Background. Four epidemiologic types of Kaposi sarcoma (KS) are known: classic KS, endemic African KS, epidemic or acquired immunodeficiency syndrome–related KS, and KS associated with immunosuppressive therapy. In most of the latter patients, KS was reported to have developed after organ transplantation, particularly renal transplantation. Thirty‐nine patients who have not had a transplant have been reported to have KS associated with corticosteroid therapy. Methods. The authors studied 10 patients with the appearance of KS during corticosteroid therapy (6 men, 4 women; age range, 42–79 years) who were treated with corticosteroids for autoimmune disorders (5 patients), lymphoproliferative disorders (2 patients), and diseases unrelated to the immune system (3 patients). Results. Genetically programmed susceptibility to corticosteroid‐related KS was suggested by the descent of the study patients as well as most of those reported previously. The prognosis was guarded in all the study patients. Conclusions. Corticosteroids should be withdrawn to achieve clinical remission.

There has been a controversy as to the origin of lupus miliaris disseminatus faciei (LMDF). It was originally thought to be associated with tuberculosis, due to its histopathological similarity. Recently, this association has been doubted, although there remain reported cases of LMDF associated with Mycobacterium tuberculosis. Three patients with the clinical and histopathological features of LMDF are described. Skin from these patients was analysed by polymerase chain reaction (PCR) using two different oligoprimers for the detection of 123 bp and 165 bp DNA fragments specific for M. tuberculosis complex. With these two PCR systems, no M. tuberculosis DNA was detected in any of the LMDF patients. It was present in all positive controls and absent in all negative controls. In this study we could not demonstrate an association between LMDF and tuberculosis.

Previous studies have shown that the prevalence of specific allergens varies by geographic area, population, age and sex. The objective of the present study was to determine the relative frequency of positive reactions to different sensitizers in Israeli patients with clinically suspected contact dermatitis (CD) and to identify possible sex and age differences. A total of 943 consecutive patients were tested for CD using the European standard patch test series. The most frequent allergen was nickel sulfate followed by potassium dichromate and fragrance mix. Positive reactions to nickel sulfate were more common among women, especially those in the younger age group (younger than 40 years). Positive reactions to balsam of Peru were more common among men, especially those in the older age group (40 years or older). This study presents the result of the standard patch test in Israel with stratification according to age and sex. The findings of the present study, combined with reports on geographic/population differences in the prevalence of specific allergens in CD, indicate the need for further investigations to identify prominent local allergens for better adaptation of the standard patch test to local needs.

Background/objectives: Childhood allergic contact dermatitis is recognized as a sig-

Exposure to formaldehyde is common from both consumer products and industry. The reliability of the patch test is essential for the diagnosis of formaldehyde allergy as it is difficult to suspect from the patient's history. The recommended formaldehyde patch test concentration has been reduced over the last decades from 4-5% to 2% and is currently 1%. The changes have not been based upon formal studies, but driven by an intention to reduce irritancy and false-positive results. The aim of the present study was prospectively to compare the outcome of simultaneous testing with formaldehyde 1% and 2% in consecutively patch-tested patients, with respect to frequency of positive patch test reactions, strength of patch test reactions to different formaldehyde test concentrations, irritancy and relevance. The study included 3734 consecutively patch tested patients. 121 gave a positive reaction to 1% and/or 2% formaldehyde in water. There was no statistically significant difference between 1 and 2% with respect to allergic reactions, but 2% gave significantly more irritant reactions. Doubtful, positive and follicular reactions at day (D) 2 frequently developed into true positive reactions at D 3 to 4. Reading at D 7 gave few additional positive cases compared to D 3/4. Problems related to relevance are discussed. Based on present knowledge, a 1% patch test concentration for formaldehyde is recommended.

The reproducibility of the patch test is of great importance to its diagnostic utility. The objective of this study was to quantitatively and qualitatively compare the reproducibility of patch test reactions between the manufacturer-loaded TRUE Test (TT) panel and the investigator-loaded IQ Chamber (IQC) system using the European Standard Series (ESS) (Chemotechnique Diagnostics, Malmö, Sweden). Consecutive patients were simultaneously patch tested with 21 allergens using the TT and IQC system. The concordance and discordance of the 2 methods were analysed. Testing was performed in 207 patients (85 men and 122 women) who yielded 317 positive reactions, 188 with the IQ system and 129 with the TT. A total of 204 tests were positive with both methods, showing a positive concordance rate of 64.4%, with IQC producing more positive results. A high concordance rate of positive results was achieved for Cl+ Me- isothiazolinone (81.5%), nickel sulfate (79%), formaldehyde (76.9%), and paraphenylenediamine (PPD) (72.7%); a moderate concordance was noted for quaternium 15 (66.7%), potassium dichromate (64.3%), and fragrance mix (58.1%); and a low concordance was noted for cobalt chloride (27.6%) and Balsam of Peru (18.2%). The IQC and the TT are similar in finding allergy to allergens with high concordance. The IQC system has an advantage in detecting clinically relevant reactions to allergens that have a moderate and a low concordance.

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Patients should be instructed to avoid the allergens identified. Sensitization to essential oils has important implications for the occupational future of affected individuals.