Αναδρομική και επιδημιολογική μελέτη της ευαισθητοποίησης ασθενών πασχόντων από δερματίτιδα μετά από επιδερμικές δοκιμασίες με εξ' επαφής αλλεργιογόνα στον ελλαδικό χώρο

Εισαγωγή: Η δερματίτιδα επαφής είναι μια συχνή διαταραχή του δέρματος που σχετίζεται με περιβαλλοντικές εκθέσεις, που επηρεάζουν όλες τις ηλικιακές ομάδες και τα δύο φύλα. Το πρότυπο της ευαισθητοποίησης της επαφής σε μια σειρά αλλεργιογόνων που περιλαμβάνονται στην ευρωπαϊκή σειρά βάσης έχει ήδη μελετηθεί για αρκετές χώρες της ΕΕ από το δίκτυο ESSCA. Η παρούσα μελέτη στοχεύει να διερευνήσει τα πρότυπα της αλλεργικής εξ’ επαφής δερματίτιδας στην Ελλάδα μέσω μιας δοκιμασίας εμπλοκής έναντι ενός μεγάλου αριθμού αλλεργιογόνων που προκαλούν δερματίτιδα εξ επαφής. Μέθοδοι: Η αναδρομική ανάλυση των δεδομένων ρουτίνας των 1978 ασθενών συλλέχθηκε κατά τη διάρκεια του 2014-2016 στο Εργαστήριο Εθνικό Κέντρο Αναφοράς Επαγγελματικών Δερματοπαθειών, της Πανεπιστημιακής Κλινικής Δερματικών και Αφροδισίων Νόσων του ΕΚΠΑ . Η ευαισθητοποίηση σε όλες τις περιπτώσεις δοκιμάστηκε με μια συλλογή από 28 αλλεργιογόνα της ευρωπαϊκής σειράς βάσης και πρόσθετες με στόχο τον εντοπισμό νέων ευαισθητοποιήσεων για την ενημέρωση της εθνικής γραμμής αναφοράς για τα αλλεργιογόνα. παρέχονται πληροφορίες για εκτεταμένο δείκτη MOAHLFA. Αποτελέσματα: Ένα τουλάχιστον θετικό αποτέλεσμα βρέθηκε στο 61.5% των ασθενών, ενώ το 19.1% των ευρισκομένων ευαισθητοποιημένων σε δύο ή περισσότερα αλλεργιογόνα. Τα συχνότερα αλλεργιογόνα στο συνολικό πληθυσμό, ήταν το Nickel Sulphate, το Fragrance Mix και το Balsam of Peru, καθώς και σε σχέση με το φύλο. Το Nickel Sulphate είναι το συχνότερο αλλεργιογόνο της σειράς βάσης, αποτέλεσμα που συμφωνεί με άλλες εκθέσεις. Συμπεράσματα: Τα αποτελέσματά μας συμφωνούν σε μεγάλο βαθμό με τα ευρήματα άλλων πολυκεντρικών μελετών ανά την Ευρώπη. Σε όλες τις μελέτες, υπάρχει αρκετή διαφοροποίηση μεταξύ των παρατηρούμενων ποσοστών ευαισθητοποίησης, από χώρα σε χώρα. Ένας πιθανός λόγος για τη διαφοροποίηση αυτή αναφέρεται ότι μπορεί να είναι οι διαφορετικότητα στη μεθοδολογία μέτρησης της δερματίτιδας, η επιλογή των ασθενών ήτοι το δείγμα μελέτης και τέλος πραγματικές διαφορές που υπάρχουν λόγω των διαφορετικών κοινωνικών ή εθνικών χαρακτηριστικών. Τέλος, από την παρούσα μελέτη αναδεικνύεται η σημαντικότητα μελέτης του φαινομένου της αλλεργικής εξ’ επαφής δερματίτιδας και μάλιστα η συστηματική καταγραφή του αλλά και συμμετοχή της χώρας μας σε διεθνείς βάσεις δεδομένων (registries).Background: Contact dermatitis is a common skin disorder related to environmental exposures affecting, all age groups, and both genders. The pattern of contact sensitization to a series of allergens included in the European baseline series has already been studied for a number of EU countries by the ESSCA Network. The current study aims to explore the patterns of contact dermatitis in Greece through a patch test against a large number of allergens provoking contact dermatitis. Methods: Retrospective analysis of routine data of 1978 patients were collected during 2014-2016 in the Laboratory of Patch Testing, National Referral Centre of Occupational Dermatoses. Sensitization in all cases was tested with a battery of 28 allergens of the European baseline series and additional ones aiming to identify new sensitizations to inform the national baseline of allergens; information for an extended MOAHLFA index was also collected. Results: One at least positive result was found in 61.5% of the patients while 19.1% of those found to be sensitized in two or more allergens. Nickel Sulphate, Fragrance Mix and Balsam of Peru were the most prevalent allergens in the total population, as well as with respect to gender. Nickel is the most frequent allergen of baseline series, a result which is in agreement with other reports. Conclusion: Our results are consistent with previous studies across Europe. Among contact dermatitis studies, there is a sufficient, country-dependent degree of variation. One possible reason for this differentiation is that it may due to the differences patch test measurement methodology, the selection of patient cohort and finally the actual differences that exist due to different social or national characteristics. Finally, this study highlights the significance of the phenomenon of allergic contact dermatitis and shows that its systematic observation along with Greece’s international in international registries is imperative

