A dramatic increase in the rate of contact allergy caused by MI in cosmetics is occurring in Belgium. Notwithstanding the recent recommendation to discontinue the use of MI in leave-on cosmetics, safer use concentrations should also be determined for rinse-off products. Close monitoring of MI sensitization in the near future will be necessary, and the highest test concentrations reported for MI and MCI/MI should be included in the baseline series.

It is generally thought that dendritic cells (DCs) loaded with full-length tumor antigen could improve immunotherapy by stimulating broad T-cell responses and by allowing treatment irrespective of the patient's human leukocyte antigen (HLA) type. To investigate this, we determined the specificity of T cells from melanoma patients treated with DCs loaded with mRNA encoding a full-length tumor antigen fused to a signal peptide and an HLA class II sorting signal, allowing presentation in HLA class I and II. In delayed-type hypersensitive (DTH)-biopsies and blood, we found functional CD8(+) and CD4(+) T cells recognizing novel treatment-antigen-derived epitopes, presented by several HLA types. Additionally, we identified a CD8(+) response specific for the signal peptide incorporated to elicit presentation by HLA class II and a CD4(+) response specific for the fusion region of the signal peptide and one of the antigens. This demonstrates that the fusion proteins contain newly created immunogenic sequences and provides evidence that ex vivo-generated mRNA-modified DCs can induce effector CD8(+) and CD4(+) T cells from the naive T-cell repertoire of melanoma patients. Thus, this work provides definitive proof that DCs presenting the full antigenic spectrum of tumor antigens can induce T cells specific for novel epitopes and can be administered to patients irrespective of their HLA type.

EditorA 12-year-old boy was referred by his dermatologist who wanted to treat his severe acne vulgaris using isotretinoin (Roaccutane â ). In the past, he developed urticaria, facial oedema and dyspnoea (grade 2 anaphylaxis; classification of Ring and Messmer) 1 after peanut consumption. Diagnosis of peanut allergy was confirmed by specific IgE. Prescribing information leaflets state that oral isotretinoin is contra-indicated in patients with known soybean or peanut allergy, because of the presence of soybean oil in the capsule and the known cross-reactivity between soybean and peanut. * To the best of our knowledge, all European commercialized oral isotretinoin formulations contain soybean oil. As a consequence, patients with known allergy to soybean or peanut cannot be treated with oral isotretinoin. Since isotretinoin is an important dermatologic treatment option, and because symptoms from soy cross-reactivity in peanut-allergics are mostly mild, we assessed whether oral challenge can be used to evaluate the safety of isotretinoin in known peanut-allergic patients who have no soybean allergy. In our patient, total serum IgE was elevated (959 kIU/L). RAST and skin prick testing confirmed the presence of specific IgE for peanut (RAST 3.93 kU/L; wheal size 8 mm) but not for soybean (RAST <0.35 kU/L). Component-resolved diagnostic IgE was positive for Ara h2 (0.71 kU/L), confirming the risk of symptomatic peanut allergy.2,3 Skin prick testing with the isotretinoin capsule (Roaccutane â ) and its content were negative. A subsequent oral challenge with 10 and 20 mg isotretinoin (Roaccutane â ) was tolerated without any clinical symptoms. After observation for 7 hours without development of allergic symptoms, the patient was discharged. In the following 6 months isotretinoin was well tolerated and the treatment is still ongoing. This patient with documented peanut allergy tolerated Roaccutane â treatment, despite the prescribing information describing it as a contra-indication. Peanut and soybean stem from the same plant family of legumes. Because of the worldwide increasing prevalence of peanut and soybean allergy and its potentially severe reactions, these food allergies are a major health concern. 4,5 Peanut and soybean proteins share extensive amino acid sequence homology in the legume seed storage proteins and exhibit in vitro and in vivo cross-reactions. 6 While peanut allergy provokes severe anaphylaxis, soybean allergy is less likely to elicit life-threatening reactions. 5 Also, the isotretinoin capsule contains soybean oil and it has been documented that proteins present in the oil of soybean have little antigenicity with regard to soybean allergy. 7Two prior studies documented the reaction of oral soybean intake in known peanut-allergic individuals. In the first study, after soybean ingestion, two of 31 patients (6.5%) with severe peanut allergy were stated to have developed mild reactions (pruritus, cutaneous papules, erythema and nausea).8 In a second cohort study, three of six fatal reactions in peanut-a...

Vitamin D seems to be associated with a protective effect in a vast range of diseases, including cardiovascular, autoimmune and oncologic conditions. Since ultraviolet (UV) B light is the most important prerequisite for the cutaneous synthesis of vitamin D, sunbeds are able to increase serum vitamin D levels, although only transiently in most cases. In this scenario, the artificial tanning industry relentlessly tries to promote the use of sunbeds as a ‘safe’ therapeutic measure to achieve an adequate serum vitamin D status. The World Health Organization classified UV‐emitting tanning devices, as well as the whole UV spectrum, as group‐1 carcinogens, as they significantly increase the risk of melanoma and non‐melanoma skin cancer. In case of vitamin D deficiency or insufficiency, the current risk‐benefit ratio is therefore in favour of vitamin D supplementation instead of sunbed use. Artificial tanning devices should never be considered as an option to achieve an appropriate vitamin D status. Their supposedly beneficial effects, vastly publicised by the artificial tanning industry, are not worth the carcinogenic risk associated with sunbed use.