Dermatitis, Contact & Allergic Irritant

P249HOW DOES THE DIAGNOSIS OF LATEX ALLERGY AFFECT PEOPLE’S LIVES?Victoria J Lewis, MBBS, University Hospital of Wales, Cardiff, Wales, Barry Statham, MBBS,Singleton Hospital, Swansea, Wales, Mabs Chowdhury, MBBS, University Hospital ofWales, Cardiff, Wales

50 patients who had been diagnosed with latex allergy in the past 6 years in Swansea andCardiff were sent a questionnaire about how their lives had changed following theirdiagnosis. They also completed the Dermatology Life Quality Index on symptoms beforeand after their diagnosis.

36 patients responded (72%), 22 of whom worked in the healthcare service. 9 hadchanged the nature of their job since diagnosis. Of the 26 people regularly working withlatex 21 employers had assisted them with these changes. However 1/3 who visited theirdoctor or dentist since diagnosis had encountered ill-informed staff, some patients evenhaving to supply their own gloves.

14 out of 36 had a food allergy, the commonest being to bananas or kiwi fruit. Thecommonest reported symptoms were urticaria (17/36), chronic hand dermatitis (11/36)and angioedema (13/36).

Most staff switching to latex free gloves noticed an improvement in their symptoms, andaverage DLQI scores reduced from 18 to 11 following diagnosis, although this was inretrospect.

In this study the patients questioned had experienced symptoms for up to 10 years beforediagnosis. It highlights the importance of early diagnosis, both to improve quality of lifeand avoid problems in the workplace. It also exposes the lack of knowledge still prsentin medical staff about this condition.

Disclosure not available at press time.

P250THE USE OF CLOBETASOL .05% FOAM IN THE TREATMENT OF CHRONIC HANDDERMATITISJ. Mark Jackson, MD, University of Louisville Div of Dermatology, Louisville, KY, UnitedStates, Joseph F. Fowler Jr., MD, University of Louisville Div of Dermatology, Louisville,KY, United States

The goal of this double-blind randomized placebo controlled study is to determine theeffectiveness of the topical corticosteroid Clobetasol propionate in a foam vehicle 0.05%in the treatment of hand dermatitis including allergic and irritant contact dermatitis,atopic dermatitis and endogenous dermatitis. The study will also determine the impact onquality of life issues associated with the dermatitis as well as with the aesthetics of thevehicle compared to previous topical lotions, creams, gels and ointments.

Thirty patients (10 placebo and 20 active agent) will be enrolled and will apply placeboor vehicle twice daily for two weeks. Evaluations will be performed at baseline 2 weeksand 2 weeks post treatment. Global assessments and patient evaluations will be per-formed at baseline and two week post treatment.

Disclosure not available at press time.

Study was sponsored wholly by Connetics corporation

P251DETERMINATION OF INCIDENCE OF DERMAL SENSITIZATION TO A TOPICALTRIPLE ANTIBIOTIC OINTMENT IN A NORMAL HEALTHY POPULATIONRita A Wanser, BS, Pfizer Inc, Morris Plains, NJ, United States, Kays Kaidbey, MD, PfizerInc, Morris Plains, NJ, United States, James Leyden, MD, Pfizer Inc, Morris Plains, NJ,United States, Bruce Kohut, DMD, Pfizer Inc, Morris Plains, NJ, United States

The objective of this controlled, clinical study was to determine the incidence of dermalsensitization to a topical triple antibiotic ointment (TAO) containing Neomycin, Bacitra-cin and Polymyxin B in a generally normal healthy population that had potential to priorexposure to this ointment, when tested under 48 hours of semi occlusive patch testconditions. This study was a multicenter, randomized, evaluator blind, single patchapplication. A vehicle control treatment (petroleum) was included to determine potentialsubject reaction to the base and a negative control (distilled water) was used to verifyreliability of the methodology and determine potential subject hypersensitivity to patch-ing/patch wear. Sensitization was assessed by evaluating the response at 24 and 48 hourspost patch removal using the 5-point grading system recommended by the InternationalContact Dermatitis Research Group and the North American Contact Dermatitis group.Dermal irritation was assessed using a 6-point scale.

Of the total of 512 healthy subjects who qualified for the study, over 500 subjectscompleted the study. Except for a transient upper respiratory infection or headache in afew subjects, no significant adverse events were encountered. No significant primaryirritant reactions were encountered. Three of the completing subjects developed raisedpruritic spreading reactions at the site of the TAO and these reactions were suggestive ofdelayed contact hypersensitivity. All three subjects reported prior exposure to TAO.Therefore, based on the results of this study, the incidence of delayed contact hypersen-sitivity to TAO in a normal healthy population is less than 1.0%.

Primary and co presenter #3 are Pfizer employees.

100% is sponsored by Pfizer Consumer Health Care

P252DETERMINATION OF THE CUMULATIVE IRRITATION POTENTIAL OF ADAPALENECREAM AND GEL 0.1% COMPARED TO TRETINOIN MICRO, 0.04% AND MICRO,0.1% AFTER REPEATED APPLICATIONS TO THE SKIN OF HEALTHY SUBJECTSJonathan S Dosik, MD, TKL Research, Inc, Paramus, NY, United States, Stephanie Arson-naud, Galderma R&D Inc, Princeton, NY, United States

Objective: To assess the cumulative irritation potential of adapalene cream and gel, 0.1%compared to tretinoin micro gel, 0.04% and 0.1%.

Methods: Single center, active- and negative-controlled, investigator blinded, intra-indi-vidual comparison with randomized applications. The 4 products and the negativecontrol were randomly applied on the upper area of the back under occlusive conditions.There were twelve 24-hour applications and three 72-hour applications on weekendduring 3 weeks. A White Petrolatum site served as a negative control. Skin reactions(erythema score � other local reaction) were assessed 15 to 30 minutes after removal ofproducts. The Mean Cumulative Irritation Index (MCII) was calculated for each productby averaging individual CII’s across subjects.

Results: Thirty-one subjects were included. Five subjects withdrew from the study Morethan 90% of the subjects were females with a mean age of 39.7 years and more than 77%were of Caucasian origins There was no significant difference for the MCII betweenadapalene gel (0.0471 � 0.1460) and cream (0.0920 � 0.1647). Significant differenceswere shown (p � 0.01 and p � 0.05) between both adapalene concentrations and bothtretinoin concentrations (gel micro 0.04%: 0.7138 � 0.4593; gel micro 0.1%: 0.6747 �0.4178). There was no significant difference between both adapalene formulations andwhite petrolatum (0.0126 � 0.0681) but significant differences (p � 0.01 and p � 0.05)between white petrolatum and both retinoin concentrations. There were no adverseevents reported.

Conclusions: The results of this stressful test clearly indicate that a concentration of 0.1%of adapalene in a gel or a cream formulation is well tolerated as compared to tretinoin.

The results of this study showed that adapalene should be considered as the first linetopical therapy for treating acne vulgaris.

Disclosure not available at press time.

Study granted by Galderma Inc

P66 J AM ACAD DERMATOL MARCH 2004