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| 2. |
- Börve, Alexander, et al.
(författare)
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Use of the mobile phone multimedia messaging service for teledermatology
- 2012
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Ingår i: Journal of Telemedicine and Telecare. - : SAGE Publications. - 1357-633X .- 1758-1109. ; 18:5, s. 292-296
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Tidskriftsartikel (refereegranskat)abstract
- We examined the feasibility of using mobile phone Multimedia Messaging Service (MMS) to send teledermatology referrals from a general practitioner to a dermatologist. Digital photographs of skin conditions in 40 consecutive patients were sent together with relevant clinical information to dermatologists at a university hospital. Two dermatologists separately assessed the MMS referrals. The suspected diagnosis, triage and management decisions were compared to those given after separate face-to-face (FTF) visits, and again after agreeing on a final clinical and/or histopathological diagnosis. Thirty-two patients (80%) were diagnosed with skin tumours and 8 patients (20%) with other skin conditions. Both dermatologists were able to make a correct diagnosis in 31 patients (78%) based solely on the MMS referral. They also provided adequate management recommendations for 98% of the patients. Adequate triage decisions after assessment of the MMS referrals were made for 34 (85%) and 38 (95%) patients by the two dermatologists. There was an inter-observer concordance of 68% for the teledermatology diagnosis, compared to 88% concordance after the separate FTF visits. The diagnostic accuracy and adequacy of the triage and management decisions achieved using MMS referrals were similar to those obtained with other store-and-forward teledermatology methods.
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| 3. |
- Gente-Lidholm, Anette, et al.
(författare)
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Comparison of reactivity to a metallic disc and 2% aluminium salt in 366 children, and reproducibility over time for 241 young adults with childhood vaccine-related aluminium contact allergy
- 2018
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873. ; 79:1, s. 26-30
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Tidskriftsartikel (refereegranskat)abstract
- Background: An aluminium hydroxide-adsorbed pertussis toxoid vaccine was studied in 76 000 children in the 1990s in Gothenburg, Sweden. Long-lasting itchy subcutaneous nodules at the vaccination site were seen in 745 participants. Of 495 children with itchy nodules who were patch tested for aluminium allergy, 377 were positive. In 2007-2008, 241 of the positive children were retested. Only in one third were earlier positive results reproduced. Objectives: To further describe patch test reactions to different aluminium compounds in children with vaccine-induced aluminium allergy. Patients/Methods: Positive patch test results for metallic aluminium (empty Finn Chamber) and aluminium chloride hexahydrate 2% petrolatum (pet.) were analysed in 366 children with vaccine-induced persistent itching nodules tested in 1998-2002. Of those, 241 were tested a second time (2007-2008), and the patch test results of the two aluminium preparations were analysed. Results: Patch testing with aluminium chloride hexahydrate 2% pet. is a more sensitive way to diagnose aluminium contact allergy than patch testing with metallic aluminium. A general decrease in the strength of reactions to both aluminium preparations in 241 children tested twice was observed. Conclusions: Aluminium contact allergy can be diagnosed by patch testing without using metallic aluminium.
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| 4. |
- Gente-Lidholm, Anette, et al.
(författare)
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Long-term clinical course and prognosis of vaccine-related persistent itching nodules (1997-2019): An observational study
- 2022
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Ingår i: Vaccine: X. - : Elsevier BV. - 2590-1362. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Background: Vaccines adsorbed to aluminium can induce long-lasting intensely itching subcutaneous nodules (granulomas) at the injection site as well as contact allergy to aluminium. In clinical trials of a new acellular pertussis vaccine performed in the 1990s (Gothenburg, Sweden) with 76 000 participants, itching nodules were reported in 745 children. A positive patch test to aluminium was verified in 77% of the tested children with itchy nodules. Aim: To describe the long-term clinical course and prognosis of vaccine-related itching nodules caused by aluminium-containing pediatric vaccines and to estimate the risk for new symptoms after future vaccination with aluminium-containing vaccines. Methods: 745 children with vaccine-related itching nodules were followed by regular interviews/questionnaires for more than 20 years. 723 of them received a booster dose of diphtheria/tetanus vaccine either with or without aluminium adjuvant during the follow-up time. Results: Most study participants (86%) reported a full recovery from their itching nodules after a median duration of 6.6 years. Only a few of the diphtheria/tetanus-booster-vaccinated children (3%) reported mild transient itching and swelling at the new injection site. Conclusion: Vaccine-induced itching granulomas caused by an aluminium-adsorbed acellular pertussis toxoid vaccine seem to disappear over time. Future vaccinations with aluminium-adsorbed vaccines can be performed with little risk for new itching nodules later in life. (c) 2022 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http:// creativecommons.org/licenses/by/4.0/).
