Dermatitis de contacto alérgica

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Dermatitis de contacto alergica

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  • Cocamidopropylbetaine (CAPB) is an organic compound derived from coconut oil 
  • A, e: +B-d, i-k: ++M-n: NiSO4F-h: 48 hrs, 72 hrs, 96 hrs
  • A, e: +B-d, i-k: ++M-n: NiSO4F-h: 48 hrs, 72 hrs, 96 hrs
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  • Dermatitis de contacto alérgica

    1. 1. Dr. Héctor Cuevas Castillejos
    2. 2. Respuesta inflamatoria cutánea Eczema Eritema  Prurito  Pápulas  Vesículas  Excoriaciones  Costras  Descamación Dermatitis World Allergy Organization. Disease Summaries: Contact Dermatitis. http://www.worldallergy.org/public/allergic_diseases_center/contactdermatitis/ (accessed 24 August 2013) Contacto de la piel con alguna sustancia de contacto X alérgica Hipersensibilidad tipo IV
    3. 3. Wright RC, Goldman, L. Contact Dermatitis: A historical perspective. International Journal of Dermatology, 1979;18: 665–668 Antecedentes históricos Papiro de Ebers (1500 A.C) “En el primer día la cabeza es pintada con una loción de frutas de palma y es envuelta, en el segundo día la cabeza se pinta con aceite de pescado…”
    4. 4. Wright RC, Goldman, L. Contact Dermatitis: A historical perspective. International Journal of Dermatology, 1979;18: 665–668 Antecedentes históricos Papiro de Ebers (1500 A.C) Antiguo Testamento (900 A.C.) “No haréis sajaduras en vuestro cuerpo por un muerto, ni os haréis tatuajes; yo soy el Señor” Levítico 19:28
    5. 5. Wright RC, Goldman, L. Contact Dermatitis: A historical perspective. International Journal of Dermatology, 1979;18: 665–668 Antecedentes históricos Papiro de Ebers (1500 A.C) Antiguo Testamento (900 A.C.) Celso (45 D.C.) “Úlceras producidas por cáusticos”
    6. 6. Wright RC, Goldman, L. Contact Dermatitis: A historical perspective. International Journal of Dermatology, 1979;18: 665–668 Antecedentes históricos Papiro de Ebers (1500 A.C) Antiguo Testamento (900 A.C.) Celso (45 D.C.) Paracelso (1491) “…efectos perniciosos que ejercen algunas profesiones sobre la piel…” De Morbis Metalicis
    7. 7. Wright RC, Goldman, L. Contact Dermatitis: A historical perspective. International Journal of Dermatology, 1979;18: 665–668 Antecedentes históricos Papiro de Ebers (1500 A.C) Antiguo Testamento (900 A.C.) Celso (45 D.C.) Georgius Agricola (1556 D.C.) Paracelso (1491) “…úlceras que sufren los mineros” De Re Metallica
    8. 8. Wright RC, Goldman, L. Contact Dermatitis: A historical perspective. International Journal of Dermatology, 1979;18: 665–668 Antecedentes históricos Papiro de Ebers (1500 A.C) Antiguo Testamento (900 A.C.) Celso (45 D.C.) Georgius Agricola (1556 D.C.) Paracelso (1491) Bernardino Ramazzini (1713) “…enfermedades que aquejan a los artesanos…” De Morbis Artificum
    9. 9. Wright RC, Goldman, L. Contact Dermatitis: A historical perspective. International Journal of Dermatology, 1979;18: 665–668 Antecedentes históricos Revolución Industrial (1750)
    10. 10. Wright RC, Goldman, L. Contact Dermatitis: A historical perspective. International Journal of Dermatology, 1979;18: 665–668 Antecedentes históricos Description and treatment of cutaneous diseases • Psoriasis palmar de los zapateros • Psoriasis difusa de los panaderos • Eczema de las lavanderas Revolución Industrial (1750) Willan (1798 D.C.)
    11. 11. Wright RC, Goldman, L. Contact Dermatitis: A historical perspective. International Journal of Dermatology, 1979;18: 665–668 Antecedentes históricos Leçons théoriques et cliniques sur les affections cutanées parasitaires Características cutáneas de 40 profesiones Revolución Industrial (1750) Willan (1798 D.C.) Bazin (1862 D.C.)
    12. 12. Rycroft RJG. Textbook of Contact Dermatitis. Springer, Jan 1, 2001 - 1114 pages Antecedentes históricos Funktionelle Hautprüfung Describe el proceso de hipersensibilidad retardada ante químicos simples Revolución Industrial (1750) Willan (1798 D.C.) Bazin (1862 D.C.) Jadassohn (1895 D.C.)
