array:24 [
  "pii" => "S0365059620302154"
  "issn" => "03650596"
  "doi" => "10.1016/j.abd.2020.03.013"
  "estado" => "S300"
  "fechaPublicacion" => "2020-11-01"
  "aid" => "252"
  "copyright" => "Sociedade Brasileira de Dermatologia"
  "copyrightAnyo" => "2020"
  "documento" => "article"
  "crossmark" => 1
  "licencia" => "http://creativecommons.org/licenses/by/4.0/"
  "subdocumento" => "sco"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:1 [
    "total" => 0
  ]
  "Traduccion" => array:1 [
    "pt" => array:19 [
      "pii" => "S2666275220302939"
      "issn" => "26662752"
      "doi" => "10.1016/j.abdp.2020.09.007"
      "estado" => "S300"
      "fechaPublicacion" => "2020-11-01"
      "aid" => "252"
      "copyright" => "Sociedade Brasileira de Dermatologia"
      "documento" => "article"
      "crossmark" => 1
      "licencia" => "http://creativecommons.org/licenses/by/4.0/"
      "subdocumento" => "sco"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:1 [
        "total" => 0
      ]
      "pt" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Carta &#8211; Investiga&#231;&#227;o</span>"
        "titulo" => "Testes fotoepicut&#226;neos&#58; s&#233;rie de 37 pacientes brasileiros"
        "tienePdf" => "pt"
        "tieneTextoCompleto" => "pt"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "766"
            "paginaFinal" => "767"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "pt" => true
        ]
        "contienePdf" => array:1 [
          "pt" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Figura 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 1160
                "Ancho" => 1508
                "Tamanyo" => 140712
              ]
            ]
            "descripcion" => array:1 [
              "pt" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Teste fotoepicut&#226;neo&#58; DAC ao perfume mix e FDAC a b&#225;lsamo Peru e prometazina&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Maria Antonieta Rios Scherrer, Vanessa Barreto Rocha"
            "autores" => array:2 [
              0 => array:2 [
                "nombre" => "Maria Antonieta Rios"
                "apellidos" => "Scherrer"
              ]
              1 => array:2 [
                "nombre" => "Vanessa Barreto"
                "apellidos" => "Rocha"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "pt"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S0365059620302154"
          "doi" => "10.1016/j.abd.2020.03.013"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059620302154?idApp=UINPBA00008Z"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275220302939?idApp=UINPBA00008Z"
      "url" => "/26662752/0000009500000006/v1_202012150903/S2666275220302939/v1_202012150903/pt/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S0365059620302233"
    "issn" => "03650596"
    "doi" => "10.1016/j.abd.2020.03.017"
    "estado" => "S300"
    "fechaPublicacion" => "2020-11-01"
    "aid" => "260"
    "copyright" => "Sociedade Brasileira de Dermatologia"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by/4.0/"
    "subdocumento" => "sco"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:9 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Research Letter</span>"
      "titulo" => "UVB&#44; UVA&#44; and visible light &#40;blue-violet range&#41; transmittance of clothing used in Brazil"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "768"
          "paginaFinal" => "770"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Melissa Mari Yoshida, Ana Cl&#225;udia Cavalcante Esposito, H&#233;lio Amante Miot"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "Melissa Mari"
              "apellidos" => "Yoshida"
            ]
            1 => array:2 [
              "nombre" => "Ana Cl&#225;udia Cavalcante"
              "apellidos" => "Esposito"
            ]
            2 => array:2 [
              "nombre" => "H&#233;lio Amante"
              "apellidos" => "Miot"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "pt" => array:9 [
        "pii" => "S2666275220303015"
        "doi" => "10.1016/j.abdp.2020.03.010"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "pt"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275220303015?idApp=UINPBA00008Z"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059620302233?idApp=UINPBA00008Z"
    "url" => "/03650596/0000009500000006/v2_202011230629/S0365059620302233/v2_202011230629/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S0365059620302221"
    "issn" => "03650596"
    "doi" => "10.1016/j.abd.2020.03.016"
    "estado" => "S300"
    "fechaPublicacion" => "2020-11-01"
    "aid" => "259"
    "copyright" => "Sociedade Brasileira de Dermatologia"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by/4.0/"
    "subdocumento" => "sco"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Research Letter</span>"
      "titulo" => "Assessing beauticians&#8217; knowledge of cutaneous melanoma and willingness to contribute to melanoma surveillance practices on the general population"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "764"
          "paginaFinal" => "765"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:8 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 3843
              "Ancho" => 1508
              "Tamanyo" => 250078
            ]
          ]
          "detalles" => array:1 [
            0 => array:3 [
              "identificador" => "at0005"
              "detalle" => "Figure "
              "rol" => "short"
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Percentage of beauticians who received training about skin cancer at beauty school &#40;A&#41;&#44; beauticians who are willing to learn more about melanoma detection &#40;B&#41;&#44; and percentage of beauticians who are willing to inform and refer clients to dermatologists for suspected lesions after receiving proper training &#40;C&#41;&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Laura Vollono, Giovanni Paolino, Anna Buonocore, Michele Donati"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Laura"
              "apellidos" => "Vollono"
            ]
            1 => array:2 [
              "nombre" => "Giovanni"
              "apellidos" => "Paolino"
            ]
            2 => array:2 [
              "nombre" => "Anna"
              "apellidos" => "Buonocore"
            ]
            3 => array:2 [
