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ePaper created 2014-09-15, 12:31:02 | version 1.32.01
Contact allergy Nater started a new line of research on contact allergy. He was known for his work on chromate allergy in masons. His co-worker Pieter-Jan Coenraads extended the work to eczema of the hands in the general population. There was a remarkable lack of knowledge during this time regarding the debilitating effect and costs for society of this form of hand eczema. In a broader context the work was continued on hand eczema generally, including studies on barrier function.[1,2] Their work on the role of nickel and the role of the barrier function of the skin is still a relevant issue. The development of validated photographic guidelines for clinical trials in patients with hand eczema was essential.[3] The department participated in a study on the use of a new retinoid in severe hand eczema.[4] An important contribution was made in the European Guideline Hand Eczema in a Cochrane Systematic Review.[5] References 1. Pinnagoda J, Tupker RA, Agner T, et al. Guidelines for transepidermal water loss (TEWL) measurement. A report from the standardization group of the European Society of Contact Dermatitis. Contact Dermatitis. 1990; 22: 164-78. 2. Smit HA, A v Rijssen, J Vandenbroucke, et al. Individual susceptibility and the incidence of hand dermatitis in a cohort of apprentice hairdressers and nurses. Scand J Work Environ Health 1994; 20: 113-21. 3. Coenraads PJ. van der Walle H, Thestrup-Pedersen K, et al. Construction and validation of a photographic guide for assessing severity of chronic hand dermatitis. Br J Dermatol 2005; 152: 296-301. 4. Schmitt-Hoffmann AH, Roos B, Sauer J, et al. Pharmacokinetics, efficacy and safety of alitretinoin in moderate or severe chronic hand eczema. Clin Exp Dermatol 2011; 36 Suppl 2: 29-34. 5. Coenraads PJ. Hand eczema. Nw Engl J Med 2012; 367: 1829-37. Dexamethasone pulse therapy in TEN Already before his appointment as a professor in Groningen in 1991, Van der Meer had a special interest in blistering diseases. His appointment coincided with an existing interest in cutaneous adverse drug reactions (cADR) by department dermatologist Sylvia Kardaun. As a consequence, a study on the treatment of Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) was started. It is eminently important to restore the barrier function of the skin and mucosae as quickly as possible and in the meantime prevent the negative effects of its loss. Attempts have been made to decrease mortality by improved supportive care and several modalities of specific treatment. For most of these treatments, however, results are variable and placebo-controlled trials are difficult to accomplish because of the low incidence of SJS/TEN and the large number of patients required for a study to be statistically meaningful. 54 Chronic hand eczema. BWEADVSMGFINCORR:Opmaak 1 21-07-2014 17:40 Pagina 54