Showing papers in "Contact Dermatitis in 1986"
TL;DR: Repeated open application tests (ROATs) were performed with common ingredients of vehicles in 86 patients with contact dermatitis, finding that of the patients with a questionable (?+) patch test result, 44% were positive in ROATs.
Abstract: Repeated open application tests (ROATs) were performed with common ingredients of vehicles in 86 patients with contact dermatitis. The substances were applied twice daily for 7 days to the flexor aspect of the forearm near the cubital fossa, unless dermatitis appeared earlier. Of the patients with a questionable (?+) patch test result, 44% were positive in ROATs. The corresponding figure was 80% in the patients with a positive (+ or ++) response in the patch test, when the results of ROAT with propylene glycol were excluded. Only 5 of 14 patients reacting to 30% or to 10% propylene glycol but not to 1% in water in patch testing, showed a positive result to a cream containing 5% propylene glycol in ROAT. All 5 patients with a positive patch test reaction to 1% propylene glycol reacted to 5% propylene glycol in ROAT. The results suggest that ROATs should be performed more often, especially in patients in whom little known or new allergens are suspected as being the cause of allergic contact dermatitis.
226 citations
TL;DR: Latex used in the manufacture of surgical gloves should be included in a list of allergens because it is found in the tree Hevea braziliensis.
Abstract: Latex used in the manufacture of surgical gloves should be included in a list of allergens. It is found in the tree Hevea braziliensis.
For approximately the last year, minutes after using surgical gloves a female doctor had severe pruritus followed by a rash and angio-oedema of the contact areas. During the last 4 months, on opening the glove-bag, she experienced severe rhinitis and respiratory distress. The symptoms ceased in 1 h Standard patch tests and with substances used in the manufacture of rubber were negative.
Prick tests with glove and natural latex were strongly positive. The presence of specific IgE against natural latex was demonstrated by means of a histamine release asssay as well as by immunoenzymatic methods. The antigen seems to have MW higher than 30,000 d and is trypsin-sensitive. These facts that the allergen could be a protein present in the “crude natural latex”.
142 citations
TL;DR: To determine whether the prevalence of allergic reactions to certain preservatives warrants their inclusion in a routine series for patch testing, a tray of 14 preservatives was tested in 501 consecutive suspected contact dermatitis patients and Kathon CG® and alkyl trimethyl ammonium chloride only was found.
Abstract: To determine whether the prevalence of allergic reactions to certain preservatives warrants their inclusion in a routine series for patch testing, a tray of 14 preservatives was tested in 501 consecutive suspected contact dermatitis patients. More than 1% positive reactions were found with DMDM hydantoin, Kathon CG, and alkyl trimethyl ammonium chloride only. The concentration of alkyl trimethyl ammonium chloride (0.1% aqua) was considered too high. Of 6 patients reacting to the formaldehyde releaser DMDM hydantoin, 4 were positive to formaldehyde. Kathon CG may be an important allergen in the Netherlands, and it is worthwhile for dermatologists there to add it to the standard test series. The recent inclusion of quaternium-15 in the ICDRG standard series appears to be of little value to them.
118 citations
TL;DR: The number and nature of allergic occupational glove dermatoses were analysed and 68 (12.5%) were caused by rubber or plastic gloves, while 2 patients had contact urticaria due to rubber gloves.
Abstract: The number and nature of allergic occupational glove dermatoses were analysed. 542 cases of allergic contact dermatosis were diagnosed during 1974-1983. Amongst these, 68 (12.5%) were caused by rubber or plastic gloves. 2 patients had contact urticaria due to rubber gloves. Gloves were the main cause of occupational allergic rubber eczema, inducing 63 (58.3%) of 108 rubber eczema cases. 38 of them had positive reactions to rubber chemicals and glove material, 14 to glove material only, and 11 to rubber chemicals. 5 cases of allergic eczema from plastic gloves were diagnosed, all due to polyvinyl chloride (PVC). 2 cases of contact urticaria from natural rubber gloves were diagnosed by a provocation test. Epicutaneous testing with material of natural rubber gloves and rubber chemicals was negative. The present study shows that allergy to rubber gloves is usual, while allergy to plastic gloves is rare. Thus, plastic gloves should be used, when possible. Patch testing with protective gloves should always be used when patients develop prolonged hand dermatitis and where the possibility of glove eczema exists.