              "nombre" => "Michele"
              "apellidos" => "Donati"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "pt" => array:9 [
        "pii" => "S2666275220303003"
        "doi" => "10.1016/j.abdp.2020.09.013"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "pt"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275220303003?idApp=UINPBA00008Z"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059620302221?idApp=UINPBA00008Z"
    "url" => "/03650596/0000009500000006/v2_202011230629/S0365059620302221/v2_202011230629/en/main.assets"
  ]
  "en" => array:17 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Research Letter</span>"
    "titulo" => "Photoepicutaneous tests&#58; a series of 37 Brazilian patients"
    "tieneTextoCompleto" => true
    "saludo" => "Dear Editor&#44;"
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "766"
        "paginaFinal" => "767"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Maria Antonieta Rios Scherrer, Vanessa Barreto Rocha"
        "autores" => array:2 [
          0 => array:2 [
            "nombre" => "Maria Antonieta Rios"
            "apellidos" => "Scherrer"
          ]
          1 => array:4 [
            "nombre" => "Vanessa Barreto"
            "apellidos" => "Rocha"
            "email" => array:1 [
              0 => "vanessabarreto.vbr@gmail.com"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Dermatology Sector&#44; Hospital das Cl&#237;nicas&#44; Universidade Federal de Minas Gerais&#44; Belo Horizonte&#44; MG&#44; Brazil"
            "identificador" => "aff0005"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1159
            "Ancho" => 1508
            "Tamanyo" => 132919
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Positive reactions on the irradiated side of the photo epicutaneous test&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Photoepicutaneous tests or photopatch tests &#40;PPT&#41; are indicated for the diagnosis of allergic contact photodermatitis &#40;ACPD&#41;&#44; a delayed hypersensitivity reaction that occurs when a photoallergen is applied to the skin that is subsequently exposed to ultraviolet &#40;UV&#41; and&#47;or visible radiation&#46;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">1&#8211;3</span></a> Its incidence is unknown&#59; it is estimated to range from 2&#37; to 10&#37; of patients referred for investigation of photodermatoses&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Patients treated at the Contact Dermatitis Outpatient Clinic&#44; Dermatology Annex&#44; Hospital das Cl&#237;nicas&#44; UFMG between 2007 and 2019&#44; with diagnostic suspicion of photodermatosis due to eczematous lesions in exposed areas&#44; exacerbated after sun exposure&#44; were selected to undergo PPT for diagnostic purposes after the epicutaneous test with the standard Brazilian panel revealed no clinical relevance&#46; Allergens from FDA-Allergenic&#44; Rio de Janeiro and Chemotechnique Diagnostics&#44; Sweden &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41; were used in Finn Chambers&#174; with Scanpor&#174; &#40;Smartpractice&#44; United States&#41; or Allergochambers&#174; &#40;Neoflex&#44; S&#227;o Paulo&#41; applied in duplicate on the skin of the back&#46; The set of allergens tested was chosen based on the literature and availability in this service&#46;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">1&#8211;5</span></a> The allergen panel was removed after 48<span class="elsevierStyleHsp" style=""></span>h&#44; read&#44; and covered with surgical dressing and aluminum foil&#46; As no patient presented a minimal erythematous dose less than 10<span class="elsevierStyleHsp" style=""></span>J&#47;cm<span class="elsevierStyleSup">2</span> of UVA&#44; the other set of allergens was irradiated with 10<span class="elsevierStyleHsp" style=""></span>J&#44; followed by immediate reading and subsequent occlusion&#46; New readings were performed 48<span class="elsevierStyleHsp" style=""></span>h later&#44; following the International Contact Dermatitis Research Group criteria&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> If only the irradiated side showed a positive reaction&#44; the diagnosis of photoallergic contact reaction was made&#46; If both sides had positive reactions&#44; but there was a stronger reaction on the irradiated side&#44; the diagnosis was photodermatitis and allergic contact dermatitis&#59; if the reactions were equal on both sides&#44; the diagnosis was allergic contact dermatitis &#40;ACD&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a></p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Among 1712 patients undergoing epicutaneous tests&#44; 37 &#40;2&#46;2&#37;&#41; were selected&#58; 19 men &#40;51&#46;4&#37;&#41; and 18 women &#40;48&#46;6&#37;&#41;&#44; aged 30&#8211;80 years&#44; 22 &#40;59&#46;4&#37;&#41; of phototypes II and III&#44; seven &#40;19&#37;&#41; of IV and V&#44; and eight &#40;21&#46;6&#37;&#41; of VI&#46; Six patients &#40;16&#46;2&#37;&#41; had a history of atopy&#44; 15 &#40;40&#46;5&#37;&#41; used sunscreens&#44; 31 &#40;84&#37;&#41; had varied occupations&#44; four &#40;11&#37;&#41; were bricklayers&#44; and two &#40;5&#46;4&#37;&#41; were farmers&#46; The time of evolution of the lesions ranged from five months to 20 years and the most affected sites were exposed areas&#44; predominantly the face &#40;33&#37;&#8211;89&#37;&#41;&#44; upper limbs &#40;25&#37;&#8211;67&#37;&#41;&#44; and neck &#40;24&#37;&#8211;65&#37;&#41;&#46; Three patients &#40;8&#37;&#41; had disseminated lesions&#46; Prior patch test indicated Kathon and quaternium-15 reaction in one patient&#44; formaldehyde in one&#44; and potassium bichromate in two&#59; one patient reacted to nickel&#44; thimerosal&#44; and hydroquinone&#46; A total of 74 positive reactions were observed&#44; 54 on the irradiated side and 20 on the non-irradiated side&#44; which led to the diagnosis of ACDP in 23 &#40;62&#37;&#41; patients&#44; and ACD in 12 &#40;32&#37;&#41; &#40;<a class="elsevierStyleCrossRefs" href="#fig0005">Figs&#46; 1 and 2</a>&#41;&#46; The photoallergic reactions detected were due to chlorpromazine &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>9&#59; 24&#37;&#41;&#44; balsam of Peru &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>6&#59; 16&#37;&#41;&#44; perfume mix &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5&#59; 13&#46;5&#37;&#41;&#44; promethazine&#44; chlorhexidine&#44; and potassium bichromate &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#59; 11&#37;&#41;&#44; oxybenzone and BHT &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#59; 8&#37;&#41;&#44; paraphenylenediamine and <span class="elsevierStyleItalic">Compositae</span> mix &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#59; 5&#46;4&#37;&#41;&#44; sesquiterpene lactone mix&#44; thiourea&#44; and butyl methoxybenzoylmethane &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#59; 2&#46;7&#37;&#41;&#46; Six patients &#40;16&#37;&#41; tested negative on both sides&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Positive reactions to PPT are mainly caused by topical anti-inflammatory drugs such as ketoprofen&#44; widely used in Europe&#46; Studies show co-sensitization with benzophenones&#44; fenofibrate&#44; and perfume mix&#46; Reactions to other anti-inflammatory drugs&#44; such as etofenamate and diclofenac&#44; have been described in the literature&#46; These are the most frequent photoallergens in Europe&#46;<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">2&#44;4</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">In the United States&#44; sunscreens and antibacterials are the most frequent photoallergens&#44; and a progressive reduction in the incidence of fragrances is being observed&#46; In India&#44; <span class="elsevierStyleItalic">Parthernium</span> is the most common&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> There are no data published in Brazil&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">In the present patients&#44; reactions to chlorpromazine were the most frequent&#44; similarly to the findings of a Chinese series&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> It is an antipsychotic derived from phenothiazine whose analogs&#44; such as dihydrochlorothiazide and promethazine&#44; are widely used as diuretics and antipruritics in Brazil&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> Promethazine was the fourth most common photoallergen&#44; tied for fourth place with chlorhexidine and potassium bichromate&#44; but only one patient showed a co-reaction between chlorpromazine and promethazine&#46; The second in frequency was balsam of Peru&#44; followed by perfume mix&#46; In the Chinese research&#44; potassium bichromate was also the fourth most frequently identified photoallergen&#44; showing one more similarity with the present study&#44; in addition to chlorpromazine&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The pattern of photopositivity varies according to the area and population studied&#46; This is a preliminary investigation&#44; which reflected the population&#39;s habits&#44; such as the use of oral and topical promethazine as an antipruritic&#44; and professional or domestic exposure to cement&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">The authors suggest that a standard PPT panel should be defined for Brazil&#46; This set of allergens used is a preliminary suggestion to establish a Brazilian panel for photoepicutaneous tests&#44; since it is an effective and important tool in the diagnosis of photosensitive dermatitis&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Financial support</span><p id="par0045" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Authors&#8217; contributions</span><p id="par0050" class="elsevierStylePara elsevierViewall">Maria Antonieta Rios Scherrer&#58; Statistical analysis&#59; approval of the final version of the manuscript&#59; conception and planning of the study&#59; elaboration and writing of the manuscript&#59; obtaining&#44; analyzing&#44; and interpreting the data&#59; intellectual participation in propaedeutic and&#47;or therapeutic conduct of studied cases&#59; critical review of the literature&#59; critical review of the manuscript&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Vanessa Barreto Rocha&#58; Approval of the final version of the manuscript&#59; obtaining&#44; analyzing&#44; and interpreting the data&#59; intellectual participation in propaedeutic and&#47;or therapeutic conduct of studied cases&#59; critical review of the literature&#59; critical review of the manuscript&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflicts of interest</span><p id="par0060" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:4 [
        0 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Financial support"
        ]
        1 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Authors&#8217; contributions"
        ]
        2 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Conflicts of interest"
        ]
        3 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2019-12-01"
    "fechaAceptado" => "2020-03-05"
    "NotaPie" => array:2 [
      0 => array:2 [
        "etiqueta" => "&#8902;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">How to cite this article&#58; Scherrer MAR&#44; Rocha VB&#46; Photoepicutaneous tests&#58; a series of 37 Brazilian patients&#46; An Bras Dermatol&#46; 2020&#59;95&#58;766&#8211;7&#46;</p>"
      ]
      1 => array:2 [
        "etiqueta" => "&#8902;&#8902;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Study conducted at the Dermatology Clinic&#44; Hospital das Cl&#237;nicas&#44; Universidade Federal de Minas Gerais&#44; Belo Horizonte&#44; MG&#44; Brazil&#46;</p>"
      ]
    ]
    "multimedia" => array:3 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1160
            "Ancho" => 1508
            "Tamanyo" => 139533
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Epicutaneous photo test&#58; DAC to perfume mix and allergic contact photodermatitis &#40;ACPD&#41; to balsam of Peru and promethazine&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1159
            "Ancho" => 1508
            "Tamanyo" => 132919
