BackgroundMetals are common agents of allergic contact dermatitis, occupational or not,
with decreasing incidence over the last years in some countries that have
regulated the amount of nickel in objects.ObjectivesTo analyze and compare with previous studies the profile of metal
sensitization between 2003-2015.MethodsPatients who underwent patch testing between 2003-2015 were evaluated
retrospectively regarding the sensitization rates to metals, the
associations between them, the relationship with profession and
epidemiology.ResultsOf the 1,386 patients tested, 438 (32%) had positive test to some metal,
similar results to the 404/1,208 (33%) of the previous study (1995-2002)
performed at the same service (p=0.32). The frequency of nickel (77%),
cobalt (32%) and chromium (29%) changed slightly (p=0.20). Most cases of
sensitization to chromium were related to the occupation (64%), in contrast
to nickel and cobalt (p<0.0001). There was a predominance of females
among those sensitized to metal in both studies (p=0.63) and the age group
of 20-49 years old (p=0.11); the number of fair-skinned individuals
increased (p<0.001), as well as the lesions in the cephalic segment
(50.5%; p<0.0001) and hands (45%; p<0.0001), which are not the most
frequent location anymore. The number of cleaners decreased (39% vs. 59%;
p<0.0001), which still lead in front of bricklayers/painters, which
increased (14% vs. 9%; p=0.013). The frequency of wet work reduced (65% vs.
81%; p<0.0001).Study limitationsThe study included a single population group; only patients with positive
tests to metals were considered - the others were not evaluated for the
possibility of false negatives.ConclusionThe sensitization to metals, occupational or not, has been significant over
the last 21 years, with few epidemiological changes.
In conclusion, testicular metastases from prostate cancer are a rare event, observed in 1.8 per 1,000 cases. As other visceral metastases, testicular metastases might also be considered as an unusual additional factor of poor prognosis.
Whether parapsoriasis represents an early stage of T-cell cutaneous lymphoma is still
the subject of controversy. We evaluated the efficacy of phototherapy in the
treatment of parapsoriasis and its relation with TCCL. Patients diagnosed with
parapsoriasis and treated with phototherapy PUVA or UVB-NB were selected. Between 1
to 8 years following treatment the evolution of their disease was evaluated. In 62
patients the cure rate was 79.3% and 17.2% showed improvement of the lesions. Only
two patients developed full blown T-cell cutaneous lymphoma. Phototherapy is an
excellent treatment for parapsoriasis, with high cure rates, regardless of the type
of phototherapy employed. Of the 62 patients under study, parapsoriasis showed no
general tendency to progress to T-cell cutaneous lymphoma.
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