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| 5. |
- Gente-Lidholm, Anette, et al.
(författare)
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Long-term prognosis of vaccine-induced contact allergy to aluminium: Third patch-test with additional test preparations
- 2023
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Ingår i: Contact Dermatitis. - 0105-1873. ; 89:5, s. 359-367
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Tidskriftsartikel (refereegranskat)abstract
- Background A high incidence of local itching subcutaneous nodules and aluminium allergy was observed in clinical trials of a new aluminium adsorbed pertussis vaccine in Gothenburg, Sweden, in the 1990s. A total of 495 children with itching nodules were patch tested with aluminium chloride hexahydrate 2% and an empty Finn Chamber (R), 377 (76%) with positive reactions. When 241 of them were re-tested some years later 186 (3 out of 4) had unexpectedly lost their patch test reactivity.Aim To investigate the long-term prognosis of vaccine-induced contact allergy to aluminium by a third patch test about 20 years after Patch test I.Methods Twenty individuals with positive and 11 with negative results in Patch test II were tested a third time with the same sensitisers as in in the first two tests. Three additional aluminium preparations were also tested.Results A total 15 out of 20 persons with positive results in the second test had lost their patch test reactivity. Two of 11 with negative tests had turned positive again. The addition of the preparations gave no conclusive results.Conclusion Contact allergy to aluminium caused by vaccination with aluminium-adsorbed vaccines in childhood seems to fade away with time as measured by loss of patch test reactivity.
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| 6. |
- Gente-Lidholm, Anette, et al.
(författare)
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Loss of patch-test reaction to aluminium years after vaccination with aluminium adjuvants in a population of 76.000 children.
- 2010
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Ingår i: Contact Dermatitis. - 0105-1873 .- 1600-0536.
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Konferensbidrag (refereegranskat)abstract
- During trials of aluminium adsorbed diphtheria–rntetanus/acellular pertussis vaccines from a single producer,rnpersistent intensely itching nodules at the vaccination site werernobserved in an unexpectedly high frequency (about 1%) in thernstudy area around Gothenburg, Sweden. All afflicted childrenrnwere offered patch testing for aluminium. Among the childrenrnsensitisation to aluminium was demonstrated in a highrnfrequency (77%). The children demonstrated positive patchrntests for aluminium were offered to repeat the test 5 years later.rnObjectives: To study the clinical course of itching nodules andrncontact allergy to aluminium.rnMethods: Two hundred and fifty children with itching nodulesrnat the injection site after vaccination with aluminium adsorbedrndiphtheria–tetanus/acellular pertussis vaccines that earlier hadrnshown a positive patch test reaction to aluminium, wherernrepeated the patch test more than 5 years later. Thernchildren were patch tested in the same way as beforernwith aluminiumchloridehexahydrate 2% in petrolatumrn(Chemotechnique Diagnostics, Sweden) in plastic chambersrnfrom the same manufacturer, and also with an empty FinnrnChamber (Epitest, Finland). The tests were read on day threernusing the ICDRG’s criteria.rnResults: Among the 250 children tested, approximately 75% hadrnno remaining positive patch test to aluminium. Only a few of thernchildren presented still itching nodules.rnConclusion: Three out of four children with earlier shownrncontact allergy to aluminium had lost their patch testrnreactivity 5 years later.
