Pedal dermatophyte infection in psoriasis.

Background Dermatophyte infections have been considered rare in psoriasis. However, there are data indicating that tinea unguium is as common or even more common in psoriasis compared with healthy controls. Tinea unguium is generally a secondary event to tinea pedis infection. Objectives To study the prevalence of tinea pedis and tinea unguium in psoriasis compared with a control group. Methods Consecutive psoriasis outpatients aged 18-64 years attending a department of dermatology were examined. Samples for direct microscopy and culture were taken from the interdigital spaces, soles and toenails. Consecutive patients without signs of psoriasis or atopic dermatitis seeking examination of moles constituted the control group. Results In total, 239 patients with psoriasis and 245 control patients were studied. The prevalence of tinea pedis was 8·8%[95% confidence interval (CI) ± 3·6%] in the psoriasis group and 7·8% (95% CI ± 3·4%) in the control group. The corresponding figures for prevalence of tinea unguium were 4·6% (95% CI ± 2·7%) and 2·4% (95% CI ± 1·9%), respectively. The differences found in the psoriasis vs. the control groups were not statistically significant. Conclusions This study does not support the hypothesis that the prevalence of tinea pedis and tinea unguium in patients with psoriasis differs from that in a normal population

Allergic contact dermatitis from dicyclohexylmethane-4,4 '-diisocyanate

From August 1999 to April 2001, there was an outbreak of severe eczema at a factory manufacturing medical equipment. A glue, mainly based on the isocyanate dicyclohexylmethane-4,4'-diisocyanate (DMDI), was suspected as being the cause of the problem. 16 workers with recent episodes of eczema were patch tested with a standard series, an isocyanate series and work material. The latter consisted of, among other things, the glue, DMDI, and an amine, dicyclohexylmethane-4,4'-diamine (DMDA), which is formed when DMDI reacts with water. 13 patients reacted to DMDI, 9 to 1,6-hamethylenediisocyanate (HDI) and 4 to isophoronediisocyanate (IPDI), all of which are aliphatic isocyanates. None reacted to the aromatic isocyanates, diphenylmethane-4,4'-diisocyanate (MDI) or toluenediisocyanate (TDI). One explanation for this pattern could be that aromatic diisocyanates are more reactive than the aliphatic ones and that, therefore, they are inactivated before penetrating the skin. 5 patients reacted to DMDA and 5 to 4,4-diaminodiphenylmethane (MDA). Concurrent reactions to DMDA and or MDA with DMDI could be due to cross-reactivity. The positive reactions to MDA could also be a marker of MDI exposure. Yet another patient, investigated in 1997 with suspected work-related contact dermatitis from the glue, is described. She, however, showed no positive reactions to any isocyanates

Hand eczema in healthcare workers : a questionnaire survey of risk factors and work-related exposures

Recent data on the prevalence and causes of hand eczema among healthcare workers in Sweden are lacking. Multidrug-resistant bacteria have necessitated improved hand hygiene and preventive measures. This has led to an increase in the use of disposable rubber gloves and hand disinfectants, which might influence the risk of hand eczema. Our aims were to identify healthcare workers with hand eczema; to estimate quantitative and qualitative exposure to rubber gloves, hand disinfectants and other exposures; and to survey constitutional factors. An electronic questionnaire was distributed to all employees at the hospitals in southern Sweden. The results were statistically analysed using χ2-tests and binary logistic regression. The 1-year prevalence of self-reported hand eczema was 20% among the responding 9051 nurses and physicians. On a daily basis, 30% reported hand washing >20 times at work, 45% reported using hand disinfectants >50 times, and 28% used >20 pairs of nonsterile rubber gloves. The prevalence of hand eczema was significantly higher among the employees reporting a higher exposure to hand washing, hand disinfectants and rubber gloves than in those reporting a lower exposure. The prevalence of hand eczema was also significantly higher among respondents with a history of childhood eczema, who were smokers, who had a body mass index >30 kgm-2, who spent >30 min per day working in the kitchen or who had children age

Continuous glucose monitoring systems give contact dermatitis in children and adults despite efforts of providing less ‘allergy- prone’ devices : investigation and advice hampered by insufficient material for optimized patch test investigations

Background: Medical devices are increasingly being reported to cause contact allergic dermatitis reactions. Objective: Review of patients with diabetes type I referred for suspected allergic contact dermatitis to insulin pump or glucose sensor systems. Method: We have reviewed 11 referred diabetes mellitus patients investigated for allergic contact dermatitis reactions to medical devices and specifically Dexcom G6®. Extracts from the medical devices were analysed. Results: The majority of patients was children, the majority had relevant allergies and particularly allergy to isobornyl acrylate which was also found in the glucose sensor system Dexcom G6®. Conclusions: The following case reports bring in focus the fact that patients sensitized through use of one medical device and being advised the use of another, or find another product for a while useful, are not by necessity free from future episodes of allergic contact dermatitis. The case reports emphasize the need for collaboration since it is impossible for even well-equipped laboratories to properly investigate the medical devices when information on the substances used in production is not uniform and complete and material to investigate are scarce. The importance of adequate patch test series and testing with own material and furthermore the importance to re-analyse medical devices and re-analyse test data are emphasized

Feasibility of future epidemiological studies on possible health effects of mobile phone base stations

The increasing deployment of mobile communication base stations led to an increasing demand for epidemiological studies on possible health effects of radio frequency emissions. The methodological challenges of such studies have been critically evaluated by a panel of scientists in the fields of radiofrequency engineering/dosimetry and epidemiology. Strengths and weaknesses of previous studies have been identified. Dosimetric concepts and crucial aspects in exposure assessment were evaluated in terms of epidemiological studies on different types of outcomes. We conclude that in principle base station epidemiological studies are feasible. However, the exposure contributions from all relevant radio frequency sources have to be taken into account. The applied exposure assessment method should be piloted and validated. Short to medium term effects on physiology or health related quality of life are best investigated by cohort studies. For long term effects, groups with a potential for high exposure need to first be identified; for immediate effect, human laboratory studies are the preferred approach