Essential oils are widely incorporated in cosmetic products, perfumes and related household products due to the variety of their properties but mainly due to their pleasant odour. The composition of these volatile natural complex mixtures may vary depending on the quality of plant material from which they were obtained and the extraction method by which they were derived. These factors are also important in ensuring the safe use of essential oils in personal care products. As they contain compounds with varied chemical structure and effects, skin sensitivity and irritations as well as other symptoms may arise after their application. Although essential oils are considered as safe and nontoxic when used at low concentrations, available scientific literature indicates that essential oils and their compounds may possess a strong allergy potential. This review focuses on side effects and allergy contact dermatitis caused by selected essential oils and their single compounds in cosmetic products, summarizing data from the most recent scientific literature.

Essential Oils and Their Single Compounds in Cosmetics—A Critical Review

The guidelines aim to provide advice on the management of hand eczema (HE), using an evidence- and consensus-based approach. The guidelines consider a systematic Cochrane review on interventions for HE, which is based on a systematic search of the published literature (including hand-searching). In addition to the evidence- and consensus-based recommendation on the treatment of HE, the guidelines cover mainly consensus-based diagnostic aspects and preventive measures (primary and secondary prevention). Treatment recommendations include non-pharmacological interventions, topical, physical and systemic treatments. Topical corticosteroids are recommended as first line treatment in the management of HE, however continuous long-term treatment beyond six weeks only when necessary and under careful me-dical supervision. Alitretinoin is recommended as a second line treatment (relative to topical corticosteroids) for patients with severe chronic HE. Randomized control trials (RCT) are missing for other used systemic treatments and comparison of systemic drugs in “head-to-head” RCTs are needed.The guidelines development group is a working group of the European Society of Contact Dermatitis (ESCD) and has carefully tried to reconcile opposite views, define current optimal practice and provide specific recommendations, and meetings have been chaired by a professional moderator of the AWMF (Arbeitsgemeinschaft der Wis-senschaftlichen Medizinischen Fachgesellschaften; Association of the Scientific Medi-cal Societies in Germany).No financial support was given by any medical company. The guidelines are expected to be valid until December 2017 at the latest.

Guidelines for diagnosis, prevention and treatment of hand eczema

Zinc is a key element for growth and development. In this narrative review, we focus on the role of dietary zinc in early life (including embryo, fetus and preterm neonate), analyzing consequences of zinc deficiency and adequacy of current recommendations on dietary zinc. We performed a systematic search of articles on the role of zinc in early life. We selected and analyzed 81 studies. Results of this analysis showed that preservation of zinc balance is of critical importance for the avoidance of possible consequences of low zinc levels on pre- and post-natal life. Insufficient quantities of zinc during embryogenesis may influence the final phenotype of all organs. Maternal zinc restriction during pregnancy influences fetal growth, while adequate zinc supplementation during pregnancy may result in a reduction of the risk of preterm birth. Preterm neonates are at particular risk to develop zinc deficiency due to a combination of different factors: (i) low body stores due to reduced time for placental transfer of zinc; (ii) increased endogenous losses; and (iii) marginal intake. Early diagnosis of zinc deficiency, through the measurement of serum zinc concentrations, may be essential to avoid severe prenatal and postnatal consequences in these patients. Typical clinical manifestations of zinc deficiency are growth impairment and dermatitis. Increasing data suggest that moderate zinc deficiency may have significant subclinical effects, increasing the risk of several complications typical of preterm neonates (i.e., necrotizing enterocolitis, chronic lung disease, and retinopathy), and that current recommended intakes should be revised to meet zinc requirements of extremely preterm neonates. Future studies evaluating the adequacy of current recommendations are advocated.

https://www.mdpi.com/2072-6643/7/12/5542/pdf

Zinc in Early Life: A Key Element in the Fetus and Preterm Neonate

Background. Classification of hand eczema has traditionally been based both on aetiology and clinical appearance. For 20% of cases, the aetiology is unknown.



Objectives. To suggest a classification based on well-defined aetiology as well as on predefined clinical patterns and on the dynamics of hand eczema.



Methods. Literature studies and discussions among members of the Danish Contact Dermatitis Group.



Results. Criteria are given for the aetiological diagnoses of allergic contact dermatitis of the hands, irritant contact dermatitis of the hands, protein contact dermatitis of the hands, atopic hand eczema and aetiologically unclassifiable hand eczema. Six different clinical patterns are described and illustrated. Suggestions for general treatment principles are given.



Conclusion. Operational guidelines for the diagnosis and treatment of hand eczema are described.

