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Introduction: The hypersensitivity reaction associated with tattoo ink and its management represent a growing challenge, despite having precedents in diagnostic and treatment experience in other reports or case series in recent decades, no one has been found homogeneous offer that is effective and safe. Therefore, a review is presented with what has been described in pathophysiological theories, as well as therapeutic proposals and the response found in related cases that have been reported to date. Clinical case: 30-year-old male, with dermatosis located on the right upper extremity, affecting the inner side of the forearm and the outer side of the arm, unilateral, asymmetric, monomorphic in appearance, made up of an artificial macula, caused by red ink (tattoo), with development of papular-like lesions in original trace, pruritic, referred evolution time of one month. Tattoo completion time of 5 and 2 years on the outer side of the right arm and inner side of the ipsilateral forearm, respectively. Conclusions: According to antecedents in other reports and case series, including the experience of our patient, there is no proven efficacy with the use of topical immunomodulators, in turn, patients who shows complete improvement until the elimination of the allergen, either from excisional or laser.

Introducción: la reacción de hipersensibilidad asociada a tinta de tatuaje y su manejo representan un reto diagnóstico y terapéutico, ya que no se ha realizado una guía de manejo homogénea, eficaz y segura. Por lo que se presenta una revisión con lo que se ha descrito en teorías fisiopatológicas, así como las propuestas terapéuticas y la respuesta encontrada en los casos relacionados que se han reportado. Caso clínico: paciente hombre de 30 años que inicia con dermatosis localizada en extremidad superior derecha, unilateral, asimétrica, de aspecto monomorfo, constituida por mácula artificial, provocada por tinta roja (tatuaje), con desarrollo de lesiones de aspecto papular en trazo original, pruriginosa, tiempo de evolución referido de un mes. El hallazgo histopatológico corresponde a reacción de cuerpo extraño con respuesta parcial a esteroide tópico de baja potencia. Conclusiones: según antecedentes en otros reportes y series de casos, incluyendo la experiencia con nuestro paciente, no existe una eficacia aplicable para la mayoría de los pacientes con el uso de inmunomodulares tópicos, ya que muestran mejoría completa hasta la eliminación del hapteno, ya sea de forma escicional o con láser.

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Pain is one of the most frequent causes for patients to seek medical care. It interferes with daily functioning and affects the quality of life of the patient. There is a clear need to investigate nonopioid or non-nonsteroidal anti-inflammatory drug alternatives for the treatment of pain. In this study, we determined the effect of acute pre- and posttreatment with pramipexole (PPX), a dopamine D2/D3 selective agonist, on formalin 1%-induced acute and long-lasting nociceptive behavior sensitivity in rats. Moreover, we sought to investigate whether the antiallodynic and antihyperalgesic effect induced by PPX was mediated through the nuclear factor-κB (NF-kB) signaling pathway. Moreover, acute systemic pretreatment with PPX (1 and 3 mg/kg, ip) suppressed the formalin-induced nociceptive behavior during both phases of the formalin test and the development of formalin-induced secondary mechanical allodynia and hyperalgesia in both paws. Acute systemic posttreatment with PPX (3 mg/kg, ip) reverted the formalin-induced long-lasting secondary mechanical allodynia and hyperalgesia. Furthermore, PPX inhibits the protein expression of NF-κB-p65 and the levels of tumor necrosis factor-α and interleukin-1ß in the spinal cord of animals with secondary mechanical allodynia and hyperalgesia induced by formalin. These data suggest that PPX has a potential role in producing anti-inflammatory activity. Moreover, the antiallodynic and antihyperalgesic effects induced by PPX can be mediated through the NF-kB signaling pathway.

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Context: Ketoprofen is widely used to remove pain. A steady increase on allergic reactions and photoallergic contact dermatitis related to ketoprofen has been reported when there is topical use. However, there are few documented cases of hypersensitivity when it is administered systemically.Objective: Present a case of hypersensitivity reaction after systemic administration of ketoprofen for pain control in nephritis crisis.Case description: A 43-years-old Caucasian man diagnosed with renal colic (kidney lithiasis), who was initially treated with 100 mg of tramadol (IV), followed by 4 mg of thiocolchicoside (IM) which caused no relief. Then 100 mg of ketoprofen was administered (IV). Right after the patient began to show hypersensitivity reaction type I characterized by intense coughing, rhinitis, angioedema, periorbital edema, rash, and scleral jaundice.Discussion and conclusion: Maybe it was a case of drug-induced liver disease, however therapeutic dosages of all administered drugs only once. The mechanisms involved were not investigated, but may be the result of allergic and immunologic aspects caused by ketoprofen and facilitated by a history of hypersensitivity to other NSAIDs as reported by the patient. As for jaundice can be attributed to drug toxicity since laboratory parameters did not reveal any evidence of liver disease.

