Contact Sensitization in Patients with Chronic Leg Ulcers: Results of a 5-Year Retrospective Analysis

Raudonis, Tadas; Vankevičiūtė, Rasa Aurelija; Lideikaitė, Andrė; Grigaitytė, Anna Greta; Grigaitienė, Jūratė

doi:10.1097/01.asw.0000582628.52901.43

Cited by 11 publications

(8 citation statements)

References 13 publications

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“…Contact allergies were also described with QAC contained in topical medicinal products. For example, contact allergy was found to be common in patients using BAC-containing topical medicine for chronic leg ulcers or stasis dermatitis, with a sensitization prevalence ranging from 7% to 18.6% ( Saap et al, 2004 ; Barbaud et al, 2009 ; Valois et al, 2015 ; Raudonis et al, 2019 ; Silverberg et al, 2021 ). Another condition, flexural eczema (eczema affecting the skin where the joint bends with low pruritic lesions) and irritant dermatitis were also reported after the use of BAC in antiseptic bath oil at high concentrations ( Ling and Highet, 2000 ; Loo et al, 2003 ; Storer et al, 2004 ; Hann et al, 2007 ).…”

Section: Quaternary Ammonium Compounds-associated Delayed Hypersensit...mentioning

confidence: 99%

Quaternary ammonium compounds in hypersensitivity reactions

et al. 2022

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Quaternary ammonium compounds (QAC) are commonly used disinfectants, antiseptics, preservatives, and detergents due to their antibacterial property and represent the first used biocides before phenolic or nitrogen products. Their common structure consists of one or more quaternary ammonium bound with four lateral substituents. Their amphiphilic structure allows them to intercalate into microorganism surfaces which induces an unstable and porous membrane that explains their antimicrobial activity towards bacteria, fungi, and viruses. QAC are thus found in many areas, such as household products, medicines, hygiene products, cosmetics, agriculture, or industrial products but are also used in medical practice as disinfectants and antiseptics and in health care facilities where they are used for cleaning floors and walls. QAC exposure has already been involved in occupational asthma in healthcare workers or professional cleaners by many authors. They also have been suggested to play a role in contact dermatitis (CD) and urticaria in workers using cosmetics such as hairdressers or healthcare workers, inciting reglementary agencies to make recommendations regarding those products. However, distinguishing the irritant or sensitizing properties of chemicals is complex and as a result, the sensitizing property of QAC is still controverted. Moreover, the precise mechanisms underlying the possible sensitization effect are still under investigation, and to date, only a few studies have documented an immunological mechanism. Besides, QAC have been suggested to be responsible for neuromuscular blocking agents (NMBA) sensitization by cross-reactivity. This hypothesis is supported by a higher prevalence of quaternary ammonium (QA)-specific IgE in the professionally exposed populations, such as hairdressers, cleaners, or healthcare workers, suggesting that the sensitization happens with structurally similar compounds present in the environment. This review summarizes the newest knowledge about QAC and their role in hypersensitivities. After describing the different QAC, their structure and use, the most relevant studies about the effects of QAC on the immune system will be reviewed and discussed.

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Section: Quaternary Ammonium Compounds-associated Delayed Hypersensit...mentioning

confidence: 99%

Quaternary ammonium compounds in hypersensitivity reactions

et al. 2022

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“…A highly exsudative infection of the skin between the toes caused by gram‐negative bacteria or by mixed infections including these bacteria [26] is called ‘gram‐negative bacterial toe web infection’ (GNBTWI) oder ‘toe web intertrigo’ [27]. The lesions usually start between the toes and spread in a proximal direction [28]. Frequently, patients report a history of tinea pedis between the toes that has been treated with topical antimycotics for a prolonged period.…”

Section: Intertriginous Dermatitismentioning

confidence: 99%

Moisture‐associated skin damage (MASD): A best practice recommendation from Wund‐D.A.CH.

