Quiz questions from contact dermatitis

ANSWERS

1. Bruno Bloch

   Patch testing is the diagnostic tool for allergic dermatitis. Josef Jadassohn is generally accepted as its founder. Bruno Bloch expanded and enhanced Jadassohn’s technique. He created a grading system for patch test reactions in 1895.^[1]

2. Nickel

   Nickel is the most frequent contact allergen. The prevalence of nickel sensitivity recorded in patch test clinics ranges between 15% and 30%.^[1]

3. Tetraethylthiuramdisulfide/disulfiram

   Tetraethylthiuramdisulfide/disulfiram chelates nickel and has been reported to be of value in the treatment of nickel allergy. However, liver enzymes must be monitored carefully, as side effects are frequent.^[1]

4. Tosylamide formaldehyde resin

   It can cause allergic CD, occupational CD, and onycholysis.^[1,2]

5. Onion, garlic

   Onion and garlic are usually held in the non-dominant hand, while the dominant hand holds a tool to cut them.^[1]

6. Disperse dyes

   Among textile dyes, disperse dyes show the maximum potential to cause sensitization. They are chiefly anthroquinone and azo dyes. Disperse dyes may contain more than one component, along with impurities, all of which can contribute to sensitization.^[1]

7. Crescendo-decrescendo^[1]

8. Quenching^[1]

   Quenching phenomenon has been explored chiefly in fragrance material aldehydes. The combined substances may alter the available bonding sites or may form a compound that follows a different detoxification pathway.

9. Amin, Maibach^[1]

   The following staging system for contact urticaria syndrome has been described by Amin and Maibach.

   • Stage 1: Localized urticaria, dermatitis and non specific symptoms (itching, tingling, and burning sensation)

   • Stage 2: Generalized urticarial

   • Stage 3: Bronchial asthma, rhinitis, conjunctivitis, orolaryngeal symptoms (lip swelling, hoarseness, and dysphagia), and gastrointestinal symptoms (nausea, vomiting, diarrhea, and cramps)

   • Stage 4: Anaphylactoid reactions (features of shock)

10. Cosmetic exhaustion

    It may be possible to arrive at a diagnosis only by comprehensive patch testing for all the suspected products and their ingredients.^[3]

11. Erythema

    Laser Doppler flowmetry measures the superficial blood flow through the transmission of monochromatic light emitted from a helium–neon laser to the skin surface through optic fibers. Tristimulus colorimetry uses a system for color definition known as the Commission Internationale de l’Eclairage (CIE) L*a*b* color system, which employs a three dimensional coordinate system. L* stands for an axis for brightness, a* for a green-red axis, and b* represents a yellow-blue axis.^[3]

12. McDonald’s acne

    Acne lesions on face and chest can occur in people who come in contact with oil and grease while working in fast-food restaurants, particularly in those engaged in frying hamburgers.^[4]

13. Toxicodendron (poison ivy) plant

    Black-spot poison ivy is an uncommon manifestation of contact with poison ivy (Toxicodendron) plants. Oxidation of the oleoresin results in formation of a black lacquer within hours of contact with the plant, which causes the appearance of irregular black spots on the skin. After a few days to weeks, an irritant dermatitis-like picture often develops. The development of an irregular black skin lesion might be alarming to patients and may encourage them to seek evaluation.^[5]

14. (2-hydroxyethyl) dimethylsulfoxonium ion

    Dogger bank itch is CD of exposed skin while handling nets containing marine organisms (bryozoans) during summer, common in European fishermen.^[1]

15. Ranade, Lonkar, and Jog, Pune, 1968

    Parthenium dermatitis is caused by contact with Parthenium hysterophorus plant and is the most common cause of phytodermatitis in India. A member of the Compositae family of plants, it has multiple synonyms including “bitterweed,” “feverfew,” or “escobar amarga.” In India, it is also known by the names “Congress grass” or “Congress weed,” which alludes to the US congress that had allocated a shipment to Pune, India. Originally a native of tropical America, it was transported to Asia as a contaminant in cereal and grass seed shipments from America during the 1950s. Parthenium hysterophorus has become known as the “scourge of India” and has caused epidemics of phyto-CD.^[6,7]

16. Repeated application of fragrance to anterior neck in a sensitized individual resulting in the development of dermatitic plaque on the neck.^[8]

17. Gold salts

    Gold chloride, gold sodium thiosulfate, and gold sodium thiomalate have been reported to cause persistent patch test reactions.^[8,9]

18. Patch test, repeat open application test (ROAT), and usage test

    ROAT is used to assess the significance of doubtful positive patch test reactions to preparations that contain the suspected allergen in low concentration. However, false negative results may occur. The usage test is performed by reintroducing the suspected cosmetic products, one at a time, and using each product for up to 3 days.^[1]

19. Nickel, balsam of Peru^[8]

20. Fisher^[1]

21. von Pirquet^[1]

22. Halogenated aromatic hydrocarbons^[1]

23. Sunscreens and topical nonsteroidal anti-inflammatory agents

    Ketoprofen may produce cross sensitization with the UV (ultraviolet) filter benzophenone as well.^[1]

24. Hair dyes

    The dye is applied to the retroauricular area. Examination of the site 2 days later is an accurate method of detecting sensitization.^[1]

25. Oral allergy syndrome

    The oral allergy syndrome, also known as the pollen-fruit syndrome, occurs as a result of eating raw/unprocessed fruits, vegetables, and nuts. Symptoms include irritation, tingling, and mucosal swelling. Anaphylaxis has been reported rarely.^[1]

26. Ethylenediamine

    Ethylenediamine can cross-react with hydroxyzine, meclizine, and aminophylline.^[10]

27. 20 mg^[1]

28. Lignocaine

    The local anesthetics known to cross-react with PPD are ester anesthetics such as benzocaine, procaine, and tetracaine. Amide local anesthetics such as lignocaine do not cross react with PPD.^[8]

29. 1-(b), 2-(a), 3-(d), 4- (c)^[1,8]

30. 1-(b), 2-(e), 3-(d), 4-(a), 5-(c).^[1,8,11]