on the PRM task. Performance improved across sessions on the PAL task, and moreover the dose of isotretinoin correlated with improvement in the total trial score, reduction in total error rate and stage completed at the first trial.
Isotretinoin does not reduce learning and memory and our study suggests that it may instead lead to a dose-related improvement in specific aspects of hippocampal learning and memory. Retinoic acid functions in the hippocampus as the active metabolite of vitamin A, suggesting that this may be a limiting factor in the human hippocampus and addition of exogenous retinoic acid brings levels closer to an optimal state.
Psychopharmacologia 12/2011; 221(4):667-74. · 4.08 Impact Factor
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ABSTRACT: Abstract Objectives: This study evaluated self-reported patient adherence to different types of treatment in psoriasis and factors that affect adherence. Patients and methods: Patients attending a Dermatology Department for treatments of psoriasis completed a questionnaire about adherence to each of their therapies, Self-assessed Psoriasis Area and Severity Index (SAPASI) and Dermatology Life Quality Index (DLQI). Results: Hundred and six patients participated, 98 on topical treatments, 43 on oral systemic therapies, 39 on phototherapy and 29 were on biologic therapies. The overall rate of self-reported treatment adherence was 85.8%. There was a significant relationship between the types of treatment (topical, oral systemic, phototherapy and biologic therapy) and the number of combinations of treatments and adherence. Adherence ranked significantly better on biologic therapies 100%, followed by oral therapy 96%, phototherapy 93% and then topical therapy 75%. Being too busy, being fed up and cigarette smoking were associated with reduced adherence. About 56.8% of patients reported that messiness of treatment prevented them from adhering. Patients with mild psoriasis and those with DLQI of 5 or less adhered less to topical therapy. Conclusions: There is a significant relationship between the types of treatment (topical, oral systemic, phototherapy and biologic therapy) and the number of combinations of treatments and adherence.
Journal of Dermatological Treatment 07/2011; · 1.23 Impact Factor
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British Journal of General Practice 04/2011; 61(585):291-2. · 1.83 Impact Factor
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ABSTRACT: UV radiation is responsible for vitamin D synthesis and skin tanning. Longitudinal data relating skin color to vitamin D status are lacking.
Our objective was to determine whether seasonal facial skin color changes are related to changes in 25-hydroxyvitamin D [25(OH)D].
We conducted a prospective observational cohort study (Aberdeen Nutrition Sunlight and Vitamin D) with five visits over 15 months, starting spring 2006 with an additional visit in spring 2008 at a university medical research center in Scotland, 57° N.
Participants included 314 Caucasian postmenopausal women, age 60-65 yr.
Facial skin color was assessed by skin reflectance and expressed as the individual typology angle (ITA) (higher number indicates paler skin). 25(OH)D was measured by immunoassay.
Most women (43%) reported Fitzpatrick skin type III (always burns, always tans), 32% type II, and 25% type I (always burns, never tans). Overall, mean (sd) ITA in degrees were 36.6 (7.7), 38.2 (6.5), and 42.8 (5.3), respectively, for summer, autumn, and winter (P < 0.001). Linear regression showed that a 5° summer-winter change in ITA, was associated with a 15 nmol/liter change in 25(OH)D (P < 0.001) but did not predict winter 25(OH)D. Reported sunscreen use was associated with higher 25(OH)D. Mean (SD) 25(OH)D (nanomoles per liter) but not skin color was lower for the top body mass index quartile (Q4) compared with the other quartiles (summer: Q1, 57.1(19.9); Q4, 49.7 (20.4); P = 0.010).
Skin color change between summer and winter predicts seasonal 25(OH)D change. Low vitamin D status in obese women was not due to reduced sun exposure, suggesting that increased requirements or inaccessibility of vitamin D stores may be responsible.
