DOCSLIB.ORG

Fcer11/CD23 Receptor Distribution in Patch Test Reactions to Aeroallergens in Atopic Dermatitis

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Fcer11/CD23 Receptor Distribution in Patch Test Reactions to Aeroallergens in Atopic Dermatitis FceRll/CD23 Receptor Distribution in Patch Test Reactions to Aeroallergens in Atopic Dermatitis Colin C. Buckley, Carol Ivison, Leonard W. Poulter, and Malcolm H.A. Rustin Departments of Dermatology and Immunology (LWP), The Royal Free Hospital and School of Medicine, London, U.K. There is increasing evidence that exposure to organic aller­ The numbers of Langer hans cells were reduced in the epider­ gens may induce or exacerbate lesional skin in patients with mis :and increased in the dermis in patch test reactions and atopic dermatitis. In this study, patients with atopic dermati­ lesional skin compared to their controls. Double staining tis were patch tested to 11 common organic allergens and to reve:aled a change in the distribution of CD23 antigen. In control chambers containing 0.4% phenol and 50% glycerin patch test control and non-Iesional biopsies many macro­ in 0.9% saline. In biopsies from positive patch test reactions, phages and only a few Langerhans cells within the dermal patch test control skin, lesional eczematous and non-lesional infiltrates expressed this antigen. In patch test reaction and skin from atopic individuals, and normal skin from non­ lesional skin samples, however, the proportion of CD23+ atopic volunteers, the presence and distribution of macro­ dermal Langerhans cells had increased compared to macro­ phages (RFD7+), dendritic cells (RFD1 +), and Langerhans phages. Furthermore, in these latter samples an increased cells, and the expression of the low-affinity receptor for IgE proportion of dermal CD 1+ cells expressed the dendritic cell (CD23) were investigated. (RFD 1+) marker. These results show that following antigen In patch test reactions and lesional skin samples, inflamma­ challenge there are marked similarities between the pheno­ tory infiltrates of diffusely distributed macrophages type of the cellular infiltrate in patch test reaction and le­ (RFD7+), dendritic cells (RFD1+), T lymphocytes sion:al skin biopsies, and also demonstrate a changing distri­ (RFTmix+), and Langerhans cells (CD1+) were seen, the bution of CD23 on antigen-presenting cells.] Invest Dermatol latter being present in both the epidermis and the dermis. 99:184-188,1992 or many years the role of IgE in the pathogenesis of It has been shown that AD can relapse following environmental atopic dermatitis (AD) has been controversial. Approxi­ Contact with specific allergens, and the dermatosis remits if these mately 80% of patients with AD show an immediate allergens are removed from the patient'S environment [6,10]. The type hypersensitivity reaction to environmental aller­ aeroallergens in these and other studies [5,7,8,11,12] were identi­ gens when given intradermally as a skin prick test, to­ fied by their ability to induce both positive skin prick test reactivity getFher with elevated serum IgE levels with a specificity to these and positive patch test reactions. Delayed patch test reactions oc­ allergens [1] . Despite this, the cellular characteristics of the eczema­ curred only to allergens to which the patient reacted when chal­ tous lesion are repeatedly described as that of a delayed-type hyper­ lenged in the skin prick test. Significantly, these reactions uni­ sensitivity reaction, with the T lymphocyte as the predominant cell formly failed to exhibit the clinical or histologic features of an type in the dermal infiltrate [2 - 4] . Epicutaneous patch testing with immediate hypersensitivity reaction when analyzed at 48 h. It has ae roallergens such as house dust mite (Dermatophagoides pterol1Ys­ therefore been suggested that the skin lesions of AD result from a sinus) produces an eczematous reaction, which also has the dy­ chronic delayed hypersensitivity reaction involving epidermal Lan­ namics and histology of a delayed-type hypersensitivity reaction gerhans cells that present antigen to sensitized T lymphocytes [13]. [5-9]. Though the positive patch test reaction and lesional skin in pa­ tients with AD do not exhibit the clinical or histologic features of a type 1 hypersensitivity reaction, IgE may playa role in presenting aeroallergens. In a recent in vitro study, cell-bound IgE on Langer­ Manuscript received July 9, 1991; accepted for publication February 27, hans cells was required to initiate T-cell responses to allergens [14]. 