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La presencia de metales en contacto con piel o mucosas puede ocasionar en personas sensibles, reacciones de distintos tipo que, muchas veces, no es posible determinar su origen. Ante la sospecha se puede recurrir a un estudio hematológico de laboratorio (Test Melisa) (AU)

The metal exposure in sensitive people could produce, local or general, different reactions of hypersensitive. The Melisa Test is a blood work that could make a diagnosis of those types of allergies (AU)

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Biological membranes allow the regulation of numerous cellular processes, which are affected when unfavorable environmental factors are perceived. Lipids and proteins are the principal components of biological membranes. Each lipid has unique biophysical properties, and, therefore the lipid composition of the membrane is critical to maintaining the bilayer structure and functionality. Membrane composition and integrity are becoming the focus of studies aiming to understand how plants adapt to its environment. In this study, using a combination of di-4-ANEPPDHQ fluorescence and spectral phasor analysis, we report that the drought hypersensitive/squalene epoxidase (dry2/sqe1-5) mutant with reduced major sterols such as sitosterol and stigmasterol in roots presented higher membrane fluidity than the wild type. Moreover, analysis of endomembrane dynamics showed that vesicle formation was affected in dry2/sqe1-5. Further analysis of proteins associated with sterol rich micro domains showed that dry2/sqe1-5 presented micro domains function altered.

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Se presentó el caso de una niña de 10 años de edad con antecedentes de ingestión de carbamazepina por diagnóstico presuntivo de epilepsia, quien ingresó en el Hospital Provincial Pediátrico Docente Eliseo Noel Caamaño, en Matanzas, en mayo del 2010, por cuadro de fiebre, rash cutáneo y vómitos al inicio, con evolución severa y la aparición de ictericia, hepato-esplenomegalia. Se realizó diagnóstico de síndrome DRESS, con evolución satisfactoria sin el uso de la terapia esteroidea. Se revisó la literatura sobre síndrome de hipersensibilidad por anticonvulsivantes, medicamentos de uso cada vez más frecuente.

We presented the case of a 10-years-old girl with antecedents of carbamazepine ingestion for epilepsy presumptive diagnosis, who entered the Teaching Pediatric Provincial Hospital Eliseo Noel Caamaño, in Matanzas, in May 2010, with fever, skin rash and vomiting at the beginning, followed by severe evolution, with jaundice and hepato-splenomegaly. We diagnosed the DRESS syndrome, with satisfactory evolution without using the steroidal therapy. We reviewed the literature about the hypersensibility syndrome for anticonvulsants, drugs of more and more frequent use.

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A fin de determinar la prevalencia de hipersensibilidad tipo IV al contacto con níquel (Ni) y su relación con una historia clínica de alergia positiva, el uso de prótesis parcial removible (PPR) y la presencia de restauraciones metálicas en boca, se estudiaron 61 pacientes en edades comprendidas entre 19 y 75 años que requerían en su tratamiento odontológico integral la instalación de una PPR nueva y quienes firmaron un consentimiento informado. Este trabajo se llevó a cabo en la Facultad de Odontología de la Universidad de Los Andes, Mérida, Venezuela, entre mayo 2006 y mayo 2007. A cada paciente se le elaboró una historia clínica de alergia. Los pacientes fueron sometidos a la prueba del parche con sulfato de Ni al 5% durante 72 horas y de acuerdo con los criterios de observación del Grupo Internacional de Investigación de Dermatitis de Contacto se determinó la respuesta a dicha prueba. Los resultados revelan una prevalencia de hipersensibilidad tipo IV al contacto con níquel de 24,6% en los pacientes observados. También se encontró que los pacientes sin restauraciones metálicas en boca y sin historia de alergia a las joyas metálicas presentaron baja prevalencia de reacciones de hipersensibilidad tipo IV al sulfato de Ni y, en contraposición, alta prevalencia en pacientes con restauraciones metálicas en la cavidad oral y antecedentes de alergia a las joyas metálicas. La relación entre la historia positiva o negativa de alergia a las joyas metálicas y la presencia o ausencia de restauraciones metálicas en boca con la alta y baja, respectivamente, prevalencia de hipersensibilidad tipo IV al níquel sugiere que las condiciones "positivas" son causantes directa o indirectamente de la sensibilización al níquel.

