RESUMO
BACKGROUND: Kathon CG, a combination of methylchloroisothiazolinone and methylisothiazolinone, is widely used as preservative in cosmetics, as well in household cleaning products, industrial products such as paints and glues. It has emerged as an important sensitizing agent in allergic contact dermatitis. OBJECTIVES: This study evaluated the reactivity to this substance in patients subjected to patch tests at the Dermatology Institute in Bauru, São Paulo from 2015 to 2017 and its correlation with other preservatives, the professional activity and location of the lesions. METHODS: The patients were submitted to standard series of epicutaneous tests, standardized by the Brazilian Group Studies on Contact Dermatitis. RESULTS: Out the 267 patients tested, 192 presented positivity to at least one substance and 29 of the patients (15.10%) presented reaction to Kathon CG, with predominance of the female gender (n=27); main professional activity associated with Kathon CG sensibilization was cleaning (17.24%), followed by aesthetic areas (13.79%) and health care (10.34%). The most prevalent sensitizations among the substances tested were nickel sulphate (56.3%), followed by cobalt chloride (23.4%), neomycin (18.2%), potassium dichromate (17.7%), thimerosal (14.5%), formaldehyde (13.2%), paraphenylenediamine (9.3%), and fragrance mix (8.3%). STUDY LIMITATIONS: We do not have data from patients that were submitted to patch test a decade ago in order to confront to current data and establish whether or no sensitization to Kathon CG has increased. CONCLUSION: High positivity to Kathon CG corroborates the recent findings in the literature, suggesting more attention to concentration of this substance, used in cosmetics and products for domestic use.
Assuntos
Dermatite Alérgica de Contato/diagnóstico , Testes do Emplastro/métodos , Tiazóis/análise , Adulto , Brasil , Cosméticos/efeitos adversos , Cosméticos/química , Dermatite Alérgica de Contato/etiologia , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Testes do Emplastro/estatística & dados numéricos , Conservantes Farmacêuticos/efeitos adversos , Conservantes Farmacêuticos/química , Estudos Retrospectivos , Estatísticas não Paramétricas , Tiazóis/efeitos adversosRESUMO
Abstract Background: Kathon CG, a combination of methylchloroisothiazolinone and methylisothiazolinone, is widely used as preservative in cosmetics, as well in household cleaning products, industrial products such as paints and glues. It has emerged as an important sensitizing agent in allergic contact dermatitis. Objectives: This study evaluated the reactivity to this substance in patients subjected to patch tests at the Dermatology Institute in Bauru, São Paulo from 2015 to 2017 and its correlation with other preservatives, the professional activity and location of the lesions. Methods: The patients were submitted to standard series of epicutaneous tests, standardized by the Brazilian Group Studies on Contact Dermatitis. Results: Out the 267 patients tested, 192 presented positivity to at least one substance and 29 of the patients (15.10%) presented reaction to Kathon CG, with predominance of the female gender (n = 27); main professional activity associated with Kathon CG sensibilization was cleaning (17.24%), followed by aesthetic areas (13.79%) and health care (10.34%). The most prevalent sensitizations among the substances tested were nickel sulphate (56.3%), followed by cobalt chloride (23.4%), neomycin (18.2%), potassium dichromate (17.7%), thimerosal (14.5%), formaldehyde (13.2%), paraphenylenediamine (9.3%), and fragrance mix (8.3%). Study limitations: We do not have data from patients that were submitted to patch test a decade ago in order to confront to current data and establish whether or no sensitization to Kathon CG has increased. Conclusion: High positivity to Kathon CG corroborates the recent findings in the literature, suggesting more attention to concentration of this substance, used in cosmetics and products for domestic use.
