漂亮101皮膚科診所

最近一項研究調查美國城鄉地區共計九家美髮沙龍和兩個零售販賣組合包中的理髮工具是否會釋放鎳金屬的情況。

在經過測試的89個工具中，有27%的工具經測試後發現呈陽性釋放鎳金屬的反應。這些工具包括修剪器（100%），捲髮夾（100%），剪刀（50%），髮夾（36%），造型剪（26%）和修剪的剪刀（4%）。釋放鎳的工具比起同類型的非釋放鎳金屬的工具通常更為便宜。

因此，臨床醫師在評估懷疑過敏性接觸性皮炎的患者時，特別是那些使用美髮工具的美髮業者或患者，應高度考慮職業性的鎳金屬過敏。

Contact Dermatitis. 2023 Sep 5. doi: 10.1111/cod.14411. Online ahead of print.

1.  Hand eczema (HE) among professional hospital cleaners and found that the self-reported lifetime prevalence of HE was 30.3%

2.  Risk factors:

a. The use of hydrochloric acid for ≥4 days/week in the past 12 months

b. Washing hands ≥20 times during a working day

 ACD due to ophthalmic products are older than 40 years

Eyelid dermatitis was the main clinical presentation.

67.7% of patients who tested positive to an ophthalmic medication, 56.8% reacted to an active ingredient and 50% reacted to an excipient. Overall, 36.4% reacted to their own products tested “as is.” 

Main allergens: aminoglycoside antibiotics, including neomycin, gentamycin, and kanamycin.

Other allergens: beta blockers, primarily timolol and some non-active ingredients, including sodium metabisulfite, lanolin alcohol, benzalkonium chloride, and thimerosal.

1. Paradoxical psoriasis is becoming a readily recognized side effect of biologics therapy, occurring in approximately 2–5% of patients.

2. Paradoxical psoriasis showed pustulosis, prominent scalp involvement with alopecia, or erythroderma,  due to a pleomorphic interferon response.

3. Paradoxical psoriasis severity is associated with the use of adalimumab and is more common in older patients.

Patients with diabetes who have allergic contact dermatitis due to insulin pumps or glucose sensors may show positive patch testing reactions to:

1. isobornyl acrylate

2. benzoyl peroxide

3. adhesive remover wipes

4. lidocaine/prilocaine plaster

Transmission from socks is an important reservoir for frequent dermatophyte reinfection.

Complete disinfection with 24-hour soaking of fabrics with quaternary ammonium (QAC) -based detergent prior to laundering.

Domestic washing disinfecting only 7% of specimens and freezing and steam washing actually demonstrated no disinfection. 

Mycoses 2022 Jul 01;65(7)741-746.

Isobornyl acrylate (IBOA) in the adhesive patch components may trigger allergy.

2,2'-methylenebis(6-tert-butyl-4-methylphenol) monoacrylate (MBPA) in the new adhesive patch components may also trigger allergy.

All suspected patients should be tested with MBPA at 0.5%, and IBOA at 0.1%.

Avoiding the use of MBPA in glucose monitoring systems should help prevent contact allergy, as it appears to be the primary sensitizer in patients with ACD to the newer Dexcom G6 Glucose Monitoring System.
.

After adjusting for age, sex, ethnicity, and poverty income ratio,

a 1-gram increase in dietary sodium intake was associated with an increased risk for current atopic dermatitis.

Adjusted odds ratio: 1.22; 95% confidence interval: 1.02 to 1.45.

Reference:

Whey protein supplements contain alpha-lactalbumin, beta-lactalbumin, minerals, big amounts of branched amino acids and glutamine.

Concurrent isotretinoin therapy and whey protein supplementation might be an under-reported combination among teenagers undergoing acne treatment and protein supplementation regimes to increase muscle mass.

This combination may lead to major hepato-toxicity, since individual liver damage of isotretinoin and whey protein has been confirmed.

Given isotretinoin and whey protein documented individual liver toxicity, their combination may synergize major liver toxicity.

No studies supporting the use of coconut oil or castor oil for hair loss.

Only animal studies showing some potential for the use of pumpkin seed oil, henna, and aloe vera.

Two randomized controlled trials supporting the use of rosemary oil for hair loss.

Three studies showed that topical capsaicin improved hair regrowth specifically in patients with alopecia areata.

Stinging nettle did improve the hair pull test in one human study and accelerated hair growth in one animal study in rats.

Upadacitinib 30 mg and Abrocitinib 200 mg were more effective than Dupilumab for reducing EASI scores.

Upadacitinib 15 mg is similar to Dupilumab in terms of reduction in EASI scores

Tralokinumab, Baricitinib, and Abrocitinib 100 mg were less effective

Contact Sensitization to Essential Oils:

8.3% reacted to 1 essential oil.

Six essential oils were positive in more than 1% of those patch tested.

These essential oils include ylang ylang oil, lemon -grass oil, jasmine absolute, sandalwood oil, clove oil and neroli oil.

The essential oils found to have the lowest reactions were eucalyptus, laurel leaf oil, lemon oil, orange oil and peppermint oil.

Lab tests affected by biotin supplementation:

1. Thyroid function
2. Troponin (58.6%)
3. 25-Hydroxy vitamin D
4. Beta-human chorionic gonadotropin (b-hCG)

Neuropathic Itch: brachioradial pruritus, notalgia paresthetica, lichen amyloidosis on the shins, groin pruritus. topical strontium based product:  Dermeleve

Moisturize with a Pill:L-Histidine to increases filaggrin and natural moisturizing factor in atopic dermatitis/dry skin/elderly, 2000-4000 mg/d.

Moisturize with a Pill: phytoceramides, Lipowheat 350 mg/d 

PPD (paraphenylenediamine) allergic: use modified PPD (methoxymethyl-PPD, Wella Koleston Perfect with Me+).
 

Linalool: a fragrance, floral odor,  88% of essential oils, aromatherapy, and botanical usage, test to the linalool hydroperoxides. 

Limonene: citrus odor, essential oils, test to limonene hydroperoxides.

Alkyl glucosides: Allergen of the Year in 2017, surfactant, decyl glucoside, and lauryl glucoside.

Isobornyl acrylate: Allergen of the Year in 2020, glucose monitoring devices

Acetophenone azine: Allergen of the Year in 2021,  shin pads and footwear, sneakers, flip flops, ski boots, insoles, foam, elastomer ethyl vinyl acetate.