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24 - Allergic Contact Dermatitis Flashcards

1
Q

ACD accounts for _____% of new incident cases of contact dermatitis

A

20

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2
Q

Most prevalent contact allergens (retrospective study between 1996 and 2007

A

Nickel
Thimerosal
Fragrance mix

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3
Q

Y/N: Adults are more likely to develop ACD than children

A

No - equally likely

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4
Q

Increase in _____ (2) allergies with increasing age

A

Fragrance

Preservative

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5
Q

_____ sensitivity much higher among women

A

Nickel

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6
Q

Significant risk factor for the development of nickel allergy

A

Pierced ears

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7
Q

Sensitizing substance in poison ivy, poison oak, or poison sumac

A

Uroshiol

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8
Q

Key symptom for ACD

A

Pruritus

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9
Q

Type of ACD that occurs at the periphery of allergen application; linked primarily to exotic woods and topical medicaments

A

Erythema multiforme-like ACD

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10
Q

Type of ACD mainly described in Asian-ethnicity populations

A

Pigmented ACD

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11
Q

Type of ACD mainly observed on the lower legs and/or feet; associated with rubber and textile dyes

A

Purpuric ACD

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12
Q

Type of ACD based only on histopathologic criteria

A

Lymphomatoid ACD

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13
Q

Lymphomatoid ACD: presence of significant dermal infiltrate displaying features of

A

Pseudolymphoma

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14
Q

ACD hypersensitivity reaction

A

Cell-mediated (type IV) delayed hypersensitivity

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15
Q

Phases in the development of ACD

A
  1. Sensitization

2. Elicitation

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16
Q

Pigmented ACD also known as

A

Riehl melanosis

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17
Q

Unprocessed allergens which are typically small, lipophilic molecules with a low molecular weight (<500 daltons)

A

Haptens

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18
Q

Complete antigen is made up of

A

Hapten-protein complex

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19
Q

Hapten penetrates the skin and binds with

A

Epidermal carrier proteins

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20
Q

Sensitization phase generally lasts

A

10-15 days

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21
Q

Primary cells responsible for contact sensitization

A

CD1a+/CD141+ dermal dendritic cells

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22
Q

Most important population of cells in allergic sensitization

A

Th1/Tc1 subset

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23
Q

ACD phase that corresponds to clinical disease

A

Elicitation phase

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24
Q

Antigen-specific effector T cells containing their target antigen interact with antigen-presenting cells and cluster around postcapillary venukes

