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A 56-year-old Hispanic female with a past medical history significant for basal cell carcinoma presented with a history of itchy, erythematous papules on her right cheek. Four days prior, she presented for suture removal after reconstruction with an island pedicle flap following Mohs micrographic surgery. She experienced a similar rash on her forearm following another surgery in the past.
a) Cellulitis
b) Contact dermatitis
c) Herpes simplex virus
Diagnosis: Contact dermatitis secondary to Mastisol and Steri-Strips
Contact dermatitis is a localized, pruritic, erythematous rash that occurs after contact with a certain allergen or irritant. The disorder is typically classified as either allergic contact dermatitis or irritant contact dermatitis.
Allergic contact dermatitis is a T cell–mediated, type-IV, delayed-type hypersensitivity reaction that requires prior sensitization with the causative agent before the patient becomes allergic to it. The typical rash of pruritus, erythema, edema, and vesicle formation occurs with further exposures.
The mechanism of immune response to a particular allergen requires that the antigen be of low molecular weight (less than 500 d) in order to penetrate the stratum corneum and gain access to the immunologic system. CD4, CD8, T regulatory cells, and natural killer T cells have all been implicated.
The process is composed of an afferent (sensitization) phase and an efferent (elicitation) phase.
Common haptens or immunogenic agents include nickel, urushiol from poison ivy resin, ultraviolet light, dyes, and fragrances.
This patient revealed a history of a similar reaction to the one presented in this case following wound dressing on her forearm with two products: Steri-Strips and Mastisol liquid adhesive. Unfortunately, she did not reveal this history until she had experienced the reaction a second time. The patient was instructed to apply hydrocortisone 1% cream twice daily to the red areas only and to follow up with a clinic visit in 4-5 days. Documentation of her allergy was included in her medical record.
This case was submitted by Dr. Keyvan Nouri; Dr. Katlein Franca; Jennifer Ledon; and Jessica Savas of the University of Miami.
–Donna Bilu Martin, M.D.
A 56-year-old Hispanic female with a past medical history significant for basal cell carcinoma presented with a history of itchy, erythematous papules on her right cheek. Four days prior, she presented for suture removal after reconstruction with an island pedicle flap following Mohs micrographic surgery. She experienced a similar rash on her forearm following another surgery in the past.
a) Cellulitis
b) Contact dermatitis
c) Herpes simplex virus
Diagnosis: Contact dermatitis secondary to Mastisol and Steri-Strips
Contact dermatitis is a localized, pruritic, erythematous rash that occurs after contact with a certain allergen or irritant. The disorder is typically classified as either allergic contact dermatitis or irritant contact dermatitis.
Allergic contact dermatitis is a T cell–mediated, type-IV, delayed-type hypersensitivity reaction that requires prior sensitization with the causative agent before the patient becomes allergic to it. The typical rash of pruritus, erythema, edema, and vesicle formation occurs with further exposures.
The mechanism of immune response to a particular allergen requires that the antigen be of low molecular weight (less than 500 d) in order to penetrate the stratum corneum and gain access to the immunologic system. CD4, CD8, T regulatory cells, and natural killer T cells have all been implicated.
The process is composed of an afferent (sensitization) phase and an efferent (elicitation) phase.
Common haptens or immunogenic agents include nickel, urushiol from poison ivy resin, ultraviolet light, dyes, and fragrances.
This patient revealed a history of a similar reaction to the one presented in this case following wound dressing on her forearm with two products: Steri-Strips and Mastisol liquid adhesive. Unfortunately, she did not reveal this history until she had experienced the reaction a second time. The patient was instructed to apply hydrocortisone 1% cream twice daily to the red areas only and to follow up with a clinic visit in 4-5 days. Documentation of her allergy was included in her medical record.
This case was submitted by Dr. Keyvan Nouri; Dr. Katlein Franca; Jennifer Ledon; and Jessica Savas of the University of Miami.
–Donna Bilu Martin, M.D.
A 56-year-old Hispanic female with a past medical history significant for basal cell carcinoma presented with a history of itchy, erythematous papules on her right cheek. Four days prior, she presented for suture removal after reconstruction with an island pedicle flap following Mohs micrographic surgery. She experienced a similar rash on her forearm following another surgery in the past.
a) Cellulitis
b) Contact dermatitis
c) Herpes simplex virus
Diagnosis: Contact dermatitis secondary to Mastisol and Steri-Strips
Contact dermatitis is a localized, pruritic, erythematous rash that occurs after contact with a certain allergen or irritant. The disorder is typically classified as either allergic contact dermatitis or irritant contact dermatitis.
Allergic contact dermatitis is a T cell–mediated, type-IV, delayed-type hypersensitivity reaction that requires prior sensitization with the causative agent before the patient becomes allergic to it. The typical rash of pruritus, erythema, edema, and vesicle formation occurs with further exposures.
The mechanism of immune response to a particular allergen requires that the antigen be of low molecular weight (less than 500 d) in order to penetrate the stratum corneum and gain access to the immunologic system. CD4, CD8, T regulatory cells, and natural killer T cells have all been implicated.
The process is composed of an afferent (sensitization) phase and an efferent (elicitation) phase.
Common haptens or immunogenic agents include nickel, urushiol from poison ivy resin, ultraviolet light, dyes, and fragrances.
This patient revealed a history of a similar reaction to the one presented in this case following wound dressing on her forearm with two products: Steri-Strips and Mastisol liquid adhesive. Unfortunately, she did not reveal this history until she had experienced the reaction a second time. The patient was instructed to apply hydrocortisone 1% cream twice daily to the red areas only and to follow up with a clinic visit in 4-5 days. Documentation of her allergy was included in her medical record.
This case was submitted by Dr. Keyvan Nouri; Dr. Katlein Franca; Jennifer Ledon; and Jessica Savas of the University of Miami.
–Donna Bilu Martin, M.D.