    13. 13. Nater JP. Oscar Wilde's skin disease: allergic contact dermatitis? Contact Dermatitis. 1992 Jul;27(1):47-9. Antecedentes históricos Dermatitis en cara, brazos, pecho, espalda Revolución Industrial (1750) Willan (1798 D.C.) Bazin (1862 D.C.) Jadassohn (1895 D.C.) Oscar Wilde (1900)
    14. 14. Antecedentes históricos Grupo Internacional de Investigación para la Dermatitis de Contacto Revolución Industrial (1750) Willan (1798 D.C.) Bazin (1862 D.C.) Jadassohn (1895 D.C.) Oscar Wilde (1900) ICDRG (1966) International Contact Dermatitis Research Group. http://www.icdrg.org/ (accessed 24 August 2013)
    15. 15. Epidemiología Peiser M et al. Allergic contact dermatitis: epidemiology, molecular mechanisms, in vitro methods and regulatory aspects. Current knowledge assembled at an international workshop at BfR, Germany. Cell Mol Life Sci [Internet]. 2012 [cited 2012 Mar];69(5):763-81. In: Ovid MEDLINE(R) [Internet].  15 – 20 % de la población mundial
    16. 16. Epidemiología  Profesionistas más afectados • Industria metalúrgica • Estilistas • Trabajadores de la Salud • Industria alimentaria • Trabajadores de la Construcción • Pintores Peiser M et al. Allergic contact dermatitis: epidemiology, molecular mechanisms, in vitro methods and regulatory aspects. Current knowledge assembled at an international workshop at BfR, Germany. Cell Mol Life Sci [Internet]. 2012 [cited 2012 Mar];69(5):763-81. In: Ovid MEDLINE(R) [Internet].
    17. 17. Epidemiología Thyssen JP. The epidemiology of contact allergy in the general population--prevalence and main findings. Contact Dermatitis. 2007 Nov;57(5):287-99.  Sensibilización: (12.5 – 40.6 %) 21 %
    18. 18. Epidemiología Thyssen JP. The epidemiology of contact allergy in the general population--prevalence and main findings. Contact Dermatitis. 2007 Nov;57(5):287-99.  Sensibilización: • Níquel • Timerosal • Fragancias
    19. 19. Pratt MD et al. North American Contact Dermatitis Group patch-test results, 2001–2002 study periods. Dermatitis. 2004;15:176-83. Níquel, Neomicina, Bálsamo de Perú
    20. 20. Britton et al. The British standard series of contact dermatitis allergens: Validation in clinical practice and value for clinical governance. Br J Dermatol. 2003;148:259-64. Níquel, Fragancias, Bálsamo de Perú
    21. 21. García-Bravo B et al. Estudio epidemiológico de la dermatitis alérgica de contacto en España (2001). Actas Dermosifiliogr. 2004;95:14-24. Níquel, Cobalto, Dicromato Potásico
    22. 22. Lazarov A. European standard series patch test results from a contact dermatitis clinic in Israel during the 7 year period from 1998 to 2004. Contact Dermatitis. 2006;55:73-6. Níquel, Fragancias, Dicromato Potásico
    23. 23. Pratt MD et al. North American Contact Dermatitis Group patch-test results, 2001–2002 study periods. Dermatitis. 2004;15:176-83. Níquel, Fragancias, Cobalto
    24. 24. Olumide Y M. Contact dermatitis in Nigeria. Contact Dermatitis 1985: 12: 241–246. Factores ambientales
    25. 25. Barros M A, Baptista A, Correia T M, Azevedo F. Patch testing in children: a study of 562 schoolchildren. Contact Dermatitis 1991: 25: 156–159. Factores culturales
    26. 26. Menne T, Rasmussen K. Regulation of nickel exposure in Denmark. Contact Dermatitis 1990: 23: 57–58. Factores culturales
    27. 27. Menne T et al. Regulation of nickel exposure in Denmark. Contact Dermatitis 1990: 23: 57–58. Factores político-sociales
    28. 28. Dermatitis de contacto Alérgica Irritativa World Allergy Organization. Disease Summaries: Contact Dermatitis. http://www.worldallergy.org/public/allergic_diseases_center/contactdermatitis/ (accessed 24 August 2013) 80%20%
