The toxicity associated with the long-term administration of isotretinoin, even at the low dose used in this trial, must be weighted in planning future prevention trials.
Peanuts and soybeans are frequent causes of food hypersensitivity reactions in children. Sera from 12 patients with atopic dermatitis and a positive double-blind placebo-controlled food challenge to peanut and sera from 5 patients with atopic dermatitis and a positive double-blind placebo-controlled food challenge to soybean were used to identify and characterize specific legume allergens. Identification of a minor allergen from peanut and a minor allergen from soybean was accomplished using various physicochemical techniques. The peanut fraction, peanut agglutinin, isolated by anion-exchange chromatography and electrolution and confirmed by amino acid sequencing, bound IgE in only 50% of the peanut challenge positive patients. The soybean fraction, soybean trypsin inhibitor, identified by gel filtration and electroelution and confirmed by amino acid sequencing, bound IgE in only 20% of the soy challenge positive patients. The identification of these two known legume proteins as minor allergens should allow further immunologic and structural investigations to compare the major and minor legume allergens.
Between April 2001 and October 2003, 215 persons presented with eyelid dermatitis for the first time. They ranged in age from 4 months to 95 years, with an average age of 49.6 years and a median age of 51 years. There were 173 females and 42 males. 165 of 215 had allergic contact dermatitis (ACD) and another 9 had protein contact dermatitis without relevant positive patch tests. Atopic eczema comprised 37 of 215 (17%), but 33 of 37 also had contact allergies. Seborrheic dermatitis, psoriasis or both were found in 35 (16%). Sources of ACD included personal care products in 54 (25%), including 12 with at least 1 positive patch test to cosmetic applicators and 12 sensitive to at least 1 botanical ingredient. Allergy to artificial nails and/or nail lacquer occurred in 18 of 215 (8%). 5 persons had rosacea or periorbital dermatitis, and 2 had dermatomyositis. Other causes included bacterial, fungal and viral infections, some of which were quite unusual. The evaluation of persons presenting with eyelid dermatitis remains a relatively complex but rewarding discipline.
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