1992. Further work has shown that in patients with AD the ratio of This resea rch was supported by grants from The Sir Jules Thorn Charita­ CD 1- + /IgE+ cells in the epidermis decreases after 1 week of treat­ ble Trust and The Skin Disease Research Fund. ment with topical corticosteroid, with complete disappearance of Part of this work was presented at the 52nd annual meeting of the Sociery IgE+ cells after 2 weeks [15]. Low-affinity receptors for IgE have for Investigative Dermatology, Seattle, May 1991. been identified on epidermal Langerhans cells as well as on macro­ Reprint requests to: Dr. C. Buckley, Department of Dermatology, The Royal Free Hospital, Pond Street, Hampstead, London NW3 2QG, En­ phages, Band T lymphocytes, and platelets [16] . This has been gland. observed in biopsies both from patients with AD and non-atopic Abbreviations: individuals [17]. Although the precise function of these receptors in AD: atopic dermatitis AD is unclear, it could be hypothesized that they may playa role in APAAP: alkaline phosphatase - anti alkaline phosphatase the presentation of antigen to activated T lymphocytes. In this FlTC: fluorescein isothiocyanate study, we have investigated CD23 expression on Langerhans cells, MoAb: monoclonal antibody dendritic cells (RFDl +), and macro phages (RFD7+) in both posi­ RF: The Royal Free Hospital School of Medicine ti"e patch test reactions and non-patch tested lesional skin from TBS: Tris-buffcred saline patients with AD. We also wished to study the relative distribution TRITC: tetramethylrhodamine isothiocyanate 0022-202X/92/S05.00 Copyright © 1992 by The sociery for Investigative Dermatology, Inc. 184 VOL. 99, NO.2 AUGUST 1992 CD23 RECEPTORS IN ATOPI C DERMATITIS 185 of these subsets of non-lymphoid immunocompetent cells in the Table I. List of Monoclonal Antibodies Used in the Study positive patch test reaction, patch test control, lesional, and non-le­ Reactivity in sional biopsies. Name CD Subclass Source Normal Tissues MATERIALS AND METHODS RFDl IgMp RFHSM' Epitope of HLA-DR Patients Fifty-six patients (37 male, 19 female) with atopic der­ with restricted ex- matitis (age range, 22 - 38 years) diagnosed according to the criteria pression to dendritic of Hanifin and Rajka [18] were studied. Patients had moderate to cells severe dermatitis requiring daily topical corticosteroids. Seven of RFD7 IgGl RFHSM Mature tissue macro- the patients had bronchial as thma and 20 suffered from seasonal phages RFT6 CDl IgGy RFHSM Thymocytes and Lan- allergic rhinitis. .. gerhans cells All patients were skl11 prick test~d on the volar aspect of the RFTmix CDS,8, IgGy RFHSM Pan T lymphocyte non-dominant forearm to the followl11g common mhaled allergens: CDll Cladosporium herbartlm, Alternaria telnlis, Candida albican s, Dermato­ FceR11 CD23 IgG1y Dakopatts Low-affinity IgE recep- phago ides pteronyssinus, Dermatophago ides jarinae? cat and dog dander, UK Ltd. tor birch and plane tree extracts, rye grass, and ttmothy grass pollens • RFHSM, Royal Free Hospital School of Medicine. (Pharmacia Ltd.), using 1 % histamine as a positive control and 0.4% phenol and 50% glycerin in 0.9% saline as a negative contro!' Aeroallergen Patch Testing and Skin Biopsies All patients Quantification of the distribution of specific cell rypes was per­ had not applied topical corticosteroids to the areas to be patch tested formed using an image analyzer to define and measure framed areas for 2 weeks prior to testing and none had received ultra-violet 13 of section (one high-power field [X 400] below the dermo-epider­ irradiation, PUV A, or treatment with immunosuppressive agents in mal junction) to be counted and point counts made of the positively the previous month. stained cells in at least six areas. The results were expressed as the Epicutaneous patch testl11g was perfor.me? O? all pattents .wah number of cells per unit area. Counts of RFD 1+ cells were) per­ 8-mm Finn chambers (Epltest Ltd, Helsl11b, Fmland) contalmng formed using a fluorescence microscope and the results expressed as the same allergens in the same concentrations as used for skin prick the number of cells per high-power view (X 400). testing, on clinically normal skin on both sides of the upper back, one side having been prepared by Sellotape stripping 15 times. One Statistical Methods Where appropriate, statistical differences chamber on either side contained diluent as contro!' The patch tests between densities of the cellular infiltrates were determined using were examined at 48 h and the positive patch test reactions were the Wilcoxon sign rank test for paired data; a value of p < 0.05 was graded according to the International Contact Dermatitis Group considered significant. guidelines [19]. RESULTS Ten patients consented to have 4-mm .punch bIOpSies from the Sellotape-strippe~ poslt.lve pa.tch test reactlO~ and pat~h test control All patients with AD were skin prick test positive to one or more sites. For companson, SIX pattents With atopic dermatttts who were inhalant allergens. Seventeen patients showed positive patch test skin prick test positive had biop.sies tak~n from non-t a p ~ -stripped reactions to one or more epicutaneously applied allergens. The lesional eczematous and non-leslOnal skl11. Non - tape-stnpped skin commonest reactions were to Dermatophagoides pteronyssinus and biopsies from five age- and sex-matched normal individuals with nO Dermatophagoides jarinae, cat dander, Candida albicans and Cladospor­ personal or family history of atopy and who were skin prick test ium herbanlm, and rye grass pollen. T en patients reacted to more negative acted as further control samples. Specimens were placed in than one allergen and four patients developed positive patch test embedding compound (Bright Instruments Company Ltd, UK), reactions on both the Sellotape-stripped and non-stripped sides, snap frozen in liquid nitrogen, and stored at -70 ° C.
Load more

Recommended publications
  • International Survey on Skin Patch Test Procedures, Attitudes and Interpretation Luciana K
    Tanno et al. World Allergy Organization Journal (2016) 9:8 DOI 10.1186/s40413-016-0098-z ORIGINAL RESEARCH Open Access International survey on skin patch test procedures, attitudes and interpretation Luciana K. Tanno1*, Razvigor Darlenski2, Silvia Sánchez-Garcia3, Matteo Bonini4, Andrea Vereda5, Pavel Kolkhir6, Dario Antolin-Amerigo7, Vesselin Dimov8, Claudia Gallego-Corella9, Juan Carlos Aldave Becerra10, Alexander Diaz11, Virginia Bellido Linares12, Leonor Villa13, Lanny J. Rosenwasser14, Mario Sanchez-Borges15, Ignacio Ansotegui16, Ruby Pawankar17, Thomas Bieber18 and on behalf of the WAO Junior Members Group Abstract Background: Skin patch test is the gold standard method in diagnosing contact allergy. Although used for more than 100 years, the patch test procedure is performed with variability around the world. A number of factors can influence the test results, namely the quality of reagents used, the timing of the application, the patch test series (allergens/haptens) that have been used for testing, the appropriate interpretation of the skin reactions or the evaluation of the patient’s benefit. Methods: We performed an Internet –based survey with 38 questions covering the educational background of respondents, patch test methods and interpretation. The questionnaire was distributed among all representatives of national member societies of the World Allergy Organization (WAO), and the WAO Junior Members Group. Results: One hundred sixty-nine completed surveys were received from 47 countries. The majority of participants had more than 5 years of clinical practice (61 %) and routinely carried out patch tests (70 %). Both allergists and dermatologists were responsible for carrying out the patch tests. We could observe the use of many different guidelines regardless the geographical distribution.
    [Show full text]
  • Allergy and Dermatology Patch Test Clinic (ADPT)
    4 Skin Patch Tests – Allergy and Dermatology Patch Test Clinic (ADPT) Questions the doctor or nurse will ask you during your first visit. Your answers can help us with collecting your medical information: • When did your symptoms begin? • Have your symptoms changed over time? • What at home treatments have you used? • How did those treatments work? • What, if anything, appears to make your symptoms worse? • Do allergies run in your family? Skin Patch Tests Plan your schedule Allergy and Dermatology Patch Test Clinic (ADPT) Patches are applied on Monday, and then you return on Wednesday for patch removal and Friday for final reading. On Wednesday wear an old or dark coloured shirt. We mark the back after the patches are removed and the ink Why have skin patch testing? may rub off on your clothing. The cause of an allergy is usually found based on: Day Length of visit During the visit Special care • Your symptoms, a rash is very common. Monday 30 to 60 minutes Discussion about the No water or sweat on • A history of contact with substances that cause the allergy. history of your the patches for 2 days. These substances are called allergens. rash/symptoms. Physical exam. When the cause of an allergy is not clear, a skin patch test may be done to Patches applied. help find the cause of your allergy. Skin patch tests are done to see if a Wednesday Short visit Patches removed. Wear an old or dark certain substance is causing an allergic skin reaction. 10 to 15 minutes shirt to this visit.
