Contact dermatitis clinical presentation

A retrospective study was performed of 3851 patients who presented at a clinic with suspected allergic contact dermatitis over a 5-year period. Workup of each case included standard patch tests for delayed-type sensitivity. Of the 3851 patients, 145 had type IV allergies to one or more rubber constituents. Five of the 145 were positive to MBT. 

Schmutz JL. Unusual clinical presentation in a case of contact dermatitis due to corticosteroids diagnosed by ROAT. Contact Dermatitis 2001 44(2) 105-6. 

VKC is differentiated from GPC and AKC by its clinical presentation. Distinguishing features include age at onset, male predisposition, geographic distribution, lack of relationship to contact lens use, and absence of atopic dermatitis. 

Webster and Thompson (1974) have shown that lymphocytes can be stimulated in vitro by polymers of ampicillin and McKenzie et al. (1976) have found that patients with infectious mononucleosis have raised levels of IgM and IgG antibodies against ampicillin. These interesting observations may contribute to our understanding of the pathogenesis. The fact that ampicillin possesses sensitizing properties is evident from clinical observations in patients with occupational contact dermatitis. The amino group present in the side chain has been shown to play an essential part in determining specificity (Schulz et al. 1970). 

Nitrofurazone (Furacin) has over the years been used in solution or powder for leg ulcers and varicose eczema. Many cases of contact allergy occurred and subsequently descreased the dermatologic use of this drug topically (Braun and ScHUTZ 1968). Each individual case tends to be dramatic, i.e., the extent and severity of the dermatitis is clinically striking, so that, unlike neomycin dermatitis, diagnosis presents no problem. The frequency of the dermatitis has probably been exaggerated, and may be less than that due to neomycin. 

Tabar AI, Quirce S, Garcia BE, Rodriguez A, Olaguibel JM (1994) Primula dermatitis versatility in its clinical presentation and the advantages of patch tests with synthetic 147. primin. Contact Dermatitis 30 47-48... 

High intakes of thiamin administered orally are nontoxic. The rapidly saturable thiamin absorption mechanism limits the amount taken up from a single dose to 2.5 mg, and thiamin present in excess of protein binding capacity is excreted. However, there are reports of toxicity from chronic intakes in excess of 50mg/kg or >3 g/day with a wide variety of clinical signs, including headache, irritability, insomnia, rapid pulse, weakness, rapid pulse contact dermatitis, pruritus, and, in one case, death. 

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