Assuntos
Tiazóis/análise , Testes do Emplastro/métodos , Dermatite Alérgica de Contato/diagnóstico , Conservantes Farmacêuticos/efeitos adversos , Conservantes Farmacêuticos/química , Tiazóis/efeitos adversos , Brasil , Testes do Emplastro/estatística & dados numéricos , Modelos Logísticos , Estudos Retrospectivos , Dermatite Alérgica de Contato/etiologia , Estatísticas não Paramétricas , Cosméticos/efeitos adversos , Cosméticos/química , Pessoa de Meia-IdadeRESUMO
As tubercúlides são reações de hipersensibilidade cutânea aos antígenos do Mycobacterium tuberculosis. Este é o caso de uma mulher de 45 anos que procurou a Unidade Básica de Saúde (UBS) com um quadro de eritema nodoso com mais de 10 anos de evolução, de etiologia desconhecida, e que evoluía como nódulos em pescoço e membros, que se tornavam úlceras necróticas, cicatrizavam e recidivavam periodicamente. Biópsias das lesões evidenciavam um processo inflamatório granulomatoso com extensa necrose, sugestivo de tuberculose, mas sem a presença do bacilo. Após anos sem tratamento adequado, finalmente levantou-se a hipótese de tubercúlide papulonecrótica. A paciente iniciou tratamento com o esquema básico (2RHZE/4RH) e dessensibilização vacinal, recebendo alta por cura.
Las tubercúlides son reacciones de hipersensibilidad cutánea a los antígenos del Mycobacterium tuberculosis. Este es el caso de una mujer de 45 años que buscó la Unidad Básica de Salud (UBS) con un cuadro de eritema nodoso con más de 10 años de evolución, de etiología desconocida, y que evolucionaba como nódulos en cuello y miembros, que se tornaban úlceras necróticas, cicatrizaban y recidivaban periódicamente. Las biopsias de las lesiones evidenciaban un proceso inflamatorio granulomatoso con una extensa necrosis, sugestiva de tuberculosis, pero sin la presencia del bacilo. Después de años sin tratamiento adecuado, finalmente se levantó la hipótesis de tubercúlide papulonecrótica. La paciente inició tratamiento con el esquema básico (2RHZE / 4RH) y desensibilización vacunal, recibiendo alta por curación
The tuberculids are cutaneous hypersensitivity reactions to Mycobacterium tuberculosis antigens. This is the case of a 45-year-old woman who sought the Basic Health Unit (BHU) with erythema nodosum with a 10-year evolution, of unknown etiology, that evolved as nodules in the neck and limbs, which became necrotic ulcers, cicatrized and recurred periodically. Biopsies of the lesions revealed a granulomatous inflammatory process with extensive necrosis, suggestive of tuberculosis, but without the presence of the bacillus. After years without adequate treatment, the hypothesis of papulonecrotic tuberculids finally arose. The patient started treatment with the basic regimen (2RHZE/4RH) and vaccine desensitization, receiving discharge by cure.
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Tuberculina , Tuberculose Cutânea , Hipersensibilidade Tardia , Mycobacterium tuberculosisRESUMO
Con el objetivo de evaluar la especificidad de la leishmanina en pacientes con enfermedad de Chagas, sin antecedente clínico de leishmaniosis, actual o antigua. Una muestra de 102 personas infectadas por Trypanosoma cruzi (14 casos agudos con diagnóstico parasitológico y 88 casos crónicos a través de la demostración de anticuerpos IgG por ELISA e inmunofluorescencia indirecta (IFI) fueron evaluados con leishmanina, antígeno soluble que contenia Leishmania (Viannia) peruviana a la concentración de 25-30 ug/mL. Solo cinco personas presentaron reacción de hipersensibilidad cutánea a la aplicación del antígeno a las 48-72 h. La leishmanina evaluada fue negativa en 97 personas infectadas con T. cruzi, con lo cual se alcanzó una especificidad del 95,1%. En conclusión, la prueba intradérmica de Montenegro es una herramienta diagnóstica simple y eficaz, que además podría ser utilizada para discriminar infecciones por Leishmania o T. cruzi, en áreas geográficas del Perú donde ambos parásitos están presentes.
In order to assess the specificity of the leishmanin skin test in Chagas disease patients without clinical history of leishmaniasis, present or former. A sample of 102 persons infected with Trypanosoma cruzi (14 acute cases with parasitological diagnosis and 88 chronic cases) through the demonstration of IgG antibodies by ELISA and indirect immunofluorescence (IIF) were evaluated with leishmanin soluble antigen which contained Leishmania (Viannia) peruviana concentration of 25-30 ug/mL. Only five people showed cutaneous hypersensitivity reaction to the application of the antigen between hours 48 and 72. The Leishmanin skin test evaluated was negative in 97 people infected with T. cruzi, thus specificity of 95.1% was achieved. In conclusion, the intradermal Montenegro test is a simple and effective diagnostic tool that also could be used to discriminate infections by Leishmania or T. cruzi, in Peruvian geographic areas where both parasites are present.