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| 7. |
- Gente-Lidholm, Anette
(författare)
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Vaccine-induced aluminium allergy and long-lasting subcutaneous itching nodules
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Aluminium contact dermatitis is rare even though aluminium is frequently used in antiperspirants and sunscreens. Sensitisation to aluminium is mostly a side effect of aluminium-adsorbed vaccines. These can also induce long-lasting intensely itching subcutaneous nodules (granulomas) at the injection site. During clinical trials on an acellular aluminium-adsorbed pertussis vaccine in the 1990s in Gothenburg, Sweden, persistent itching nodules were -unexpectedly- reported in 745 of ~ 76 000 vaccinated. Contact dermatitis to aluminium was verified by patch test in 377 children with itching nodules. Aim: This thesis aims to study the long-term clinical prognosis of itching subcutaneous nodules and aluminium allergy in children who received an aluminium-adsorbed pertussis vaccine in a clinical trial. Patients and Methods: All 745 vaccinated children with itching nodules in the pertussis vaccine trial were enrolled in a long-term follow-up study (>20 years). Results: The median duration of itching was 6.6 years. During the follow-up time 637/745 (86%) of the participants experienced full symptom recovery. The remaining were markedly improved. In 186 of 241 (77%) children who were tested twice, aluminium hypersensitisation was no longer detectable. A negative patch test was significantly correlated with loss of itching. 3-7% of the participants who received other aluminium-adsorbed vaccines later in life reported mild and transient itching at the new injection site. The optimal compound to establish aluminium hypersensitivity could not be determined. Conclusion and recommendations: Vaccine-induced subcutaneous itching nodules associated with aluminium allergy in infants and children can cause great suffering and have a protracted course. However, long-term prospective studies5 show that both clinical symptoms and delayed hypersensitivity for aluminium disappear over time. Further vaccination with aluminium-adsorbed vaccines is safe in older children given that the original nodule has vanished and the itching will have resolved or nearly resolved.
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| 8. |
- Inerot, Annica, 1949, et al.
(författare)
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LOCAL ITCHING AND SWELLING THREE DAYS AFTER TATTOOING WITH YELLOW AND GREEN COLORS IN A YOUNG WOMEN, KNOWN TO BE CONTACT ALLERGIC TO ALUMINIUM
- 2013
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Ingår i: European Congress on Tattoo and Pigment Research, Nov 13-14, 2013, Copenhagen.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Aim: To highlight the risk of local contact dermatitis from aluminum in a tattoo, a case report. Method: Observing an 18 years of age women seeking medical care three days after having tattooed a flower decoration on her right arm. Background: At the age of 10 she had problems with itching and eczema on her upper left arm after vaccination and in her armpits, when using deodorants. A dermatologist referred her to a patch test clinic on the suspicion of contact allergy to aluminum. The patch test showed a strong reaction (+++) to aluminum chloride hexahydrate 2, 0 % in petrolatum. Eight years later – on a Monday – she asked a tattoo parlor to make a four-colored decoration of her right arm. She asked them before if there were any aluminum in the tattoo and was reassured that this was not the case. The tattooing was done in black, red, yellow and green colors. On Thursday she had severe itching and swelling where there was yellow and green tattooing. She had no reaction at all where there were black or red colors. She was recommended local steroid application. Results: The itching continued for around a year. The yellow color was analysed and contained 960 microgram aluminum per gram. Conclusions: Individuals with an earlier subcutaneous itching nodule from vaccination could get long lasting contact dermatitis after a tattoo.
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| 9. |
- Lidholm, Anette Gente, et al.
(författare)
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Unexpected loss of contact allergy to aluminium induced by vaccine
- 2013
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Ingår i: Contact Dermatitis. - : John Wiley & Sons. - 0105-1873 .- 1600-0536. ; 68:5, s. 286-292
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:In studies in Gothenburg, Sweden, in the 1990s of an aluminium hydroxide-adsorbed pertussis toxoid vaccine, 745 of ~76 000 vaccinated children developed long-lasting itchy subcutaneous nodules at the vaccination site. Of 495 children with itchy nodules patch tested for aluminium allergy, 376 (76%) were positive.OBJECTIVES:To study the prognosis of the vaccine-induced aluminium allergy.PATIENTS AND METHODS:Two hundred and forty-one children with demonstrated aluminium allergy in the previous study were patch tested again 5-9 years after the initial test, with the same procedure as used previously.RESULTS:Contact allergy to aluminium was no longer demonstrable in 186 of the retested 241 children (77%). A negative test result was more common in children who no longer had itching at the vaccination site; it was also related to the age of the child, the time after the first aluminium-adsorbed vaccine dose, and the strength of the reaction in the first test.CONCLUSIONS:Patch test reactivity to aluminium seems to disappear or weaken with time.
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