Tattoos have become increasingly common in the United States. Historically, tattoo inks were comprised of metallic pigments, which have the potential to cause allergic contact dermatitis. Data have ...been lacking on the current use of these pigments in tattoo ink.
Identify pigments currently used in tattoo inks manufactured in or sold by wholesalers in the United States and investigate cases of allergic contact dermatitis caused by these pigments.
Using specific key words, we performed an internet search. Pigment information listed in tattoo product inserts was collated and evaluated.
In total, 1416 unique inks were surveyed. The average bottle of ink contained 3.0 pigments. We identified 44 distinct pigments, of which 10 contained metallic pigments, including iron, barium, zinc, copper, molybdenum, and titanium. The remaining 34 pigments contained carbon, azo, diketopyrrolopyrrole, quinacridone, anthraquinone, dioxazine, or quinophthalone dyes. A literature search revealed that 11 of the 44 (25%) pigments had been suspected to cause contact dermatitis. Five were confirmed by patch testing.
These findings highlight the diversity of pigments currently used in tattoos. Relatively few inks contained metallic pigments to which allergic contact dermatitis has historically been attributed. Patch-test clinicians should be aware of these new pigments.
Sodium disulfite, also known as sodium metabisulfite or sodium pyrosulfite, is an inorganic compound, which may cause allergic contact dermatitis. Sulfites act as antioxidants and preservatives; ...common sources include food/beverages, pharmaceuticals, and personal care products. Importantly, sulfites are not included in most screening patch test series and thus may be missed as a relevant contact allergen. The American Contact Dermatitis Society chose sulfites as the Allergen of the Year for 2024 to raise awareness about this significant allergen.
Objective We performed a systematic review of the literature addressing teledermatology: (1) diagnostic accuracy/concordance; (2) management accuracy/concordance; (3) clinical outcomes; and (4) ...costs. Methods Peer-reviewed controlled trials published in English between 1990 and 2009 were identified through MEDLINE and PubMed searches. Results Of 78 included studies, approximately two-thirds comparing teledermatology and clinic dermatology found better diagnostic accuracy with clinic dermatology. Diagnostic concordance of store and forward with clinic dermatology was good; concordance rates for live interactive and clinic dermatology were higher, but based on fewer patients. Overall rates of management accuracy were equivalent, but teledermatology and teledermatoscopy were inferior to clinic dermatology for malignant lesions. Management concordance was fair to excellent. There was insufficient evidence to evaluate clinical course outcomes. Patient satisfaction and preferences were comparable. Teledermatology reduced time to treatment and clinic visits and was cost-effective if certain assumptions were met. Limitations Heterogeneity in studies (design, skin conditions, outcomes) limited the ability to pool data. Conclusion The benefits of teledermatology need to be evaluated in the context of potential limitations.
Background Teledermatology may be less optimal for skin neoplasms than for rashes. Objectives We sought to determine agreement for skin neoplasms. Methods This was a repeated measures study. Each ...lesion was examined by a clinic dermatologist and a teledermatologist; both generated a primary diagnosis, up to 2 differential diagnoses, and management. Macro images and polarized light dermoscopy images were obtained; for pigmented lesions only, contact immersion dermoscopy image was obtained. Results There were 3021 lesions in 2152 patients. Of 1685 biopsied lesions, there were 410 basal cell carcinomas (24%), 240 squamous cell carcinomas (14%), and 41 melanomas (2.4%). Agreement was fair to substantial for primary diagnosis (45.7%-80.1%; kappa 0.32-0.62), substantial to almost perfect for aggregated diagnoses (primary plus differential; 78.6%-93.9%; kappa 0.77-0.90), and fair for management (66.7%-86.1%; kappa 0.28-0.41). Diagnostic agreement rates were higher for pigmented lesions (52.8%-93.9%; kappa 0.44-0.90) than nonpigmented lesions (47.7%-87.3%; kappa 0.32-0.86), whereas the reverse was found for management agreement (pigmented: 66.7%-79.8%, kappa 0.19-0.35 vs nonpigmented: 72.0%-86.1%, kappa 0.38-0.41). Agreement rates using macro images were similar to polarized light dermoscopy; contact immersion dermoscopy, however, significantly improved rates for pigmented lesions. Limitations We studied a homogeneous population. Conclusions Diagnostic agreement was moderate to almost perfect whereas management agreement was fair. Polarized light dermoscopy increased rates modestly whereas contact immersion dermoscopy significantly increased rates for pigmented lesions.
Topical antibiotics are widely used to treat cutaneous, ocular, and otic infections. Allergic contact dermatitis to topical antibiotics is a rare but well-documented side effect, especially in ...at-risk populations. The purpose of this article is to review the epidemiology, responsible allergens, and management of allergic contact dermatitis to topical antibiotics. Learning objective After completing this learning activity, participants should be able to describe the epidemiology of allergic contact dermatitis related to topical antibiotics; show knowledge of the most common allergenic topical antibiotics; and understand the allergenic cross-reactivity pattern amongst topical antibiotics.
Pityriasis lichenoides and its subtypes Bowers, Sacharitha; Warshaw, Erin M.
Journal of the American Academy of Dermatology,
10/2006, Letnik:
55, Številka:
4
Journal Article
Recenzirano
Pityriasis lichenoides represents a unique group of inflammatory skin disorders that include pityriasis lichenoides et varioliformis acuta (PLEVA), febrile ulceronecrotic Mucha-Habermann disease (a ...subtype of PLEVA), and pityriasis lichenoides chronica. The history, epidemiology, clinical features, pathophysiology, and treatment of this group of conditions are reviewed in this manuscript.
At the completion of this learning activity, participants should be familiar with the clinical manifestations, histopathological findings, proposed mechanisms for pathogenesis, methods of treatment, and potential outcomes of pityriasis lichenoides and its subtypes.