    29. 29. Tipo I (Anticuerpos IgE) Tipo II (Anticuerpos IgG/IgM) Tipo III (Anticuerpos IgG/IgM) Tipo IV (Linfocitos T) Tipo IVa Th1 Tipo IVb Th2 Tipo IVc LTc Tipo IVd LTh17 Antígeno Antígeno soluble (alergeno) Antígeno celular o asociado a la matriz Antígenos solubles Antígenos solubles Antígenos solubles Antígeno asociado a células Antígeno asociado a células Mecanismos efectores FCɛRI o FCɤRIII activación dependiente de células cebadas, con liberación de mediadores/citocinas Células FCɤR+ (fagocitos, células NK), complemento Células FCɤR+, complemento Activación de macrófagos Activación de eosinófilos Activación de linfocitos Tc Activación de neutrófilos Ejemplos • Anafilaxia sistémica • Asma • Rinitis alérgica • Urticaria • Angioedema IIa: o Ciertas reacciones a fármacos o Reacciones a incompatibilidad sanguínea IIb: o Enfermedad de Graves o Urticaria idiopática crónica • Reacción de Arthus • Otras reacciones mediadas por complejos inmunes o Enfermedad del suero o Endocarditis bacteriana subaguda • Dermatitis de contacto • Diabetes tipo I • Reacción tuberculínica • Inflamación alérgica crónica o Asma crónica o Rinitis alérgica crónica • Sindrome de Stevens- Johnson • Epidermolisis epidérmica tóxica • Pustulosis exantemática • Psoriasis pustular • Enfermedad de Behcet Uzzaman A and Cho S. Chapter 28: Classification of hypersensitivity reactions. Allergy Asthma Proc 2012; 33: S96 -9
    30. 30. Dermatitis de contacto Alérgica Irritativa Frecuencia Etiología Antígeno Sensibilización Concentración Diagnóstico Apariencia Demarcación Síntomas Latencia Resolución 20% 80% Hipersensibilidad tipo IV No inmunológico Haptenos No Sí No Independiente Dependiente Pruebas de Parche Historia clínica / Examen físico Herro E. Contact Dermatitis: Part I. Presented at the Conferences On-Line Allergy of the Children’s Mercy Hospitals & Clinicis. Kansas city, Missouri, USA. 2011 http://www.youtube.com/watch?v=6ICTSX-xqSM (accessed 24 August 2013) Eritema macular, pápulas, vesículas, bulas, y/o excoriaciones Descamación, eritema difuso, pápulas, excoriaciones. No Sí Prurito Dolor urente 72 – 120 horas 48 horas 1 -2 semanas 90 horas
    31. 31. Werfel T, Kapp A. Atopic dermatitis and allergic contact dermatitis. In: Holgate ST, Church MK, Broide DH, Martinez FD (eds.) Allergy. 4th edition. Edinburgh, SCT: Elsevier; 2012. p263-276 24 – 48 horas > 48 horas
    32. 32. Werfel T, Kapp A. Atopic dermatitis and allergic contact dermatitis. In: Holgate ST, Church MK, Broide DH, Martinez FD (eds.) Allergy. 4th edition. Edinburgh, SCT: Elsevier; 2012. p263-276 24 – 48 horas > 48 horas  Infiltrado inflamatorio linfocitario en dermis y epidermis  Eosinófilos en dermis y epidermis  Basófilos y células cebadas  Espongiosis importante  Infiltrado inflamatorio linfocitario menos prominente  Infiltrado de macrófagos  Espongiosis leve y microvesículas  Diagnóstico diferencial  Enfermedades vesiculares  Impétigo buloso  Herpes simplex  Diagnóstico diferencial  Eczema numular  Procesos infiltrativos  Rosácea  Sarcoidosis  Linfoma cutáneo de células T  Eritrodermia  Psoriasis  Reacción a fármacos  Síndrome de Sézary
    33. 33. Fisiopatología
    34. 34. Kaplan DH et als. Early immune events in the induction of allergic contact dermatitis. Nature Reviews Immunology 12, 114- 124 (February 2012) Pre-haptenos Pro-haptenos Haptenos Célula cutánea • Especies reactivas de oxígeno (ERO) • ATP • Otros DAMPs Ácido hialurónico de bajo peso molecular P2X7 Inflamosoma Activación caspasa 1 Pro-IL-1β Pro-IL-18 TLR-2 TLR-4 MYD 88 TRIF NFKB IL-1β IL-18 IFN-ɑ IFN- β IRF3 IL-1β IL-18 IFN-ɑ IFN- β Níquel
    35. 35. Alergenos del Año 2013 Metilisotiazolinona Castanedo-Tardana 2012 Acrilatos Sasseville 2011 Dimetil Fumarato Bruze et al. 2010 Neomicina Sasseville 2009 Dialquil Tioureas Anderson 2008 Níquel Komik 2007 Fragancias Storrs 2006 Fenil E Diaminas (PPD) DeLeo 2005 Corticoesteroides Isaksson 2004 Cocoamidopropil Betaína Fowler J 2003 Bacitracina Sood 2002 Timerosal Belsito 2001 Oro Fowler 2000 Tintes azules dispersables Storrs Herro E. Contact Dermatitis: Part I. Presented at the Conferences On-Line Allergy of the Children’s Mercy Hospitals & Clinicis. Kansas city, Missouri, USA. 2011 http://www.youtube.com/watch?v=6ICTSX-xqSM (accessed 24 August 2013)
    36. 36. Manifestaciones clínicas
    37. 37. Lacey A. BBC News Health. http://www.bbc.co.uk/news/health-22956874 (accesed 24 September 2013)
    38. 38. Bercovitch L , and Luo J CMAJ 2008;178:23-24
    39. 39. Hillen, U., Haude, M., Erbel, R. and Goos, M. (2002), Evaluation of metal allergies in patients with coronary stents. Contact Dermatitis, 47: 353–356.
