Immunological Contact Urticaria

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Immunological contact urticaria (ICU) are immediate (Type I) allergic reactions in people who have previously been sensitized to the causative agent. ICU is IgE mediated and is more common in atopic individuals. Food substances are common causes of ICU. 2

ACNEGENICITY

This refers to the capacity of some agents to cause acne or aggravate existing acne lesions. This term may be subdivided to include comedogenicity and pustulogenicity.

Comedogenicity

This is the capability of an agent to cause hyperkeratinous impactions in the sebaceous follicle, or the formation of microcomedones, usually in a relatively short period of time.

Pustulogenicity

This refers to the capability of an agent to cause inflammatory papules and pustules, usually in a relatively short period of time.

SENSITIVE SKIN

This term is a neologism for consumers' feelings about their intolerance to a variety of topical agents, be it topical medicaments or cosmetics and toiletries. Individuals present with very similar complaints, such as burning, stinging or itching sensations, on contact with certain cosmetic products that most people do not seem to react to, sometimes accompanied by slight erythema or edema. They frequently complain of a ''tight feeling'' in their skin, secondary to associated dry skin. Sensitive skin describes the phenotype noted by the consumer; mechanisms include sensory irritation, suberythematous irritation, acute and cumulative irritation, contact urticaria, allergic contact dermatitis, as well as photoal-lergic and phototoxic contact dermatitis. Sensory irritation and suberythematous irritation are believed to be far more common than the remaining mechanisms.

Cosmetic Intolerance Syndrome

The term cosmetic intolerance syndrome (CIS) is applied to the multifactorial syndrome in which certain susceptible individuals are intolerant of a wide range of cosmetic products. CIS is thought to be caused by one or more underlying occult dermatological conditions, such as subjective irritation, objective irritation, allergic contact dermatitis, contact urticaria, or subtle manifestations of endogenous dermatological diseases, such as atopic eczema, psoriasis, and rosacea.

Status Cosmeticus

Status cosmeticus is a condition in which every cosmetic product applied to the face produces itching, burning or stinging, rendering the sufferer incapable of using any cosmetic product. The patient's history usually includes ''sensitivity'' to a wide range of § products. This diagnosis is only declared after a full battery of tests have proved negative, and may be considered the extreme end of the spectrum of sensitive skin. -c

BIBLIOGRAPHY J

Irritant Contact Dermatitis S

Elsner P, Maibach HI, eds. Irritant Dermatitis: New Clinical and Experimental Aspects. Current S

Problems in Dermatology Series, Vol. 23, Basel; Karger, 1995. 2

Lammintausta K, Maibach HI. Irritant contact dermatitis. In: Moschella SL, Hurley HJ, eds. Dermatology, 3rd edition. Philadelphia; W.B. Saunders Company, 1992:425-432.

Van Der Valk PGM, Maibach HI. The Irritant Contact Dermatitis Syndrome. Boca Raton: CRC Press, 1996.

Wilkinson JD, Rycroft RJG. Contact dermatitis. In: Champion RH, Burton JL, Ebling FJG, eds. Rook/Wilkinson/Ebling Textbook of Dermatology, 5th edition. Oxford; Blackwell Scientific Publications, 1992:611.

Allergic Contact Dermatitis

Cronin E. Contact Dermatitis. Edinburgh; Churchill Livingstone, 1980.

Larsen WG, Maibach HI. Allergic contact dermatitis. In: Moschella SL, Hurley HJ, eds. Dermatology, 3rd edition. Philadelphia; W.B. Saunders Company, 1992; 17:391-424.

Rietschel RL, Fowler JF Jr, eds. Fisher's Contact Dermatitis, 4th edition. Williams & Baltimore; Williams and Wilkins, 1995.

Phototoxic/Photoallergic Contact Dermatitis

DeLeo VA, Maso MJ. In: Moschella SL, Hurley HJ, eds. Dermatology, 3rd edition. Philadelphia: W.B. Saunders Company, 1992:507.

Harber LC, Bickers DR, eds. In: Photosensitivity Diseases: Principles of Diagnosis and Treatment, 2nd edition. Ontario; BC Decker Inc. 1989.

Marzulli FN, Maibach HI. Photoirritation (phototoxicity, phototoxic dermatitis). In: Dermatotoxicol-ogy, 5th edition. Washington, DC: Taylor & Francis, 1996; 231-237.

Contact Urticaria Syndrome

Amin S, Lahti A, Maibach HI. Contact Urticaria Syndrome. Boca Raton: CRC Press, 1997.

Lahti A, Maibach HI. Contact Urticaria Syndrome. In: Moschella SL, Hurley HJ, eds. Dermatology, 3rd edition. Philadelphia; W.B. Saunders Company, 1992, 19:433.

Acnegenicity

Mills OH Jr, Berger RS. Defining the susceptibility of acne-prone and sensitive skin populations to extrinsic factors. Dermatologie Clinics, 1991; 9(1):93-98.

Sensitive Skin

Amin S, Engasser P, Maibach HI. Sensitive skin: what is it? In: Baran R, Maibach HI. Textbook of Cosmetic Dermatology, 2nd edition. London; Martin Dunitz Ltd, 1998; 343-349.

Fisher AA. Cosmetic actions and reactions: Therapeutic, irritant and allergic. Cutis 1980; 26:2229.

Maibach HI, Engasser P. Management of cosmetic intolerance syndrome. Clin Dermatol 1988; 6(3): 102-107.

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