INTRODUCTION: Norwegian or crusted scabies is a rare and highly contagious form of skin parasitosis caused by Sarcoptes scabiei var. hominis. Individuals maffffinly affected are considered to be immunocompromised such as those on prolonged glucocorticosteroid therapy, with AIDS or organ transplant patients. This disease presents as a hyperkeratotic dermatosis with an acral distribution. CASE REPORT: This is a case of a 2-month-old healthy Filipino male, who was previously managed as a case of miliaria rubra and treated with clobetasol 0.05% – ketoconazole 2% cream for 1 week. The papules and plaques became widespread. Consult with a pediatrician revealed widespread scabies and for which patient was prescribed topical permethrin with no improvement. On examination, patient presented with multiple erythematous papules and plaques with crusts on the face, trunk, extremities, palms and soles. Thickened yellowish plaques were observed on the palms and soles. Both parents also presented with widespread papules most prominent on the flexural areas accompanied by nocturnal pruritus. On dermoscopy, numerous mites and burrows were seen in a “jet with contrail pattern.” Prominent yellowish scales were also noted. Patient was admitted due to fever and superimposed bacterial infection and was given IV oxacillin, paracetamol, 8% precipitated sulfur in a hypoallergenic lotion applied twice daily and sodium fusidate ointment. On the 4th hospital day, the patient was afebrile and the lesions were noted to decrease in both erythema and crusting. Follow-up dermoscopy revealed absence scales, burrows and mites. CONCLUSION: Prolonged, unsupervised use of topical corticosteroids in our case most likely induced an immunocompromised state thus predisposing the patient to develop Norwegian scabies. In countries were cases of Norwegian scabies have been unresponsive to permethrin and when ivermectin is not available, the use of precipitated sulfur may still be the best therapeutic and safest option for infants.
Infant ; Scabies ; Mometasone Furoate ; Anti-Allergic Agents ; Adrenal Cortex Hormones

Anti-Allergic Agents ; therapeutic use ; Chronic Disease ; Humans ; Rhinitis, Allergic, Perennial ; drug therapy ; Sinusitis ; drug therapy

While histamine plays an important role in the pathogenesis of allergic diseases, such as allergic rhinitis, H1-antihistamines, which have been using in the treatment of allergic diseases for more than 70 years, are considered as the cornerstone of the medication of allergic diseases. In this review, we discuss the history of histamine studies and anti-histamine discovery, the histamine receptors, as well as the mechanisms and the safety of H1-antihistamines.
Anti-Allergic Agents ; therapeutic use ; Histamine H1 Antagonists ; therapeutic use ; Humans ; Rhinitis, Allergic, Perennial ; drug therapy

OBJECTIVETo systematically evaluate the efficacy of intranasal antihistamine in the treatment of allergic rhinitis.

METHODSThe randomized controlled trials (RCT) about intranasal antihistamines for the treatment of allergic rhinitis between January 1985 and January 2014 were searched in OVID, PubMed, EMBASE, CNKI, WanFang Data and Cochrane Library. Two reviewers independently screened the literatures, extracted the data, and evaluated the methodological quality, then meta-analysis was performed by using RevMan 5.1 software.

RESULTSA total of thirteen RCTs were included. The results of meta-analysis showed that the efficacy of intranasal antihistamine group was superior to the placebo group in total nasal symptom scores (TNSS), the difference was significant[WMD = -1.96, 95%CI (-2.06;-1.85), P < 0.01], and individual nasal symptom scores (blocked nose, rhinorrhea, and sneezing) [WMD = -0.18, 95%CI (-0.28;-0.08); WMD = -0.45, 95%CI (-0.52;-0.38); WMD = -0.41, 95%CI (-0.58;-0.24), all P < 0.01], with significant differences. There was no significant difference between the intranasal antihistamine group and the corticosteroid group in TNSS [WMD = -1.51, 95%CI (-3.51;0.49), P = 0.14], but the intranasal antihistamines group was superior to the corticosteroid group in individual nasal symptom scores (blocked nose, rhinorrhea, and sneezing) [WMD = -0.23, 95%CI (-0.40;-0.06); WMD = -0.35, 95%CI (-0.65;-0.05); WMD = -0.25, 95%CI (-0.42;-0.08), all P < 0.05], with significant differences. The intranasal antihistamine group was superior to the oral antihistamines group in TNSS [WMD = -0.88, 95%CI (-1.51;-0.25), P < 0.01].