Hand eczema guidelines based on the Danish guidelines for the diagnosis and treatment of hand eczema.

Protein contact with the skin can be associated with 2 major clinical conditions: contact urticaria and protein contact dermatitis. This article reviews the pathogenesis, clinical pictures and the literature on the proteins having caused immunological occupation-related skin problems, i.e. fruits, vegetables, spices, plants, and woods; animal proteins; grains and enzymes, all affecting a wide variety of jobs. This is illustrated with some cases observed in the contact-allergy unit in Leuven.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1600-0536.2007.01267.x

Immunological occupational contact urticaria and contact dermatitis from proteins: a review.

SummaryBackground
The increasing use of long-lasting nail aesthetic products has led to a growing number of cases of allergic contact dermatitis (ACD) caused by (meth)acrylates in recent years

Objectives
To provide information on ACD caused by (meth)acrylates related to nail cosmetic products

Methods
We retrospectively reviewed files of patients with ACD caused by (meth)acrylates related to nail cosmetic products, who were patch tested between January 2011 and December 2015 in 13 departments of dermatology in Portugal

Results
Two-hundred and thirty cases of ACD caused by (meth)acrylates (55 technicians, 56 consumers, and 119 with mixed exposure) had been documented, mostly as chronic hand eczema (93%) The most common sensitizers were: 2-hydroxyethyl methacrylate (HEMA), which was positive in 90% of the tested patients, 2-hydroxypropyl methacrylate (HPMA), which was positive in 641%, and ethyleneglycol dimethacrylate, which was positive in 545%

Conclusion
HEMA and HPMA were the most frequent positive allergens HEMA, which identified 90% of cases, can be considered to be a good screening allergen The high number of cases of ACD caused by (meth)acrylates in nail cosmetic products certainly warrants better preventive measures at the occupational level, and specific regulation in the field of consumer safety

/pdf/allergic-contact-dermatitis-caused-by-meth-acrylates-in-nail-2ynortgly4.pdf

Allergic contact dermatitis caused by (meth)acrylates in nail cosmetic products in users and nail technicians – a 5‐year study

Protein contact with the skin can be associated with two major clinical conditions: immunological contact urticaria (ICU) and protein contact dermatitis (PCD), of which the latter will be discussed here. This chapter reviews the pathogenesis, clinical pictures and the causal proteins, most of which are responsible for occupation-related skin problems, i.e. fruits, vegetables, spices, plants and woods, animal proteins, grains and enzymes.

Protein Contact Dermatitis

A 37-year-old atopic woman presented with a 1-week history of eczematous lesions affecting both axillae. She had been using a new deodorant, Mineral® (Garnier, L’Oreal, Portugal), for the previous 2 weeks. There was a past history of jewellery intolerance, and she did not report any previous skin reactions to perfumes and deodorants. She was treated with topical corticosteroids, and there was complete remission of the lesions in a few days. Patch testing was performed with Finn Chambers® and according to the International Contact Dermatitis Research Group criteria, with the Portuguese baseline series, a fragrance series, and her own product. The patient reacted to nickel (++), MCI/MI 100 ppm (++),

/pdf/contact-allergy-to-methylisothiazolinone-in-a-deodorant-1pggqbze3b.pdf

Contact allergy to methylisothiazolinone in a deodorant

The genus Alternaria is one of the most common black moulds and appears to be increasing as a causative agent of subcutaneous phaeohyphomycosis, particularly among immunosuppressed patients. A 53-year-old patient who had received a kidney transplant presented with multiple verrucous lesions on the distal extremities. Positive histopathology and cultures, in addition to rDNA ITS region sequencing, identified the fungal isolate as Alternaria infectoria. Oral itraconazole was administered for 10 months. A follow-up at 15 months demonstrated no signs of infection. Clinical manifestations of cutaneous alternariosis vary significantly and only a few cases have been described in the literature. Although optimal treatment options remain controversial, this case of phaeohyphomycosis was successfully treated with itraconazole monotherapy.

/pdf/phaeohyphomycosis-caused-by-alternaria-infectoria-presenting-2j9y7pbxmf.pdf

Cristina Amaro

Papers

Immunological occupational contact urticaria and contact dermatitis from proteins: a review.

Allergic contact dermatitis caused by (meth)acrylates in nail cosmetic products in users and nail technicians – a 5‐year study

Protein Contact Dermatitis

Contact allergy to methylisothiazolinone in a deodorant

Phaeohyphomycosis caused by Alternaria infectoria presenting as multiple vegetating lesions in a renal transplant patient