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Background: Photodermatoses are sun‐related inflammatory skin diseases. They usually require phototesting in diagnosis. However, fewer and fewer medical centers in France are equipped with photobiological equipment. Objectives: The main purpose was to evaluate the relevance of phototesting in photodermatosis diagnosis. The second goal was to study the proportions of the different kinds of photodermatosis found in this particular study. Methods: This study was descriptive, retrospective, and mono‐centric. It was based on 100 consecutive patients, who have been phototested in a French University Hospital from 2014 to 2018. Phototesting included determination of the minimal erythematous dose (MED), UVA and UVB phototests, and photopatch testing. Results: The use of phototesting led to 60% of photodermatosis diagnosis and formally eliminated the latter in 13% of the cases. The diagnosis remained undetermined in 27% of the cases. Nineteen cases of polymorphous light eruption (PLE), 14 cases of photocontact dermatitis (PCD), 10 cases of solar urticaria, 8 cases of photo‐aggravated atopic eczema, 5 cases of chronic actinic dermatitis, and 2 cases of systemic photosensitization were diagnosed. The allergens involved in PCD were topical non‐steroidal anti‐inflammatory drug (NSAID) in 9 cases, sunscreens in 3 cases, and fragrance in 2 cases. The average amount of time between the first symptoms and actual phototesting was about 7,5 years. Conclusion: This study confirms phototesting is truly useful. PLE was the most common form of photodermatosis, followed by PCD and solar urticaria. As photodermatosis could imply severe diseases sometimes requiring hospitalization, it is critical to maintain this expertise. [ABSTRACT FROM AUTHOR]

Three months later, following contact with the manufacturers, we received the different ingredients, albeit only from the after-sun, which were tested as above, and revealed positive reactions (D3, D4) to sodium stearoyl glutamate (1% aq.) (++), and also to the related AAAA capryloyl glycine (1% aq.) (+), the latter also being present in the after-sun (Figure 1). Allergic contact dermatitis, CAS no. 38517-23-6, case report, cosmetics, sodium stearoyl glutamate, amino acid alkyl amides, capryloyl glycine Keywords: allergic contact dermatitis; amino acid alkyl amides; capryloyl glycine; CAS no. 38517-23-6; case report; cosmetics; sodium stearoyl glutamate EN allergic contact dermatitis amino acid alkyl amides capryloyl glycine CAS no. 38517-23-6 case report cosmetics sodium stearoyl glutamate 453 454 2 10/06/22 20221101 NES 221101 Recently, several cases of allergic contact dermatitis (ACD) have been reported due to amino acid alkyl amides (AAAAs) in cosmetics.1,2 We here report a first case of ACD from sodium stearoyl glutamate (CAS no. 38517-23-6), an AAAA derived from glutamic acid/glutamate, used for its conditioning, cleansing and emulsifying properties. [Extracted from the article]

The article presents a case study of a 69-year-old white woman with fixed drug eruption (FDE) drug reaction after administration with fulvestrant and denosumab for metastatic breast cancer treatment. It notes the patient's medical history including being administered with drugs such as indapamide, atorvastatin, with complaints of multiple erythematous skin lesions.

Background: Allergic contact dermatitis to gloves is mostly induced by rubber accelerators. The European baseline series (EBS) appears insufficient to detect glove allergy. Since 2017, it is recommended to use the European rubber series (ERS) and to test the patients' own gloves. Objectives: To investigate the clinical profile of glove‐wearing patients with hand eczema (HE) and to evaluate their sensitisation profile to glove allergens and the value of testing the patients' own gloves. Methods: We conducted a French multicentre study of patients evaluated for HE between 2018 and 2020 and tested with the EBS, the ERS and their own gloves in patch tests and semi‐open (SO) tests. Results: A total of 279 patients were included; 32.6% of patients had positive tests to their own gloves or to glove allergens. Almost 45% of the sensitisations to glove allergens were detected only by the ERS. Among the patients tested both in patch tests and SO tests with their own gloves with positive results, 28% had positive SO tests only. Polyvinylchloride (PVC) gloves were positive in four patients. Conclusion: Our series confirms the need to test the ERS. All the patients' gloves must also be tested including PVC gloves. SO tests with gloves are useful as a complement to patch tests. [ABSTRACT FROM AUTHOR]

