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Query: UMLS:C0033774 (pruritus)
14,546 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In the previous few years, there has been a startling escalation in intraoperative and radiologic anaphylactic episodes, some of them lethal, that have been assigned to rubber exposure. Immediate hypersensitivity reactions to natural rubber pose a significant risk to patient with spina bifida and urogenital abnormalities, health care workers, and rubber industry workers. It has been estimated that 2% to 10% of physicians and nursing personnel are latex allergic. The clinical syndromes associated with reactions to latex may be divided into three broad categories a) contact dermatitis--limited to skin directly in contact with latex, b) contact urticaria syndrome a broad spectrum of contact reactions including not only immediate wheal and flare reactions, but also dyshidrotic vesiculation, and accelerated contact reactions including erythema, burning or pruritus occurring within 10-30 minutes after contact, c) systemic allergic reactions-including generalized urticaria or pruritus, rhinoconjunctivitis or asthma, as well as the multiple presentations of anaphylaxis. Contact dermatitis reactions are thought to be a T-cell mediated type IV reaction, systemic reactions to latex appear to be an IgE-mediated phenomenon. Contact urticaria syndrome seems to be a heterogeneous group of reactions. Diagnosis of latex allergy is made on clinical grounds, however, history alone is insufficient to recognize all patients at risk, and conscientious testing materials are not yet available. Prick tests utilizing extracts from latex gloves or from raw latex preparation can be used but the specificity of this test remains unknown. Skin prick testing must be considered experimental and should be only done by experienced physician. Serologic testing for latex allergy remains a safe alternative, although the sensitivity and specificity of this procedure is still undefined. Prophylactic regimes to avoid rubber exposure and decrease the antigen content of natural rubber products by the rubber industry should be implemented to decrease the rate of sensitization in the future and prevent allergic reactions.
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PMID:[Allergic reaction to products made of natural rubber]. 785 99

Itching is usually manifested by scratching. It is lacking before three months of age. The practitioner must determine whether itching is generalised or localised and whether a skin disease is present. The main skin diseases responsible for generalised itching are scabies, atopic dermatitis, urticaria and papular urticaria. When itching is localised, contact dermatitis or pediculosis are usually responsible. Diagnosis rests on careful analysis of symptoms. In patients without skin lesions, an external cause (irritation, environment) or an internal cause (cholestasis, chronic uraemia, lymphoma, drug and psychological problems) should be considered. Therapy should be causal when possible. If not, antihistaminic drugs should be used.
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PMID:[Pruritus in children]. 793 81

Workers in a Swedish spice factory (n = 70), and in the office (n = 23) of the same company, were investigated by questionnaire regarding skin symptoms. In a 2nd part of the study, subjects reporting skin symptoms were examined and investigated by patch and prick testing. Skin symptoms were reported by 1/2 the factory workers. Pruritus and skin irritation, particularly from cinnamon powder, were common. Patch test reactions to cinnamic aldehyde were found in 11/25 factory workers, but in several cases, the nature of the reactions was difficult to evaluate. Irritant patch test reactions were seen from powders of cardamom, paprika and white pepper. On prick testing, 6/25 workers reacted to cinnamic aldehyde. The results illustrate the difficulties of patch testing with spices and indicate the need for further research and validation of methods.
Contact Dermatitis 1993 Oct
PMID:Skin symptoms among workers in a spice factory. 828 84

A 5-year-old Japanese boy visited our clinic for treatment of a dark bluish papulonodular lesion on his right thigh. The histopathology of the lesion indicated angiokeratoma corporis circumscriptum naeviforme. Topical antibiotics were prescribed for occasional bleeding from the site. Frequent bleeding started in April of 1992, when erythema and itching were observed around the angiokeratoma. Histopathology of the lesion showed heavy lymphoid cell infiltration around dilated capillaries and irregular acanthosis engulfing dilated capillaries. Interestingly, there were confined masses of red blood cells in the epidermal layer as well as both in and on the horny layer. This is a feature of transepidermal elimination. This transepidermal elimination appeared to be triggered or enhanced by the concomitant contact dermatitis due to topical antibiotics. To the best of our knowledge, this is the first report of angiokeratoma in which the angiokeratoma itself reduced in size through transepidermal elimination, possibly caused by contact dermatitis.
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PMID:Angiokeratoma corporis circumscriptum naeviforme with transepidermal elimination. 831 16