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Positive reactions on the irradiated side of the photo epicutaneous test&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Hapten&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Vehicle&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Number of photoallergic reactions&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PABA 10&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Vaseline&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Oxybenzone &#40;benzophenone-3&#41; 10&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Vaseline&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Butyl methoxybenzoylmethane 10&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Vaseline&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sesquiterpene lactone mix 0&#46;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Vaseline&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Musk xylene 1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Vaseline&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Balsam of Peru 35&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Vaseline&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Promethazine 1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Vaseline&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Perfume mix 7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Vaseline&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Irgasan 1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Vaseline&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Potassium bichromate 0&#46;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Vaseline&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Chlorpromazine hydrochloride 0&#46;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Vaseline&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Thiourea 0&#46;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Vaseline&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Chlorhexidine 0&#46;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Water&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Paraphenylenediamine 1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Vaseline&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Compositae</span> mix 5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Vaseline&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Butyl hydroxytoluene &#40;BHT&#41; 2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Vaseline&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2433437.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Panel of photoepicutaneous tests and number of photoallergic reactions</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:5 [
            0 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Photopatch testing in chinese patients over 10 years"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "Y&#46; Hu"
                            1 => "D&#46; Wang"
                            2 => "Y&#46; Shen"
                            3 => "H&#46; Tang"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/DER.0000000000000170"
                      "Revista" => array:6 [
                        "tituloSerie" => "Dermatitis"
                        "fecha" => "2016"
                        "volumen" => "27"
                        "paginaInicial" => "137"
                        "paginaFinal" => "142"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27172309"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "European photopatch test baseline series&#58; a 3-year experience"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "D&#46; Subiabre-Ferrer"
                            1 => "A&#46; Esteve-Mart&#237;nez"
                            2 => "R&#46; Blasco-Encinas"
                            3 => "C&#46; Sierra-Talamantes"
                            4 => "A&#46; P&#233;rez-Ferriols"
                            5 => "V&#46; Zaragoza-Ninet"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Cont Dermat"
                        "fecha" => "2019"
                        "volumen" => "80"
                        "paginaInicial" => "5"
                        "paginaFinal" => "8"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Photopatch and UV-irradiated patch testing in photosensitive dermatitis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "R&#46; Rai"
                            1 => "M&#46; Thomas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.4103/2229-5178.174319"
                      "Revista" => array:6 [
                        "tituloSerie" => "Indian Dermatol Online J"
                        "fecha" => "2016"
                        "volumen" => "7"
                        "paginaInicial" => "12"
                        "paginaFinal" => "16"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26955581"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A European multicentre photopatch test study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "Taskforce EMPTSE"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1365-2133.2012.10857.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "2012"
                        "volumen" => "166"
                        "paginaInicial" => "1002"
                        "paginaFinal" => "1009"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22283432"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Fisher&#39;s contact dermatitis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46; Fowler"
                            1 => "M&#46; Zirwas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:4 [
                        "edicion" => "7th ed&#46;"
                        "fecha" => "2019"
                        "editorial" => "Contact Dermatitis Institute"
                        "editorialLocalizacion" => "Phoenix"
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/03650596/0000009500000006/v2_202011230629/S0365059620302154/v2_202011230629/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "82768"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Research Letter"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/03650596/0000009500000006/v2_202011230629/S0365059620302154/v2_202011230629/en/main.pdf?idApp=UINPBA00008Z&text.app=https://clinics.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059620302154?idApp=UINPBA00008Z"
]
Compartilhar
Informação da revista
Vol. 95. Núm. 6.
Páginas 766-767 (1 novembro 2020)
Compartilhar
Compartilhar
Baixar PDF
Mais opções do artigo
Visitas
5796
Vol. 95. Núm. 6.
Páginas 766-767 (1 novembro 2020)
Research Letter
Open Access
Photoepicutaneous tests: a series of 37 Brazilian patients
Visitas
5796
Maria Antonieta Rios Scherrer, Vanessa Barreto Rocha
Autor para correspondência
vanessabarreto.vbr@gmail.com