    40. 40. L. Host: A case of severe metal hypersensitivity post tibial plating. The Internet Journal of Orthopedic Surgery. 2009 Volume 11 Number 2.
    41. 41. Diagnóstico
    42. 42. Abordaje del paciente Antecedente de exposición Localización: Pistas geográficas Prueba de Parche • Agente identificado • Entorno ambiental • Párpados: fragancias, níquel, formaldehíd o • Mano: Quarternio 15, CAPB • Selección adecuada de los antígenos
    43. 43. Es el único método práctico, científico y objetivo para el diagnóstico Prueba de Parche Herro E. Contact Dermatitis: Part I. Presented at the Conferences On-Line Allergy of the Children’s Mercy Hospitals & Clinicis. Kansas city, Missouri, USA. 2011 http://www.youtube.com/watch?v=6ICTSX-xqSM (accessed 24 August 2013)
    44. 44. Escribir Desprender Aplicación Colocación Retiro Lectura temprana Clasificación Lectura tardía
    45. 45. Stefan Wöhrl et al. Copper allergy revisited. Journal of the American Academy of Dermatology Volume 45, Issue 6, Pages 863-870, December 2001
    46. 46. Stefan Wöhrl et al. Copper allergy revisited. Journal of the American Academy of Dermatology Volume 45, Issue 6, Pages 863-870, December 2001
    47. 47. Pruebas de Parche Estandarizados No estandarizados Herro E. Contact Dermatitis: Part I. Presented at the Conferences On-Line Allergy of the Children’s Mercy Hospitals & Clinicis. Kansas city, Missouri, USA. 2011 http://www.youtube.com/watch?v=6ICTSX-xqSM (accessed 24 August 2013)
    48. 48. T.R.U.E. Test AllergEAZE Trolab - Hermal Dormer 36 520 380 548 Estandarizados
    49. 49. T.R.U.E. Test® Panel 1.2 1. Nickel sulfate 2. Wool alcohols 3. Neomycin sulfate 4. Potassium dichromate 5. Caine mix 6. Fragrance mix 7. Colophony 8. Paraben mix 9. Negative control 10. Balsam of Peru 11. Ethylenediamine dihydrochloride 12. Cobalt Dichloride Panel 2.2 13. p-tert-Butylphenol formaldehyde resin 14. Epoxy resin 15. Carba mix 16. Black rubber mix 17. Cl+ Me- isothiazolinone (MCI/MI) 18. Quaternium-15 19. Methyldibromo glutaronitrile 20. p-Phenylenediamine 21. Formaldehyde 22. Mercapto mix 23. Thimerosal 24. Thiuram mix Panel 3.2 25. Diazolidinyl urea 26. Quinoline mix 27. Tixocortol-21-pivalate 28. Gold sodium thiosulfate 29. Imidazolidinyl urea 30. Budesonide 31. Hydrocortizone-17-butyrate 32. Mercaptobenzothiazole 33. Bacitracin 34. Parthenolide 35. Disperse blue 106 36. 2-Bromo-2-nitropropane-1,3- diol (Bronopol)
    50. 50. Seleccionar Desprender Aplicación Escribir
    51. 51. T.R.U.E. Test AllergEAZE Trolab - Hermal Dormer 36 520 380 550 Estandarizados
    52. 52. Dormer® 1. European Baseline Series 2. International Comprehensive Baseline Series 3. Bakery Series 4. Corticoesteroids Series 5. Cosmetic Series 6. Cutaneous Adverse Drug Reaction Series 7. Dental Screening 8. Dental Materials Patients 9. Dental Materials Staff 10. Epoxy Series 11. European Photopatch Baseline Series 12. European Photopatch Extended Series 13. Fragrance Series 14. Hairdressing Series 15. International Standard Series 16. Isocyanate Series 17. Leg Ulcer Series 18. Medicament Series 19. Metal Series 20. (Meth) Acrylate Series [Adhesives Dental & Other] 21. (Meth) Acrylate Series [Nails – Artificial] 22. (Meth) Acrylate Series [Printing] 23. Oil & Cooling Fluid Series 24. Photographic Chemicals Series 25. Plant Series 26. Plastics & Glues Series 27. Rubber Additives Series 28. Scandinavian Photo Patch 29. Shoe Series 30. Sunscreen Series 31. Textile Colours & Finish 32. Various Haptens 28 80 19 9 56 29 31 24 10 14 19 33 42 28 21 7 27 14 43 15 13 24 35 16 14 25 26 20 23 20 33 65 Trolab – Hermal® 1. Baseline Series (European) 2. Irritant control 3. Antioxidants 4. Bakery Allergens 5. Cosmetics 6. Cutting Oils I (current) 7. Cutting Oils II (historical) 8. Dental Materials 9. Disinfectants 10. Epoxy Resin Systems 11. Hairdressing 12. Industrial