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Атлас аллергодерматологии

Atopic dermatitis of childhood

Very itchy exudative eczematous lesions of the eyelids and atopic angular cheihtis.

Atopic dermatitis of the folds in a child

Lichen ified and very itchy patches in the knee flexures, transversed by scratch lines. In the present case similar lesions are present in other folds (e.g. of elbows, behind the ears, under the buttocks). The lesions can persist into adulthood. 

Acute exudative contact dermatitis

Acute exudative allergic contact dermatitis of the flexor surfaces of the forearms and arms after repeated application of an antiseptic lotion. Allergic reaction to hexamidine. Countless small translucent vesicles on a background of congestive erythema, rupturing and exuding a clear serous liquid.

Vesicular contact dermatitis

The diffuse erythema, with an unsharp and fragmented margin, is covered with small translucent vesicles.

Scaly dry erythematous contact dermatitis

Allergic contact dermatitis of the eyelids caused by the use of an antiwrmkle cream. Allergic reaction to Kathon CG-rr the cream's preservative. Diffused demarcated and itchy erythematous patches of eczema with fine scales.

Acute irritant dermatitis

Acute irritant dermatitis of the back of the hand and fingers, caused by contact with detergents. Diffuse itchy erythema. The margins of the erythema are distinct, corresponding to the zone of contact with the irritants.

Atopic dermatitis of the face in an infant

Bright red oedernatous patches of eczema with weeping vesicles. The margins are poorly defined. The lesions predominate on the convex areas of the face: forehead, cheeks, chin.

Infected retro-auricular dermatitis

Itchy exudative erythematous lesions of the retro-auricular groove, centred on a fissure at the base of the fold. Yellowish crusts are the sign of a rnicrobial infection. These lesions, classical in childhood, can persist into adulthood.

Atopic cheilitis

Atopic cheilitis affects the upper and lower lips and extends over the penoral region. Dry eczematous lesions causing chronic desquamation.

Atopic dermatitis in the adult: xerosis, lichenification and pruriqo

Very particular polymorphism of the lesions: skin dry and rough (xerosis), lie hen if led patches. There are also papules of various sizes, very strongly infiltrated, hard in consistency and often excoriated. These are prurigo papules (which used to be called "Besnier's prurigo").

Atopic dermatitis of the hands in the adult

Chronic scaly erythematous eczema of the back of the hands. One quite characteristic feature is the irregular distribution [patchy pattern) of the lesions. Some fingers are affected, whereas others are not. The back of the hands is irregularly affected. This "disordered" topography of the lesions is frequently found in atopic dermatitis.

Atopic conjunctivitis

Atopic conjunctivitis associated with blepharitis.This inflammation of the conjunctiva is embarrassing, sometimes painful, and often distressingly chronic. It is not unusual in the atopic adult.

Latex contact urticaria

Urticanal weals occurring within minutes of putting on surgical latex gloves. These weals can spread beyond the actual site of contact because this is an immunoallergic urticaria (specific IgE are sometimes present). Generalized urticaria with systemic symptoms can therefore occur: allergic rhinitis, conjunctivitis, asthma-like attacks, anaphylactic shock, etc.

Prick test with latex

Diagnosis of latex contact urticaria: the prick test is performed with a lancet using incubation liquid from the suspected latex gloves.

Provocative use test with latex gloves

In cases of doubt (prick test difficult to interpret), a provocation test can be performed, if necessary with the suspected glove. This will always be done initially with a finger-stall, which is slipped onto a moistened finger for 10 mm. The provocation test must always be done in a hospital environment.

Pressure urticaria

Very itchy deep oedema occurringn several hours (6 to 12 hours) after strong pressure on a precise area, e.g. on palmar side. Feet can be affected after walking, as can buttocks after prolonged sitting.

Cold urticaria

Eruption triggered by cold: the application of an ice-cube for 3 to 10 mm systematically reproduces an urticanal weak Nevertheless, in the present case it would be appropriate to perform a second test to eliminate aguagenic urticaria (with immersion of one hand in water at ambient temperature).

Solar urticaria

This very rare variant of urticaria occurs within minutes on exposure to sunlight. The eruption can persist for three to four hours. Photobiological investigation very easily confirms the diagnosis (photosensitivity test positive with UVA and/or UVB).

Urticated weals

Eruption of oedematous urticated weals which can coalesce into broad patches. Itching is constant and can prevent sleep. This urticaria can be the first sign of anaphylactic shock.

Papular urticaria

Urticarial weals spread symmetrically over the body, most often blamed on medicines. Specific foods can sometimes trigger this type of urticaria (acute urticaria). Strawberries, shellfish, fish, certain cereals, milk, eggsH and some particular food additives are most frequently the cause. The diagnosis is based mainly on provocation tests (withdrawal and remtroduction of the suspected medicine or food).

Figured urticaria

The urticarial papules describe curlicues or geographical shapes. In this case, the cause would most often be a drug (aspirin, codeine, penicillin, etc.). Again, a withdrawal test with re-intreduction, if appropriate, makes it possible to reach an exact diagnosis.

Hereditary angio-oedema

Not particularly itchy, deep urticaria mainly affecting the face (particularly eyelids and lips), the glottis, and even the larynx. This is an emergency which requires rapid therapeutic intervention {adrenaline and corticosteroids in particular), latrogenic causes are not uncommon.

Urticarial vasculitis

Combination of urticaria with lesions of leucocytoclastic vascuhtis. The urticarial lesions are more fixed than in classical urticaria. They last for 2 to 3 days and are frequently accompanied by joint pains and by fever. Reduced complement levels in blood are observed.

Dermographism

Drawing on the skin with a blunt tip produces a linear erythema with an oedematous component. The dermographism appears 5 to 10 mm after the rubbing. It can be isolated or associated with chronic idiopathic urticaria.

Drug-induced phototoxic eruption

Drug-induced phototoxic eruption associated with the ingestion of a tetracycline. Erythematous oedematous lesions whose pattern corresponds strictly to the skin areas exposed to sunlight. The borders of the lesions are as if "cut with a knife".

Drug-induced photoallergic eruption

Drug-induced photoallergic reaction associated with the ingest ion of a phenothiazine. The symptoms comprise erythema, confluent papules, and plaques of weeping vesicular eczema. The lesions, which are accompanied by severe itching, spread beyond the areas exposed to the sun, in contrast to the phototoxic reactions.

Acneiform facial eruption

This drug-induced eruption is associated in the present case with intramuscular injections of vitamin B12. It is clinically monomorphic, i.e. it is characterized by the presence of papules and pustules and by the absence of comedones.

Psoriatiform eruption

Psonatifortn eruption associated with the ingestion of a B-blocker. In certain cases this is an aggravation of existing psoriasis. The lesions are not usually very scaly. They can be itchy. There is an increasingly large number of suspected groups of drugs

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