The Journal of clinical endocrinology and metabolism 03/2011; 96(6):1677-86. · 6.50 Impact Factor
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Anthony D Ormerod
British Journal of Dermatology 10/2010; 163(4):667-9. · 3.67 Impact Factor
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ABSTRACT: Vitiligo is a common disease that causes a great degree of psychological distress. In its classical forms it is easily recognised and diagnosed. This review provides an evidence based outline of the management of vitiligo, particularly with the non-specialist in mind. Treatments for vitiligo are generally unsatisfactory. The initial approach to a patient who is thought to have vitiligo is to make a definite diagnosis, offer psychological support, and suggest supportive treatments such as the use of camouflage cosmetics and sunscreens, or in some cases after discussion the option of no treatment. Active therapies open to the non-specialist, after an explanation of potential side effects, include the topical use of potent or highly potent steroids or calcineurin inhibitors for a defined period of time (usually 2 months), following which an assessment is made to establish whether or not there has been a response. Patients whose condition is difficult to diagnose, unresponsive to straightforward treatments, or is causing psychological distress, are usually referred to a dermatologist. Specialist dermatology units have at their disposal phototherapy, either narrow band ultraviolet B or in some cases photochemotherapy, which is the most effective treatment presently available and can be considered for symmetrical types of vitiligo. Depigmenting treatments and possibly surgical approaches may be appropriate for vitiligo in selected cases. There is no evidence that presently available systemic treatments are helpful and safe in vitiligo. There is a need for further research into the causes of vitiligo, and into discovering better treatments.
Postgraduate medical journal 08/2010; 86(1018):466-71. · 1.38 Impact Factor
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Barry N. Statham,
Emma V. Smith,
Owen G. Bodger,
Cathy M. Green,
Clodagh M. King, Anthony D. Ormerod,
Jane E. Sansom,
John S. C. English,
Mark S. Wilkinson,
David J. Gawkrodger,
Mahbub M. U. Chowdhury
Contact Dermatitis 01/2010; 62(1):56 - 57. · 3.51 Impact Factor
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Sanjay Rajpara,
Mark S Wilkinson,
Claudah M King,
David J Gawkrodger,
John S C English,
Barry N Statham,
Cathy Green,
Jane E Sansom,
Mabs M U Chowdhury,
Helen L Horne, Anthony D Ormerod
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ABSTRACT: Propolis is widely used in 'natural' cosmetics, remedies, and over-the-counter products. The incidence of propolis allergy is increasing, and cross-reaction with fragrance mix I (FMII), colophonium, and Myroxylon pereirae can occur.
To find out the prevalence and clinical relevance of positive patch tests to propolis and assess cross-reactions with Myroxylon pereirae, colophonium, FMI, and beeswax.
Two thousand eight hundred and twenty-eight subjects in 10 UK centres were patch tested with propolis and beeswax. Generic data were acquired from British Contact Dermatology Society (BCDS) database and further relevant information was requested by survey of participating centres.
The prevalence of propolis allergy was 1.9% (55/2828). Out of these 55 subjects, only 4 (7.2%) were allergic to beeswax, 22 (40%) to Myroxylon pereirae, 15 (27.2%) to colophonium, and 6 (10.9%) to FMI. Additional data for 41 propolis allergic subjects were collected by questionnaire. Hands were the most common sites of involvement, and cosmetics were the most common source of contact. Eight out of 12 subjects reported improvement in eczema following avoidance of propolis.
Propolis is an important allergen of increasing frequency and its inclusion in BCDS baseline series is appropriate. Cross-sensitivity to beeswax is rare.
Contact Dermatitis 11/2009; 61(5):287-90. · 3.51 Impact Factor
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Wolfgang Uter,
Christiane Rämsch,
Werner Aberer,
Fabio Ayala,
Anna Balato,
Aiste Beliauskiene,
Anna Belloni Fortina,
Andreas Bircher,
Jochen Brasch,
Mahbub M U Chowdhury, [......], Anthony D Ormerod,
David I Orton,
Andrea Peserico,
Tapio Rantanen,
Thomas Rustemeyer,
Jane E Sansom,
Dagmar Simon,
Barry N Statham,
Mark Wilkinson,
Axel Schnuch
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ABSTRACT: Continual surveillance based on patch test results has proved useful for the identification of contact allergy.
To provide a current view on the spectrum of contact allergy to important sensitizers across Europe.
Clinical and patch test data of 19 793 patients patch tested in 2005/2006 in the 31 participating departments from 10 European countries (the European Surveillance System on Contact Allergies' (ESSCA) www.essca-dc.org) were descriptively analysed, aggregated to four European regions.
