Hand eczema (HE) imposes a significant socioeconomic burden, particularly in severe and occupational cases. To identify major allergens and associated factors in Chinese patients with HE referred for patch testing, we conducted a retrospective cohort study included 788 cases of HE detected from 4438 patients who were patch-tested in Shanghai, China, between 2018 and 2023. The HE group had an 82.23% patch-test positivity rate. N-Isopropyl-N-Phenyl-4-Phenylenediamine were more common in the HE than in the non-HE group after false discovery rate (FDR) correction (FDR-adjusted p < 0.05), while other rubber allergens showed similar trends (multivariable-adjusted p < 0.05). The top five allergens associated with HE were nickel sulfate, dodecyl gallate, methylisothiazolinone, cobalt chloride, and methylisothiazolinone/methylchloroisothiazolinone. Polysensitization was more common in females than in males, while sensitivity to occupation-related allergens was more common in males. Fragrance allergies were more frequent in patients over 40 years old, and those with a history of atopic dermatitis showed no significant allergen trends. Among occupational exposures, hairdressers and beauticians showed heightened hand sensitivity to preservatives and p-phenylenediamine. Although few allergens reached significance after FDR correction in other occupations, multivariable-adjusted analyses suggested certain allergens as potentially occupational, warranting further surveillance. These findings highlight the notable difference in positive patch test reactions between individuals with HE and without HE and emphasize the role of allergens in HE, as well as the risks posed by sex, age, history of allergic dermatitis, and occupation. Further studies with balanced samples are warranted.

The global use of nutraceuticals and dietary supplements-including vitamins, minerals, probiotics, and botanical extracts-has increased substantially, driven largely by consumer perceptions of safety and health benefits. However, their potential to cause hypersensitivity reactions (HSRs) is underrecognized. This review synthesizes published case reports, case series, systematic reviews, and pharmacovigilance data to characterize HSRs linked to these products, identify risk factors, and examine diagnostic and regulatory challenges. We classified reactions as immediate (< 1-6 h after administration), non-immediate (> 1-6 h after administration to several weeks). Immediate HSRs, including anaphylaxis, have been reported after vitamins B complex, short-chain galacto-oligosaccharides (GOS), whole-food supplements such as spirulina, natto (poly[γ-glutamic acid]) and royal jelly, and botanical/plant derived products; diagnosis commonly used skin-prick and intradermal testing and basophil activation tests. Non-immediate HSRs-ranging from maculopapular eruptions to severe cutaneous adverse reactions-have been associated with cobalamin, chromium picolinate, alpha-lipoic acid, diindolylmethane (DIM), glucosamine/chondroitin, and euglena; diagnosis often relies on patch testing, lymphocyte transformation assays, and cautious drug provocation when indicated. These products can also cause allergic contact dermatitis, and occupational sensitization (e.g., rhinitis/asthma) has been reported in workers exposed to psyllium and Aspergillus oryzae-derived lactase. Diagnostic accuracy is limited by nonstandardized reagents, variable test concentrations, complex product formulations, and cross-reactivity (notably within botanical families such as Asteraceae and among plant proteins/legumes), complicating interpretation and increasing risk for atopic individuals. Evidence remains dominated by case-based reports and passive surveillance. To reduce risk, we recommend heightened clinician awareness, development of standardized diagnostic reagents and protocols, mandatory adverse-event reporting, clearer ingredient labeling, and premarket allergenicity assessment.

Atopic dermatitis (AD) and allergic contact dermatitis (ACD) are common inflammatory skin diseases in both children and adults that present similarly and often coexist. Patch testing is the gold standard for establishing the diagnosis of ACD and can often help distinct between the 2 conditions. Patch testing is more challenging in patients with underlying AD due to potential for angry back reactions. In this review, we discuss the current evidence and guidelines regarding the screening for contact allergies in patients with AD. We also discuss the most frequent relevant allergens in adults and children with atopic dermatitis.

Background Smoking remains a major contributor to preventable disease and mortality. Although smoking cessation programs are widely implemented, quit rates remain low and relapse is common. Pharmacological therapies such as nicotine replacement therapy, varenicline, and bupropion can improve quit rates, but their real-world effectiveness is often limited by poor adherence. This study aimed to evaluate adherence to smoking cessation clinic follow-up, adherence to prescribed pharmacotherapy, smoking cessation outcomes, and associations between selected demographic and treatment-related factors and smoking cessation success. Methodology A cross-sectional study was conducted at four primary care smoking cessation clinics affiliated with King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia. All smokers who attended these clinics were eligible, with pregnant women excluded. Using OpenEpi, a random sample of 344 participants was selected from 1,860 patients. Data were collected from medical records and a validated telephone-administered Arabic questionnaire. Smoking cessation outcomes, pharmacotherapy adherence, and reasons for non-adherence were assessed by participant self-report during telephone interviews. Statistical analysis was performed using SPSS version 26, applying descriptive statistics and chi-square tests with significance set at p-values <0.05. Results A total of 344 patients were analyzed, with a mean age of 42 years (SD = ±12); nearly half (49.1%) were aged 40-59 years, and 98.5% were male. Most participants attended only one visit (47.1%). Pharmacologic interventions were prescribed to 44.8% of patients, primarily varenicline (74.7%). The overall smoking cessation success rate was 32.6%. Among participants who reported discontinuation of follow-up visits, lack of motivation was the most commonly reported reason (64.1%). Among participants who provided a reason for non-adherence to pharmacotherapy, medication side effects were the leading reason (24.1%), with nausea being the most frequently reported side effect (9.9%). Younger participants (10-17 years) achieved the highest quit rate (66.7%, p = 0.009); however, this finding should be interpreted cautiously because the age group included only three participants. Clinic visit frequency was not associated with smoking cessation success (p = 0.117). Patients prescribed pharmacotherapy had numerically higher quit rates than those who did not receive pharmacotherapy (35.1% vs. 30.5%); however, this difference was not statistically significant (p = 0.372). Adherence to prescribed medication was significantly associated with higher quit rates (43.4% vs. 14.3%, p = 0.001). Conclusions The clinic achieved a quit rate comparable to international standards. Adherence to prescribed pharmacotherapy was associated with higher smoking cessation rates, whereas receipt of pharmacotherapy alone was not significantly associated with smoking cessation success. Low motivation and medication side effects were commonly reported barriers and may represent important targets for interventions aimed at improving engagement and smoking cessation outcomes.