CONCLUSIONIntranasal antihistamine is effective in the control of nasal symptoms in AR patients.

Administration, Intranasal ; Adrenal Cortex Hormones ; Anti-Allergic Agents ; administration & dosage ; therapeutic use ; Histamine Antagonists ; Histamine H1 Antagonists ; Humans ; Nasal Obstruction ; Rhinitis, Allergic ; drug therapy ; Rhinitis, Allergic, Seasonal ; Software

Antiseptics are substances that kill or prevent the growth of microorganisms when applied to living tissue. They must be effective against microorganisms but must also retain their activity in presence of body fluids without being harmful locally or systemically. Among many antiseptics, Betadine(R) has been widely used because of its low toxicity and high germicidal efficacy. We reported 2 cases of allergic contact dermatitis to Betadine(R) in surgical patients. They had eczematous eruption along the Betadine(R) applying sites. Path tests Betadine(R) confirmed the diagnosis.
Anti-Infective Agents, Local ; Body Fluids ; Dermatitis, Allergic Contact* ; Diagnosis ; Humans

PURPOSE: To investigate the biological effects and cytotoxicity of anti-allergic ophthalmic agents on the cultured conjunctival cells of rabbit in vitro. METHODS: Conjunctival cells of rabbit were exposed to anti-allergic ophthalmic agents. Azelan(R) (Taejoon, Korea), Zaditen(R) (Novartis, USA), Patanol(R) (Alcon, USA) at a concentration 10, 20 and 30% for a period of 30 minutes, 4, 12, and 24 hours respectively. Cell injury assay was performed using lactate dehydrogenase (LDH) leakage assay. We checked the composition, pH, osmolarity of three anti-allergic agents. Light and transmission electron microscopy were performed to compare the cellular damage of rabbit conjunctival cells under various culture treatments. RESULTS: In cultured conjunctival cells of rabbit, the LDH titers increased up to 4 hours after exposure, maintained until 12 hours and then decreased 12 hours after exposed. Azelan(R) and Zaditen(R) showed a higher LDH titer and severe cellular damage of the conjunctival cells, compared with Patanol(R). Of anti-allergic solutions, Azelan(R) and Zaditen(R) revealed markedly lower Na+, Cl- and pH levels than Patanol(R). However, there was no difference in the concentration of preservative or osmolarity of the eye solution among the three anti-allergic agents. CONCLUSIONS: Patanol(R) caused markedly more damage to cultured rabbit conjunctival cells than Azelan(R) and Zaditen(R). If these anti-allergic these agents are clinically used for long periods of time, they may induce the cellular damage of conjunctival cells depending on the composition and pH of anti-allergic drugs.
Anti-Allergic Agents ; Hydrogen-Ion Concentration ; L-Lactate Dehydrogenase ; Microscopy, Electron, Transmission ; Osmolar Concentration

Ethanol extracts of brown seaweeds from Pakistan and China were isolated and compared for their antiallergenic activities. They included Sargassum tennerimum (ST) and Sargassum cervicorne (SC) from Pakistan, and Sargassum graminifolium turn (SG), Sargassum thunbergii (STH), and Laminaria japonica (LJ) from China. The ethanol extracts of these brown seaweeds were optimized at 85% (v/v) ethanol for the maximum yield of phlorotannin, an inhibitor against hyaluronidase. Total phlorotannins contained in the crude extracts were measured as 1.71% (SG), 0.74% (STH), 0.97% (LJ), 3.30% (SC), and 5.06% (ST). The 50% inhibitory concentrations (IC(50)) of Pakistani SC and ST were 109.5 and 21 microg/ml, respectively, lower than those of Chinese SG, STH, and LJ (134, 269, and 148 microg/ml, respectively). An antiallergic drug, disodium cromoglycate (DSCG), had an IC(50)=39 microg/ml, and a natural inhibitor of hyaluronidase, catechin, had an IC(50)=20 microg/ml. The IC(50) of ST extract was found similar to that of catechin (21 vs 20 microg/ml) and lower than that of DSCG (21 vs 39 microg/ml). This suggests that ST is a potent inhibitor of hyaluronidase, indicating a promising future development of natural antiallergic medicines or functional foods.
Anti-Allergic Agents ; pharmacology ; Hyaluronoglucosaminidase ; antagonists & inhibitors ; Seaweed ; chemistry ; Tannins ; analysis ; pharmacology

