Dermatitis®

Overwhelming evidence supports a causal relationship between occurrence of asthma and atopic dermatitis (AD).

The aims of the study were to determine the incidence of asthma in children with AD and to examine the health care utilization and drug use for asthma in children with AD.

Children with hospital-diagnosed AD (cases) were matched with individuals from the background population (controls) in a 1:4 ratio.

In the final cohort (18,625 cases and 74,500 controls), the incident cases of asthma were 4203 among AD cases and 5298 in controls, corresponding to incidence rates of 34 and 9 in cases and controls per 1000 person-years, respectively (hazard ratio [HR] = 3.82, 95% confidence interval [CI] = 3.65–4.00). During the 1-year follow-up period from asthma diagnosis, children with concomitant AD had a significantly higher risk of hospital admission (HR = 1.97, 95% CI = 1.63–2.37), emergency department visits (HR = 1.62, 95% CI = 1.22–2.14), outpatient visits (HR = 1.97, 95% CI = 1.74–2.23), asthma medication (HR = 1.31, 95% CI = 1.27–1.35), and rescue course corticosteroids (HR = 1.74, 95% CI = 1.13–2.69) compared with children with asthma only.

The risk of being diagnosed with asthma was higher in children with AD. Risk of health care utilization and drug use for asthma was higher in children with both AD and asthma compared with asthma only.

Patch testing while taking systemic immunosuppressants is sometimes unavoidable. Methotrexate (MTX) is the immunosuppressant currently considered least likely to negatively impact patch testing.

The aim of the study was to characterize a cohort of patients patch tested while taking MTX.

This is a retrospective review of patients patch tested at the University of North Carolina Dermatology in Chapel Hill, North Carolina, from 2010 to 2019, comparing patch test results of patients taking MTX with those of a control group.

An overall 52.8% positivity rate (356/674) was observed. Sixty two of 674 patients were patch tested while taking MTX, with a 46.8% positivity rate (29/62) compared with 53.4% (327/612) in the control group. The control group experienced 975 reactions, including 637 1+ reactions, 291 2+ reactions, and 47 3+ reactions. The MTX group experienced 50 reactions, including thirty-two 1+ reactions, fourteen 2+ reactions, and four 3+ reactions. The difference between the distributions was not statistically significant. Mean weekly MTX dose was 15.6 mg, whereas mean total accumulated dose was 251.6 mg. There was no statistically significant difference between weekly dose and total accumulated dose in patients with positive or negative results.

In our cohort, MTX had no discernible effect on patch test results, supporting use during patch testing with minimal false-negative risk.

Although bullous pemphigoid (BP), atopic dermatitis (AD), and allergic rhinitis (AR) are associated with shared pathogenic mechanisms the epidemiological relationship between these conditions remains to be investigated.

To evaluate the bidirectional association of BP with AD and AR.

A population-based retrospective cohort study was performed comparing BP patients (n = 3924) with age-, sex-, and ethnicity-matched control subjects (n = 19,280), with respect to incident cases of AD and AR. A case-control design was additionally adopted to assess the odds of BP in individuals with a preexisting diagnosis of AD and AR.

The odds of BP was increased after a preexisting diagnosis of AD (fully adjusted odds ratio, 1.76; 95% confidence interval [CI], 1.44–2.15; P < 0.001) and AR (fully adjusted odds ratio, 1.13; 95% CI, 1.01–1.28; P = 0.047). Patients with BP were at an increased risk of subsequent AD (fully adjusted hazard ratio, 2.00; 95% CI, 1.60–2.51; P < 0.001) but not AR (fully adjusted hazard ratio, 1.00; 95% CI, 0.83–1.20; P = 0.997). Compared with other patients with BP, those with BP and comorbid AD and AR were more frequently managed by adjuvant drugs and long-term systemic and topical corticosteroids and had decreased all-cause mortality.

A history of AD and AR confers susceptibility to the development of BP. Awareness of this association may be of help for physicians managing patients with these diseases.

Chronic inflammatory skin disorders, such as atopic dermatitis, have significant disease burden worldwide. Although efficacious, the adverse effect profile of topical corticosteroids limits long-term use. As an alternative, cannabinoids have been shown to have anti-inflammatory therapeutic effects.

The aim of this study was to assess the effects of a topical cannabinoid product using dermatitis mouse model.

Thirty-five mice were randomized into treatment groups. 12-O-tetradecanoylphorbol-13-acetate was used as an irritant on 1 ear with the contralateral ear serving as a control. Ear edema was calipered. The test product containing 0.9% cannabidiol and palmitoylethanolamide was compared with a potent topical corticosteroid.