With the purpose of determining the prevalence of type IV hypersensibility to nickel (Ni) contact and its relation with a positive allergic clinic history, the use of removable partial denture (RPD) and the presence of metallic restoration in mouth, they were studied 61patients with ages between 19 and 75 years old who required as an integral dentistry treatment the installation of a new RPD and who formally agree (signed a document) to be part of this study. This work was carried out at the Dentistry College of the Universidad de Los Andes, Mérida, Venezuela, between May 2006 and May 2007. It was filled up a clinic history to each patient. The patch testing with nickel sulphate at 5% was applied to each patient for 72 hours which results were determined following the International Contact Dermatitis Research Group criteria. The results reveled a prevalence of 24,6% of type IV hypersensibility in the observed group. It was also found that patients without any metallic restoration in mouth and without allergic clinic history to the metallic jewelry presented low prevalence of type IV hypersensibility reaction to the nickel sulphate. In opposition, it was found high prevalence in patients with metallic restoration in the oral cavity and allergic antecedents to the metallic jewelry. The relationship between a positive or negative allergic history to the metallic jewelry and the presence or absence of metallic restoration in mouth with the high or low, respectively, prevalence of type IV hypersensibility to the nickel suggests that the positive conditions are direct or indirect causes of nickel sensibilization.

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Objetivo: Verificar a existência de associação entre enxaqueca e manifestações alérgicas. Método: Este estudo retrospectivo do tipo caso-controle foi conduzido por meio de entrevistas com 200 pacientes consecutivos aleatórios, com idades entre 25 e 59 anos, de ambos os sexos, distribuídos em dois grupos: Grupo 1 (n=100): pessoas sem relato de enxaqueca. Grupo 2 (n=100): pessoas com relato de enxaqueca. Os entrevistados foram identificados de acordo com a idade, sexo e cor de pele, a existência de alergia e suas características. O diagnóstico de enxaqueca foi confirmado por médico especialista. Os pacientes tiveram seu quadro clínico classificado conforme o Headache Classification Subcommittee of International Headache Society e foram investigados sobre alergia. Foram excluídos os casos que não preencheram os critérios deste trabalho e quando houve dúvida em relação às respostas. Foram utilizados os testes t de Student, Quiquadrado e exato de Fisher para avaliação dos resultados. Calculou-se também o odds ratio e o intervalo de confiança. A significância foi considerada para p<0,05. Resultados: Houve maior incidência de enxaqueca em mulheres e em pessoas melanodérmicas. Os pacientes com enxaqueca apresentaram maior incidência de alergia quando comparados ao grupo-controle (p=0,000001). Crise alérgica de via respiratória teve relação com o início da enxaqueca (p=0,000004). Conclusão: De acordo com o presente estudo, as mulheres apresentam enxaqueca com maior freqüência que os homens e há relação entre manifestações alérgicas e enxaqueca.

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INTRODUCTION: Multiple sclerosis (MS) is a chronic, inflammatory and progressive disease of the central nervous system in which local inflammatory injuries of the brain white matter appears, being the most outstanding feature the myeline loss (demyelination). OBJECTIVE: To determine if the complement system might be involved in the MS immunopathogeny favouring the mechanism intervening in the myelin destruction. METHOD: Samples of sera and CSF from twelve patients with a diagnosis of MS obtained at the moment of the admission to the hospital at the beginning of the break out, were collected. Levels of C3c and albumin in sera and in CSF were quantified using radial immunodiffusion plates. RESULTS: High values over 80 percent of intrathecal synthesis were obtained except in one of the patients. CONCLUSION: Intrathecal synthesis of C3c and its liberation to the CSF means that the activation of the complement system in any of the two ways has taken place, and that once performed its biological functions, has suffered a degradation process.

INTRODUCCION: La esclerosis múltiple (EM) es una enfermedad crónica, inflamatoria y progresiva del sistema nervioso central que cursa con la aparición de lesiones inflamatorias focales en la sustancia blanca cerebral, en las que lo más llamativo es la pérdida de mielina (desmielinización). OBJETIVO: Conocer si el sistema de complemento puede estar involucrado en la inmunopatogenia de la EM favoreciendo los mecanismos que median la destrucción de la mielina. MÉTODO: Se colectaron muestras de suero y LCR de doce pacientes con diagnóstico de EM obtenidas en el momento del ingreso al inicio del brote. Se cuantificaron los niveles de C3c y albúmina en suero y en LCR en placas de inmunodifusión radial. RESULTADOS: Se obtuvieron altos valores que superan el 80 por ciento de síntesis intratecal, menos en uno de los pacientes. CONCLUSION: La síntesis intratecal de C3c y su liberación al LCR significa que ha sucedido la activación del sistema de complemento en alguna de las dos vías y que una vez cumplidas sus funciones biológicas, ha sufrido un proceso de degradación y liberación al LCR en forma de C3c.

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