    [Show full text]
  • Allergy Testing
    Effective February 26, 2018 Policy Replaced by LCD L33417 Name of Blue Advantage Policy: Allergy Testing Policy #: 071 Latest Review Date: February 2017 Category: Laboratory/Medical Policy Grade: D Background: Blue Advantage medical policy does not conflict with Local Coverage Determinations (LCDs), Local Medical Review Policies (LMRPs) or National Coverage Determinations (NCDs) or with coverage provisions in Medicare manuals, instructions or operational policy letters. In order to be covered by Blue Advantage the service shall be reasonable and necessary under Title XVIII of the Social Security Act, Section 1862(a)(1)(A). The service is considered reasonable and necessary if it is determined that the service is: 1. Safe and effective; 2. Not experimental or investigational*; 3. Appropriate, including duration and frequency that is considered appropriate for the service, in terms of whether it is: • Furnished in accordance with accepted standards of medical practice for the diagnosis or treatment of the patient’s condition or to improve the function of a malformed body member; • Furnished in a setting appropriate to the patient’s medical needs and condition; • Ordered and furnished by qualified personnel; • One that meets, but does not exceed, the patient’s medical need; and • At least as beneficial as an existing and available medically appropriate alternative. *Routine costs of qualifying clinical trial services with dates of service on or after September 19, 2000 which meet the requirements of the Clinical Trials NCD are considered reasonable and necessary by Medicare. Providers should bill Original Medicare for covered services that are related to clinical trials that meet Medicare requirements (Refer to Medicare National Coverage Determinations Manual, Chapter 1, Section 310 and Medicare Claims Processing Manual Chapter 32, Sections 69.0-69.11).
    [Show full text]
  • Dermatology Patch Allergy Testing Post Service - Information Request Form
    Dermatology Patch Allergy Testing Post Service - Information Request Form Blue Cross NC will review associated claim(s) for services rendered on the patient listed below. In order to determine benefits are available for the reported condition, please answer the questions below. If you would prefer to send medical records, relating to the condition for the dates listed you may do so. In this case, all answers must be supported by documentation in the patient's medical record. Please submit the completed form to Blue Cross NC per the Medical Record Submission instructions found on the bcbsnc.com provider site (https://www.bcbsnc.com/assets/providers/public/pdfs/submissions/how_to_submit_provider_initiated_medical_records.pdf) or if requested by Blue Cross NC via a bar-coded coversheet, please fax the form/medical records to the number noted on the bar-coded cover sheet within 7-10 days to facilitate the claim payment. This form must be filled out by the patient's physician or their designee which may be any of the following: Physician Assistant (PA), Nurse Practitioner (NP), Registered Nurse (RN), or Licensed Practical Nurse (LPN). Note: Credentials must be provided with signature or the form will be returned. PROVIDER INFORMATION Requesting Provider Information Place of Service Provider Name Facility Name Provider ID Facility ID PATIENT INFORMATION Patient Name:_____________________________ Patient DOB :_____________ Patient Account Number______________ Patient ID:______________ CLAIM INFORMATION Date(s) of Service_____________ CPT_________ Diagnosis_______ Dermatology Patch Allergy Testing - Information Request Form Page 1 of 3 CLINICAL INFORMATION Did the patient have direct skin testing (for immediate hypersensitivity) by: Percutaneous or epicutaneous (scratch, prick, or puncture)? ________________ Intradermal testing? ___________________________________ Inhalant allergy evaluation? _________________ Did the patient have patch (application) testing (most commonly used: T.R.U.E.