Severe dengue is a vascular immunopathology characterized by plasma leakage, thrombocytopenia, hemorrhage, and, in its most critical form, dengue shock syndrome. Although NS1-mediated endothelial injury, glycocalyx disruption, inflammatory myeloid activation, and coagulation/platelet abnormalities have all been implicated, it remains unclear which mechanisms are most consistently supported and whether they form a coherent functional architecture capable of explaining vascular decompensation. This review asks two linked questions: which dengue mechanisms are supported by the contemporary evidence base, and whether the strongest supported components are logically sufficient, when coupled, to generate a synthetic analog of connected endothelial-barrier failure.

This study investigated the dermatological outcomes of a transferosomal gel encapsulating Niacinamide and Co-enzyme Q10 compared with a conventional base gel in healthy female volunteers over a 12-week period, with a particular focus on key biophysical and aesthetic skin parameters. Before human use, both formulations underwent primary skin irritation testing on rabbit skin, followed by a patch test on healthy volunteers to establish safety. A randomized split-face study design was implemented. Skin hydration, elasticity, melanin, erythema, sebum content, pore size, spots, and wrinkle indices were systematically assessed. Sensory evaluation and appropriate statistical analyses complemented the biophysical measurements. Irritation and patch-test assessments confirmed the nonirritant, well-tolerated nature of both formulations. The transferosomal gel demonstrated significantly higher efficacy (p < .05) across multiple parameters, including hydration, elasticity, melanin, erythema reduction, and sebum regulation. Improvements in pore size, spot reduction, and wrinkle were also more substantial and became evident as early as week 2, with continual enhancement observed throughout the 12-week study. Transferosomal delivery of Niacinamide and Co-enzyme Q10 demonstrates improved topical efficacy compared with conventional formulation, as evidenced by the performance outcomes. It offers a safe, noninvasive delivery strategy for improving skin-related parameters within the study conditions.

Glyphosate exposure is commonly assessed using either passive dosimetry or biomonitoring. This study tests the hypothesis that internal dose estimates derived from passive dosimetry are higher and more uncertain than those derived from biomonitoring by comparing concurrently collected passive dosimetry and biomonitoring data from a controlled simulation of heavy residential herbicide application. The two predominant exposure routes were evaluated separately: six applicators were protected from dermal exposures with hooded Tyvek[®] coveralls and gloves and six were protected from inhalation exposure with a respirator. Urine was serially collected from all applicators between 30 min prior to and up to 36 h after application, while breathing-zone air samplers (left and right lapel) and four dermal patches were collected from dermally protected applicators. Internal doses were independently estimated from air and dermal patch measurements (passive dosimetry) and from urinary glyphosate residues (biomonitoring; dilution-adjusted). Average total internal daily doses of glyphosate estimated from passive dosimetry were approximately seven times greater than biomonitoring-based estimates. This overestimation appeared attributable to the dermal pathway and was consistent with the uncertainty in the assumed dermal absorption and clothing penetration factors as well as with the uncertainty introduced by extrapolating a limited number of dermal patch measurements to larger body regions. Even so, the highest individual internal daily dose of glyphosate derived from passive dosimetry remained below the internal-dose benchmark derived from conservative regulatory health-based guidance values (60 µg/kg/day), suggesting a low likelihood of adverse health effects under the tested conditions. By directly comparing concurrently collected passive dosimetry and biomonitoring data in applicators with detectable urinary glyphosate, this study provides empirical support for using biomonitoring to evaluate and refine dermal passive-dosimetry assumptions in glyphosate exposure assessment.

I investigated the key causes and mechanisms of skin sensitization, evaluated existing diagnostic methods, and proposed new strategies to reduce the risk for allergic reactions. My research focused on sensitization to cosmetic components, including synthetic fragrances, preservatives (i.e., methylisothiazolinone, chlorphenesin), and natural extracts. I used patch testing and molecular diagnostics based on pro-inflammatory markers (i.e., interleukin-6, tumor necrosis factor-alpha). Positive reactions occurred in 69.2% of participants, with synthetic fragrances (51.7%) and methylisothiazolinone (39.2%) as the most common allergens. Women aged 30-45 showed higher susceptibility to severe allergic responses. The study confirmed the effectiveness of patch testing and molecular diagnostics in accurately detecting and predicting skin allergies. Based on the findings, I recommend stricter regulation of sensitizing agents in cosmetics, the introduction of hypoallergenic alternatives, and a shift toward personalized product formulation. The results of my study also highlight the need for updated diagnostic standards, including non-invasive techniques and expanded molecular analyses as well as the revision of regulatory frameworks to enhance cosmetic safety and consumer well-being. Expanding professional knowledge in allergy diagnosis and prevention is essential for raising the standards of care and protecting the health of users.