Allergy and Immunology
Review Corner

Chapter 87 of the 6th edition of Middleton’s Allergy Principles and Practice, edited by N. Franklin Adkinson, et al.

Questions prepared by Drs. Bret Haymore, Walter Reed Army Medical Center and Soo Kim-Delio, Walter Reed Army Medical Center.

Chapter 87: Contact Dermatitis

1. Which of the following conditions appear to have the least risk of allergic contact dermatitis
A. Atopic dermatitis
B. Children >8 years old
C. Psoriasis
D. Ichthyosis

2. Patch testing has a sensitivity and specificity of approximately:
A. 50 percent
B. 70 percent
C. 80 percent
D. 90 percent

3. Quaternium-15 has significant cross-reactivity on patch testing with which of the following agents:
A. Thiuram mix
B. Tixocortol pivalate
C. Nickel sulfate
D. Formaldehyde

4. Most allergic contact dermatitis reactions to latex are due to which of the following:
A. Carbamates
B. Mercapto compounds
C. Thiurams
D. Natural rubber

5. The most frequently encountered plant allergic contact dermatitis is caused by:
A. Fragaria
B. Toxicodendron
C. Erythronium
D. Aconitum

6. What cells are the primary source of interleukin-1 alpha in the epidermis?
A. Keratinocytes
B. Langerhans’ cells
C. Neurons
D. CD4+ helper T-lymphocytes

7. Inflammatory stimuli cause up-regulation of which chemokine to direct migration of Langerhans’ cells to regional draining lymph nodes?
A. CCR5
B. CCR6
C. CCR7
D. CXCR3

8. What area of the body is involved in more than half of all cases of contact dermatitis?
A. Face
B. Hands
C. Feet
D. Genitals

9. What description is consistent with a 2+ reaction to patch testing?
A. Vescicles or bullae
B. Papules with erythema and edema
C. Erythema and edema
D. No detectable change

10. Which of the following is an important occupational sensitizer present in chrome plated metals, tanned leathers, and construction materials?
A. Nickel
B. Carba mix
C. Colophony
D. Potassium dichromate

Answers:
1. A, page 1588
2. B, page 1589
3. D, page 1591
4. C, page 1592
5. B, page 1593
6. A, page 1584. Note: IL-1 beta is mainly produced by Langerhans’ cells in the epidermis
7. C, page 1587
8. B, page 1589
9. B, page 1593
10. D, page 1591