Clinical and Experimental DermatologyVolume 24, Issue 5 p. 425-427 Treatment of unilateral Darier's disease with topical isotretinoin McKenna, McKenna Department of Dermatology, Craigavon Area Hospital Group Trust, Craigavon, Departments of,Search for more papers by this author Walsh, Walsh Pathology, Royal Victoria Hospitals Trust, Belfast, Northern Ireland, UKSearch for more papers by this author Burrows, Burrows Dermatology and,Search for more papers by this author McKenna, McKenna Department of Dermatology, Craigavon Area Hospital Group Trust, Craigavon, Departments of,Search for more papers by this author Walsh, Walsh Pathology, Royal Victoria Hospitals Trust, Belfast, Northern Ireland, UKSearch for more papers by this author Burrows, Burrows Dermatology and,Search for more papers by this author First published: 24 December 2001 https://doi.org/10.1046/j.1365-2230.1999.00519.xCitations: 12AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume24, Issue5September 1999Pages 425-427 RelatedInformation

Pyoderma gangrenosum (PG) is a painful chronic ulcerative skin disorder often occurring in association with systemic disease. It typically affects the lower limbs, but may also involve other sites, or sometimes develop after trauma of surgical procedures. We report the case of a woman with rheumatoid arthritis who developed disfiguring and severe PG of the right breast, a rare site, following biopsy for a benign breast lesion, and who was subsequently successfully treated with low-dose cyclosporin A.

This article describes the results of an EECDRG multicentre study on contact allergy to corticosteroids. A total of 7238 patients were investigated: 6238 in 13 centres in the course of 1993, and 1000 patients in 1 centre in 1993 and 1994. The 5 corticosteroids tested were budesonide 0.1% pet., betamethasone‐17‐valerate 1% pet., clobetasol‐17‐propionate 1% pet., hydrocortisone‐17‐butyrate 1% eth., and tixoeortol‐21‐pivalate 1%., pet.; 189 (2.6%) gave a positive patehtest reaction (+, ++, +++)to at least 1 of the corticosieroids. The data regarding the corticosteroid‐sensitive patients, as well as the patchtest results, were recorded on a standardized form.

In a multicentre study, the value of adding sorbitan sesquioleate (SSO) to the constituents of the 8% fragrance mix (FM) was investigated. In 7 centres, 709 consecutive patients were tested with 2 types of FM from different sources, its 8 constituents with 1% SSO, its 8 constituents without SSO, and 20% SSO. 5 patients (0.71%) reacted to the emulsifier SSO itself, read as definitely allergic on day 3/4. 53 patients reacted to either one of the mixes with an allergic type of reaction. When tested with the constituents without SSO, 41.5% showed an allergic reaction versus 54.7% with SSO. If both types of reactions were considered (allergic and irritant) 38.3% of 73 patients showed a positive "breakdown" result without SSO, versus 54.8% with SSO. The differences were statistically significant. Reactivity to FM constituents was changed in a specific pattern by addition of SSO--irritant reactions increased, particularly for cinnamic alcohol, eugenol, geraniol, oak moss and hydroxycitronellal, whereas others showed only a slight change. Allergic reactions were also increased by SSO, but the rank order of the top 3 sensitizers (isoeugenol, oak moss and eugenol) did not change. Cinnamic alcohol was the only constituent with decreased reactivity after addition of SSO. A positive history of fragrance sensitivity (HFS) was clearly associated with a positive allergic reaction to either the mix or 1 of its constituents (51% versus 28.6% with a negative HFS). Irritant reactions were linked to a negative HFS in a high proportion (64.3%).(ABSTRACT TRUNCATED AT 250 WORDS)