Biocides 13. Medicaments I - Antibiotics 14. Medicaments II - Antiseptics, Antimycotics 15. Medicaments III - Miscellaneous 16. Medicaments IV - Local Anaesthetics 17. Medicaments V - Corticosteroids 18. Medicaments VI - Ophthalmics 19. Metal Compounds 20. Methacrylates 21. Perfumes, Flavours 22. Photoallergens 23. Photographic Chemicals 24. Plants 25. Plastic Materials 26. Preservatives 27. Rubber Chemicals 28. Shoe Allergens 29. Sunscreen Agents 30. Textile and Leather Dyes 31. Vehicles, Emulsifiers 32. Miscellaneous 28 1 6 14 14 27 11 20 6 12 9 15 9 5 5 5 7 5 7 9 45 16 14 2 12 22 18 8 9 13 9 5 AllergEAZE® 1. Antibiotics / Antimycotics 2. Corticosteroids 3. Eye Medicaments 4. Local Anesthetics 5. Medicinal Substances (various) 6. Antimicrobials / Preservatives 7. Dye Colorants 8. External Agents / Emulsifiers 9. Food Aditives 10. Metal Compounds 11. Natural Origin & Plants 12. Perfumes & Flavors 13. Plastics / Glues 14. Rubber Chemicals 15. Supplemental Allergens 16. Core Allergen Series 17. Supplement Core Allergen Series 18. Australian Baseline Series 19. British Baseline Series 20. European Baseline Series 21. Japanese Standard Series 22. Minimum International Baseline Series 23. North American Standard Series 24. Supplement North American Standard Series 25. Bakery 26. Cosmetics 27. Cooling Lubricants (Metalworking) 28. Dental Screening Patients 29. Dental Screening Technicians / HCPs 30. Eyelid Dermatitis 31. Footwear 32. Hairdressing 33. Leg Ulcer 34. Metal Implants 35. Photoallergens 36. Photochemicals 37. Sunscreens 24 21 25 11 31 74 26 34 22 53 21 57 55 36 3 80 50 60 41 28 24 32 70 42 20 64 40 29 25 30 30 33 34 29 26 19 10
    53. 53. Dormer® 1. European Baseline Series 2. International Comprehensive Baseline Series 3. Bakery Series 4. Corticoesteroids Series 5. Cosmetic Series 6. Cutaneous Adverse Drug Reaction Series 7. Dental Screening 8. Dental Materials Patients 9. Dental Materials Staff 10. Epoxy Series 11. European Photopatch Baseline Series 12. European Photopatch Extended Series 13. Fragrance Series 14. Hairdressing Series 15. International Standard Series 16. Isocyanate Series 17. Leg Ulcer Series 18. Medicament Series 19. Metal Series 20. (Meth) Acrylate Series [Adhesives Dental & Other] 21. (Meth) Acrylate Series [Nails – Artificial] 22. (Meth) Acrylate Series [Printing] 23. Oil & Cooling Fluid Series 24. Photographic Chemicals Series 25. Plant Series 26. Plastics & Glues Series 27. Rubber Additives Series 28. Scandinavian Photo Patch 29. Shoe Series 30. Sunscreen Series 31. Textile Colours & Finish 32. Various Haptens 28 80 19 9 56 29 31 24 10 14 19 33 42 28 21 7 27 14 43 15 13 24 35 16 14 25 26 20 23 20 33 65 Trolab – Hermal® 1. Baseline Series (European) 2. Irritant control 3. Antioxidants 4. Bakery Allergens 5. Cosmetics 6. Cutting Oils I (current) 7. Cutting Oils II (historical) 8. Dental Materials 9. Disinfectants 10. Epoxy Resin Systems 11. Hairdressing 12. Industrial Biocides 13. Medicaments I - Antibiotics 14. Medicaments II - Antiseptics, Antimycotics 15. Medicaments III - Miscellaneous 16. Medicaments IV - Local Anaesthetics 17. Medicaments V - Corticosteroids 18. Medicaments VI - Ophthalmics 19. Metal Compounds 20. Methacrylates 21. Perfumes, Flavours 22. Photoallergens 23. Photographic Chemicals 24. Plants 25. Plastic Materials 26. Preservatives 27. Rubber Chemicals 28. Shoe Allergens 29. Sunscreen Agents 30. Textile and Leather Dyes 31. Vehicles, Emulsifiers 32. Miscellaneous 28 1 6 14 14 27 11 20 6 12 9 15 9 5 5 5 7 5 7 9 45 16 14 2 12 22 18 8 9 13 9 5 AllergEAZE® 1. Antibiotics / Antimycotics 2. Corticosteroids 3. Eye Medicaments 4. Local Anesthetics 5. Medicinal Substances (various) 6. Antimicrobials / Preservatives 7. Dye Colorants 8. External Agents / Emulsifiers 9. Food Aditives 10. Metal Compounds 11. Natural Origin & Plants 12. Perfumes & Flavors 13. Plastics / Glues 14. Rubber Chemicals 15. Supplemental Allergens 16. Core Allergen Series 17. Supplement Core Allergen Series 18. Australian Baseline Series 19. British Baseline Series 20. European Baseline Series 21. Japanese Standard Series 22. Minimum International Baseline Series 23. North American Standard Series 24. Supplement North American Standard Series 25. Bakery 26. Cosmetics 27. Cooling Lubricants (Metalworking) 28. Dental Screening Patients 29. Dental Screening Technicians / HCPs 30. Eyelid Dermatitis 31. Footwear 32. Hairdressing 33. Leg Ulcer 34. Metal Implants 35. Photoallergens 36. Photochemicals 37. Sunscreens 24 21 25 11 31 74 26 34 22 53 21 57 55 36 3 80 50 60 41 28 24 32 70 42 20 64 40 29 25 30 30 33 34 29 26 19 10
    54. 54. Dormer® 1. European Baseline Series 2. International Comprehensive Baseline Series 3. Bakery Series 4. Corticoesteroids Series 5. Cosmetic Series 6. Cutaneous Adverse Drug Reaction Series 7. Dental Screening 8. Dental Materials Patients 9. Dental Materials Staff 10. Epoxy Series 11. European Photopatch Baseline Series 12. European Photopatch Extended Series 13. Fragrance Series 14. Hairdressing Series 15. International Standard Series 16. Isocyanate Series 17. Leg Ulcer Series 18. Medicament Series 19. Metal Series 20. (Meth) Acrylate Series [Adhesives Dental & Other] 21. (Meth) Acrylate Series [Nails – Artificial] 22. (Meth) Acrylate Series [Printing] 23. Oil & Cooling Fluid Series 24. Photographic Chemicals Series 25. Plant Series 26. Plastics & Glues Series 27. Rubber Additives Series 28. Scandinavian Photo Patch 29. Shoe Series 30. Sunscreen Series 31. Textile Colours & Finish 32. Various Haptens 28 80 19 9 56 29 31 24 10 14 19 33 42 28 21 7 27 14 43 15 13 24 35 16 14 25 26 20 23 20 33 65 Trolab – Hermal® 1. Baseline Series (European) 2. Irritant control 3. Antioxidants 4. Bakery Allergens 5. Cosmetics 6. Cutting Oils I (current) 7. Cutting Oils II (historical) 8. Dental Materials 9. Disinfectants 10. Epoxy Resin Systems 11. Hairdressing 12. Industrial Biocides 13. Medicaments I - Antibiotics 14. Medicaments II - Antiseptics, Antimycotics 15. Medicaments III - Miscellaneous 16. Medicaments IV - Local Anaesthetics 17. Medicaments V - Corticosteroids 18. Medicaments VI - Ophthalmics 19. Metal Compounds 20. Methacrylates 21. Perfumes, Flavours 22. Photoallergens 23. Photographic Chemicals 24. Plants 25. Plastic Materials 26. Preservatives 27. Rubber Chemicals 28. Shoe Allergens 29. Sunscreen Agents 30. Textile and Leather Dyes 31. Vehicles, Emulsifiers 32. Miscellaneous 28 1 6 14 14 27 11 20 6 12 9 15 9 5 5 5 7 5 7 9 45 16 14 2 12 22 18 8 9 13 9 5 AllergEAZE® 1. Antibiotics / Antimycotics 2. Corticosteroids 3. Eye Medicaments 4. Local Anesthetics 5. Medicinal Substances (various) 6. Antimicrobials / Preservatives 7. Dye Colorants 8. External Agents / Emulsifiers 9. Food Aditives 10. Metal Compounds 11. Natural Origin & Plants 12. Perfumes & Flavors 13. Plastics / Glues 14. Rubber Chemicals 15. Supplemental Allergens 16. Core Allergen Series 17. Supplement Core Allergen Series 18. Australian Baseline Series 19. British Baseline Series 20. European Baseline Series 21. Japanese Standard Series 22. Minimum International Baseline Series 23. North American Standard Series 24. Supplement North American Standard Series 25. Bakery 26. Cosmetics 27. Cooling Lubricants (Metalworking) 28. Dental Screening Patients 29. Dental Screening Technicians / HCPs 30. Eyelid Dermatitis 31. Footwear 32. Hairdressing 33. Leg Ulcer 34. Metal Implants 35. Photoallergens 36. Photochemicals 37. Sunscreens 24 21 25 11 31 74 26 34 22 53 21 57 55 36 3 80 50 60 41 28 24 32 70 42 20 64 40 29 25 30 30 33 34 29 26 19 10
    55. 55. Internacional Grupo Internacional de Investigación para la Dermatitis de Contacto ICDRG Europeo Sociedad Europea de Dermatitis de Contacto ESCD