Corresponding author.
Dermatology Sector, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
Este item recebeu

Under a Creative Commons license
Informação do artigo
Texto Completo
Bibliografia
Baixar PDF
Estatísticas
Figuras (2)
Tabelas (1)
Table 1. Panel of photoepicutaneous tests and number of photoallergic reactions
Texto Completo
Dear Editor,

Photoepicutaneous tests or photopatch tests (PPT) are indicated for the diagnosis of allergic contact photodermatitis (ACPD), a delayed hypersensitivity reaction that occurs when a photoallergen is applied to the skin that is subsequently exposed to ultraviolet (UV) and/or visible radiation.1–3 Its incidence is unknown; it is estimated to range from 2% to 10% of patients referred for investigation of photodermatoses.4

Patients treated at the Contact Dermatitis Outpatient Clinic, Dermatology Annex, Hospital das Clínicas, UFMG between 2007 and 2019, with diagnostic suspicion of photodermatosis due to eczematous lesions in exposed areas, exacerbated after sun exposure, were selected to undergo PPT for diagnostic purposes after the epicutaneous test with the standard Brazilian panel revealed no clinical relevance. Allergens from FDA-Allergenic, Rio de Janeiro and Chemotechnique Diagnostics, Sweden (Table 1) were used in Finn Chambers® with Scanpor® (Smartpractice, United States) or Allergochambers® (Neoflex, São Paulo) applied in duplicate on the skin of the back. The set of allergens tested was chosen based on the literature and availability in this service.1–5 The allergen panel was removed after 48h, read, and covered with surgical dressing and aluminum foil. As no patient presented a minimal erythematous dose less than 10J/cm2 of UVA, the other set of allergens was irradiated with 10J, followed by immediate reading and subsequent occlusion. New readings were performed 48h later, following the International Contact Dermatitis Research Group criteria.5 If only the irradiated side showed a positive reaction, the diagnosis of photoallergic contact reaction was made. If both sides had positive reactions, but there was a stronger reaction on the irradiated side, the diagnosis was photodermatitis and allergic contact dermatitis; if the reactions were equal on both sides, the diagnosis was allergic contact dermatitis (ACD).5