Background: Cancer patients are being exposed to antineoplastic drugs more frequently and for longer periods, resulting in a higher risk of hypersensitivity reactions. The aim of this study was to assess the pharmaceutical time and direct cost of drug allergy explorations following immediate hypersensitivity reactions to antineoplastic agents. Methods: A micro-costing method was used to collect data on consumption of human and material resources for allergy exploration preparations. The monetisation was carried out on the basis of prices and hourly wage costs applied in 2018. The number and type of allergy explorations prepared by the pharmacy as well as nature of antineoplastic drugs tested, and the number of culprit drugs reintroductions were collected. Results: Almost 1.5 h is required to realise allergy tests for one patient including pharmacist time for prescription analysis and pharmacy technician's time for tests preparation. The mean manufacturing cost of these tests is estimated at €62.87 (€57.82–65.49) per culprit drug for one patient. Programming patients according to culprit drugs tested allows rationalising healthcare provider time and increasing efficiency. From January 2010 to December 2018, 277 patients were tested and 490 allergy explorations were performed, corresponding to more than 5000 preparations. Mostly, the culprit drug could be reintroduced (n = 383, 78.2%) allowing patients to receive the best possible treatment. Conclusion: Management of hypersensitivity reactions is constantly progressing, as it contributes to improving patient care in oncology. This activity is time-consuming for the pharmacy team but allows patients with previous hypersensitivity reaction to continue effective treatment. [ABSTRACT FROM AUTHOR]

Background: An aqueous antiseptic containing "chlorhexidine digluconate/benzalkonium chloride/benzyl alcohol" (CBB) is widely used in France. The only previous documented study dealing with allergic contact dermatitis (ACD) to this antiseptic is one small case series in children. The French Vigilance Network for Dermatology and Allergy (REVIDAL‐GERDA) has collected many cases in the last few years. Objectives: To evaluate the clinical and sensitization profiles of patients diagnosed with ACD to CBB. Methods: We performed a retrospective study of patients with contact dermatitis to CBB and positive tests to CBB and/or at least one of its components. All patients had to be tested with all components of CBB. Results: A total of 102 patients (71 adults and 31 children) were included. The lesions were extensive in 63% of patients and 55% had delayed time to diagnosis. CBB patch tests were positive in 93.8% of cases. The allergen was identified in 97% of patients, mainly benzyl alcohol in adults (81.7%) and chlorhexidine digluconate in children (54.8%). About 32.4% of the patients were sensitized to several components. Conclusion: CBB is a cause of ACD at all ages. The components of the antiseptic should be tested. The sensitization profile seems to be different between adults and children. [ABSTRACT FROM AUTHOR]

Background: Skin exposure to chemicals may induce an inflammatory disease known as contact dermatitis (CD). Distinguishing the allergic and irritant forms of CD often proves challenging in the clinic. Methods: To characterize the molecular signatures of chemical‐induced skin inflammation, we conducted a comprehensive transcriptomic analysis on the skin lesions of 47 patients with positive patch tests to reference contact allergens and nonallergenic irritants. Results: A clear segregation was observed between allergen‐ and irritant‐induced gene profiles. Distinct modules pertaining to the epidermal compartment, metabolism, and proliferation were induced by both contact allergens and irritants; whereas only contact allergens prompted strong activation of adaptive immunity, notably of cytotoxic T‐cell responses. Our results also confirmed that: (a) unique pathways characterize allergen‐ and irritant‐induced dermatitis; (b) the intensity of the clinical reaction correlates with the magnitude of immune activation. Finally, using a machine‐learning approach, we identified and validated several minimal combinations of biomarkers to distinguish contact allergy from irritation. Conclusion: These results highlight the value of molecular profiling of chemical‐induced skin inflammation for improving the diagnosis of allergic versus irritant contact dermatitis. [ABSTRACT FROM AUTHOR]