Nickel sulfate remains the most common allergen with standardized prevalences ranging from 19.7% (central Europe) to 24.4% (southern Europe). While a number of allergens shows limited variation across the four regions, such as Myroxylon pereirae (5.3-6.8%), cobalt chloride (6.2-8.8%) or thiuram mix (1.7-2.4%), the differences observed with other allergens may hint on underlying differences in exposures, for example: dichromate 2.4% in the UK (west) versus 4.5-5.9% in the remaining EU regions, methylchloroisothiazolinone/methylisothiazolinone 4.1% in the South versus 2.1-2.7% in the remaining regions.
Notwithstanding residual methodological variation (affecting at least some 'difficult' allergens) tackled by ongoing efforts for standardization, a comparative analysis as presented provides (i) a broad overview on contact allergy frequencies and (ii) interesting starting points for further, in-depth investigation.
Contact Dermatitis 08/2009; 61(1):31-8. · 3.51 Impact Factor
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ABSTRACT: Preservative sensitivity in the UK was last assessed in 2000. Given the changes in preservative usage, we have re-evaluated our patch test data in order to detect any changes in the trend of sensitization. The results of patch testing using the extended British Contact Dermatitis Society Standard series were collected from 9 dermatology centres in the UK. Positive reactions to each of 10 preservative allergens were captured together with the MOAHFLA indices for each centre. In total, 6958 patients were tested during the period 2004-2005. The current data were compared with previously published data. Formaldehyde and methylchloroisothiazolinone/methyl-isothiazolinone have the highest positivity rates at 2.0% and chloroxylenol the lowest at 0.2%. Parabens mix has the highest irritancy rate. Compared with the UK data in 2000, the positivity rate of imidazolidinyl urea (0.02 < P < 0.05) has significantly increased and that of methyldibromo glutaronitrile has significantly reduced (P < 0.001).
Contact Dermatitis 09/2007; 57(3):165-8. · 3.51 Impact Factor
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ABSTRACT: Tixocortol pivalate (TP) is a good marker for hydrocortisone allergy. The concentration of TP to be included in the standard series for patch testing has been the subject of debate. The objective of this study was to investigate the right concentration of TP to be included in the standard series for patch testing. 3747 consecutive patients with dermatitis were patch tested simultaneously with TP 1% and 0.1% in petrolatum at 9 centres in the UK from August 2004 to December 2005. Statistical analysis of the results was performed using STATISTICA, version 6 software. 41 patients had positive reactions of current or past relevance. 20 were positive for both concentrations, 13 positive only for TP 1% concentration, and 8 positive only for 0.1% concentration. Statistical analysis, using a two-tailed difference in proportions test, did not show a significant difference between the 2 concentrations (P=0.21). There was no statistically significant difference between the 2 concentrations of TP. The number of allergens that can be included in the standard series is limited for practical considerations. When testing for screening purposes, TP 1% is recommended.
Contact Dermatitis 08/2007; 57(1):44-6. · 3.51 Impact Factor
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ABSTRACT: Allergens used for patch testing in the hairdressing series vary between dermatology centres in the UK. The aim of our study is to ascertain the hairdressing allergens currently in use and their test results in several dermatology centres in the UK. Data were obtained from databases in 9 dermatology departments. The allergens with positive results and current/past relevance were included in a new hairdressing series based on collective experience, for wider use and further evaluation.
Contact Dermatitis 10/2005; 53(3):130-2. · 3.51 Impact Factor
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ABSTRACT: Footwear allergens used for patch testing vary between dermatology centres in the UK. The aim of our study is to ascertain the footwear allergens currently in use and their test results in several dermatology centres in the UK. Data were obtained from databases in 9 dermatology departments. A new footwear series consisting of 19 allergens including those with positive results and current/past relevance in this study based on collective experience is proposed for wider use and further evaluation.
Contact Dermatitis 10/2005; 53(3):133-5. · 3.51 Impact Factor
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Anthony D Ormerod
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ABSTRACT: Alefacept is a lymphocyte function-associated antigen-3/IgG1 fusion protein that inhibits T-cells by antagonizing CD2, which has been developed and launched by Biogen for the potential treatment of psoriasis. In February 2003, Biogen launched alefacept in the US for use in adults with moderate-to-severe chronic plaque psoriasis, and by March 2003, the company was preparing for psoriasis trials to commence in Japan by the end of December 2003.
Current opinion in investigational drugs (London, England: 2000) 06/2003; 4(5):608-13. · 3.31 Impact Factor