Table 1.

Panel of photoepicutaneous tests and number of photoallergic reactions

Hapten  Vehicle  Number of photoallergic reactions 
PABA 10%  Vaseline 
Oxybenzone (benzophenone-3) 10%  Vaseline 
Butyl methoxybenzoylmethane 10%  Vaseline 
Sesquiterpene lactone mix 0.1%  Vaseline 
Musk xylene 1%  Vaseline 
Balsam of Peru 35%  Vaseline 
Promethazine 1%  Vaseline 
Perfume mix 7%  Vaseline 
Irgasan 1%  Vaseline 
Potassium bichromate 0.5%  Vaseline 
Chlorpromazine hydrochloride 0.1%  Vaseline 
Thiourea 0.1%  Vaseline 
Chlorhexidine 0.5%  Water 
Paraphenylenediamine 1%  Vaseline 
Compositae mix 5%  Vaseline 
Butyl hydroxytoluene (BHT) 2%  Vaseline 

Among 1712 patients undergoing epicutaneous tests, 37 (2.2%) were selected: 19 men (51.4%) and 18 women (48.6%), aged 30–80 years, 22 (59.4%) of phototypes II and III, seven (19%) of IV and V, and eight (21.6%) of VI. Six patients (16.2%) had a history of atopy, 15 (40.5%) used sunscreens, 31 (84%) had varied occupations, four (11%) were bricklayers, and two (5.4%) were farmers. The time of evolution of the lesions ranged from five months to 20 years and the most affected sites were exposed areas, predominantly the face (33%–89%), upper limbs (25%–67%), and neck (24%–65%). Three patients (8%) had disseminated lesions. Prior patch test indicated Kathon and quaternium-15 reaction in one patient, formaldehyde in one, and potassium bichromate in two; one patient reacted to nickel, thimerosal, and hydroquinone. A total of 74 positive reactions were observed, 54 on the irradiated side and 20 on the non-irradiated side, which led to the diagnosis of ACDP in 23 (62%) patients, and ACD in 12 (32%) (Figs. 1 and 2). The photoallergic reactions detected were due to chlorpromazine (n=9; 24%), balsam of Peru (n=6; 16%), perfume mix (n=5; 13.5%), promethazine, chlorhexidine, and potassium bichromate (n=4; 11%), oxybenzone and BHT (n=3; 8%), paraphenylenediamine and Compositae mix (n=2; 5.4%), sesquiterpene lactone mix, thiourea, and butyl methoxybenzoylmethane (n=1; 2.7%). Six patients (16%) tested negative on both sides.

Figure 1.

Epicutaneous photo test: DAC to perfume mix and allergic contact photodermatitis (ACPD) to balsam of Peru and promethazine.

