tretinoin and Dermatitis--Allergic-Contact

Sticky skin has been reported relatively infrequently in the literature in association with etretinate and doxorubicin/ketoconazole administration. It has a poorly understood pathogenesis, and the associated histologic changes have not been described. We report a case of a patient who experienced sticky skin in areas treated with tretinoin. These reverted to normal after cessation of treatment. In comparison to a biopsy taken while the skin was not sticky, the histologic findings included a thickened, compact stratum corneum and granulosum. The basal epithelial cells showed proliferation with slight crowding and a tall, columnar shape. To our knowledge, this is the first report of sticky skin occurring in response to topical retinoid application. We suggest that the histologic changes observed could represent a modified keratin maturation profile.

Topics: Administration, Cutaneous; Adult; Dermatitis, Allergic Contact; Drug Eruptions; Humans; Keratolytic Agents; Male; Thorax; Tretinoin

Skin irritation induced by tretinoin is commonly observed, whereas allergic contact dermatitis to this drug is very rarely found in the literature. We report the case of a 34-year-old man who developed contact dermatitis in areas where a topical tretinoin preparation was applied. Patch tests were positive to tretinoin in low concentration and to isotretinoin. Oral administration of isotretinoin to this patient would carry a risk of systemic complications.

Topics: Administration, Topical; Adult; Dermatitis, Allergic Contact; Drug Eruptions; Humans; Isotretinoin; Male; Patch Tests; Tretinoin

Dermo-epidermal atrophy is one of the main side effects of long-term treatment with topical corticosteroids (TC). Retinoic acid (RA) may prevent and even reverse these effects in animals. It has been previously established that topical RA (TRA) does not inhibit corticosteroid-induced vasoconstriction in humans, thus suggesting that RA, combined with TC, does not interfere with its anti-inflammatory property. The next step was to test this association in patients with inflammatory skin disorders. In this symmetrical double-blind study, triamcinolone acetonide (TA) cream 0.1% and a cream containing TA 0.1% plus RA 0.025% (TARA) were compared in 18 subjects with eczema. No statistical difference between both treatments was observed after 1, 2 and 3 weeks, although on the TARA-treated sides the anti-inflammatory responses were slightly less pronounced. Subjective irritation was significantly more frequent in TARA-treated side (3/17, p = 0.05) but did not lead to interruption of the treatment. This indicates that addition of RA 0.025% to a medium-range potency topical steroid does not abrogate the anti-inflammatory property of the latter and that the association can be tolerated by inflamed skin.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Dermatitis, Allergic Contact; Dermatitis, Atopic; Dermatitis, Irritant; Double-Blind Method; Drug Combinations; Drug Tolerance; Eczema; Female; Humans; Male; Middle Aged; Tretinoin; Triamcinolone Acetonide

Topics: Administration, Topical; Adrenal Cortex Hormones; Apiaceae; Blister; Dermatitis, Allergic Contact; Dermatitis, Phototoxic; Disinfection; Forearm; France; Furocoumarins; Humans; Keratolytic Agents; Male; Middle Aged; Photosensitizing Agents; Sunlight; Treatment Outcome; Tretinoin

Hand eczema, which is frequently caused by delayed-type allergy, is treated with 9-cis-retinoic acid (9cisRA). However, knowledge on how 9cisRA modulates skin immunity is sparse.. As dendritic cells (DCs) are central in the pathogenesis of contact allergy, we investigated 9cisRA modulation of DC function in murine contact hypersensitivity (CHS).. 9cisRA-differentiated DCs (9cisRA-DCs) were analysed for phenotype and function. In vivo 9cisRA-DCs were tested in the CHS model.. 9cisRA induces the differentiation of a distinct CD103. This study describes 9cisRA-mediated differentiation of a distinct DC phenotype that relies on OPN for Treg transformation and suppresses established CHS through Treg induction.

