RESUMEN
We report a case of contact dermatitis caused by both efinaconazole, a topical triazole antifungal drug, and luliconazole, a topical imidazole antifungal drug. Positive patch test reactions were observed with efinaconazole and luliconazole. A patch test with lanoconazole also elicited a positive reaction. We hypothesized that structural similarity between luliconazole and lanoconazole led to cross-reaction, and that the dithiolane ring common to both drugs or the structure of the vinyl imidazole with a dithiolane ring could be the antigenic determinant. Since efinaconazole and luliconazole have no common structures, patients could be sensitized to both drugs separately. The antigenic determinant of efinaconazole is unknown. However, the chemical formula of ravuconazole, an oral triazole antifungal drug, is similar to that of efinaconazole. Clinicians should carefully consider potential cross-reactivity between these drugs.
Asunto(s)
Antifúngicos/efectos adversos , Dermatitis por Contacto/etiología , Dermatosis del Pie/inducido químicamente , Imidazoles/efectos adversos , Triazoles/efectos adversos , Administración Tópica , Anciano , Antifúngicos/uso terapéutico , Epítopos , Dermatosis del Pie/tratamiento farmacológico , Humanos , Imidazoles/uso terapéutico , Masculino , Pruebas del Parche , Triazoles/uso terapéuticoRESUMEN
BACKGROUND: For laser therapy, darker skin types should be carefully treated, however, the precise role of melanin content, subspecies, and the heat effect of the laser has not been well studied in vivo. METHODS: We generated three groups of mice that have epidermal melanocytes producing only eumelanin, dominant pheomelanin, and no melanin. Using these mice, the effect of a frequency-doubled Nd:YAG laser was studied. RESULTS: The mouse epidermis that contained eumelanin underwent heat degeneration at a lower fluence when compared with the mouse epidermis with dominant pheomelanin. The mouse skin with no melanin did not show any degeneration of the epidermis. CONCLUSION: The effect of the Nd:YAG laser on the cells containing different melanin subspecies was shown to be different in an in vivo irradiation system.