Delayed skin

Exposure-. INGESTION have victim drink milk and water. Do NOT induce vomiting. EYES flush with a gentle stream of water for at least 10 min. And consult an ophthalmologist for further treatment without delay. SKIN wash off the lime and consult a physician Toxicity by Inhalation (Threshold Limit Value)-. Not pertinent Short-Term Exposure Limits-. Not pertinent Toxicity by Ingestion Grade 1 LDjq 5 to 15 g/kg (rat) Late Toxicity None Vapor (Gas) Irritant Characteristics Not pertinent Liquid or Solid Irritant Characteristics None Odor Threshold Not pertinent. 

Numerous positive delayed skin tests in patients with contrast medium-induced non-immediate skin reactions have been reported when the patients were tested with the culprit contrast medium [summarized in 1]. In a large European multicenter study, 37% of patients with non-immediate reactions were positive in delayed IDEs and/or patch tests [13]. The majority of the patients also reacted to the culprit contrast medium and also to other, structurally similar RCM. Notably, in more than 30% of those skin test-positive patients a RCM had been administered for the first time. Thus, there is a lack of a sensitization phase. Again it may be hypothesized that these previously non-exposed patients may have already been sensitized. Different patterns of RCM cross-reactivity indicate that several chemical entities could be involved. No positive skin tests have been obtained with other contrast medium excipients, such as ethylenediaminetetraacetic acid (EDTA), and only rarely patients have been found to react to inorganic iodide. 

Skin Contact Wash skin at once to remove cyanide while removing all contaminated clothing including shoes do not delay Skin absorption can take place from cyanide dust, solutions, or hydrogen cyanide vapor. Absorption is slower than with inhalation, often measured in minutes rather than seconds (AC or HCN is absorbed much faster than metal cyanides from solutions such as sodium, potassium or copper cyanide solutions). After going though decontamination on the victim(s), watch him or her for at least one to two hours, if possible, since absorbed cyanide can continue to work into the blood stream. As a final note, wash clothing before reuse, and destroy contaminated shoes. 

The authors of the last report commented that generalized delayed type hypersensitivity to systemic administration of a glucocorticoid is rare. Despite the potent immunosuppressive effect of glucocorticoids on immunocompetent cells, the clinical features, the skin biopsy specimen, and the positive delayed skin test reactions strongly suggested an immunological mechanism T cells were clearly involved and the high concentrations of interleukins 5, 6, and 10 were consistent with a T helper type 2 reaction. The raised concentrations of interleukin-5 were probably responsible for the blood and tissue eosinophilia. 

TABLE I. Salmonella typhimurium Infection in Calves Delayed Skin Reactivity with Specificity for O-Antigenic Polysaccharide Chain... 

Arranz, L. J., Suarez, N. C., Barthe, G. P. and Rojo, O. J. (1995). Evaluation of angiogenesis in delayed skin flaps using a monoclonal antibody for the vascular endothelium. Br. J. Plast. Surg. 48, 479-486. 

Delayed skin rashes have been noted in 5% of patients undergoing urography. AUergic-like skin reactions to intravascular contrast media can develop 24-96 hours after administration (204). 

This reaction shared the features of a delayed hypersensitivity reaction (exanthematous rash, positive patch test) and of a late phase reaction (CD4+ lymphocjdic infiltrate together with eosinophils). The authors emphasized the importance of skin testing in the diagnosis of delayed skin reactions to contrast media. 

Other cases of delayed skin reactions have been reported. 

Delayed skin reactions after contrast media have the featnres of true delayed hypersensitivity reactions, including positive skin tests (SEDA-24, 523). A generalized macnlar rash 24 hours after injection of ioversol with positive skin tests has been reported (208). 

Racial differences could be a factor in the high incidence of delayed skin reactions to contrast media in Japan, as 43% of Japanese are deficient in acetaldehyde dehydrogenase. This deficiency results in the accumulation of acetaldehyde, which potentiates the ability of contrast agents (especially dimers), to bridge proteins, which is a probable causative factor in many of their adverse effects (11). 