In a multicentre study, the value of adding sorbitan sesquioleate (SSO) to the constituents of the 8% fragrance mix (FM) was investigated. In 7 centres, 709 consecutive patients were tested with 2 types of FM from different sources, its 8 constituents with 1% SSO, its 8 constituents without SSO, and 20% SSO. 5 patients (0.71%) reacted to the emulsifier SSO itself, read as definitely allergic on day 3/4. 53 patients reacted to either one of the mixes with an allergic type of reaction. When tested with the constituents without SSO, 41.5% showed an allergic reaction versus 54.7% with SSO. If both types of reactions were considered (allergic and irritant) 38.3% of 73 patients showed a positive “breakdown” result without SSO, versus 54.8% with SSO. The differences were statistically significant. Reactivity to FM constituents was changed in a specific pattern by addition of SSO‐irritant reactions increased, particularly for cinnamic alcohol, eugenol, geraniol, oak moss and hydroxycitronellal, whereas others showed only a slight change. Allergic reactions were also increased by SSO, but the rank order of the top 3 sensitizers (isoeugenol, oak moss and eugenol) did not change. Cinnamic alcohol was the only constituent with decreased reactivity after addition of SSO. A positive history of fragrance sensitivity (HFS) was clearly associated with a positive allergic reaction to either the mix or 1 of its constituents (51% versus 28.6% with a negative HFS). Irritant reactions were linked to a negative HFS in a high proportion (64.3%). In 17 patients, a repeated open application test (ROAT) was performed with a total of 43 patch‐test‐positive materials. The ROAT was positive in 20/31 (64.5%) tests in 11 patients with a positive HFS, but negative in all 6 patients with a negative HFS (0/12 tests). In conclusion, addition of SSO to the constituents of FM increases both irritant and allergic reactions, though the difference from the results obtained without SSO is not as high as previously reported. The ROAT is a valuable tool in validating such patch test results.

The objective of this study was to determine the frequency of reactivity to a series of commonly fragrances in dermatological patients. A total of 48 fragrances (FF) were chosen, based on the publication of Fenn in 1989 in which the lop 25 constituents of 3 types (1. perfumes, 2. household products, 3. soaps) of 400 commercial products on the US market had been determined. In a pilot study on a total of 1069 patients in 11 centres, the appropriate test concentration and vehicle were examined. For most fragrances, 1% and 5% were chosen, and petrolatum proved to be the best vehicle in comparison to isopropyl myristate and diethyl phthalate. In the main study, a set of 5 to 10 fragrances at 2 concentrations was patch tested in each centre on a minimum of 100 consecutive patients seen in the patch test clinic. These patients were also patch tested to a standard series with the 8% fragrance mix (FM) and its 8 constituents. In patients with a positive reaction to any of the 48 FF, a careful history with regard to past or present reactions to perfumed products was taken. A total of 1323 patients were tested in 11 centres. The 8% FM was positive in 89 patients (8.3% of 1072 patients). Allergic reactions to the constituents were most frequent to oak moss (24), isoeugenol (20), eugenol (13), cinnamic aldehyde (10) and geraniol (8). Reactions read as allergic on day 3/4 were observed only 10 × to 7 materials of the new series (Iso L: Super® (2), Lyral® (3), Cyclacet® (1), DMBCA (1), Vertofix® (1), citronellol (1) and amyl salicylate (1)). The remaining 41 fragrances were negative. 28 irritant or doubtful reactions on day 3/4 were observed to a total of 19 FF materials (more than 1 reaction: 5% citronellol (2), 1%amyl salicylate (2), 1%isononyl acetate (3), 0.1% musk xylol (2). 1%citral (2), and 1% ionone beta (2)). Clinical relevance of positive reactions to any of the FF series was not proved in a single case. This included the 4 reactions in patients who were negative to the 8% FM. In conclusion, the top 25 fragrances commonly found in various products caused few reactions in dermatological patients and these few appeared to be clinically irrelevant, with the possible exeption of Lyral®. However, this data should be interpreted in the light of the relatively small number of patients tested (only 100 in most centres).