Treatment with topical cannabinoid formulation reduced ear edema by 51.27% at 24 hours' and 65.69% at 48 hours' postapplication. Alternatively, mometasone reduced ear edema by 89.82% at 24 hours and 98.25% at 48 hours. Natural reduction (control) in ear edema was 26.32% at 24 hours and 44.21% at 48 hours. Both test groups resulted in significantly decreased edema when compared with baseline (P < 0.05), as well as compared with the negative control group (P < 0.05).

Significant reduction in ear edema, a marker for localized cutaneous inflammation, could be attributed to anti-inflammatory properties of cannabinoids. Although effects were less robust than topical corticosteroid use, cannabinoid formulations have therapeutic promise for dermatitis.

Narrowband (NB) UV-B is known as an effective and safe treatment for atopic dermatitis (AD). However, there is a lack of studies regarding prognostic factors for favorable response and its duration.

The aim of the study was to evaluate the efficacy of NB-UV-B for AD, in a large cohort and “real-life” setting.

This is a retrospective cohort study based on the medical records of patients with moderate to severe AD treated with NB-UV-B therapy between 2000 and 2017 with a long-term follow-up (≥3 years) after completing therapy.

A total of 390 of 555 AD patients who were scheduled for NB-UV-B were included; among them, 55.4% responded well to treatment. Facial involvement, presence of adverse effects, lower number of treatments, and pretreatment immunoglobulin E levels greater than 4000 were related to poorer response. There was an overall median response duration of 12 months with a greater relapse rate among the patients younger than 18 years.

Narrowband UV-B phototherapy shows high and long-lasting efficacy in AD. Patients with facial involvement and patients with high immunoglobulin E levels respond less to treatment. Response duration seems to be shorter for patients younger than 18 years.

Since the spring of 2020, we have seen several patients experiencing severe allergic contact dermatitis (ACD) from the Dexcom G6 glucose sensor after the composition of the sensor's adhesive patch had been changed. We have previously reported the finding of a new sensitizer, 2,2′-methylenebis(6-tert-butyl-4-methylphenol) monoacrylate, in the Dexcom G6 adhesive patch. Three patients with ACD from Dexcom G6 tested positive to this sensitizer. They were also allergic to isobornyl acrylate, a sensitizer present both in Dexcom G6 and in other medical devices previously used by these patients.

The aim of the study was to report the first 4 cases sensitized to 2,2′-methylenebis(6-tert-butyl-4-methylphenol) monoacrylate without a simultaneous allergy to isobornyl acrylate.

The cases were patch tested their own materials, a medical device series, and 2,2′-methylenebis(6-tert-butyl-4-methylphenol) monoacrylate in several concentrations.

All 4 cases tested positive to 2,2′-methylenebis(6-tert-butyl-4-methylphenol) monoacrylate at either 1.0% or 1.5% in petrolatum, whereas 20 controls tested negative to both concentrations.

The cases reported here provide further evidence of 2,2′-methylenebis(6-tert-butyl-4-methylphenol) monoacrylate as a relevant culprit sensitizer in patients with ACD from Dexcom G6. However, the initially used patch test concentration (0.3%) did not suffice to elicit positive reactions in these cases, which is why patch testing at 1.5% is recommended.

Allergic contact dermatitis involving the hands is a common occupational skin disease for hairdressers and the potent sensitizers p-phenylenediamine (PPD) and toluene-2,5-diamine (PTD) are associated with the development of occupational allergic contact dermatitis.

The aim of the study was to analyze whether the use of the moderate sensitizer 2-methoxymethyl-PPD (ME-PPD) in professional hair dyes is a suitable tool to reduce the occupational contact allergy risk for hairdressers.

Hand exposure of hairdressers (N = 11) to ME-PPD was analyzed under routine hair coloring conditions in commercial salons. By accounting for wet work and uneven hand exposure, the daily hand exposure was derived and compared with the occupational acceptable exposure level (AEL), that is, the sensitization induction threshold of ME-PPD adjusted for interindividual variability among workers.

The daily hand exposure to ME-PPD was 1.6 μg/cm², and the occupational AEL was 215 μg/cm². The ratio of hand exposure to AEL was calculated as the margin of safety (MOS) against occupational sensitization. For ME-PPD, the MOS of 134 indicates a low likelihood of sensitization versus PPD and PTD with MOS values of 2.7 and 5.9, respectively.

Our data predict that the use of ME-PPD in professional hair color products improves the protection of hairdressers against hair dye–related contact allergy versus the use of PPD and PTD.