In P63‐related ectodermal dysplasias (ED), the clinical characteristics focus on extra‐cutaneous manifestations. The dermatological phenotype remains incompletely characterized. We report the dermatological features of 22 patients carrying a TP63 mutation. Erosions, erythroderma and pigmentary anomalies are characteristics of P63‐related ED. Our data suggest that patients might be classified into two major P63‐related disorders: AEC and EEC. RHS and ADULT represent mild AEC and EEC forms, respectively.
1,2-Benzisothiazolin-3-one (BIT) is an antimicrobial agent that is widely used as a preservative in non-cosmetic products. 1 It has been recognized as an allergen since 1976, 2 and has been shown to be responsible for occupational contact dermatitis in workers involved in the manufacture of paints, plastic emulsions, air fresheners, textile and paper dyes, water softeners, and pottery moulds, and in the metallurgy and carpet industries. 3 We report two cases of allergic contact dermatitis caused by BIT in chemists working on the development of micro-encapsulated perfumes for detergents. CASE REPORTS Case 1A 31-year-old atopic male, with no previous history of contact allergy, was referred because of vesicular hand dermatitis. The dermatitis had begun 6 months earlier, when he started a new job in the perfume industry. He was working on the development of a new detergent containing micro-encapsulated perfumes. He reported pruritus on his face every time that he entered the office, and that the dermatitis improved during holidays. Patch testing was performed with the European baseline series, a preservative series, an emulsifier series, and some personal products. Patch test materials were supplied by Chemotechnique Diagnostics (Vellinge, Sweden). Readings on day (D) 3 and D5 showed positive reactions to BIT 0.1% pet. (+++) and no reaction to methylisothiazolinone (MI) 0.2% aq. or octylisothiazolinone (OIT) 0.1% pet. The source of exposure was found to be Proxel GXL, which is a commonly used industrial biocide that the patient was using for the perfume's micro-encapsulation elaboration, and was also present in the soap that he used at work. Case 2A 37-year-old non-atopic male presented with dermatitis on his hands. His previous history included allergic contact dermatitis to cobalt. The hand dermatitis appeared a few months after he started a new job in the same perfume industry as our previous patient. He also noticed an improvement during holidays. Patch testing was performed, with the same methods, with the European baseline series, a preservative series, and some personal products. Readings on D3 and D5 showed positive reactions only to BIT 0.1% pet. (+++) and no reaction to MI 0.2% aq. or OIT 0.1% pet. The patient was also exposed to Proxel GXL. DISCUSSIONWe describe two cases of occupational allergic hand dermatitis caused by BIT used as a preservative agent in the development of microencapsulated substances. Encapsulation is a process of enclosing a substance inside a membrane. It is widely used in diverse fields, and particularly to control the release of fragrances in textiles or detergents. 4Apart from professional exposure, the most common sources of BIT exposure are all-purpose cleaners. 5 A study conducted in Switzerland showed that 42.9% of detergents, 7.7% of adults' cosmetics and 6.4% of cosmetic baby products were preserved with at least one isothiazolinone. BIT (31.2%) and MI (31.1%) were the most frequently found isothiazolinones, alone or in combination, in non-cosmetic
Mucocutaneous adverse events are commonly observed under immune checkpoint inhibitors (ICIs) therapy. Here, we report the case of a 43-year-old male patient with a stage IIIC melanoma disease who developed hidradenitis suppurativa (HS) three months after the beginning of an anti-PD-1 (nivolumab) adjuvant therapy. The patient had no comorbidities other than obesity and severe acne during adolescence. After an unsuccessful course of lymecycline while he was still treated with nivolumab, he gradually improved under zinc gluconate therapy and, more importantly, after nivolumab cessation. HS is a recurrent follicular inflammatory disease in the apocrine gland-bearing areas of the body often associated with obesity, metabolic syndrome, tobacco smoking, inflammatory bowel diseases, psoriasis, and arthritis. In our patient, the latency period between drug initiation and onset of HS symptoms and the improvement after immunotherapy discontinuation, argued strongly in favor of an anti-PD-1-induced HS. Anti-PD-1 therapies often trigger T cells-mediated adverse events that mimic Th17-mediated inflammatory and neutrophilic diseases. We suggest that HS, as other pustular skin reactions and ICIs-induced neutrophilic colitis, can be part of the anti-PD-1 mucocutaneous adverse event spectrum.
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