Dissemond

Assenheimer

Gerber³

et al. 2021

J Deutsche Derma Gesell

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Summary Wund‐D.A.CH., as the umbrella organization of German‐speaking wound treatment societies, has currently developed a best practice recommendation for skin damage caused by body fluids, which is known as moisture‐associated skin damage (MASD) in English‐speaking countries. In this expert consensus, the diseases incontinence‐associated dermatitis (IAD), intertriginous dermatitis, including intertrigo, gram‐negative bacterial toe web infection and toxic contact dermatitis, including periwound and peristomal dermatitis are presented in a differentiated manner. A common feature of these clinical diseases is a deterioration of skin integrity due to prolonged exposure to body fluids such as urine, stool, sweat or wound exudate with associated physical‐irritative and/or chemical irritation. In addition, other comorbidities and cofactors play an important role. The diagnosis of these interdisciplinary and interprofessionally relevant MASD is difficult in everyday clinical practice because there are currently no uniform definitions and many relevant differential diagnoses. Effective strategies for the prevention and therapy of these skin diseases are, for example, continence management, use of efficient, absorbent aids with good retention as well as consistent skin protection and adequate skin care. Another important aspect is the education of patients and relatives about the origin, treatment and prevention of MASD.

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“…Im englischen Sprachraum wird oft die Bezeichnung gram‐negative bacterial toe web infection (GNBTWI) oder toe web intertrigo verwendet [27]. Die Hautveränderungen beginnen meist in den Zehenzwischenräumen und breiten sich nach proximal aus [28]. Bei den Patienten besteht initial oft eine Tinea pedis der Zehenzwischenräume, die über einen längeren Zeitraum mit antimykotischen Externa behandelt wurde.…”

Section: Intertriginöse Dermatitisunclassified

Flüssigkeits‐assoziierte Hautschäden (FAH): Eine Best Practice Empfehlung von Wund‐D.A.CH

Dissemond

Assenheimer

Gerber

et al. 2021

J Deutsche Derma Gesell

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Zusammenfassung Wund‐D.A.CH. hat sich als Dachverband deutschsprachiger Wundbehandlungs‐Fachgesellschaften in dieser Best Practice Empfehlung mit Flüssigkeits‐assoziierten Hautschäden (FAH) befasst, die im englischsprachigen Raum als moisture‐associated skin damage (MASD) bezeichnet werden. In diesem Expertenkonsens werden die Krankheitsbilder Inkontinenz‐assoziierte Dermatitis (IAD), intertriginöse Dermatitis, inklusive Intertrigo, gramnegativer Fußinfekt und toxische Kontaktdermatitis, inklusive Wundumgebungsdermatitis und peristomale Dermatitis differenziert vorgestellt. Die Krankheitsbilder haben gemeinsam, dass es infolge der Verschlechterung der Hautintegrität durch längere Exposition gegenüber Körperflüssigkeiten wie Urin, Stuhl, Schweiß oder Wundexsudat zu physikalisch‐irritativer und/oder chemischer Reizung kommt. Zudem spielen weitere Begleiterkrankungen und Kofaktoren eine wichtige Rolle. Die Diagnostik der interdisziplinär und interprofessionell relevanten FAH gestaltet sich im klinischen Alltag schwierig, da es aktuell keine einheitlichen Definitionen und viele relevante Differenzialdiagnosen gibt. Wirksame Strategien der Prävention und Therapie sind beispielsweise Kontinenzmanagement, Verwendung leistungsfähiger aufsaugender Hilfsmittel mit guter Retention sowie konsequenter Hautschutz und adäquate Hautpflege. Ein weiterer wichtiger Aspekt ist die Edukation von Patienten und Angehörigen über die Entstehung, Behandlung und Vermeidung der FAH.

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Contact Sensitization in Patients with Chronic Leg Ulcers: Results of a 5-Year Retrospective Analysis

Cited by 11 publications

References 13 publications

Quaternary ammonium compounds in hypersensitivity reactions

Quaternary ammonium compounds in hypersensitivity reactions

Moisture‐associated skin damage (MASD): A best practice recommendation from Wund‐D.A.CH.

Flüssigkeits‐assoziierte Hautschäden (FAH): Eine Best Practice Empfehlung von Wund‐D.A.CH

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