Povidone-iodine(PVP-I) is a widely used antiseptic for the skin because of its low toxicity and high germieidal efficacy, Allergic contact dermatitis to PVP-I is known to be rare. Two patients who recently underwent surgical operations were referred to us due to pruritic well-demarcated eczematous skin lesions around the wounds. Their operation wounds had persisted in spite of the treatments using systemic antibiotics and topical antiseptics. Patch tests were performed with antiseptics including PVP-I, hydrogen peroxide, and benzalkonium chloride which had been used to dress their wounds. The patch tests resulted in positive reactions to PVP-I at the concentrations of 1% in one patient and 0.01% in another.
Anti-Bacterial Agents ; Anti-Infective Agents, Local ; Benzalkonium Compounds ; Dermatitis, Allergic Contact* ; Humans ; Hydrogen Peroxide ; Patch Tests ; Povidone-Iodine* ; Skin ; Wounds and Injuries

Povidone-iodine is one of the most widely used antiseptics and rarely has been reported to produce allergic contact dermatitis. Nitrofurazone has beeo widely used for the prevention and the treatment of the superficial bacterial infection and infrequently causes allergic contact dermatitis. A 48-year-old man was present with a 3-week history of pruritic skin lesion on the right forearm. He had treated the right forearm with antiseptics including Betadine and nitrofurazone and thereafter suffered from the skin lesion. Patch tests with Korean standard antigens, antiseptics and topical antibacterial agents revealed positive reactions to povidone-iodine and nitrofurazone.
Anti-Bacterial Agents ; Anti-Infective Agents, Local* ; Bacterial Infections ; Dermatitis, Allergic Contact* ; Forearm ; Humans ; Middle Aged ; Nitrofurazone ; Patch Tests ; Povidone-Iodine ; Skin

PURPOSE: To investigate the biologic effects of topical anti-allergic agents with H1-receptor antagonism and inhibition of histamine release from mast cells in the cultured conjunctival cells of patients with vernal keratoconjunctivitis in vitro. METHODS: Conjunctival cells of vernal keratoconjunctivitis were exposed to the anti-allergic agents SCD-P101 (Fexofenadine, Samchundang, Korea), Patanol(R) (Alcon, USA), Zaditen(R) (Novartis, USA), and Azelan(R) (Taejoon, Korea). Efficacy of the topical antihistamine/mast cell stabilizers was evaluated using the MTT assay, measuring the concentration of procollagen and inflammatory cytokines. Cell damage was determined using the lactate dehydrogenase (LDH) assay with dilution rates of 10, 20, and 30% and compared with the balanced salt solution-treated group. Cellular morphologic results were examined by inverted light microscopy and transmission electromicroscopy. RESULTS: Metabolic activity of conjunctival cells decreased at higher concentrations and longer exposure durations, except for the SCD-P101 agent. The procollagen, laminin, IL-6 and IL-8 titers tended to be lower than that of the control in the eyes exposed to all the anti-allergic drugs tested in this study, but the concentration of TNF-beta was similar to that of the control group. Zaditen(R) and Azelan(R) tended to show a greater LDH titer and edema, as well as cytoplasmic and nuclear degeneration of the conjunctival cells than did SCD-P101 or Patanol(R). CONCLUSIONS: Cellular metabolic activity was the highest in the new anti-allergic agent SCD-P101. SCD-P101 and Patanol(R) caused marginally less damage to cultured conjunctival cells than did Zaditen(R) and Azelan(R).
Anti-Allergic Agents ; Conjunctivitis, Allergic ; Cytokines ; Cytoplasm ; Edema ; Eye ; Histamine Release ; Humans ; Interleukin-6 ; Interleukin-8 ; L-Lactate Dehydrogenase ; Laminin ; Light ; Lymphotoxin-alpha ; Mast Cells ; Microscopy ; Procollagen