C039 Photopatch testing

Courses Table (continued) Comoound 26 2-Monomethylol phenol 27 Methyl methacrylate. 28 Phenol formaldehyde resin, acid catalyzed 29 Diphenyl thiourea 30 Phenol formaldehyde resin, alkali catalyzed 3 1 Urea formaldehyde resin 32 Melamine formaldehyde resin 33 alphaPinene 34 4-tewButylcathecho1 35 Diethyl phthalate 36 Diisodecyl phthalate 37 Dimethyl phthalate 38 Di-Zethylhexyl phthalate 39 Isophoronediamine (IPDA) 40 oCresy1 glycidyl ether 41 n-Butyl glycidyl ether 42 Phenyl glycidyl ether 43 Phenyl isocyanate 44 Triphenylmethane ttiiso. cyanate 45 N.N-Dimetbyl-4. toluidine 46 Epiclorohydrin 47 Abietic acid 48 Acrylonitrile 49 Cyanoacrylate 50 Phenol formaldehyde resin

rlCO39

1.0 5.0

T T

181156 174

10.0 10.0 15.0 1.0 5.0 5.0 5.0 5.0 0.5 0.25

T T T T T T T T T T

143 143 144 143 143 144 144 144 146 146

0.25

T

145

0.25 0.1 0.1

T T T

145 144 144

5.0

C

143

0.1 10.0 0.1 2.0 5.0

T C E E 0

145 142 142 142 142

Phlebology

Allereic reactions

2 3

110 2 1 2 2 2

3

School,

Dundee

Unit, Ninewells Hospital DDI 9Sz Scotland

I

-

5

University

Hospital,

Odense,

I CO41 Epidemiology and investigation of leg ulcers H.A.M. Neumann. Academisch Maastricht,

1 2 2

i 1

and

Patch test batteries for plant dermatitis

E. Paulsen. Odense

pected Compositae allergy, supplemented with the Compositae mix, consisting of extracts of 5 Compositae species. Among 101 consecutive Compositae-sensitive eczema patients 7 1% were positive to the SL and 82% positive to the Compositae mix, making the overall detection rate 94%. Conversely, in 24 occupationally sensitized gardeners the frequency of positive reactions to the Compositae mix was almost twice as high as that of the SL mix and only 75% were positive to either one or the other of the mixes. The results emphasize that the patch test battery should include both screening mixes and single extracts for aimed patch testing to avoid missing cases of Compositae sensitization.

Phlehology in Dermatology

The combined effect of false negative, false positive and the increasing numbers of obsolete photoallergens have brought to a head the need to rationalise the photopatch test technique and the range of test substances. A recent Workshop conducted by the British Photodermatology Group reached a consensus view on methodology and recommended test substances/photopatch testing be used to investigate patients with an eczematous reaction predominantly affecting light exposed sites. Of particular interest are polymorphic light eruption patients who develop an eczematous response and patients with chronic actinic dermatitis/photosensitivity dermatitis/actinic reticuloid syndrome. That a broad band UVA photopatch test source be used at a dose below the normal MED value (5 J/cm*). That the test series should concentrate particularly on absorbent sunscreen chemicals as well as, when relevant, the patient’s own product(s).

CO40 El

S61

in Dermatology

;

Photopatch testing

J. Ferguson. Photobiology Medical

% From No. of Irritant oatients reactions (W/W) ~ , 1.0 c 173 1 2.0 c 173 2 5.0 T 174 4

-

Denmark

Only a few of the many known plant contact allergens are commercially available. Since Compositae are an important cause of allergic plant contact dermatitis, the problems of creating a useful patch test battery will be exemplified with this plant family. The most important allergens in the Compositae are the sesquiterpene lactones (SL). The SL mix, consisting of alantolactone, costunolide and dehydrocostus lactone, was included in our standard patch test series and, in case of sus-

Ziekenhuis

Maastricht,

The Netherlands

Recent epidemiologic studies give data about incidence of leg ulcers of l-3%. About 80% of them will be (mostly) venous in origin. In the last decade dermatologists are more and more confrontated with so called mixed ulcers: partly venous and complicated by arterial insufficiency and/or diabetes. As the healing time of leg ulcers is long, and the incidence is high, this disease is a major social and economic burden. Although compression therapy is widely accepted for treatment of venous leg ulcers the recurrence rate is high. Venous leg ulcers are for about 50% based on only superficial and 50% on deep venous insufficiency. In case superficial venous insufficiency is the cause cure is possible. In case deep venous insufficiency exists only maintenance compression therapy can avoid recurrence. Half of the patients with a leg ulcer are not known by any physician. This is a strong signal of failing health care system. In all patients with leg ulcers a diagnosis of the underlying disease has to be made. A leg ulcer is a symptom and not a diagnosis. In all cases a good clinical investigation combined with a full anamnesis will be done. With this simple (technical) investigation it will be possible to make a correct diagnosis. This diagnosis will be the base for a successful treatment of the ulcer. Once the ulcer is healed very often the underlying disease is not cured. So a maintenance therapy will be necessary. ElCO42 Microcirculatory

disturbances in venous leg ulcers. Facts and therapeutic consequences

M. Jtinger, T. Klyscz, M. Hahn, A. Steins, D. Zuder. Dep. of Dermatology,

Tiibingen,

Germany

With increasing degree of trophic skin changes due to chronic venous insufficiency (CVI) cutaneous blood flow worsens: number of cutaneous capillaries, transcutaneous oxygen tension and cutaneous vascular reserve (the increase of laser Doppler flux after 3 minutes of arterial occlusion) decrease more and more. The transcapillary permeability, measured by fluorescence video microscopy, revealed to be increased in severe CVI. A marked variant of this cutaneous microangiopathy characterizes venous ulcers.