Physical and Methodological Perspectives on the Optical Properties of Biological Samples: A Review

The optical properties of biological systems can be measured by imaging and microscopy methodologies. The use of X-rays, γ-radiation and electron microscopy provides information about the contents and functions of the systems. The need to develop imaging methods and analyses to measure these optical properties is increasing. On the other hand, biological samples are easily penetrated by a high-energy input, which has revolutionized the field of tissue optical properties and has now reached a point where light can be applied in the diagnosis and treatment of diseases. To this end, developing methodologies would allow the in-depth study of optical properties of tissues. In the present work, we review the literature focusing on optical properties of biological systems and tissues. We have reviewed the literature for related articles on biological samples’ optical properties. We have reported on the theoretical concepts and the applications of Monte Carlo simulations in the studies of optical properties of biological samples. Optical properties of biological samples are of paramount importance for the understanding of biological samples as well as for their applications in disease diagnosis and therapy

Physical and Methodological Perspectives on the Optical Properties of Biological Samples: A Review

The optical properties of biological systems can be measured by imaging and microscopy methodologies. The use of X-rays, γ-radiation and electron microscopy provides information about the contents and functions of the systems. The need to develop imaging methods and analyses to measure these optical properties is increasing. On the other hand, biological samples are easily penetrated by a high-energy input, which has revolutionized the field of tissue optical properties and has now reached a point where light can be applied in the diagnosis and treatment of diseases. To this end, developing methodologies would allow the in-depth study of optical properties of tissues. In the present work, we review the literature focusing on optical properties of biological systems and tissues. We have reviewed the literature for related articles on biological samples’ optical properties. We have reported on the theoretical concepts and the applications of Monte Carlo simulations in the studies of optical properties of biological samples. Optical properties of biological samples are of paramount importance for the understanding of biological samples as well as for their applications in disease diagnosis and therapy

Detecting Skin Reactions in Epicutaneous Patch Testing with Deep Learning: An Evaluation of Pre-Processing and Modality Performance

Epicutaneous patch testing is a well-established diagnostic method for identifying substances that may cause Allergic Contact Dermatitis (ACD), a common skin condition caused by exposure to environmental allergens. While the patch test remains the gold standard for identifying allergens, it is prone to observer bias and consumes valuable human resources. Deep learning models can be employed to address this challenge. In this study, we collected a dataset of 1579 multi-modal skin images from 200 patients using the Antera 3D® camera. We then investigated the feasibility of using a deep learning classifier for automating the identification of the allergens causing ACD. We propose a deep learning approach that utilizes a context-retaining pre-processing technique to improve the accuracy of the classifier. In addition, we find promise in the combination of the color image and false-color map of hemoglobin concentration to improve diagnostic accuracy. Our results showed that this approach can potentially achieve more than 86% recall and 94% specificity in identifying skin reactions, and contribute to faster and more accurate diagnosis while reducing clinician workload

The Effect of Atopy in the Prevalence of Contact Sensitization: The Experience of a Greek Referral Center

Contact dermatitis is a well-known skin condition, which is related to stimuli and environmental exposure to chemicals, affecting all ages as well as both genders. In the present work, we attempt to investigate the patterns of contact sensitization, with respect to the personal history of atopy (AT), in Greece in a large number of allergens, using patch testing. The retrospective analysis included clinical routine data of 1978 patients collected from 2014 to 2016 in the Laboratory of Patch Testing, National Referral Centre of Occupational Dermatoses. Sensitization, in all cases, was tested with 28 allergens of the European baseline series as adjusted to our local circumstances and clinical experience. A total population of 1978 patients was evaluated, with a male-to-female ratio of 0.45 (1359 females/619 males). From our patient cohort, 693 (35%) patients were evaluated with a history of atopy, while 1285 (65%) were nonatopic. The five most prevalent allergens in the total population without AT were nickel sulphate 5% (15.47%), fragrance mix (I) 8% (9.10%), balsam of Peru (6.47%), cobalt chloride 1% (4.70%), and thiomersal 0.1% (4.10%). Respectively, in the total population with AT, the five most prevalent allergens were nickel sulphate 5% (10.36%), fragrance mix (I) 8% (5.11%), balsam of Peru (3.29%), thiomersal 0.1% (3.03%), and cobalt chloride 1% (2.78%). Contact dermatitis surveillance is of great importance towards the clinical and systematic understanding of the disease. Further studies should be directed towards that end, in order to facilitate more effective health policies