    [Show full text]
  • Allergy Skin and Challenge Testing
    Corporate Medical Policy Allergy Skin and Challenge Testing File Name: allergy_skin_and_challenge_testing Origination: 7/1979 Last CAP Review: 11/2020 Next CAP Review: 11/2021 Last Review: 11/2020 Description of Procedure or Service Management of the allergic patient may include identifying the offending agent by means of allergy testing. Allergy testing can be broadly grouped into in vivo and in vitro methodologies: • In vivo testing - includes allergy skin testing such as the scratch, puncture or prick test (epicutaneous), intradermal test (intracutaneous) and patch test, and food and bronchial challenges. • In vitro testing - includes various techniques to test the blood for the presence of specific IgE antibodies to a particular antigen. Once the agent is identified, treatment is provided by avoidance, medication or immunotherapy (allergy shots). Allergic or hypersensitivity disorders may be manifested by generalized systemic reactions as well as by localized reactions in any organ system of the body. The reactions may be acute, subacute, or chronic, immediate or delayed, and may be caused by numerous offending agents: pollen, molds, dust mites, animal dander, stinging insect venoms, foods, drugs, etc. This policy only addresses in vivo (skin and challenge) testing; for vitro testing, see policy titled, Allergen Testing. Related Policies: Allergy Immunotherapy Desensitization Allergen Testing AHS – G2031 Maximum Units of Service Idi ***Note: This Medical Policy is complex and technical. For questions concerning the technical language and/or specific clinical indications for its use, please consult your physician. Policy BCBSNC will provide coverage for Allergy skin and challenge testing when it is determined to be medically necessary because the medical criteria and guidelines shown below are met.
    [Show full text]
  • Guideline on Diagnostic Procedures for Suspected Hypersensitivity to Beta-Lactam Antibiotics
    published by: guidelines Allergo J Int https://doi.org/10.1007/s40629-019-0100-8 Guideline on diagnostic procedures for suspected hypersensitivity to beta-lactam antibiotics Guideline of the German Society for Allergology and Clinical Immunology (DGAKI) in collaboration with the German Society of Allergology (AeDA), German Society for Pediatric Allergology and Environmental Medicine (GPA), the German Contact Dermatitis Research Group (DKG), the Austrian Society for Allergology and Immunology (ÖGAI), and the Paul-Ehrlich Society for Chemotherapy (PEG) Gerda Wurpts · Werner Aberer · Heinrich Dickel · Randolf Brehler · Thilo Jakob · Burkhard Kreft · Vera Mahler · Hans F. Merk · Norbert Mülleneisen · Hagen Ott · Wolfgang Pfützner · Stefani Röseler · Franziska Ruëff · Helmut Sitter · Cord Sunderkötter · Axel Trautmann · Regina Treudler · Bettina Wedi · Margitta Worm · Knut Brockow © The Author(s) 2019 Electronic supplementary material The online version of this article (https://doi.org/10.1007/s40629-019-0100-8) contains supplementary material, which is available to authorized users. Dr. G. Wurpts () · H. F.Merk · S. Röseler V. Ma h l e r Clinic for Dermatology and Allergology, Aachen Paul-Ehrlich Institute, Langen, Germany Comprehensive Allergy Center (ACAC), Uniklinik RWTH Department of Dermatology, University Hospital Erlangen, Aachen, Pauwelsstraße 30, 52074 Aachen, Germany Erlangen, Germany [email protected] N. Mülleneisen W. Aberer Asthma and Allergy Centre, Leverkusen, Germany Department of Dermatology, Graz Medical University, Graz, Austria H. Ott Division of Pediatric Dermatology and Allergology, Auf der H. Dickel Bult Children’s Hospital, Hannover, Germany Department of Dermatology, Venereology and Allergology, St. Josef Hospital, University Hospital of the Ruhr University W. Pfützner Bochum, Bochum, Germany Department of Dermatology and Allergology, University Hospital Gießen und Marburg, Marburg Site, Marburg, R.
