Contact dermatitis associated with the use of Always sanitary napkins.

OBJECTIVE: To report a clinical association between vulvar irritation or contact dermatitis and the use of Always sanitary napkins. DESIGN: Case series. SETTING: A gynecology practice in Montreal. PATIENTS: Women presenting between September 1991 and September 1994 with itching or burning of areas that would be in contact with a sanitary napkin (mons pubis, external surfaces of the vulva and perineum) beginning at least 1 day after the use of the napkins was started and less than 5 days after the use was stopped. RESULTS: Twenty-eight women experienced vulvar itching and burning, often associated with eruptions resembling contact dermatitis, of the vulvar and perineal surfaces after using Always sanitary napkins. Twenty-six reported that symptoms disappeared after they stopped using that brand of sanitary napkin. Seven women who later used the same brand again reported a recurrence of the vulvar irritation. CONCLUSION: The findings of this case series reveal Always sanitary napkins as a potentially important cause of recurrent vulvitis. Physician awareness of the association will enable effective advice and relief for a large number of women suffering "chronic vaginitis".     

Biobrane versus 1% silver sulfadiazine in second-degree pediatric burns

Partial-thickness burns in children have been treated for many years by daily, painful tubbing, washing, and cleansing of the burn wound, followed by topical application of antimicrobial creams. Pain and impaired wound healing are the main problems. We hypothesized that the treatment of second-degree burns with Biobrane is superior to topical treatment. Twenty pediatric patients were prospectively randomized in two groups to compare the efficacy of Biobrane versus 1% silver sulfadiazine. The rest of the routine clinical protocols were followed in both groups. Demographic data, wound healing time, length of hospital stay, pain assessments and pain medication requirements, and infection were analyzed and compared. Main outcome measures included pain, pain medication requirements, wound healing time, length of hospital stay, and infection. The application of Biobrane to partial-thickness burns proved to be superior to the topical treatment. Patients included in the biosynthetic temporary cover group presented with less pain and required less pain medication. Length of hospital stay and wound healing time were also significantly shorter in the Biobrane group. None of the patients in either group presented with wound infection or needed skin autografting. In conclusion, the treatment of partial-thickness burns with Biobrane is superior to topical therapy with 1% silver sulfadiazine. Pain, pain medication requirements, wound healing time, and length of hospital stay are significantly reduced.     

Genetic control of susceptibility to mite-associated ulcerative dermatitis

Variable susceptibility to mite-associated ulcerative dermatitis (MAUD) attributable to Myobia musculi infestation was studied in breeding stocks of sixteen inbred strains of mice. Statistical evaluation of 41 occurrences of lesion among 1,517 mice of the various strains indicated that significant differences in the frequency of MAUD were associated with differences in genetic background and in the H-2 type. These findings suggest that the occurrence of an ulcerative skin lesion in inbred mice exposed to M. musculi is controlled by at least two genes. Lesion susceptibility appears to be profoundly affected by a non-H-2 linked gene or gene combination shared by all C57Bl background strains. In addition, a major influence is exerted by one or more genes within the H-2 complex.     

Allergic contact dermatitis and its relationship to carcinogenicity

The relationship between allergic contact dermatitis (ACD) and carcinogenicity was investigated using a recently developed and validated simulation approach. The analyses indicated that while there are electrophilic and non-electrophilic components to ACD, these were not identical to those operating in carcinogenicity. Accordingly, with respect to carcinogenicity prediction, the results of ACD do not improve the results based upon mutagenicity testing alone, the latter being a surrogate for potential electrophilicity.     

Follicular contact dermatitis due to coloured permanent-pressed sheets

A delayed hypersensitivity type of allergic contact dermatitis was observed following exposure to certain brands of 50% cotton, 50% polyester coloured permanent-pressed sheets produced by a particular manufacturer. The dermatitis presented as an extremely pruritic follicular eczema of the body and vesicular edema of the ears and face. Patch testing excluded formalin as the allergen but suggested permanent-pressing chemicals as a possibility. Several washings of the sheets did not prevent the development of the dermatitis. The removal of sheets did not immediately result in improvement: the condition could persist for up to eight weeks after their discontinuance.