Analysis of Prevalence and Risk Factors of Contact Sensitization with respect to the Occupational Profiles in a Greek Patient Cohort: A Retrospective Analysis of a Greek Referral Centre and Future Perspectives

Contact dermatitis is a frequent skin disorder related to environmental and occupational etiological factors, which could potentially affect all age groups, as well as both genders. The current study is aimed at exploring the patterns of contact sensitization with respect to the population’s occupational patterns in Greece. A retrospective analysis was performed in a cohort of 1978 patients from 2014 to 2016. Patients were divided into two categories; blue collars (BlC) and white collars (WhC), as well as detailed occupation was considered. Separation was performed on the basis of their profession, i.e., labor workers and handicraftsmen were sorted to the BlC group, while office employees were sorted to the WhC group. The common allergen in all occupational subgroups was nickel sulphate. The three most prevalent allergens in both BlC and WhC were nickel sulphate 5%, fragrance mix (I) 8%, and Balsam of Peru 25%. WhC males were uniquely sensitized to colophony 20% and formaldehyde 2%, and WhC females were uniquely sensitized to 5-chloro-2-methyl-4-isothiazolin-3-one (CMIT) and neomycin sulphate 20%. Sensitization to allergens manifested occupation-specific patterns. Allergic contact dermatitis surveillance is of great importance towards the clinical and systematic understanding of the disease, especially with respect to the patient’s occupational profile

Skin diseases in Greek and immigrant children in Athens

Objectives This study aimed to characterize the spectrum of skin diseases affecting children in Greece. Methods We retrospectively studied data for 4071 children, aged 0-12 years, who were examined and diagnosed with dermatoses at the outpatient clinic of a university dermatological hospital between December 2005 and August 2007. To evaluate changes in disease patterns, these data were compared with data for a cohort of 12,700 children diagnosed with skin diseases at the same clinic two to three decades earlier (in 1977, 1980, and 1983). Results The most frequent disease was dermatitis/eczema (34.7%), with atopic dermatitis found in 20.7% of children, contact dermatitis in 6.9%, pityriasis alba in 2.1%, and seborrheic dermatitis in 1.8%. Infections (19.3%), nevi (5.6%), scabies (4.8%), and insect bites (4.3%) followed. More viral (12%) than bacterial (3.7%) and fungal (3.6%) infections were noted. Warts constituted 53.2% of viral infections. Immigrants had an increased risk for bacterial infections and scabies. Conclusions Children diagnosed with skin diseases 24-30 years earlier were younger; exhibited lower prevalences of dermatitis/eczema (P = 0.01), viral infections (P < 0.001) and nevi (P < 0.001); higher prevalences of bacterial and fungal infections (P < 0.001) and insect bites (P < 0.01); and similar rates of scabies (P = 0.17). This study documents the high prevalence of atopic dermatitis in the region, the increasing incidence of viral infections and nevi, and the continuing problem of scabies, especially in immigrants

Ulvan-Based Nanofibrous Patches Enhance Wound Healing of Skin Trauma Resulting from Cryosurgical Treatment of Keloids

Keloids are skin fibroproliferative disorders, resulting from abnormal healing of deep cutaneous injuries. Cryosurgery, the most common treatment for keloids, causes skin traumas. Even though the clinical practice of cryosurgery has increased, effective wound healing therapy is still lacking. In this investigation, nonwoven nanofibrous patches composed of ulvan, a marine sulfated polysaccharide exhibiting anti-inflammatory and antioxidant activities, and polyethylene oxide (PEO) were fabricated through electrospinning and characterized. Their wound healing efficacy on skin traumas resulting from cryosurgical treatment of keloids was clinically tested and evaluated in comparison to a reference product. Twenty-four volunteer patients undergoing cryosurgery as a treatment of keloids were selected to apply either the ulvan/PEO patch or the reference product for 21 days. The ulvan/PEO patch, 21 days after cryosurgery, showed significant wound healing, elimination of skin inflammation, restoration of biophysical parameters similar to normal values and significant decrease in haemoglobin concentration, skin texture and volume, while no discomfort or adverse reaction was observed. In contrast, the reference product showed inferior performance in all evaluated parameters. The designed ulvan/PEO patch represents the first wound dressing to effectively heal skin trauma after cryosurgical treatment of keloids