When penicillamine is administered for a long time and in high doses (for example for Wilson s disease) it can cause a characteristic delayed skin eruption, with increased friability, hemorrhagic bullous lesions, and miliary papules (66,260-266). The lesions develop predominantly in those parts of the skin that are often exposed to trauma. This disorder is a manifestation of the effects of penicillamine on collagen and elastin. Occasionally, these eruptions imitate other rare... 

Vancomycin reportedly cansed a severe delayed skin reaction with allergic cross-reactivity between vancomycin and teicoplanin reqniring steroid therapy (41). 

Starting in the 1920s, very many different mixed bacterial vaccine products (including inactivated bacteria such as Staphylococcus aureus. Streptococcus species. Streptococcus pneumoniae, Moraxella catarrhalis, Klebsiella pneumoniae, H. influenzae) were marketed worldwide. Currently, there are still several products available in European countries, and one product in the USA. Most vaccines have been used for treatment of recurrent and chronic infections of the respiratory tract. The efficacy of these products is doubtful. Delayed hypersensitivity to bacterial products is common. Delayed reactions, sometimes associated with vague malaise or myalgia, can occur after the administration of maintenance doses for months. If delayed skin reactions are accompanied by any systemic symptoms, administration of the mixed vaccine should be drastically reduced or stopped (87). 

QSAR, statistical, and computational methods are used to determine the possibility that a material is a sensitizer and the potential severity of sensitization. In vivo methods are useful to diagnose skin disorders such as drug eruptions, contact dermatitis, immediate contact reactions (contact urticaria), and more. Allergic Contact Dermatitis (ACD) is an inflammatory skin disease, marked by a delayed skin response following skin contact with an allergic chemical. Test groups must be very large to assess this effect. To test for ACD, a test article or sample(s) must be initially exposed to the same skin site/area (induction phase). After a rest period of a week or more (others say over... 

Skin capillary refill - delayed Skin turgor - decreased Urine - reduced (oliguria)... 

Indeed, lecithin-cholesterol liposomes successfully substituted for mineral-oil emulsion in the induction of delayed hypersensitivity In guinea pigs, administration of liposome-suspensions containing MDP and ovalbumin induced delayed skin reactivity similar to that observed following immunization in MDP-supplemented incomplete Freund s adjuvant (IFA) or in CFA.30,45 However, 6-0-acyl-MDP derivatives of appropriate fatty acid chain length (Cx2-C22> i 2, 3A), but not C2-C8 (9, 1, JJJ, showed in-... 

A deletion of /34GalTl in mice causes a variety of problems, possibly due to the reduced ability of these mice to produce sialyl-Lewis and related structures. In the absence of the enzyme, glycan structures shift from type 2 to type 1, with a drastic reduction in P-selectin binding. Delayed skin wound healing, reduced neutrophil and... 

Current evidence suggests that cytokines play an important role in many skin ADRs (Naisbitt et al. 2007 Roychowdhury and Svensson 2005), ranging from nuld rashes to life-threatening reactions such as Steven s Johnson Syndrome (SJS) or toxic epidermal necrolysis (TEN). Skin reactions can be broadly classified into two major categories based on time-to-onset immediate (within 24 h) and delayed reactions (greater than 48 h). Because the type of immune response and the cytokines involved in immediate versus delayed skin reactions varies, each category will be discussed separately. 

The most common type of delayed skin reaction appears as wide spread erythematosus macules (flat, discolored areas) and/or papules (small red bumps) on the trunk within 1-2 weeks of dmg initiation (reviewed in Khan et al. 2006). These types of reactions are generally mild and disappear shortly after discontinuing the drug. Histologically, necrotic keratinocytes are surrounded by cellular infiltrates consisting of T cells and eosinophils. IL-5 is thought to be a major cytokine involved in this type of skin ADR due to its ability to recruit eosinophils to the site of inflammation (Pichler et al. 1997). 

The main obstacle to studying the mechanism of delayed skin ADRs is a lack of animal models. With the exception of nevirapine (Shenton et al. 2005), the vast... 

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