IntroductionThe aim of the study was to provide current data on the incidence of allergy to various contact allergens in patients with allergic contact eczema and the analysis of selected socio-demographic data of the patients.Material and methodsThe study included 1532 patients (1010 women and 522 men) treated for allergic contact dermatitis at the Department of Dermatology and Venereology and at the Dermatology Outpatient Clinic in Bialystok in 2007–2011. The assessment of selected demographic data and skin lesions was based on the MOAHFLA index, while the results of patch tests were analyzed with modified Baseline European Series consisting of 31 allergens.ResultsIn the group of patients with eczema, 34.1% were men, and 55% of all respondents were people over 40 years of age. The occupational character of skin lesions was found in 22.5%. Most frequently (38.9%) skin lesions were localized on the hands, rarely involved legs (3.98%). Atopic dermatitis was diagnosed in 4.5% of patients. The ten most frequent allergens were: nickel sulfate (24%), cobalt chloride (15.3%), fragrance mix (8.25%), potassium dichromate (6.8%), balsam of Peru (5.5%), neomycin (4.42%), paraphenylenediamine (3.85%), Quatermium-15 (2.1%), detreomycin (1.83%) and budesonide (1.44% of tested patients).ConclusionsFrequent allergy to detreomycin indicates the need of patch testing for this allergen of all examined patients with allergic contact dermatitis. The increased frequency of the nickel allergy is a worrying problem and indicates the need for education about the risk factors for nickel allergy development and the implementation of appropriate legal regulations.

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Introduction: Paraphenylenediamine (PPDA) is a chemical with strong sensitizing properties used for dyeing of hair and textiles. Paraphenylenediamine can cross-react, resulting in allergy to other related compounds. The prevalence of PPDA sensitization varies widely. The objectives were to assess the frequency of positive patch test reactions to PPDA and related chemicals among patients with allergic contact dermatitis (ACD) and to analyze them regarding their clinical pattern, occupation and cross-reactions. Material and methods: The sociodemographic and clinical data of patients with positive patch tests to PPDA, N-isopropyl-N-phenyl-4-phenylenediamine (IPPD), ethylenediamine (EDA), triethylenetetramine (TETA) and toluene-2,5diamine (TDA) were analyzed. The frequency, strength and cross-reactions with other chemicals were assessed. Results: Of 4087 ACD patients patch-tested between 2006 and 2015, positive reactions to PPDA and other amines were found in 166 (4.1%). The occupational character of PPDA allergy was established in 34.3% of patients. Personal history of atopy was reported by 36.7% of patients. In 98% of those examined, allergy presented as ACD, most frequently affecting hands. Hypersensitivity to PPDA was diagnosed in 77.1%, to IPPD in 20.5%, to TDA in 6%, to TETA in 1.2%, and to EDA in 0.6% of cases. The patients with an extremely strong PPDA reaction significantly more frequently showed reactions to other para group chemicals, especially to benzocaine. Conclusions: Paraphenylenediamine was a major cause of contact allergy of diverse clinical picture more often affecting women, especially with atopy. Every fifth PPDA-allergic person exhibited hypersensitivity to other related compounds. Strong reactions to PPDA increased the risk of cross-reactions.

Allergic contact dermatitis (ACD) is an antigen-specific, T-cell-mediated skin inflammatory disease. Matrix metalloproteinases (MMPs) and their tissue inhibitors of matrix metalloproteinases (TIMPs) play a role in degradation of extracellular matrix and subsequent tissue remodelling during inflammatory process. The objective of this study was to examine a possible role of TIMP-1 and MMP-9 in the pathogenesis of ACD. The serum levels of MMP-9 and TIMP-1 have been measured using enzyme-linked immunosorbent assay in patients with disseminated ACD during exacerbation of skin lesions and the remission stage (n= 20) and were compared with healthy subjects (n= 20). The mean serum levels of TIMP-1 were significantly higher in patients with ACD than in control group (42.8 +/- 4.9 ng/ml). This difference was more prominent in patients with ACD during remission (69.01 +/- 6.99 ng/ml, P < 0.0001) than in patients with exacerbation of disease (46.8 +/- 3.6 ng/ml, P= 0.0054). Mean values of serum MMP-9 did not differ significantly between patients with ACD, both in the acute and in the remission stage, compared with healthy persons (P= 0.76 and P= 0.29, respectively). TIMP-1 might be involved in pathogenesis of ACD. It seems that moderately increased levels of TIMP-1 could reflect degree of activity of skin inflammation, whereas markedly increased levels could contribute to the maintenance of the remission of disease.

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Przegląd Dermatologiczny 2015/4 322 STRESZCZENIE Wprowadzenie. Rozsiana postać ziarniniaka obrączkowatego (ang. generalized granuloma annulare -GGA) charakteryzuje się długotrwałym przebiegiem oraz słabą odpowiedzią na leczenie. Dotychczas opisano przypadki współwystępowania GGA z cukrzycą, hiperlipidemią, chorobami tarczycy oraz nowotworami złośliwymi.Cel pracy. Przedstawienie przypadku współwystępowania rozsianej postaci ziarniniaka obrączkowatego z przerzutami nowotworowymi bez uchwytnego punktu wyjścia choroby nowotworowej.Opis przypadku. Mężczyzna 58-letni, z rozpoznanymi w czerwcu 2014 roku przerzutami raka płaskonabłonkowego do węzłów chłonnych o nieustalonym ognisku pierwotnym, był hospitalizowany w listopadzie 2014 roku z powodu zmian skórnych utrzymujących się od kwietnia 2014 roku. W badaniu dermatologicznym stwierdzono w obrębie szyi, tułowia i kończyn górnych rozsiane zmiany rumieniowo-grudkowe o układzie obrączkowatym oraz powiększone węzły chłonne. W badaniu histopatologicznym zmian grudkowych uwidoczniono obraz ziarniniaka obrączkowatego. Po pobraniu wycinka skórnego obserwowano spłaszczenie zmian skórnych. Wnioski. Przedstawiony przypadek wskazuje na konieczność pogłę-biania diagnostyki w kierunku chorób nowotworowych u pacjentów z GGA. ABSTRACTIntroduction. Generalized granuloma annulare (GGA) is characterized by a chronic course and a poor response to treatment. So far cases of GGA coexisting with diabetes, hyperlipidemia, thyroid diseases and malignant neoplasms have been described. Objective. To present a case of generalized granuloma annulare coexisting with metastatic carcinoma of unknown primary localization. Case report. A 58-year-old patient was diagnosed with metastases to lymph nodes of squamous cell carcinoma of unknown primary local-