Topical immunotherapy with dinitro- chlorobenzene: Safety concerns

Singh, Gurcharan; Lavanya, M

doi:10.4103/0378-6323.55402

Cited by 3 publications

(4 citation statements)

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Section: Discussionmentioning

confidence: 99%

“…Clobetasol propionate 0.05% is an ultra-potent TC; meanwhile, triamcinolone acetonide 0.02% is regarded as a mid-strength TC. 32 Thus, it might be reasonable to postulate that the incidence of PIH with clobetasol propionate 0.05% was lower because of its more potent effect in reducing inflammation. Lueangarun et al 16 reported that PMCZ cream was not superior to triamcinolone acetonide 0.02% in reducing CO 2 laser postoperative downtime; however, both regimens reduced redness and swelling.…”

Section: Topical Corticosteroidsmentioning

confidence: 99%

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Postinflammatory hyperpigmentation after carbon dioxide laser: review of prevention and risk factors

2023

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The CO2 laser has been widely utilized in dermatology; its expanding clinical applications include the management of neoplastic lesions, benign growths, cosmetic conditions, and reactive disorders. The laser’s popularity is mainly due to the high precision and short recovery time this technology provides. However, postinflammatory hyperpigmentation (PIH) has been one of the challenging adverse effects of the CO2 laser. Therefore, several modalities have been studied for the prevention of PIH following CO2 laser treatment. This review aims to analyze the incidence of PIH after CO2 laser therapy, identify its risk factors, and assess the efficacy of the examined treatment modalities in preventing PIH. Pubmed and Embase databases were searched for this study, and relative clinical trials were included in the review. Descriptive findings—including age, gender, skin type, types of intervention, and incidence of PIH—were reported. When appropriate, the incidence of PIH was compared across each possible individual factor, such as skin type, gender, and type of intervention. A total of 211 articles were identified, and 14 relevant articles were included in this review. Seventy percent of the subjects were females (n=219), and 30% were males (n=94), with a mean age of 30 years (SD=7.8). The most common skin types were type IV (59%) followed by type III (25%). In total, eight studies investigated the prevention of PIH. The incidence of PIH after CO2 laser significantly varies between studies, and differs based on the type of intervention. The studies indicate that the use of Clobetasol propionate 0.05% and fusidic acid cream appeared to effectively reduce PIH, recording an incidence rate of 39% and 53.3%, respectively. The Fitzpatrick-skin-phenotype did not appear to influence the risk of PIH. There is a lack of high-powered clinical studies analyzing the incidence of PIH after CO2 laser treatment and the associated risk factors. PIH occurrence may be related to inflammation resulting from thermal damage by the CO2 laser. Consequently, the use of postoperative topical medications with anti-inflammatory properties might reduce its incidence. The use of ultra-potent topical corticosteroids and topical fusidic acid appeared to reduce PIH, possibly reducing postoperative inflammation effectively. Similarly, platelet-containing plasma may be beneficial in reducing CO2 side effects, including PIH. However, more studies are needed to further establish the influence of skin type on PIH and investigate modalities to reduce PIH occurrence after CO2 laser use.

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Section: Discussionmentioning

confidence: 99%

Section: Topical Corticosteroidsmentioning

confidence: 99%

Postinflammatory hyperpigmentation after carbon dioxide laser: review of prevention and risk factors

2023

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“…Ever since the contact sensitizers were introduced in clinical practice, the safety of the compounds has been debated. DNCB has been found to be mutagenic on Ames test, although the results remain controversial [58,[202][203][204][205]. The usual manufacturing method of DNCB produces a variety of contaminants, most of which are due to the incomplete composition and degradation [205].…”

Section: Adverse Effects and Safety Concerns Of Topical Immunotherapymentioning

confidence: 99%

“…Some claimed the contaminants are the mutagens [ 205 ], while others argued that DNCB itself is the one [ 204 ]. Although mutagenicity cannot be equated to carcinogenicity [ 203 ], the use of DNCB has declined and safer compounds such as SADBE and DPCP are now recommended [ 202 , 204 , 206 ]. SADBE does not cause mutagenicity on Ames test [ 207 ].…”

Section: Adverse Effects and Safety Concerns Of Topical Immunotherapymentioning

confidence: 99%

Use of Contact Immunotherapy in the Treatment of Skin Diseases Other than Alopecia Areata

Lai

Tsai

2022

Dermatol Ther (Heidelb)

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For decades, contact immunotherapy with dinitrochlorobenzene, diphencyprone, and squaric acid dibutylester has played an important role in both clinical practice and scientific research. It is listed as the first-line treatment for extensive alopecia areata and was more recently approved for melanoma treatment as an orphan drug in the USA. Moreover, owing to the relative low cost and safety, topical immunotherapy has also been used in many infectious, neoplastic, and inflammatory dermatological diseases. It is especially valuable in vulnerable groups, for cosmetic/pain sensitive areas, or for multiple lesions. In this review, we summarize the current evidence supporting the use of contact immunotherapy for treatment of skin diseases, from articles collected from PubMed database. Owing to space limitation and already numerous studies focusing on alopecia areata, we include only skin diseases other than alopecia areata. In addition to diseases that have been reported to be treated by contact immunotherapy, the hypothesized mechanism, prognosis prediction, efficacy, and safety of these topical agents are discussed.

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