heroin and Facial-Dermatoses

Topics: Adult; Analgesics, Opioid; Dermatitis, Allergic Contact; Dermatitis, Occupational; Facial Dermatoses; Female; Heroin; Humans; Morphine; Patch Tests

After the start of heroin (diacetylmorphine)-assisted treatment to a selected group of chronic treatment-resistant heroin-dependent patients in the Netherlands, we reported about work-related eczema and positive patch tests to heroin in some nurses and nasal and respiratory complaints. To investigate the prevalence of heroin contact allergy, we started a questionnaire-based study with follow-up by allergological examinations. Of 120 questionnaires sent, 101 (84%) was returned: 67 from nurses and 34 from other employees. Of 101 workers, 38 (38%) had reported work-related complaints: 33 of 67 (49%) nurses and 5 of 34 (15%) other employees. Patch tests to heroin were performed in 24 nurses and were positive in 8 (33%). All the 8 had eyelid or facial eczema and, in 6, accompanied by mucosal or respiratory complaints. The prevalence of heroin contact allergy in this study was 8% (8/101) among all employees and 12% (8/67) among nurses. Respiratory and mucosal complaints could not be ascribed to a contact allergy, and in these cases, serum was analysed for specific immunoglobulin E to heroin. A type 1 allergy to heroin could not be shown. These complaints are possibly due to the histamine-liberating effect of heroin, to atopic constitution, to a combination of these factors or - less likely - to other non-allergic factors.

Topics: Allergens; Dermatitis, Allergic Contact; Dermatitis, Occupational; Facial Dermatoses; Health Personnel; Heroin; Humans; Immunoglobulin E; Netherlands; Patch Tests; Prevalence; Respiratory Tract Diseases; Substance Abuse Treatment Centers; Surveys and Questionnaires

54-year-old woman presented with an unusual presentation of chronic cutaneous lupus erythematosus that mimicked pseudoxanthoma elasticum. The lesions were asymptomatic, 2-3 mm, skin-colored, smooth papules without scale or erythema; they were located on the chin, medial malar cheeks, and upper lip. She previously failed traditional treatments, which included hydroxychloroquine and dapsone. The patient responded to thalidomide with a reduction in appearance and number of lesions.

Topics: Facial Dermatoses; Female; Heroin; Humans; Lupus Erythematosus, Discoid; Middle Aged; Pseudoxanthoma Elasticum

Topics: Adult; Dermatitis, Allergic Contact; Dermatitis, Occupational; Diagnosis, Differential; Facial Dermatoses; Female; Health Personnel; Heroin; Humans; Narcotics; Patch Tests; Substance Abuse Treatment Centers