278 consecutive patients with suspected contact dermatitis were patch tested with the European standard series and gold sodium thiosulfate (0.5% pet.): 13 patients (4.6%) had a positive allergic response to gold sodium thiosulfate (GST). All of these patients were female, with a mean age of 37 years. The most frequent site of eczema in these patients was the head and neck (62%). A seborrhoeic distribution of eczema was common. 46% had involvement of the limbs, 15% had a perianal or perivulval rash. The mean duration of eczema in this group of patients was 15.8 months. 54% of patients allergic to gold were also allergic to nickel. Biopsy of positive patch test reactions to GST were consistent with allergic contact dermatitis.

4 aircraft construction workers developed allergic contact dermatitis of the hands and forearms. The allergen was hexavalent chromate in the accelerating solution of an epoxy‐based sealant (PR1422). Although chromate dermatitis from an epoxy resin has been described, epoxy system accelerators are a hitherto unrecognized source of occupational chromate dermatitis.

reported in the literature. Medicines Control Agency data suggest that EM may occur as an adverse reaction in association with terbinafine therapy. It has been reported in 15 of approximately 110.000 total patient exposures in the U.K. (Committee on the Safety of Medicines, pers. comm.). This figure compares with previously published estimates of EM reaction rates to phenobarbital at 20 per 100,000 patients, nitrofurantoin at seven per 100,000, sulphamethoxazole and trimethoprim. and ampicillin both at three per 100,000 exposed individuals.^ Of the cases of EM in association with terbinafine. including our own. where sufficient information was received, the mean time of onset of skin lesions was approximately 3 weeks after starting therapy. In only one case did the disease evolve into severe Stevens-Johnson syndrome. Resolution, in most cases, occurred within 1 week of stopping terbinafine, with or without starting prednisolone.

We report a 19-year-old woman with psoriasis who developed a severe allergic reaction within 1 week of commencement of sulphasalazine; her skin becoming erythrodermic with associated lymphadenopathy, leucopenia and thrombocytopenia. Clinical signs and haematological abnormalities rapidly returned to normal on discontinuation of sulphasalazine. It is important to monitor carefully haematological indices in the early stages of treatment with this drug.

Contact DermatitisVolume 30, Issue 3 p. 182-182 Allergy to patch test marking ink K. E. McKenna, K. E. McKenna Department of Dermatology, Royal Victoria Hospital, Belfast BT12 6BA, Northern Ireland, UKSearch for more papers by this authorD. Burrows, D. Burrows Department of Dermatology, Royal Victoria Hospital, Belfast BT12 6BA, Northern Ireland, UKSearch for more papers by this author K. E. McKenna, K. E. McKenna Department of Dermatology, Royal Victoria Hospital, Belfast BT12 6BA, Northern Ireland, UKSearch for more papers by this authorD. Burrows, D. Burrows Department of Dermatology, Royal Victoria Hospital, Belfast BT12 6BA, Northern Ireland, UKSearch for more papers by this author First published: March 1994 https://doi.org/10.1111/j.1600-0536.1994.tb00710.xCitations: 4AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume30, Issue3March 1994Pages 182-182 RelatedInformation

Journal Article Preparing a medical report Get access D. BURROWS, D. BURROWS Department of Dermatology, Royal Victoria Hospital, Courts of Justice, Belfast, Northern Ireland Search for other works by this author on: Oxford Academic Google Scholar A.E. DONALDSON A.E. DONALDSON Department of Bar Library, Courts of Justice, Belfast, Northern Ireland Search for other works by this author on: Oxford Academic Google Scholar Clinical and Experimental Dermatology, Volume 19, Issue 3, 1 May 1994, Pages 206–209, https://doi.org/10.1111/j.1365-2230.1994.tb01166.x Published: 01 May 1994 Article history Accepted: 05 May 1993 Published: 01 May 1994