    56. 56. ICDRG Trolab - Hermal® Budesonide 0.01% Budesonide 0.1% Formaldehyde 2% Formaldehyde 1% Mercapto Mix 2% Mercapto Mix 1% Methylisothiazolinone 0.01% Methylisothiazolinone 0.05% Quaternium 15 2% Quaternium 15 1% Tixocortol-21-pivalate 0.1% Tixocortol-21-pivalate 1% Patch Test Allergens and Devices. TROLAB®. http://www.almirall.de/al/dermatologie/dermatologische- produkte/epicutantest/TROLAB-brochure.pdf (accessed 24 September 2013)
    57. 57. Dormer® Concentración % Vehículo Adeps lanae Ácido Abiético Dibutyl phthalate Ammonium Persulphate Acid Yellow 36 Arnica Montana Extract Amcinonide Alantolactona 30 10 5 2.5 1 0.5 0.1 0.033 Petrolato Propylene Glycol Dimethylol dihydroxy ethylene urea Cocamidopropyl betaine Amidoamine Methylisothiazolinone 30 4.5 1 0.1 0.01 Agua Shellac 20 Alcohol Benzyl alcohol 10 Soft drink (benzoato de sodio) Patch Test Products & Reference Manual 2013. Dormer®. http://www.dormer.ca/pdf/che-webcat.pdf (accessed 24 September 2013)
    58. 58. Nomenclatura Internacional de Ingredientes Cosméticos Ingredientes Cosméticos Trolab-Hermal® Hydroabietyl Alcohol Abitol Lanolin Adeps lanae Amyl Cinnamal alpha-Amyl-Cinnamaldehyde Amylcinnamyl alcohol alpha-Amylcinnamyl Alcohol Lanolin alcohol (and) Parafinum Liquidum Amerchol® L 101 PABA 4-Aminobenzoic Acid M-Aminophenol 3-Aminophenol P-Aminophenol 4-Aminophenol Ammonium Persulfate Ammonium Persulphate Anise alcohol Ansyl Alcohol Patch Test Allergens and Devices. TROLAB®. http://www.almirall.de/al/dermatologie/dermatologische- produkte/epicutantest/TROLAB-brochure.pdf (accessed 24 September 2013)
    59. 59. No Estandarizados
    60. 60. Concentraciones para Pruebas de Parche no estandarizadas Agente Concentración Cosméticos (Maquillaje, Perfume, humectante, barniz de uña) Igual Cosméticos transitorios (Jabones, Shampoo) 1:10 – 1:100 Productos de limpieza (detergentes, limpiadores, solventes) 1:100 – 1:1000 Medicamentos tópicos - Antibacterianos, Esteroides - Tretinoína, peróxido de benzoílo -Igual - 1:10 – 1:1000 Ropa, zapatos, guantes - Igual - Humedecer en solución salina Plantas y alimentos - Igual - Cebolla y ajo diluidos al 50% Productos industriales Precaución Fonacier L. Contact Dermatitis. Presented at the Conferences On-Line Allergy of the Children’s Mercy Hospitals & Clinicis. Kansas city, Missouri, USA. 2012 http://www.youtube.com/watch?v=gJoROhyjBTM (accessed 12 September 2013)
    61. 61. Jacob S. Contact Dermatitis. Presented at the Conferences On-Line Allergy of the Children’s Mercy Hospitals & Clinicis. Kansas city, Missouri, USA. 2011 http://www.youtube.com/watch?v=HDosxIkw-ag (accessed 12 September 2013)
    62. 62. Indicaciones para Pruebas de Parche  Confirmar el diagnóstico de DCA  Identificar a los alérgenos  Determinar la causa de una dermatitis ocupacional  Demostrar la ausencia de sensibilización a una sustancia específica  Incluir o excluir el diagnóstico de DCA para aspectos médico-legales  Identificar problemas de salud potenciales Fonacier L. Contact Dermatitis. Presented at the Conferences On-Line Allergy of the Children’s Mercy Hospitals & Clinicis. Kansas city, Missouri, USA. 2012 http://www.youtube.com/watch?v=gJoROhyjBTM (accessed 12 September 2013)
    63. 63. Contraindicaciones para Pruebas de Parche  Dermatitis aguda generalizada y severa  Utilización oral de corticoesteroides  Utilización de esteroides tópicos en el área donde se aplicarán los parches  Descontinuar esteroides tópicos 5 – 7 días previos  Paciente inmunocomprometido – Quimioterapia  Los pacientes con VIH frecuentemente presentan positividad ante los alergenos de contacto  Quemaduras solares Fonacier L. Contact Dermatitis. Presented at the Conferences On-Line Allergy of the Children’s Mercy Hospitals & Clinicis. Kansas city, Missouri, USA. 2012 http://www.youtube.com/watch?v=gJoROhyjBTM (accessed 12 September 2013)