    [Show full text]
  • Practice Parameters for Allergy Diagnostic Testing INTRODUCTION
    Practice Parameters for Allergy Diagnostic Testing INTRODUCTION The purpose of the Workgroup on Practice Parameters for Allergy Diagnostic Testing was to formulate an outline of the rational basis for proper use and interpretation of the most important clinical and laboratory tests used by allergists. This should serve not only to confirm the presence of allergic factors but also guide the proper choice of therapy. The American Academy of Allergy, Asthma, & Immunology (AAAAI) and the American College of Allergy, Asthma, and Immunology (ACAAI) have jointly accepted the re- sponsibility for establishing allergy diagnostic parameters in order to pro-mote advancement and improvements in care for 35 million allergic patients and facilitate the education of physicians who care for them. Similar to the organizational process used in developing the published Prac-tice Parameters for the Diagnosis and Treatment of Asthma, more than 30 experts in the field of allergy and immunology prepared critical reviews which were coordinated and stylized into a uniform monograph by the coeditors. A substantial portion of background research for this joint endeavor has been gleaned from an expert consensus statement concerning diagnostic technology sponsored by the National Institute of Allergy and Infectious Diseases and published in the Journal of Allergy and Clinical Immunology supplement, Volume 82: September, 1988. One of the major con-clusions of that workshop was that periodic reassessment of diagnostic techniques should be mandatory in view of the rapidity of technology transfer to clinical practice. To accomplish such an up-to-date revision of diagnostic methods, the Joint Task Force commissioned an expanded national expert panel with a wide range of basic research and clinical practice experiences in allergy and immunology.
    [Show full text]
  • Patch Testing for Skin Allergies
    Patch Testing for Skin Allergies A patch test is a skin test used to find the cause of a possible allergic reaction on the skin. This reaction is called allergic contact dermatitis. Contact dermatitis is a reaction to something that came into contact with the skin. This kind of allergic reaction usually causes inflammation (redness, itching). Patch testing is done by the dermatology clinic. During patch testing, different substances are placed on the skin and taped in place. The patches are typically placed on the back, left on for 2 days and then removed. The area of skin that was tested will be evaluated by the dermatologist 2 to 4 days after the patches are removed. You will need to bring your child to the dermatology clinic 2 to 3 times during the week that the patch testing is done. Generally the test week is a total of 5 days. It is important to follow the guidelines below to get accurate results. Patch testing evaluates a slow, delayed skin reaction so it is important that the patches stay in place. The test site must also be protected throughout the entire test week. Preparation for the Test Getting the skin ready for your patch test is important. Following these instructions will help you to get more accurate, reliable results. Avoid sun exposure for 1 to 2 weeks before patch testing. Do not use topical medicines (creams and ointments) on the back and any other area where patches may be placed for at least 1 week before patch testing. You can continue to use these medicines on areas of the body where patches will not be placed.
    [Show full text]
  • Skin Patch Testing Information
    San Jose Medical Center Dermatology Department Family Health Center, 3rd Floor Unit K SKIN PATCH TESTING This informational sheet was developed to prepare you for skin patch testing. It provides answers to questions patients ask most often. Be sure to discuss any additional questions or concerns you may have with the dermatologist or the dermatology staff before the test is applied. We appreciate your cooperation in helping to make the testing successful. WHAT IS THE PURPOSE OF A SKIN PATCH TEST? Patch testing helps discover possible causes for your dermatitis. Small amounts of a number of substances are taped to your back, to find out if you are hypersensitive (allergic) to them. If a skin rash develops where a particular substance was applied to your skin, it may mean you are allergic to that substance. While there are no FDA-approved allergens for extended testing, this technique is well accepted as the gold standard for evaluating allergic contact dermatitis. HOW DO I PREPARE FOR THE PATCH TEST? You may bathe or shower before the test, but do not apply any creams/lotions/oils to your upper body area (arms, back, and chest) unless your physician specifically tells you to do so. If you have a lot of hair on your back, it will be shaved before the patch tests are applied. WHAT DO I NEED TO BRING FOR MY VISIT? Your physician may do patch testing with some of the topical products you use regularly. Please bring all your over-the-counter and prescription topical products. This includes soaps, hand sanitizers, hair products, makeup, lip products, and etc.
