Allergic contact dermatitis from Codivilla's spring

Abstract

In March 1990, a 44-year-old woman presented with eczema of the heel and posterior aspect of her left leg. She had suffered from poliomyelitis since childhood and there was marked muscular hypotrophy of the left leg. Since 1988, she had been using a Codivilla spring (Fig. 1), an orthopedic device used to support swinging feet. Unfortunately, an itchy Fig. I. Codivilla's spring. Table I p-tert-butylphenol 2% pet. phenol-formaldehyde resin 5% pet. dermatitis developed where the device touched the skin. When she stopped using the Codivilla spring, her dermatitis resolved, but when she tried to use it again, as she could not do without it, the dermatitis recurred.Cutaneous examination showed 2 erythemato-vesicular areas in the sural and calcaneal region of the left leg. The lesions had the exact shape of the spring. The patient was patch tested with the GIRDCA standard series. Patch tests with para-tertiary-butylphenol-formaldehyde resin (PTBP-FR) I% pet. and thimerosal 0.1% pet. were strongly positive ( + + +) at 2 and 4 days. A patch test with a shaving of the leather covering with some adhesive on it was also strongly positive. The patient was then patch tested with a series of phenol-formaldehyde resins (Table 1): she showed positive reactions to phenol-formaldehyde resin 5% pet. ( + + +) and to urea-phenolformaldehyde resin 10% pet. (++),while the other resins remained negative. DiscussionCodivilla's spring is an orthopedic foot device, made to measure, with a spring inserted in the posterior D2 D4 ++ +++ toluene sulfonamide-formaldehyde resin I 0% pet. dimethylolhydroxyethylene urea 10% pet. urea-phenol-formaldehyde resin 10% pet. hexamethylenetetramine I% pet. ++ ++ resorcin 1% pet. resorcinol mono benzoate 1% pet. 2-monomethylol phenol I% pet.

Clinical characteristics of paraneoplastic neurological syndrome related to different pathological lung cancers

“…The nervous system manifestation was earlier than the diagnosis time of lung cancer, accounting for 84.12%, higher than previous reports that 50%–80% of patients showed signs and symptoms of PNS before the diagnosis of the primary tumor. 7 , 8 The early detection may be due to increased awareness and development of antibody levels in recent years.…”

Allergic contact dermatitis due to orthopedic shoes and a prosthesis for an amputated foot

“…In our patient, despite chromate sensitivity having been previously diagnosed, his prosthesis was covered with leather bonded with an adhesive containing PTBPF resin (as confirmed by the manufacturer), which played an additional role in inducing contact dermatitis (2, 7, 8).…”