    64. 64. Tratamiento  Preventivo  Farmacológico
    65. 65. Contact Allergen Replacement Databse. Preventice. http://www.preventice.com/card/(accessed 24 September 2013)
    66. 66. Tratamiento Farmacológico  Tópico  Sistémico
    67. 67. Tratamiento Tópico  Shampús  Lociones / Suspensiones  Geles  Tinturas  Emulsiones  Cremas Emolientes Pomadas Ungüentos  Pastas  Polvos  Baños coloides
    68. 68. Tratamiento Tópico  Antimicrobianos  Antihistamínicos  Inmunomoduladores  Glucocorticoides  Inhibidores de la calcineurina  Otros
    69. 69. Alergenos del Año 2013 Metilisotiazolinona Castanedo-Tardana 2012 Acrilatos Sasseville 2011 Dimetil Fumarato Bruze et al. 2010 Neomicina Sasseville 2009 Dialquil Tioureas Anderson 2008 Níquel Komik 2007 Fragancias Storrs 2006 Fenil E Diaminas (PPD) DeLeo 2005 Corticoesteroides Isaksson 2004 Cocoamidopropil Betaína Fowler J 2003 Bacitracina Sood 2002 Timerosal Belsito 2001 Oro Fowler 2000 Tintes azules dispersables Storrs Herro E. Contact Dermatitis: Part I. Presented at the Conferences On-Line Allergy of the Children’s Mercy Hospitals & Clinicis. Kansas city, Missouri, USA. 2011 http://www.youtube.com/watch?v=6ICTSX-xqSM (accessed 24 August 2013)
    70. 70. Alergenos del Año 2013 Metilisotiazolinona Castanedo-Tardana 2012 Acrilatos Sasseville 2011 Dimetil Fumarato Bruze et al. 2010 Neomicina Sasseville 2009 Dialquil Tioureas Anderson 2008 Níquel Komik 2007 Fragancias Storrs 2006 Fenil E Diaminas (PPD) DeLeo 2005 Corticoesteroides Isaksson 2004 Cocoamidopropil Betaína Fowler J 2003 Bacitracina Sood 2002 Timerosal Belsito 2001 Oro Fowler 2000 Tintes azules dispersables Storrs Herro E. Contact Dermatitis: Part I. Presented at the Conferences On-Line Allergy of the Children’s Mercy Hospitals & Clinicis. Kansas city, Missouri, USA. 2011 http://www.youtube.com/watch?v=6ICTSX-xqSM (accessed 24 August 2013)
    71. 71. Producto Parabenos Aceite Fragancia Acrilatos Esteroide Propilengli col Planta Otros Cremas Cetaphil Crema Metilparabe no No No letiAT4 Metilparabe no Propilparabe no -Omega 6 - Acidos grasos esenciales - Ceramidas - Maíz Sí Sí - Linum usitassimum - Manteca de Karité Fisiogel Vegetal No - Coco - Manteca de Karite Fisiogel A.I. Vegetal No - Oliva - Palma Trixera No - Semilla de cártamo - Aceite de coco - Oenothera biennis - Semilla de glicina - Soya Nutratopic Rx - Aceite de semilla de girasol - Cera de abeja Algunos ejemplos de productos disponibles en México…
    72. 72. Producto Parabenos Aceite Fragancia Acrilatos Esteroide Propilengli col Planta Otros Cetaphil loción humectante - Butilpara beno - Metilpara beno No No Sí Cetaphil loción ultrahumect ante No No Sí - Semilla Macadamia Lociones Ureadin Rx 30 Sí Sí Sí Salicilatos Geles letiAT4 (gel de baño) - Metilpara beno - Propilpar abeno Sí Fisiogel - Acido caprilico - Triglicéridos - Ceramidas - Goma Xantano - Coco - Manteca de Carité Trixera gel - Coco - Ricino - Oenother a biennis - Soya Nutratopic Sí - Aceite Rosa Damasce na Barras Cetaphil barra Metilparabe no Sí - Almendra de Palma Emulsión Aqua Soap +
    73. 73. Alergenos del Año 2013 Metilisotiazolinona Castanedo-Tardana 2012 Acrilatos Sasseville 2011 Dimetil Fumarato Bruze et al. 2010 Neomicina Sasseville 2009 Dialquil Tioureas Anderson 2008 Níquel Komik 2007 Fragancias Storrs 2006 Fenil E Diaminas (PPD) DeLeo 2005 Corticoesteroides Isaksson 2004 Cocoamidopropil Betaína Fowler J 2003 Bacitracina Sood 2002 Timerosal Belsito 2001 Oro Fowler 2000 Tintes azules dispersables Storrs Herro E. Contact Dermatitis: Part I. Presented at the Conferences On-Line Allergy of the Children’s Mercy Hospitals & Clinicis. Kansas city, Missouri, USA. 2011 http://www.youtube.com/watch?v=6ICTSX-xqSM (accessed 24 August 2013)
    74. 74. ¡Gracias! drcuevashector@hotmail.com

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