Contact dermatitis from rubber chemicals is common and well-known in patients with hand eczema. Of late, the number of reports of allergic reactions to products containing rubber such as condoms and hospital staff gloves have been on the rise. Reports of such adverse reactions to condoms are not unusual, but are observed primarily among men. Immediate-type allergies may result in local swelling and pruritus as well as severe anaphylaxis. Allergic contact dermatitis to natural latex is rare but has been reported in conjunction with immediate-type hypersensitivity and as an isolated type 4 allergy. The authors briefly present the above information and offer case examples of one man and one woman. The 1st case is of a 32-year old male allergic to condoms and rubber gloves, while the 2nd case is of a 30-year old female treated for vulvovaginitis. Sensitization to common contact allergens and rubber additives was identified in both patients.
Contact Dermatitis 1993 Feb
PMID:Allergic contact dermatitis of the genitals from rubber additives in condoms. 845 16

Common dermatoses in the elderly include xerosis, pruritus, contact dermatitis, acne rosacea, stasis dermatitis, bullous pemphigoid and herpes zoster. Physicians must be able to recognize these pathologic changes superimposed on the intrinsic and extrinsic effects of aging. Diagnosis is dependent on clinical appearance and supportive laboratory studies. Management is based on correct diagnosis.
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PMID:Common dermatoses in the elderly. 824 67

Allergic diseases affect at least 15% of the population and are the cause of much ill-health. 'Clinical immunology and allergy', the term used by the Department of Health in England and Wales for this area of specialization, is recognized as a separate specialty of medicine under the National Health Service. Many organ-based hospital consultants (e.g. chest physicians) have allergy as a special interest or subspecialty. Allergists deal largely with 'itch, sneeze, cough and wheeze' and so are experts in: summer hay fever (seasonal, allergic, conjunctivorhinitis); perennial rhinitis (symptoms of a 'permanent cold'); allergic asthma (including occupational asthma); allergy to stinging insects (especially wasps and bees); allergy to drugs; allergy-related skin disorders, i.e. urticaria, angioedema, atopic eczema and contact dermatitis; food allergy and food intolerance; anaphylaxis (acute generalized allergic reaction); evaluating the role of allergy in non-specific/polysymptomatic illness. Children with allergic disease should be under the overall care of a paediatrician since the progression of allergies in children differs from that in adults. Good allergy practice involves teamwork by doctors, nurses and dietitians. The investigation of allergy patients includes skin tests and challenge procedures (e.g. food allergy tests) as well as various specialized laboratory investigations. Good clinical practice by providers and the effective use of allergy services by purchasers should improve prognosis and cut costs of treatment in allergic disease.
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PMID:Good allergy practice--standards of care for providers and purchasers of allergy services within the National Health Service. Royal College of Physicians and Royal College of Pathologists. 852 Nov 76

Distinguishing the cause of itching, red eyelids is often difficult. Pruritic, inflamed eyelids can reflect various etiologies and are a common clinical presentation to the office of a dermatologist or ophthalmologist. In this article, five of the more common causes of eyelid dermatitis (atopic dermatitis, contact dermatitis, contact urticaria, rosacea, seborrhea, and psoriasis) are reviewed in detail, with particular emphasis on the ocular and periocular features. Clinical clues, historical features, and patch testing in cases of eczematous eyelid dermatitis aid in differential diagnosis. In addition, pathogenesis and treatment are reviewed.
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PMID:Dermatologic diagnosis and treatment of itchy red eyelids. 865 40