Journal Article The Melkersson‐Rosenthal syndrome and food additive hypersensitivity Get access K.E. McKenna, K.E. McKenna Departments of Dermatology, Royal Victoria Hospitals Trust, Belfast BT12 6BA, Northern Ireland Search for other works by this author on: Oxford Academic Google Scholar M.Y. Walsh, M.Y. Walsh Pathology, Royal Victoria Hospitals Trust, Belfast BT12 6BA, Northern Ireland Search for other works by this author on: Oxford Academic Google Scholar D. Burrows D. Burrows Departments of Dermatology, Royal Victoria Hospitals Trust, Belfast BT12 6BA, Northern Ireland Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 131, Issue 6, 1 December 1994, Pages 921–922, https://doi.org/10.1111/j.1365-2133.1994.tb08613.x Published: 01 December 1994

A Pakistani boy had chronic ulceration of the cheeks, generalized nail dystrophy, ulceration and hypergranulation of the nail beds, conjunctiva, and vocal cords, and dental enamel hypoplasia. These features are consistent with laryngo-onycho-cutaneous (LOCS) syndrome or Laryngeal and Ocular Granulation tissue in children from the Indian subContinent (LOGIC) syndrome. Both he and his elder brother had elevated levels of serum calcium consistent with familial benign hypercalcemia. Laryngo-onycho-cutaneous syndrome is a newly recognized condition and its association with familial benign hypercalcemia has not been previously reported.

Journal Article Identification of a single base pair deletion (40 del G) in exon 1 of the ferrochelatase gene in patients with erythropoietic protoporphyria Get access David J. Todd, David J. Todd * 1Department of Medical Genetics, Queen's University of Belfast BT9 7AB and BT 12 6AB2Department of Dermatology, Royal Victoria HospitalBelfast BT12 6BA, UK *Department of Medical Genetics, Floor A, Belfast City Hospital, Lisburn Road, Belfast BT9 7AB, UK Search for other works by this author on: Oxford Academic PubMed Google Scholar Anne E. Hughes, Anne E. Hughes 1Department of Medical Genetics, Queen's University of Belfast BT9 7AB and BT 12 6AB Search for other works by this author on: Oxford Academic PubMed Google Scholar Kevin T. Ennls, Kevin T. Ennls 1Department of Medical Genetics, Queen's University of Belfast BT9 7AB and BT 12 6AB Search for other works by this author on: Oxford Academic PubMed Google Scholar Alana J. Ward, Alana J. Ward 1Department of Medical Genetics, Queen's University of Belfast BT9 7AB and BT 12 6AB Search for other works by this author on: Oxford Academic PubMed Google Scholar Desmond Burrows, Desmond Burrows 2Department of Dermatology, Royal Victoria HospitalBelfast BT12 6BA, UK Search for other works by this author on: Oxford Academic PubMed Google Scholar Norman C.Nevin Norman C.Nevin 1Department of Medical Genetics, Queen's University of Belfast BT9 7AB and BT 12 6AB Search for other works by this author on: Oxford Academic PubMed Google Scholar Human Molecular Genetics, Volume 2, Issue 9, September 1993, Pages 1495–1496, https://doi.org/10.1093/hmg/2.9.1495 Published: 01 September 1993 Article history Received: 13 May 1993 Revision received: 14 July 1993 Accepted: 14 July 1993 Published: 01 September 1993

Two cases of basal cell carcinoma (BCC) occurring in association with long-standing dermatofibroma are reported. These lesions were asymptomatic, but both were characterized clinically by central ulceration. Histopathology of both cases revealed a BCC overlying a typical dermatofibroma. The association of these two tumours has rarely been reported and is controversial. It is disputed whether the changes of BCC overlying dermatofibromata are reactive or neoplastic.

