RESUMO
Surfactants, many of which are used as detergents, can be found in many common household items, such as shampoos, conditioners, soaps, and cosmetics. One should recognize the multitude of surfactants that are used in today's products to identify any potential allergic contact dermatitis (ACD) or irritant contact dermatitis (ICD). Given their abundance in everyday products, it is understandable that many cases of occupational contact dermatitis that arise can be attributed to surfactants. The products most connected with ACD are cocamidopropyl betaine, oleamidopropyl dimethylamine, decyl glucoside, 3-dimethylaminopropylamine, amidoamine, and cocamide diethanolamine. Similarly, the most common surfactant-related causes of ICD are sodium lauryl sulfate and benzalkonium chloride. It is important for dermatologists to identify the causes and differentiate between the two, to adjust treatments and products accordingly. Here, the most frequently used surfactants, as well as their correlation between ACD and ICD, will be reviewed.
Assuntos
Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/etiologia , Dermatite Irritante/diagnóstico , Dermatite Irritante/etiologia , Irritantes/efeitos adversos , Tensoativos/efeitos adversos , Alérgenos/efeitos adversos , Alérgenos/química , Diagnóstico Diferencial , Humanos , Irritantes/química , Tensoativos/químicaRESUMO
The American Contact Dermatitis Society Core Allergen Series was introduced in 2012. After 4 years of use, changes in our recommended allergens are necessary. For the updated series, we have reordered the first 4 panels to approximately mirror the current TRUE Test and removed parthenolide, triclosan, glutaraldehyde, and jasmine. Polymyxin B, lavender, sodium benzoate, ethylhexylglycerin, and benzoic acid are new additions to the American Contact Dermatitis Society series.
Assuntos
Alérgenos/efeitos adversos , Alérgenos/imunologia , Dermatite Alérgica de Contato/imunologia , Testes do Emplastro , Humanos , Testes do Emplastro/métodosRESUMO
BACKGROUND: Contact dermatitis (CD) has been assessed by numerous disease severity indices resulting in heterogeneity across published research. OBJECTIVE: This study aims to evaluate published CD severity scales and identify a criterion standard for assessment. METHODS: Scopus and Ovid MEDLINE were searched for human randomized controlled trials (RCTs) on CD severity measures published during a 10-year period. Eligible studies were English-language RCTs reporting disease severity outcome measures for CD in humans. Studies were excluded if they were duplicates, not available in English, not related to CD, not RCTs, not conducted on human subjects, or did not report relevant outcome measures. RESULTS: A total of 22 disease outcome measures were used in 81 included RCTs. Instrument-based measures were used in 40 (49.4%) studies, and visual assessments were used in 66 (81.5%) RCTs. Only 5 (6.2%) studies reported quality of life (QoL) outcomes. Two (2.5%) studies used a clinical severity scale, which combined both QoL and visual assessments. LIMITATIONS: This study was limited by the exclusion of non-RCTs and gray literature. CONCLUSIONS: Wide variation in CD outcome measures exists including instrument-based measures, visual assessments, and QoL outcomes. A standardized outcome measure must be generated to reduce heterogeneity.
Assuntos
Dermatite de Contato/fisiopatologia , Qualidade de Vida , Índice de Gravidade de Doença , Dermatite de Contato/psicologia , Humanos , Avaliação de Resultados em Cuidados de Saúde , Inquéritos e QuestionáriosRESUMO
AbstractBackgroundThe mortality rate for melanoma continues to rise and the greatest improvement in melanoma survival is attributable to early detection with skin cancer screening exams. However, physicians feel that limited training in the examination of skin and limited clinical time both serve as barriers to adequately assess high-risk lesions.ObjectiveTo test the use of The Integrated Skin Exam film as an instructional tool to teach the examination of skin in a live classroom setting, outside of the purview of the original formal study.MethodsIdentical cross-sectional surveys were administered pre- and post-film to a class of first-year medical students at the time of viewing The Integrated Skin Exam film. Results were compared to the initial assessment of this film as a teaching tool in a research setting.ResultsOf the maximum 182 possible surveys administered, we collected 148 pre-surveys and 142 post-surveys (81.3% and 78.0% 33 response rates, respectively). After viewing the film, students showed improvement in identification of high-risk demographic 34 groups (79.3% vs 58.9%, p<0.001) and high-risk anatomic sites in both women (91.9% vs 59.6%, p<0.001) and men (92% vs 35 62.1%, p<0.001). Students demonstrated increased confidence in the skin cancer examination (SCE) (52.2% vs 6.9%, p<0.001) and a greater proportion (74.4% vs 48.3%, p<0.001) of students believed less than 3 minutes was required to integrate a skin cancer exam (SCE) into the routine examination.ConclusionsThe Integrated Skin Exam film is a valuable training tool as proven by increased knowledge of, and improved attitudes about the 2 SCE after viewing the film. In addition, there was a striking similarity in outcomes when using this film in a live classroom 3 environment compared to the original study setting.
Assuntos
Currículo , Dermatologia/educação , Educação de Graduação em Medicina/métodos , Melanoma/diagnóstico , Exame Físico , Neoplasias Cutâneas/diagnóstico , Competência Clínica , Estudos Transversais , Detecção Precoce de Câncer , HumanosRESUMO
Necrotic arachnidism is the potential cutaneous reaction to spider bite venom. In the United States, members of 7 spider families may be responsible for envenomation sufficiently severe to warrant treatment. Characteristics of several spiders, in particular Loxosceles spiders, whose bite is toxic to humans are described, and diagnostic standards, preventive measures, and treatment options are reviewed. (J Am Acad Dermatol 2001;44:561-73.) LEARNING OBJECTIVE: After the completion of this learning activity, participants should be familiar with the characteristics of several different spider families endemic to the United States. Furthermore, this learning activity should aid in the prevention and diagnosis of spider bites as well as in the classification and treatment of specific bites.