Contact Hypersensitivity to European Baseline Series and Corticosteroid Series Haptens in a Population of Adult Patients with Contact Eczema

Contact eczema/dermatitis (CE) is one of the most frequent skin diseases. The disease is regarded as a reaction pattern. Usually many different stimuli can make the skin react in the same way, some of them may be in action at the same time. A golden standard in the allergic contact dermatitis (ACD) diagnosis are patch tests. Clinical observations show that the frequency of contact allergy to topical corticosteroids constantly increases. The aim of this study was to evaluate the prevalence of contact allergy to European Standard Series and Corticosteroid Series haptens in the population of patients with CE.</p

Contact allergy in the population of patients with chronic inflammatory dermatoses and contact hypersensitivity to corticosteroids

Introduction : Clinical studies indicate that contact allergy to glucocorticosteroids (GCS) is not rare and has been increasingly reported over the past decade. Among the risk factors for developing contact hypersensitivity to topical corticosteroids, chronic inflammatory skin diseases and polyvalent contact allergy seem to be most important. Aim : To present the structure of contact allergy in the population of patients with chronic inflammatory dermatoses (CID) and contact hypersensitivity to corticosteroids. Material and methods : Twenty-seven patients with contact allergy to GCS and chronic inflammatory dermatoses were patch tested with 28 European Baseline Series allergens and 8 corticosteroid allergens. This study group consisted of 5 patients with atopic dermatitis (AD), 15 patients with contact eczema (CE) and 7 with chronic leg eczema (CLE). Nineteen (70.4%) patients were females and 8 (29.6%) were males. Results : In the study group, the most sensitizing non-steroidal allergens were nickel sulfate (51.8%), cobalt chloride (33.3%) and balsam of Peru (29.6%). The most sensitizing corticosteroid allergens were budesonide (77.8%), betamethasone valerate and clobetasol propionate (55.5% each). A total of 77.8% of patients allergic to GCS also showed sensitivity to at least one non-steroidal allergen from the European Baseline Series. Conclusions : The most important risk factors for developing contact allergy to corticosteroids appear to be chronic inflammatory dermatoses, long disease duration, extended on-and-off topical corticosteroid use, patients presenting two or more positive patch test results and polyvalent contact allergy to metal salts and to other non-steroidal haptens

Viabilidade da mensuração de marcadores de remodelação óssea em mulheres com lúpus eritematoso sistêmico

Objetivo: Investigar a viabilidade dos marcadores de remodela&#231;&#227;o &#243;ssea (MRO) na avalia&#231;&#227;o do metabolismo &#243;sseo em pacientes com l&#250;pus eritematoso sist&#234;mico (LES), de acordo com as diretrizes da International Osteoporosis Foundation e da International Federation of Clinical Chemistry and Laboratory Medicine. M&#233;todos: O estudo incluiu 43 pacientes do sexo feminino com LES. Foram medidos os n&#237;veis s&#233;ricos de propept&#237;deo N-terminal do procol&#225;geno tipo I (PINP), telopept&#237;deo C-terminal do col&#225;geno tipo I (CTX), osteocalcina, HPT, 25(OH)D, anticorpos anticardiolipina, antidsDNA e antinucleossomo. Resultados: Os n&#237;veis de PINP e CTX estavam elevados em pacientes com LES com idade > 45, em compara&#231;&#227;o com aqueles com idade < 45 anos, embora com signific&#226;ncia estat&#237;stica lim&#237;trofe (p = 0,05). Foram encontradas correla&#231;&#245;es entre os MRO: a mais forte foi entre o PINP e a osteocalcina (&#964; = 0,69, p < 0,05). Encontrou-se que o PINP e a osteocalcina est&#227;o correlacionados com o HPT (&#964; = 0,3, &#964; = 0,29, respectivamente, p < 0,05). A idade estava correlacionada com o PINP (&#964; = 0,23, p < 0,05). Valores elevados de PINP foram encontrados em maior frequ&#234;ncia do que valores elevados de osteocalcina ou CTX, tanto em pacientes com idade < 45 (p = 0,001) quanto > 45 (p < 0,001). N&#227;o houve diferen&#231;a estatisticamente significativa nos n&#237;veis de PINP, osteocalcina ou CTX com rela&#231;&#227;o &#224; esta&#231;&#227;o do ano, nem em todo o grupo de pacientes com LES, nem naqueles com mais ou menos de 45 anos. O uso pr&#233;vio de glucocorticoides n&#227;o esteve associado a diferen&#231;as nos MRO. Conclus&#245;es: O aumento nos MRO no LES parece refletir predominantemente o padr&#227;o de remodela&#231;&#227;o &#243;ssea relacionado com a idade. Pode-se esperar que o PINP aumentado seja o desfecho mais comumente encontrado entre os MRO. &#201; necess&#225;rio incluir melhores diagn&#243;sticos de dist&#250;rbios &#243;sseos com MRO, feitos de acordo com as normas internacionais de refer&#234;ncia, na abordagem de pacientes com LES, al&#233;m de avaliar a densidade mineral &#243;ssea