C-erB-2 oneoprotein expression detected immunohistochemically in primary breast cancer is a potent poor prognostic variable for patients including Irish women t.2.Also primary C-erB-2 expression indicates hormone resistance in recurrent breast cancer and relative tumour resistance to low intensity chemotherapy with mitoxanthrone (data in press).Forty young women (median age 41 years) had staining for C-erB-2 in their primary tumonrs; 11 showed positive staining and 29 did not.All subsequently had recurrences of breast cancer and were then given intensiv e chemotherapy with doxombicin 40 mg/m 2 intravenously and ifosfamide/ mesna 5 g/m 2 by intravenous infusion over 24 hours, with mesna alone for 8 hours.Cycles repeated at 21 day intervals to a total of 4 cycles in patients with responsive tumours.Response rates in recurrences (82% C-erB-2+VE vs 72% C-erB-2-ve) median response durations, and post-treatment survival were no different between patients on the basis of primary turnout C-erB-2 expression.This strongly suggests that young women with operable breast cancer and expression of C-erB-2 should be selected for intensive doxombicin based nee-adjuvant/adjuvant chemother apy.

To obtain data on the frequency of sensitization among European hairdressers, the patch test results from 9 centres were evaluated. 8 allergens recommended by the ICDRG and EECDRG in the hairdressing series and PPD from the standard series were used to patch test 809 hairdressers and 104 clients suspected of contact sensitization. Among hairdressers, the mean frequencies of sensitization ranked as follows: GMT 19%, PPD 15%, APS 8%, PTD 8%, ONPPD 4%, and PADH 4%. In contrast to GMT in acid permanent waves, the frequency of sensitization to AMT in alkaline permanent waves was only 4%. Frequencies of sensitization to pyrogallol and resorcinol were 0.8% and 0.6%, respectively. The frequencies of sensitization showed marked regional variations, particularly that to GMT, which was highest in Germany (51%), followed by Spain (22%) and London (19%). Clients of hairdressers showed a similar rank order of sensitization frequency, with the exception of APS, which was completely negative in this (small) series.

British Journal of DermatologyVolume 127, Issue s40 p. 41-42 (7) Cutaneous actinomycosis DRS MAUREEN Y. WALSH, DRS MAUREEN Y. WALSH Departments of Pathology, Royal Victoria Hospital, Belfast, U.K.Search for more papers by this authorCLAIRE M. THORNTON, CLAIRE M. THORNTON Departments of Pathology, Royal Victoria Hospital, Belfast, U.K.Search for more papers by this authorSONYA HUTCHINSON, SONYA HUTCHINSON Departments of Dermatology, Royal Victoria Hospital, Belfast, U.K.Search for more papers by this authorPROF. D. BURROWS, PROF. D. BURROWS Departments of Dermatology, Royal Victoria Hospital, Belfast, U.K.Search for more papers by this author DRS MAUREEN Y. WALSH, DRS MAUREEN Y. WALSH Departments of Pathology, Royal Victoria Hospital, Belfast, U.K.Search for more papers by this authorCLAIRE M. THORNTON, CLAIRE M. THORNTON Departments of Pathology, Royal Victoria Hospital, Belfast, U.K.Search for more papers by this authorSONYA HUTCHINSON, SONYA HUTCHINSON Departments of Dermatology, Royal Victoria Hospital, Belfast, U.K.Search for more papers by this authorPROF. D. BURROWS, PROF. D. BURROWS Departments of Dermatology, Royal Victoria Hospital, Belfast, U.K.Search for more papers by this author First published: July 1992 https://doi.org/10.1111/j.1365-2133.1992.tb01221.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume127, Issues40July 1992Pages 41-42 RelatedInformation

The keratinocyte expression of class II MHC antigens HLA‐DR, DP and DQ was studied in 20 long‐lasting allergic patch test reactions and 17 normal allergic patch tests reactions. No significicant difference in the expression of these antigens in the 2 groups was detected. No 1 allergen was responsible for the majority of long‐lasting allergic patch test reactions. The immunological mechanisms which may contribute to long‐lasting allergic patch test reactions are discussed with reference to HLA‐DR Keratinocytes.