Topics: Alitretinoin; Animals; Antigens, CD; Antigens, Surface; Antineoplastic Agents; CD11c Antigen; Cell Differentiation; Cell Proliferation; Cells, Cultured; Culture Media, Conditioned; Dendritic Cells; Dermatitis, Allergic Contact; Histocompatibility Antigens Class II; Hypersensitivity, Delayed; Integrin alpha Chains; Lectins, C-Type; Lymphocyte Activation; Mannose-Binding Lectins; Mice; Mice, Inbred BALB C; Osteopontin; Phenotype; T-Lymphocytes, Regulatory; Tretinoin

Contact dermatitis to topical tretinoin or retinoic acid is rarely described. We outline the case of a 20-year-old woman presenting with bilateral periorbital dermatitis against the background of longstanding use of retinoic acid for the ocular complications of toxic epidermal necrolysis. Patch testing confirmed a contact allergy to retinoic acid and the symptoms of the dermatitis resolved after the cessation of retinoic acid.

Topics: Administration, Topical; Dermatitis, Allergic Contact; Eye; Eye Diseases; Facial Dermatoses; Female; Humans; Keratolytic Agents; Tretinoin; Young Adult

Topics: Alitretinoin; Dermatitis, Allergic Contact; Dermatitis, Occupational; Dermatologic Agents; Gardening; Hand Dermatoses; Humans; Male; Middle Aged; Tretinoin

Patients with reactions to topical products may be eliciting a physical urticaria, dermographism, by rubbing. These reactions may be misinterpreted as allergic, and three cases demonstrating this phenomenon were reviewed. All patients with reactions to topical products due to dermographism improved with counseling and antihistamine therapy. Repeat open application testing confirmed the safety of previously suspect medications in two of the three cases, preventing unnecessary changes in the medication regimens and inaccurate diagnoses of medication allergy. We observe that intolerance to topical medications due to dermographism can usually be managed without extensive testing or treatment.

Topics: Administration, Cutaneous; Adult; Dermatitis, Allergic Contact; Diagnosis, Differential; Female; Humans; Middle Aged; Patch Tests; Pruritus; Tretinoin; Urticaria

Formaldehyde-releasing preservatives are well-known allergens found in many topical preparations including medications.. To analyze the relevance of a positive patch test to formaldehyde-releasing preservatives in medications containing these preservatives.. Patients were recruited with a history of allergy to one of these preservatives. Patch and use testing to the medications, vehicles, and preservatives were performed. The following medications and their respective preservatives were used: Renova 0.05% cream/quaternium-15, Dovonex 0.005% cream/diazolidinyl urea, and Temovate-E 0.05% cream/diazolidinyl urea.. Nine patients participated in the study. A positive patch test to the preservative was reproduced in six of nine patients, and a questionable reaction occurred in one. Two patients had a positive patch test to the topical medication and one a questionable reaction. There were no definitive positive patch tests to the vehicle but two questionable ones. Use testing revealed three positive reactions to Renova, one to Renova vehicle, and one to Temovate-E vehicle.. The concentration of the preservative in the commercial preparation was often below the threshold necessary to produce a clinical reaction. Use testing is a valuable tool in the complete evaluation of the patient with a positive patch test to a formaldehyde-releasing perservative found in topical medication.

Topics: Administration, Cutaneous; Anti-Infective Agents, Local; Anti-Inflammatory Agents; Calcitriol; Chemistry, Pharmaceutical; Clobetasol; Dermatitis, Allergic Contact; Dermatologic Agents; Double-Blind Method; Formaldehyde; Glucocorticoids; Humans; Keratolytic Agents; Methenamine; Patch Tests; Preservatives, Pharmaceutical; Tretinoin; Urea

Topics: Allergens; Dermatitis, Allergic Contact; Dermatitis, Irritant; Diagnosis, Differential; Humans; Irritants; Patch Tests; Sodium Dodecyl Sulfate; Tretinoin

Topics: Acne Vulgaris; Administration, Topical; Adult; Benzoyl Peroxide; Dermatitis, Allergic Contact; Female; Humans; Keratolytic Agents; Male; Patch Tests; Tretinoin

Topics: Acne Vulgaris; Adult; Dermatitis, Allergic Contact; Drug Eruptions; Facial Dermatoses; Female; Humans; Tretinoin

Topics: Acne Vulgaris; Administration, Topical; Adult; Dermatitis, Allergic Contact; Eczema; Female; Humans; Patch Tests; Tretinoin