Petechial reaction following patch testing with cobalt

Schmidt, Henning; Larsen, Finn Schultz; Larsen, P O; Søgaard, H

doi:10.1111/j.1600-0536.1980.tb03913.x

Cited by 16 publications

(9 citation statements)

References 3 publications

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“…Atopics are particularly prone to non-specific (erythematous) reactions (35), both irritant reactions from the test materials themselves, e.g., adhesive tapes, and from the sensitizers. Irritant reactions may present many different morphological types, from homogeneous erythema without infiltration to weak erythema with wrinkling (silk paper appearance), petechiae, pustules, bullae, and necrosis (1,(36)(37)(38).…”

Section: Irritant Reactionsmentioning

confidence: 99%

Thoughts on sensitizers in a standard patch test series

et al. 1999

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On behalf of the European Society of Contact DermatitisPatch testing is the predominant method of establishing contact allergy. The present patch test technique is the result of a continuous process of development and improvement since its first application in the late 19th century. The perfect patch test should give no false-positive and no false-negative reactions. The ideal patch test should also cause as few adverse reactions as possible, particularly no patch test sensitization. Even though the history and examination of a patient with suspected allergic contact dermatitis will give clues to possible sensitizers, it is not sufficient to patch test only with initially suspected sensitizers; unsuspected sensitizers used for patch testing frequently turn out to be the real cause of the dermatitis. Fortunately, a small number of substances are considered to account for the majority of delayed hypersensitivity reactions. Therefore, generally 20-25 test preparations consisting of chemically defined compounds, mixes of allergens, and natural and synthetic compounds, are grouped into a standard test series. The requirements to be fulfilled by a sensitizer in a standard patch test series are discussed in this article. A procedure of investigations is proposed before a sensitizer is included in a standard series.

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Section: Irritant Reactionsmentioning

confidence: 99%

Thoughts on sensitizers in a standard patch test series

et al. 1999

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“…In the upper dermis the signs of leukocytoclastic vasculitis (vessels fibrinoid degeneration, edematous endothelium, scarce perivascular lymphomonocytic and neutrophilic infiltrate, erythrocytes extravasation, and karyorrhexis) are visible. The same features are present when examining a patch test response lesion (Table 6) [47, 74]. …”

Section: Purpuric Contact Dermatitismentioning

confidence: 91%

“…Twenty-three patients were retested and developed new petechial responses in 60% of cases. Based on these authors data, the incidence of positive allergic reactions to cobalt was lower (2.9%) than the incidence of primary irritant reactions [74]. Judging on our practice, cases of petechial nonallergic reactions to cobalt and chrome are indeed rather numerous and frequently reproducible.…”

Section: Purpuric Contact Dermatitismentioning

confidence: 99%

Noneczematous Contact Dermatitis

et al. 2013

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Irritant or allergic contact dermatitis usually presents as an eczematous process, clinically characterized by erythematoedematovesicous lesions with intense itching in the acute phase. Such manifestations become erythematous-scaly as the condition progresses to the subacute phase and papular-hyperkeratotic in the chronic phase. Not infrequently, however, contact dermatitis presents with noneczematous features. The reasons underlying this clinical polymorphism lie in the different noxae and contact modalities, as well as in the individual susceptibility and the various targeted cutaneous structures. The most represented forms of non-eczematous contact dermatitis include the erythema multiforme-like, the purpuric, the lichenoid, and the pigmented kinds. These clinical entities must obviously be discerned from the corresponding “pure” dermatitis, which are not associated with contact with exogenous agents.

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“…irritant patch test reactions are frequent with some allergens, such as cobalt chloride. 4 However, purpuric patch test reactions are also observed in allergic reactions, for example, to azo dyes. 5 Surprisingly, in case 2, although the patch test reaction was not purpuric, but erythematous with induration and vesicles, the ROAT gave a negative result.…”

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confidence: 99%

Postoperative purpuric contact dermatitis: Think about antiseptics

et al. 2019

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We describe two cases of purpuric contact dermatitis occurring immediately after surgery. CASE REPORTSCase 1: A 28-year-old female patient underwent surgery for buttock synechiae as a result of previous surgery for pilonidal sinus. She was positioned prone during the reconstructive surgery. The next day, she presented with a purpuric eruption of the inguinal folds, the anterior part of the thighs, and the right flank, with itching and burning sensations. Lesions were symmetrical and sharply demarcated (Figure 1). The patient reported having a similar eruption a few years before, soon after an abdominoplasty. The lesions healed quickly after application of a corticosteroid cream, leaving residual hyperpigmentation. We suspected the antiseptic solution, povidone-iodine (PV-I) 10% (Bétadine dermique, Mylan Medical, Paris), used during the current surgery as the possible cause of this eruption. Some time after the episode, the patient was patch tested with the European baseline series (Chemotechnique Diagnostics, Vellinge, Sweden), which gave negative results. Bétadine dermique tested "as is" led to purpuric reactions on day (D) 2 and D3 (+ Supporting Information Figure S1), whereas patch tests with an antiseptic/preservative series (Chemotechnique Diagnostics) gave negative results. On the basis of these results, irritant purpuric contact dermatitis caused by PV-I was diagnosed. Case 2: A 34-year-old female patient underwent a surgical procedure for ovarian cancer in a supine position. The next day, she noted a painful and slightly itchy purpuric eruption localized on her buttocks and her back (Figure 2). This disappeared within a few days without treatment, leaving some residual pigmentation. Later, patch tests were carried out with the European baseline series (Chemotechnique Diagnostics), all of which gave negative results. Patch testing with Bétadine dermique "as is" gave positive reactions, with erythema and oedema on D2 (+), and with vesicles on D4 (++). Repeated open FIGURE 1 Case no. 1: purpuric eruptionFIGURE 2 Case no. 2: purpuric eruption CARLET ET AL. 215

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Petechial reaction following patch testing with cobalt

Cited by 16 publications

References 3 publications

Thoughts on sensitizers in a standard patch test series

Thoughts on sensitizers in a standard patch test series

Noneczematous Contact Dermatitis

Postoperative purpuric contact dermatitis: Think about antiseptics

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