Contact dermatitis
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Case Reports
Severe delayed cutaneous reaction due to Mediterranean jellyfish (Rhopilema nomadica) envenomation.
During summer, Mediterranean Sea waters are invaded by a species of jellyfish designated as Rhopilema nomadica. Their tentacles contain numerous nematocysts loaded with a toxin that causes envenomation, usually expressed as immediate appearance of redness, burning sensation and papulovesicular eruption in the affected skin. We report a lady with a severe delayed reaction due to jellyfish envenomation that developed 2 days after contact with jellyfish tentacles.
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27 patients (26 women and 1 man), all in contact with artificial nails, were tested for acrylic compounds, known to be present in nail cosmetics. The patch test results obtained in these patients demonstrated that 2-hydroxyethyl methacrylate and ethyl cyanoacrylate were the only 2 allergens needed to diagnose contact allergy to acrylic-containing nail cosmetics, except for 1 patient who reacted only to her nail preparation used and in which we were unable to identify the allergen. This concerns clearly a limited number of patients. The purpose was, however, to detect the most valuable allergen(s) to be used in a dermatologist's practice, in which not all possible allergens can be tested, in order to diagnose such cases.
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A relationship between sensitivity to poison oak or poison ivy and mango dermatitis has been suggested by previous publications. The observation that acute allergic contact dermatitis can arise on first exposure to mango in patients who have been sensitized beforehand by contact with other urushiol-containing plants has been documented previously. We report 17 American patients employed in mango picking at a summer camp in Israel, who developed a rash of varying severity. ⋯ In contrast, none of their Israeli companions who had never been exposed to poison ivy/oak developed mango dermatitis. These observations suggest that individuals with known history of poison ivy/oak allergy, or those residing in area where these plants are common, may develop allergic contact dermatitis from mango on first exposure. We hypothesize that previous oral exposure to urushiol in the local Israeli population might establish immune tolerance to these plants.
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We report the first case of immediate-type hypersensitivity caused by Emla cream. A 55-year-old woman, after using Emla cream, went on to develop urticaria. An open test was positive to Emla cream. ⋯ An intradermal test and subcutaneous administration of 3 anaesthetics that had negative patch tests and prick tests were performed and well tolerated, allowing their use. In the literature, anaphylactic reactions to lidocaine injections, delayed-type hypersensitivity after lidocaine subcutaneous injections and contact dermatitis from Emla cream have all been described. This first case of contact urticaria from Emla cream was due to lidocaine and did not show any cross-reaction with other local anaesthetics.