A

Inducible skin-associated lymphoid tissue

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25
Diagnostic algorithm for ACD (2)
1. Topographic approach | 2. Allergen-specific approach
26
Single most important clue to the diagnosis of ACD
Dermatitis distribution
27
Topographic approach does not hold in (2)
Ectopic ACD | Airborne ACD
28
One of the most potent sensitizers known and widely used as an ingredient in hair dyes
Para-phenylenediamine
29
Chemical substance used in permanent wave solutions
Glyceryl monothioglycolate
30
Most women allergen accounting for isolated eye dermatitis (2007 NACDG analysis)
Gold
31
_____ of patients with isolated cheilitis - without other areas of dermatitis - are typically found to have an allergen as a contributing factor
1/3
32
Most common cause of contact allergy in patch-tested patients with cheilitis
Fragrance mix | Balsam of Peru
33
Repeated application of fragrances to the anterior neck may result in the appearance of a dermatitic plaque on the neck which has been coined the
Atomizer sign
34
Y/N: ACD of the axillae does not spare the axillary vault
No - relative sparing of axillary vault
35
80% of occupational skin disease
Hand dermatitis
36
Scattered generalized distribution is defined as (2)
Involvement of more than 3 body sites or | Involvement of 3 body sites if the sites are the trunk, arms, and legs
37
Higher incidence of scattered generalized distribution in (2)
Males | History of atopic dermatitis
38
Systemic contact dermatitis in which erythema of the buttocks and upper thighs are seen
Baboon syndrome
39
Dietary _____ (2) are associated with dyshidrosiform hand eczema
Nickel | Balsam of Peru
40
Potential cross-reactors with balsam of Peru
Tomatoes, citrus peel/zest, chocolate, ice cream, wine, beer, dark-colored sodas, spices such as cinnamon, cloves, curry and vanilla
41
ACD syndrome stage 1
Localized ACD
42
ACD syndrome stage 2
Regional dissemination of ACD
43
ACD syndrome stage 3A
Generalized or distant involvement of ACD
44
ACD syndrome stage 3B
Systemic exposure resulting in systemic contact dermatitis
45
Most common cause of ACD
Metals
46
Most frequently patch test-positive allergen worldwide
Nickel
47
Spot test for nickel
Dimethylgloxime
48
Added to other metals to increase the overall strength of an alloy; used in ceramics, paints, and tattoos to impart a blue color
Cobalt
49
Irritant effect from a deposition of cobalt within eccrine glands
Pseudopurpuric appearance
50
Sport test for cobalt
2-nitroso-1-naphthol-4-sulfonic acid
51
Has long been considered the classic marker for allergy to leather goods and wet cement
Chromium (potassium dichromate)
52
Aside from chromium, also a relevant marker for allergy to both leather and cement
Cobalt
53
Controversial allergen as it can often give a positive patch test but fail to meet standards for relevance; frequently manifests extremely delayed hypersensitivity
Gold
54
Colorless gas with preservative and disinfectant properties; found in glues, biocides, and photographic development agents
Formaldehyde
55
Among the preservatives, the most common cosmetic allergen is
Quaternium-15
56
Liked to two forms of ACD: 1) involves glues 2) involve wrinkle-free our permanent-press fabrics and clothing
Formaldehyde-containing resins
57
Two major non-formaldehyde releasing preservatives
Methyldibromoglutaronitrile/phenoxyethanol (MDBGN/PE) | Methylchloroisothiazolinone/methylisothiazolinone (MCI/MI)
58
Most allergic reactions to nonreleasers of formaldehyde originate from
Personal care products such as creams, lotions, wet wipes, liquid soaps, and medicated tissue and toilet paper
59
Up to _____% of the general population are allergic to fragrances
4
60
Main substances used by most patch test groups for screening for fragrance allergy
M. pereirae Fragrance mix I Fragrance mix II
61
2 antibiotics most commonly implicated in ACD
Neomycin | Bacitracin
62
Persists in its ability to cause ACD: died or permed hair
Permed hair
63
Adulterant added to natural henna; darkened the henna tattoo
Para-phenylinediamine
64
Individuals allergic to either the rubber accelerator/vulcanizer chemicals (or to latex itself) can safely use _____ gloves
Vicryl
65
Carbamates, mercaptobenzothiazole and thiuram are classified as
Rubber accelerator/vulcanizer chemicals
66
Safest steroid from an allergic standpoint
Desoximethasone ointment
67
Least-allergenic steroids belong to class
C
68
Thin-layer rapid-use epicutaneous (TRUE) test consists of
3 panels with a total of 35 allergens plus 1 blank control
69
Substance is applied to the cubital fossa twice a day for 1 to 3 weeks to simulate real life use
Repeat open application test or use test
70
Useful if testing liquid products with irritant potential; substance or dilutions of test substance applied to skin surface covering 1 cm2, allowed to evaporate and dry, then covered with hypoallergenic tape
Semiopen patch test
71
Represents a weak nonvesicular reaction but with palpable erythema
+
72
Represents a strong (edemstous or vesicular) reaction
++
73
Represents an extreme (bullous or ulcerative) reaction
+++
74
Represenrs macular (nonpalpable) erythema
Doubtful
75
Irritant patch test reactions can be classified into: (3)
Erythematous reactions Purpuric reactions Pustular reactions
76
Purpuric reactions with petechial hemorrhage seen in approximately 5% of patients tested to
Cobalt chloride (punctate purpura of cobalt)
77
Pustular reactions are most commonly encountered with
Metalic salts
78
Early appearing: allergic vs irritant pattern
Irritant
79
Usually spreads, slowly disappearing: allergic vs irritant pattern
Allergic
80
Mercuric preservative that commonly causes positive patch test reactions but very seldom accounts for the patient’s dermatitis; present in vaccines
Thimerosal
81
Clinical relevance assessment classification
Current: possible or probable Past Doubtful
82
Most common side effects of patch testing
Itching at the site of a positive test reaction | Irritation or pruritus from tape application
83
Persistent patch test reactions are defined as patch test reactions that persist for
More than 1 month
84
Persistent patch test reactions occur most commonly from
Gold salts
85
Anaphylasix most often reported with
Ammonium persulfate

FD9 (108 decks)

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