    [Show full text]
  • Oral Lichen Planus and Allergy to Dental Amalgam Restorations
    STUDY Oral Lichen Planus and Allergy to Dental Amalgam Restorations Ronald Laeijendecker, MD; Sybren K. Dekker, MD, PhD; Piet M. Burger, MD; Paul G. H. Mulder, PhD; Theodoor Van Joost, MD, PhD; Martino H. A. Neumann, MD, PhD Objectives: To determine contact allergies in patients was replaced in 8 patients of group B, with significant with oral lichen planus and to monitor the effect of par- improvement. In group C, amalgam replacement in 2 tial or complete replacement of amalgam fillings follow- patients resulted in improvement in 1 patient. These ing a positive patch test reaction to ammoniated mer- results were evaluated after 3 months. No positive patch cury, metallic mercury, or amalgam. test reactions to mercury compounds were found in patients with concomitant cutaneous lichen planus and Design: In group A (20 patients), the oral lesions were in group D. confined to areas in close contact with amalgam fillings. In group B (20 patients), the lesions extended 1 cm be- Conclusions: Contact allergy to mercury compounds is yond the area of contact with amalgam fillings. In group important in the pathogenesis of oral lichen planus, es- C (20 patients), the oral lesions had no topographic re- pecially if there is close contact with amalgam fillings and lationship with amalgam fillings. Partial or complete re- if no concomitant cutaneous lichen planus is present. In placement of amalgam fillings was recommended if there cases of positive patch test reactions to mercury com- was a positive patch test reaction to ammoniated mer- pounds, partial or complete replacement of amalgam fill- cury, metallic mercury, or amalgam.
    [Show full text]
  • EURL ECVAM Recommendation on Non-Animal-Derived Antibodies
    EURL ECVAM Recommendation on Non-Animal-Derived Antibodies EUR 30185 EN Joint Research Centre This publication is a Science for Policy report by the Joint Research Centre (JRC), the European Commission’s science and knowledge service. It aims to provide evidence-based scientific support to the European policymaking process. The scientific output expressed does not imply a policy position of the European Commission. Neither the European Commission nor any person acting on behalf of the Commission is responsible for the use that might be made of this publication. For information on the methodology and quality underlying the data used in this publication for which the source is neither Eurostat nor other Commission services, users should contact the referenced source. EURL ECVAM Recommendations The aim of a EURL ECVAM Recommendation is to provide the views of the EU Reference Laboratory for alternatives to animal testing (EURL ECVAM) on the scientific validity of alternative test methods, to advise on possible applications and implications, and to suggest follow-up activities to promote alternative methods and address knowledge gaps. During the development of its Recommendation, EURL ECVAM typically mandates the EURL ECVAM Scientific Advisory Committee (ESAC) to carry out an independent scientific peer review which is communicated as an ESAC Opinion and Working Group report. In addition, EURL ECVAM consults with other Commission services, EURL ECVAM’s advisory body for Preliminary Assessment of Regulatory Relevance (PARERE), the EURL ECVAM Stakeholder Forum (ESTAF) and with partner organisations of the International Collaboration on Alternative Test Methods (ICATM). Contact information European Commission, Joint Research Centre (JRC), Chemical Safety and Alternative Methods Unit (F3) Address: via E.
    [Show full text]
  • PATCH TESTING in OCCUPATIONAL DERMATOLOGY David J Gawkrodger *823
    Occup Environ Med: first published as 10.1136/oem.58.12.823 on 1 December 2001. Downloaded from PATCH TESTING IN OCCUPATIONAL DERMATOLOGY David J Gawkrodger *823 ermatologists use the terms “eczema” and “dermatitis” interchangeably to describe a varied pattern of inflammation which, when acute, is characterised by erythema and Dvesiculation, and, when chronic, by dryness, lichenification, and fissuring (fig 1). Contact dermatitis is the consequence of a pathological response to one or more external agents that may act either as irritants, where allergic T cell mechanisms are not involved, or as allergens, where cell mediated hypersensitivity initiates the proceedings. Many studies have shown that it is very diYcult to distinguish allergic contact dermatitis from irritant and endogenous forms.1 Contact dermatitis is classified into a number of reaction patterns: acute irritant dermatitis is a severe eczematous reaction that results from a single overwhelming exposure, or a few brief expo- sures to strong irritants or a caustic agent. Chronic (cumulative) irritant dermatitis is characterised by eczematous changes that develop upon repeated exposure to weaker irritants, which are “wet”—for example, water, soaps, detergents, solvents, weak acids or alkalis—or “dry”, as in the case of environmental factors like low humidity, heat, air, and dusts.2 Many industrial substances are irritants and some are also allergens. Allergic contact dermatitis is defined as a specific immune phenomenon that is the result of a T cell mediated immune response to a defined allergen, resulting in eczema or the exacerba- tion of a pre-existing dermatitis when the patient has been re-challenged with the allergenic material.
    [Show full text]