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

We report the results of a multicentre, double-blind, placebo-controlled study of topical therapy with omega-3-polyunsaturated fatty acids (omega-3-PUFA) in 52 patients suffering from moderate plaque-type psoriasis. In each patient, two similar stable psoriatic plaques served as indicator lesions for the study. One indicator lesion was randomly assigned to treatment with topical preparations of highly purified omega-3-PUFA in one of two concentrations (1 or 10%), and the other was treated with placebo. Efficacy assessment was based on changes in local psoriasis severity index, area involved, erythema, desquamation, induration and pruritus. After 8 weeks of treatment, all indicator lesions had improved significantly, compared with baseline. However, no statistically or clinically relevant differences between the omega-3-PUFA-treated and the placebo-treated lesions were found. Therapy was well tolerated and, apart from one patient who developed perilesional eczema, no clinically relevant adverse events occurred. In conclusion, topical omega-3-PUFA were not effective in a randomized, placebo-controlled, double-blind setting. Results of non-blind trials should be (re-)considered with caution.
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PMID:Highly purified omega-3-polyunsaturated fatty acids for topical treatment of psoriasis. Results of a double-blind, placebo-controlled multicentre study. 828 57

Identification of latex sensitive individuals can be life saving. The American College of Allergy and Immunology has put forth the following recommendations: 1) Just as patients are routinely asked preoperatively about allergy to medications prior to treatment, a careful history should be obtained from every patient prior to any procedure involving contact with latex. Any patient who has a history of rash, itching, hives, rhinitis, swelling, or eye irritation or asthmatic symptoms after touching a balloon, rubber glove or any latex containing object is at risk for anaphylaxis. Previous medical history, of unexplained allergic or anaphylactic reactions during a medical procedure, may indicate sensitization. 2) Health care providers or other workers who give a history of only mild latex-glove eczema rarely have anaphylactic events. However, a history of work-related conjunctivitis, rhinitis, asthma, or urticaria may indicate allergic sensitization and increased risk for more severe reactions in the future. 3) The utility of screening tests for predicting anaphylaxis remains controversial. Suitable reagents for skin prick tests for latex are not commercially available at this time. Inasmuch as prick testing appears to carry a substantial risk of inducing anaphylaxis, this test must be considered experimental and it should only be done by experienced physicians with resuscitative equipment and personnel immediately available. Serum tests for latex-specific IgE, currently performed on a research basis at several laboratories, may confirm a suspected diagnosis in many cases but presently lack sensitivity to identify all patients with true latex allergy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Latex: a new occupational hazard for physicians. 840 30

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.
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PMID:Allergic contact dermatitis of the genitals from rubber additives in condoms. 845 16

Mercury hypersensitivity is an allergic response mediated by the immune system. allergic reactions to mercury and other constituents of amalgam have been documented, but are very rare. The common symptoms are dermatitis, eczema, urticaria, erythema, edema and itching, occurring primarily on the face, neck, limbs and upper torso. In this paper an interesting case of mercury hypersensitivity is investigated and discussed.
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PMID:Mercury hypersensitivity from amalgam: report of case. 855 Sep 29

One hundred and nineteen consecutive cases of children with atopic dermatitis aged 4-16 years (73 girls) from a pediatric dermatology outpatient clinic were included in a study of atopic sensitization. Structured interviews and clinical investigations were performed. IgE antibodies to common inhalant allergens, Pityrosporum orbiculare, Candida albicans, Tricophyton rubrum and Staphylococcus aureus were detected. Specific IgE antibodies frequently occurred to pollens, animal epithelia, C. albicans, house dust mites and moulds, whereas specific IgE antibodies to potential skin allergens were less prevalent. Twenty-six children (21.8%) had IgE antibodies to P. orbiculare, 14 (11.8%) to T. rubrum and 3 (2.5%) to S. aureus. Atopic dermatitis in children with one or several RAST positivities was worse, with a more chronic course, higher total eczema score, more frequent distribution in the head-neck-face regions and more itch compared to the children without serum detectable IgE antibodies. Severe itch disturbing nightly sleep was the only clinical feature that characterised P. orbiculare-positive cases. Allergy to P. orbiculare appears to be of little importance in early childhood atopic dermatitis but is likely to carry a poor prognosis.
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PMID:Occurrence and clinical features of sensitization to Pityrosporum orbiculare and other allergens in children with atopic dermatitis. 857 54

