Eczematous reactions

Studies indicate that isopropyl alcohol may be substantially better absorbed by the dermal route than had previously been believed, although significant toxicity by this route would require prolonged exposure. Delayed dermal absorption rather than inhalation may account for a number of pediatric poisonings that have occurred after repeated or prolonged sponged bathing with isopropyl alcohol to reduce fever. In several cases symptoms have included respiratory distress, stupor, and coma. Recovery was complete within 36 hours. Hypersensitivity characterized by delayed eczematous reactions have occasionally been observed after dermal contact with isopropyl alcohol. ... 

Poon E, Fewings JM. Generalized eczematous reaction to budesonide in a nasal spray with cross-reactivity to triamcinolone. Australas J Dermatol 2001 42(l) 36-7. 

Ethacridine (6,9-diamino-2-ethoxyacridine) is widely used in the local treatment of inflammatory or ulcerative conditions of the skin, particularly crural eczema due to venous stasis. Many publications point to the high frequency of exacerbation involving local allergic reactions and also generalized eczematous reactions (SEDA-11, 474). 

An unusual case of allergy to vitamin K, with a relapsing and remitting eczematous reaction, has been described after an intramuscular injection of vitamin Ki (28). 

Klaschka F, Beiersdorff FIU. Allergic eczematous reaction from sorbic acid used as a preservative in external medicaments. Munch Med Wschr 1965 107 185-187. 

Instead, type 2 T-helper (Th2) cells, found in atopic individuals, play an important role in the condition. Studies have demonstrated flaring of AD on exposure to various aeroallergens such as horse dander, grass, and ragweed pollen. Although variation in performance and evaluation of these tests is difficult to avoid, patch tests with allergens can result in eczematous reactions. ... 

Four patients allergic to liquid polyethylene glycols in topical medications were reported by Fisher (1978). Two had immediate urticarial reactions to PEG 400 and two had delayed allergic eczematous reactions. Cross-reactions occurred between PEG 200,300, and 400. Polyethylene glycols may form formaldehyde by autooxida-... 

In certain cases, however, the biopsies have been successively done between the 2nd and 24th hours and even later after the application of the ec2 ema producing substance, in order to follow the evolution of the primary toxic and that of the eczematous reaction. 

It seemed also (de Weck and Brun, 1957) that the course of the reaction was slightly modified by the acanthosis. After 24 hours the lesions on the acanthotic nipples were clearly less significant. Nonetheless, the histological differences observed between the reactions on the flanks and nipples with or without acanthosis do not permit us to affirm that acanthosis plays a protective role against the triggering of an eczematous reaction in animals sensitized with DNCB. . . . But we should keep in mind that under certain conditions, acanthosis can have a protective effect relative to the primary toxic reaction (see p. 8). 

F. Appearance of Histological Eczematous Reactions During Sensitization... 

Appearance of Histological Eczematous Reactions During Sensitization 25 Table 4. Appearance of histological eczematous reactions during sensitization DNCB)... 

In guinea pigs sensitized to CA, an urticarial reaction often appears 30 minutes after application of the substance. After 1 to 2 hours, this urticarial reaction is then followed by papules, which are generalized more or less over the entire body. The urticarial reaction due to CA progresses into a delayed, eczematous reaction, exactly like that seen in a test with DNCB in guinea pigs which have been sensitized to this substance. 

Passive transfer of the eczematous sensitivity is very important in understanding the mechanism of the delayed eczematous reaction, all the more so since until now, it has not been possible to prove the existence of antibodies in the serum, in either man or animals. This impossibility has led certain authors (Karush and Eisen,... 

Hence it is not possible to explain the weak eczematous reaction on the irradiated flank by deficiency of hairs. 

The resemblance of the eczematous reactions of the guinea pig and man in the histological examination has also been remarked by several authors Bloch and Steiner-Wourlisch (1930) with primine eczema, Brunsting and Bailey (1935) with ragweed, Baer, Rosenthal and Sims (1956), Grimmer and Spier (1961) with DNCB etc. 

In man, St. Epstein (1952,1956 and 1958) demonstrated tests with neomycin and nickel methiolate, which showed only dermal reactions. For W. Epstein and Kligman (1959), as for others, the dermal reactions precede the epidermal lesions, the lymphocytes play an essential part in the eczematous reaction. 

It seems that one has to differentiate between the urticarial reaction (immediate reaction) and the eczematous reactions (delayed reactions) (W. Jadassohn, 1932). 

In guinea pigs sensitized with CA, we obtained after a test an immediate urticarial reaction which evolved after 7—8 hours into a delayed eczematous reaction. 

In sensitization with Cx it is a matter of combined urticarial and eczematous reactions and they cannot be clearly distinguished from each other. 

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