Faculty Bibliography

A case is presented of a 55-year old woman who developed an eruption suggestive of contact dermatitis on repeated occasions after receiving anesthesia for dermatologic procedures. Patch testing revealed a positive reaction to lidocaine. Basic structures of anesthetics are reviewed, and the classification of immunologically-mediated allergic reactions is discussed. The presence of cutaneous lidocaine allergy has profound implications for the field of dermatology

A review of the literature of reported cases of contact dermatitis to a variety of natural herbal extracts is Presented. Natural extracts are commonly used ingredients in many cosmetic preparations and homeopathic remedies. Although the term natural botanical extracts inherently purports to have beneficial and benign properties, these extracts can cause adverse reactions in individuals. As such, dermatologists should be cognizant of these agents as possible sources of allergenicity in patients presenting with contact dermatitis

BACKGROUND: Temporary black henna tattoos are very popular as body adornment. Although contact allergy to natural henna is unusual, the inclusion of hair dye, p-phenylenediamine (PPD), increases the risk of contact sensitization. OBJECTIVE: This study was performed to identify the presence and concentration of PPD in a black henna tattoo mixture to which our patient developed contact allergy. METHODS: The presence of PPD in a black henna tattoo mixture, various samples of commercially available henna powders, and several hair dye products was qualitatively and quantitatively detected using high performance liquid chromatography (HPLC). RESULTS: This study demonstrated that PPD was present in the black henna tattoo mixture at a concentration of 15.7%, which is significantly higher than commercial hair dye preparations. CONCLUSION: The presence of PPD in black henna tattoo mixtures in high concentration poses a health hazard and a risk of allergic contact sensitization with potential long-term consequences

BACKGROUND: The panel of patch test allergens used for the evaluation of patients with suspected photoallergy typically does not include plant and pesticide allergens. The prevalence of allergic contact dermatitis and photoallergic contact dermatitis to plant and pesticide allergens was determined for this subgroup of patients. OBSERVATION: Positive reactions were detected in 12 of 26 patients who were tested with our photoallergen series: 5 with allergic contact dermatitis, 5 with photoallergic contact dermatitis, and 2 with both. Four of the 12 patients had positive patch and photo-patch test reactions to plant allergens, pesticide allergens, or both. The positive patch test reactions were to the plants Taraxacum officinale (dandelion) and Tanacetum vulgare (tansy) and to the pesticides folpet and captafol. Positive photo-patch test reactions were to the pesticides folpet and captan. The histories of the patients suggested that 2 or 3 of the 4 patients had clinically relevant reactions. In the other 8 patients, positive reactions to the patch and photo-patch tests included fragrances, sunscreens, and antibacterial agents. CONCLUSION: Plant and pesticide allergens should be included in the patch and photo-patch test series used for the evaluation of patients with suspected photoallergy