The clinical efficacy and safety of fluticasone propionate ointment, 0.005%, were compared with those of its vehicle in the treatment of moderate-to-severe eczema of long duration in two multicenter, double-blind, vehicle-controlled, randomized studies. One of the two study medications (up to 100 gm/week) was applied topically to the affected areas of the body twice daily for up to four consecutive weeks. Drug efficacy was measured in terms of three variables: the physician's gross assessment of clinical response of the target lesion, severity scores of individual signs and symptoms, and the patient's subjective assessment of treatment effects. Efficacy and safety were evaluated after seven, fourteen, twenty-one, and twenty-eight days of treatment. The total number of patients in the two studies was 372 (203 in study 1 and 169 in study 2). Fluticasone propionate ointment, 0.005%, was more effective than vehicle at all postbaseline visits in both studies (study 1 P < or = 0.015, study 2 P < or = 0.018). In study 1, approximately 80% of the patients on fluticasone were rated as cleared, excellent, or good by the investigators at treatment endpoint, compared with 38% of those receiving vehicle. In study 2, the sum of 80% of the fluticasone-treated patients was rated as cleared, excellent, or good by the investigators at the end of the study, compared with 34% of those receiving vehicle. The beneficial effect of fluticasone ointment, 0.005%, was early and sustained and was particularly noticeable for pruritus, erythema, and skin thickening. In study 1, no drug-related adverse events were reported in the fluticasone group. Four patients (4.3%) in the vehicle group experienced a total of four drug-related adverse events. The most common was burning/stinging, reported by two patients. In study 2, two patients (2.4%) in the fluticasone-treated group and three (4.1%) in the vehicle group reported a total of five drug-related adverse events, the most common event being pruritus (fluticasone group one patient, vehicle group two patients). These findings show that fluticasone propionate ointment, 0.005%, applied twice daily, is therapeutically superior to the vehicle and is well tolerated.
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PMID:Efficacy and safety of fluticasone propionate ointment, 0.005%, in the treatment of eczema. 864 73

The ability to perceive two pruritic stimuli as separate depending on the distance between them (two-point discrimination of itch) was determined in a single-blind study of 20 patients with atopic dermatitis and 20 healthy subjects. Itch was induced with pairs of histamine injections (0.1 micrograms each) given on the upper arm, either along its axis (longitudinally within a dermatome) or at right angles to it (transversally involving more than one dermatome). The interinjection distances were varied in 3-cm steps until the shortest distance at which the two itching stimuli could be perceived as separate was found. Pairs consisting of one injection of histamine (0.1 micrograms) and one of saline served as controls. The two-point discrimination of itch was significantly better in the atopic dermatitis patients than in the healthy controls, both longitudinally (atopic dermatitis: median 12 cm, range 3-21 cm; healthy controls: 15 cm, range 9-21; p < 0.01) and transversally (atopic dermatitis: median 6 cm, range 3-18; healthy controls: 12 cm, range 6-21; p < 0.001). The two-point discrimination of itch did not correlate with the subject's age, two-point discrimination of touch, or, for the atopic dermatitis patients, with their eczema scores or serum IgE levels. The quality, intensity or spatial summation of itch did not differ significantly between the two groups of subjects.
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PMID:Two-point discrimination of itch in patients with atopic dermatitis and healthy subjects. 872 93

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

541 workers with long-term history of occupational contact with antibiotics and chemicals were examined by a dermatologist, ENT specialist, neuropathologist, surgeon, ophthalmologist. Many workers complained of occasional skin eruption, rhinitis, skin itching, sneezing, cough, Quincke's edema. Allergic examination revealed the presence of allergic symptoms (allergic dermatitis, itch, vasomotor rhinitis, chronic eczema, obstructive bronchitis, bronchial asthma, Quincke's edema, acute and chronic conjunctivitis) in 98 examinees. Somatic affections are represented by hypertension, chronic hepatitis, ulcer.
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PMID:[The effect of antibiotics on the body of those working in their manufacture]. 877

Eczematous dermatitis is a common condition that can interfere with social function, sleep and employment. Its persistence and accompanying pruritus may be stressful and frustrating for patients. The most common and best characterized type of eczema, atopic dermatitis, appears to be increasing in incidence. Other common eczematous dermatoses, particularly allergic dermatitis and irritant contact dermatitis, must be accurately diagnosed, since improvement and resolution rely on appropriate diagnosis and avoidance of pertinent triggering factors. Principles of treatment include general skin care, patient education about avoidance of irritants, skin hydration and the use of topical corticosteroids when necessary. Use of systemic corticosteroids is not generally recommended for the treatment of chronic eczematous dermatitis.
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PMID:Eczematous dermatitis: a practical review. 881 70


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