When relevant allergens are identified by patch testing, and patients can avoid them in their environment, improvement of dermatitis is the rule. Some forms of chronic dermatitis may not clear completely, but patients are usually satisfied with modification of their previously more severe problem. In 1981 when asked what he felt were the five most important advances in clinical dermatology during the 20th century, Dr. Marion B. Sulzburger, an icon in American dermatology, said that, "The increased use and usefulness of the patch test and the international standardization of test concentrations and methods" was number one. Those of us who are enthusiastic patch testers and fascinated by the evaluation of patients with irritant and allergic contact dermatitis would agree. It is a thrilling clinical experience to be able to tell a machinist that he need not stop his lifelong occupation, but instead will do fine if he will simply avoid the waterless hand cleanser he has been using which is preserved with glutaraldehyde. The woman whose facial dermatitis has embarrassed her for years and clears when she stops using the Quaternium-15 preserved moisturizer that you have identified in your patch testing is grateful to you forever, and again happy in her own life. In 1991, my research assistants, Patricia Norris and Mary Lou Belozer, and I studied 30 university hospital workers who answered our advertisement asking for individuals who believed they were troubled by their rubber gloves (unreported study). By evaluating these people through history, physical examination, and patch testing, we were able to prove glove relatedness in 14 of them. Nine of the 14 had contact urticaria to latex, and only 5 had allergic contact dermatitis to rubber glove ingredients. Fifteen of our patients had irritant dermatitis. In this study, none of the patients with allergic contact dermatitis to glove ingredients had contact urticaria. However, since that time, we have observed a number of patients who had both forms of allergic reaction. Three of our patients who presented with nummular (patchy) hand dermatitis also had contact urticaria to latex, but no positive patch tests. With latex glove avoidance, their dermatitis resolved; an example of how scratching urticaria can eventuate in longer lasting dermatitis in some people ("the itch that rashes"). The patients presented to their dermatologist with dermatitis, but their true initiating event was urticaria which lasted only hours. The gratifying part of this study was that patch testing and contact urticaria testing allowed us to discover the 5 patients with allergic contact dermatitis and the 9 patients with contact urticaria who could benefit from glove alternatives. We were also able to assure patients in the remainder of the group that their hand eczema was not glove induced, but rather was related to their wet work. In most instances, therapeutic intervention helped, but in several cases job changes were required. Patch testing, when done properly, produces exciting results. When done improperly, it confuses and misleads patients and results in embarrassment to physicians who cannot properly interpret their results. Should a physician choose to include patch testing in his or her evaluation of patients with contact dermatitis it is essential, in my view, that he or she have highly developed skills in the diagnosis and treatment of skin diseases, and that these physicians be elaborately trained in the techniques of application and the methods of interpretation of patch tests.
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PMID:Technical and ethical problems associated with patch testing. 872 22

In an epidemiological study of occupational dermatitis in 5 different shoe factories, 246 workers were interviewed, examined and patch tested using standard and occupational patch test series. The prevalence of occupational contact dermatitis was 14.6% (36/246): 8.1% (20/246) irritant contact dermatitis (OICD) and 6.5% (16/246) allergic contact dermatitis (OACD). Among the latter, the most common occupational allergens were p-tert-butylphenol-formaldehyde resin and mercaptobenzothiazole. 6% (15/246) presented with hyperkeratosis of the fingertips, while 3.2% (8/246) reported pruritus sine materia (PSM) present only during working hours. 2 workers presented with vitiligo-like leukodermic patches on the backs of their hands and on their forearms. Some jobs were more frequently associated with skin complaints. In the assembly department, OACD was most frequent (11.4%), attributed to contact with adhesives and, to a lesser degree, with rubber and leather. OICD caused by contact with the solvents contained in adhesives and varnishes was most frequent in the assembly and trimming departments (17.1% and 15.6%, respectively). PSM, probably caused by the dust present in the working environment was reported by 33.3% of the workers in the sole-cutting and scraping departments. Hyperkeratosis of the fingertips, as a reaction to the continuous trauma of leather on the skin, was observed most frequently (41.6%) in the sole-cutting department.
Contact Dermatitis 1996 Jan
PMID:Occupational dermatitis in shoemakers. 878 19


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