Background Airborne allergic contact dermatitis caused by paints containing isothiazolinones has been recognized as a health hazard. Objectives To collect epidemiological, clinical and patch test data on airborne allergic contact dermatitis caused by isothiazolinone-containing paints in France and Belgium. Methods A descriptive, retrospective study was initiated by the Dermatology and Allergy Group of the French Society of Dermatology, including methylchloroisothiazolinone ( MCI)/methylisothiazolinone ( MI)- and/or MI-sensitized patients who developed airborne allergic contact dermatitis following exposure to isothiazolinone-containing paint. Results Forty-four cases were identified, with mostly non-occupational exposure (79.5%). Of the patients, 22.5% of also had mucosal symptoms. In several cases, the dermatitis required systemic corticosteroids (27.3%), hospitalization (9.1%), and/or sick leave (20.5%). A median delay of 5.5 weeks was necessary to enable patients to enter a freshly painted room without a flare-up of their dermatitis. Approximately one-fifth of the patients knew that they were allergic to MI and/or MCI/ MI before the exposure to paints occurred. Conclusion Our series confirms that airborne allergic contact dermatitis caused by paints containing isothiazolinones is not rare, and may be severe and long-lasting. Better regulation of isothiazolinone concentrations in paints, and their adequate labelling, is urgently needed. [ABSTRACT FROM AUTHOR]

The article reports a study of the different etiologies causing isolated asphyxiating angioedema (AE) of the head and neck in order to assess which one is responsible for the most AE deaths. It notes two major etiologies, mast-cell induced or bradykinin mediated; results indicated that bradykinin mediated AE was more likely to be fatal than mast-cell induced AE.

Immediate hypersensitivity (IHS) reactions to macrolides and to macrolide-derived antibiotics like pristinamycin are uncommon. In this context, there is little data available to appreciate the true value of biological tools regarding the diagnosis of immediate allergy to pristinamycin. Here we assess the clinical usefulness of the basophil activation test (BAT) to differentiate allergic from nonallergic IHS to pristinamycin. Thirty-six patients were tested with skin tests as the gold standard and BAT. The BAT achieved a sensitivity of 76% and a specificity of 100%, implying an absence of false positive results. Multicenter studies remain to be performed to better define the sensitivity, specificity and interlaboratory variation of BAT in the diagnosis of allergy to pristinamycin and macrolides. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Introduction: Atopic dermatitis (AD) is an inflammatory skin disease in which activation of specific T cells directed towards environmental allergens plays an important role. Environmental allergens' penetration through the skin is facilitated by the skin barrier impairment what causes xerosis and transepidermal water loss (TEWL) increase. As AD is a chronic disease, there are many factors responsible for exacerbations during the course of the disease, including environmental stress. Aim: Evaluation of the correlation between the level of psychological stress and epidermal barrier function in AD patients. Material and methods: Eight AD patients were included in the study during which two consultations were performed in one month's time. During each visit patients completed psychological questionnaires and had TEWL of uninvolved skin measured. The TEWL was also evaluated before and after the educational session which took place during the first visit. Results: The study did not show any statistically significant correlation between the level of psychological stress, epidermal barrier function (measured by TEWL) and AD severity both at the beginning of the study (before and after the educational session) and a month later (allp > 0.05). Conclusions: Negative observations could result from a small number of participants and a short follow-up period. However, consecutive studies excluding these limitations may play an important role in understanding the influence of stress on the skin barrier in atopic dermatitis and have reliable clinical implications. [ABSTRACT FROM AUTHOR]