(0.13MB).
Figure 2.

Positive reactions on the irradiated side of the photo epicutaneous test.

(0.13MB).

Positive reactions to PPT are mainly caused by topical anti-inflammatory drugs such as ketoprofen, widely used in Europe. Studies show co-sensitization with benzophenones, fenofibrate, and perfume mix. Reactions to other anti-inflammatory drugs, such as etofenamate and diclofenac, have been described in the literature. These are the most frequent photoallergens in Europe.2,4

In the United States, sunscreens and antibacterials are the most frequent photoallergens, and a progressive reduction in the incidence of fragrances is being observed. In India, Parthernium is the most common.3 There are no data published in Brazil.

In the present patients, reactions to chlorpromazine were the most frequent, similarly to the findings of a Chinese series.1 It is an antipsychotic derived from phenothiazine whose analogs, such as dihydrochlorothiazide and promethazine, are widely used as diuretics and antipruritics in Brazil.1 Promethazine was the fourth most common photoallergen, tied for fourth place with chlorhexidine and potassium bichromate, but only one patient showed a co-reaction between chlorpromazine and promethazine. The second in frequency was balsam of Peru, followed by perfume mix. In the Chinese research, potassium bichromate was also the fourth most frequently identified photoallergen, showing one more similarity with the present study, in addition to chlorpromazine.1

The pattern of photopositivity varies according to the area and population studied. This is a preliminary investigation, which reflected the population's habits, such as the use of oral and topical promethazine as an antipruritic, and professional or domestic exposure to cement.

The authors suggest that a standard PPT panel should be defined for Brazil. This set of allergens used is a preliminary suggestion to establish a Brazilian panel for photoepicutaneous tests, since it is an effective and important tool in the diagnosis of photosensitive dermatitis.

Financial support

None declared.

Authors’ contributions

Maria Antonieta Rios Scherrer: Statistical analysis; approval of the final version of the manuscript; conception and planning of the study; elaboration and writing of the manuscript; obtaining, analyzing, and interpreting the data; intellectual participation in propaedeutic and/or therapeutic conduct of studied cases; critical review of the literature; critical review of the manuscript.

Vanessa Barreto Rocha: Approval of the final version of the manuscript; obtaining, analyzing, and interpreting the data; intellectual participation in propaedeutic and/or therapeutic conduct of studied cases; critical review of the literature; critical review of the manuscript.

Conflicts of interest

None declared.

References
[1]
Y. Hu, D. Wang, Y. Shen, H. Tang.
Photopatch testing in chinese patients over 10 years.
Dermatitis, 27 (2016), pp. 137-142
[2]
D. Subiabre-Ferrer, A. Esteve-Martínez, R. Blasco-Encinas, C. Sierra-Talamantes, A. Pérez-Ferriols, V. Zaragoza-Ninet.
European photopatch test baseline series: a 3-year experience.
Cont Dermat, 80 (2019), pp. 5-8
[3]
R. Rai, M. Thomas.
Photopatch and UV-irradiated patch testing in photosensitive dermatitis.
Indian Dermatol Online J, 7 (2016), pp. 12-16
[4]
Taskforce EMPTSE.
A European multicentre photopatch test study.
Br J Dermatol, 166 (2012), pp. 1002-1009
[5]
J. Fowler, M. Zirwas.
Fisher's contact dermatitis.
7th ed., Contact Dermatitis Institute, (2019),

How to cite this article: Scherrer MAR, Rocha VB. Photoepicutaneous tests: a series of 37 Brazilian patients. An Bras Dermatol. 2020;95:766–7.

Study conducted at the Dermatology Clinic, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.

Copyright © 2020. Sociedade Brasileira de Dermatologia
Baixar PDF
Idiomas
Anais Brasileiros de Dermatologia (Portuguese)
Opções de artigo
Ferramentas
en pt
Cookies policy Política de cookies
To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here. Utilizamos cookies próprios e de terceiros para melhorar nossos serviços e mostrar publicidade relacionada às suas preferências, analisando seus hábitos de navegação. Se continuar a navegar, consideramos que aceita o seu uso. Você pode alterar a configuração ou obter mais informações aqui.