A bullous pemphigoid-like skin eruption after a chemical burn (original) (raw)
Dermatology Review
Introduction. Octenisept ® is an antiseptic solution which is intended to be applied on the skin, mucous membranes and wounds. Objective. To present a case study of a bullous skin lesions, which occurred in a 4-year-old girl after Octenisept ® application, and to highlight various possible side effects of this preparation. Case report. In a 4-year-old girl Octenisept ® was applied preventively three times at intervals of 12 hours on an epidermal abrasion. Erythema and hydropic papules emerged 6-8 hours after application and were followed by vesicles and bullae 8 hours later. In spite of the topical treatment with glucocorticoids and an antibiotic, the lesions persisted for several weeks. Conclusions. Taking into consideration the wide usage of Octenisept ® in many fields of medicine, there is a need to conduct further research on the allergic potential and toxicity of this product. streszczenie Wprowadzenie. Octenisept ® jest środkiem antyseptycznym przeznaczonym do stosowania na powierzchnię skóry, błon śluzowych i ran. Cel pracy. Przedstawienie przypadku reakcji pęcherzowej skóry u 4-letniej dziewczynki, która wystąpiła po aplikacji Octeniseptu ® na otarty naskórek, oraz zwrócenie uwagi na możliwe działania niepożądane tego preparatu. Opis przypadku. U 4-letniej dziewczynki zastosowano profilaktycznie Octenisept ® , spryskując otarcie naskórka 3-krotnie co 12 godzin. Zmiany skórne w postaci rumienia i grudek obrzękowych pojawiły się po 6-8 Case report/Opis przypadku bullous skin lesion reaction as an example of an adverse effect of a preparation containing 0.1% octenidine dihydrochloride and 2% phenoxyethanol (Octenisept ®) reakcja pęcherzowa skóry jako przykład niepożądanego działania preparatu zawierającego 0,1% dichlorowodorku oktenidyny i 2% fenoksyetanolu (Octenisept ®
Severe drug‐induced skin reactions: clinical pattern, diagnostics and therapy
JDDG: Journal der Deutschen …, 2009
Cutaneous drug eruptions are common, with a prevalence of approximately 2 % to 3 % in hospitalized patients.[Bigby, 2001, Bigby, et al., 1986] It has been estimated that 1 of every 1000 hospitalized patients has a serious cutaneous drug reaction.[Roujeau and Stern, 1994] In clinical practice, the diagnosis of a cutaneous drug eruption is based on a clinical history suggesting that the rash is temporally related to the consumption of a new drug, the gross morphology of the rash, and, often, the histopathologic examination of a skin biopsy. The diversity of cutaneous drug eruptions is broad.[Kaplan, 1984, Roujeau, 2005, Wintroub and Stern, 1985] The vast majority of drug reactions is represented by morbilliform (scarlatiniform or rubeoliform) exanthemas (40%).[Gerson, et al., 2008] Followed by urticaria and angioedema, they account for up to 95% of cutaneous reactions.[Crowson, et al., 2003, Kauppinen and Stubb, 1984, Stubb, et al., 1994] Although generalized and often developing fast with some systemic symptoms such as pruritus, burning or shiver, these drug reactions are not severe and usually stop rapidly without much intervention after cessation of the culprit drug. Histopathologically, drug reactions may simulate each of the patterns of inflammatory diseases of the skin and subcutaneous fat. However, by far the most common pattern evoked by them is "interface dermatitis".[Ackerman, et al., 2005] That pattern usually is joined by an infiltrate that encircles only the venules of the superficial plexus, but, episodically, the infiltrate is present around venules of both vascular plexuses. Of the two types of interface dermatitis induced by drugs, namely, vacuolar and lichenoid, the vacuolar is the most common. Severe drug-induced skin reactions include Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), moreover, generalized bullous fixed drug eruption (GBFDE), acute generalized exanthematous pustulosis (AGEP), and drug reaction with eosinophilia and systemic symptoms (DRESS). Furthermore, toxic erythemas after chemotherapy and drug-induced linear-IgA-dermatosis should be listed among them. Within the following chapter they will be elucidated from a clinical but in particular histopathologic point of view. www.intechopen.com Skin Biopsy-Perspectives 88 2. Stevens-Johnson syndrome and toxic epidermal necrolysis 2.1 Clinical presentation SJS and TEN are viewed as a single disease entity of different severity.[Bastuji-Garin, et al., 1993] Both are characterized by a macular confluent erythema evolving into sometimes extensive blistering or epidermolysis that resembles a second degree burn (figures 1A and 2A). This is accompanied by mucosal erosions, especially affecting the mouth, the lips, the (a)
Dermatitis, 2004
Skin exposure to biocides containing high concentrations of methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) may cause severe chemical burns and may also induce sensitization. We report two cases in which skin exposure to a newly launched biocide containing 2-methyl-4-isothiazolin-3-one (MI) and 1,2-benzisothiazolin-3-one led to sensitization to MI, which in the second case was preceded by a chemical burn. A study was performed to investigate the pattern of reactivity to MCI and MI in two patients who presumably had a primary sensitization to MI and in one patient who had been sensitized to MCI/MI by being patch-tested. The patients were patch-tested with serial dilutions of MCI/MI, MCI, MI, and 2-n-octyl-4-isothiazolin-3-one. The first two patients reacted to both MCI/MI and the separate active ingredients, with a higher level of reactivity to MI than to MCI. The third patient reacted to MCI/MI and MCI only. A biocide containing MI caused sensitization and occupational contact dermatitis in the first two patients, through contact with wallpaper glue in one case and after a chemical burn in the other case.