109 citations
TL;DR: Serological studies were performed in 3 patients with typical contact urticaria to latex surgical gloves and specific IgE antibodies to natural latex as well us to vulcanized glove material have been detected by radioimmunoassay.
Abstract: Serological studies were performed in 3 patients with typical contact urticaria to latex surgical gloves. Specific IgE antibodies to natural latex as well as to vulcanized glove material have been detected by radioimmunoassay. Contact urticaria to latex is considered to be of the immunologic type.
94 citations
TL;DR: Kathon® CG has become the second most common contact sensitizer, but the sensitivity cannot be traced in all patients with clinically relevant allergy without an unacceptable risk of patch test sensitization.
Abstract: Of 976 patients routinely patch tested with Kathon CG (Rohm & Haas), 300 ppm, 43 (4.4%) gave a positive reaction. Of 170 patients routinely tested with Kathon CG 250 ppm, 10 (5.9%) gave a positive reaction. Out of 34 patients tested with serial dilutions of Kathon CG, 17 (50%) reacted to 100 ppm, 8 to 30 ppm and 2 to 10 ppm. The concentration of 1000 ppm of Kathon CG was irritant in some cases, but 300 ppm was not irritant. Of the 976 patients tested with Kathon CG 300 ppm, 8 (0.8%) showed a "flare-up" reaction, indicating patch test sensitization. Of the 170 tested with Kathon CG 250 ppm, 2 (1.2%) were sensitized. When the patch-test-sensitized patients were retested with serial dilutions, they showed the same pattern as the other patients. 13 sensitized patients were use tested and 7 (54%) gave responses. In the literature, Kathon CG 100 ppm is recommended as the routine patch test concentration. However, 50% of the sensitive persons may then be overlooked. In our clinics, Kathon CG has become the second most common contact sensitizer, but the sensitivity cannot be traced in all patients with clinically relevant allergy without an unacceptable risk of patch test sensitization.
86 citations
TL;DR: The investigations show that nickel ions are capable of permeating the skin barrier when applied under occlusion and conclude that the choice of salt is an important consideration in patch testing.
Abstract: The impact of occlusion and the role of the counter ion on the permeation of nickel ions through skin have been examined using excised human skin. A highly sensitive electrochemical method was used to quantify the amount of nickel permeating the skin. The investigations show that nickel ions are capable of permeating the skin barrier when applied under occlusion. The process is slow, having a lag time of approximately 50 h. The permeation rate, and thus the physical amount being bioavailable, is considerably increased when aqueous nickel chloride is used in comparison with aqueous nickel sulphate. With respect to nickel permeation of the skin, we conclude that the choice of salt is an important consideration in patch testing.
85 citations
TL;DR: A patient with a positive patch lest reaction Lo Al (OH), who hail been sensitized by (aluminium adsorbed triple vaccine) is reported, who is reported to have had contact sensitivity to aluminium.
Abstract: Contact sensitivity to aluminium is extremely rare. Sensitization occurs during continuous application of aluminium containing antiperspirants or by aluminium adjuvants in vaccines and pollen extracts. Two types of reaction pattern are known: persistent granuloma at the injection site and recurrent eczema. We report a patient with a positive patch test reaction to Al (OH)3, who had been sensitized by aluminium adsorbed triple vaccine, Previous reports are reviewed.
82 citations
TL;DR: The prevalence of contact allergy was significantly higher in those above 40, compared to those under 40, and among foreigners in Singapore was high compared to the 3 major races.
Abstract: Among 1873 patch tested patients, the prevalence of contact allergy was 47.1 % (421/894) in females and 51.2% (501/979) in males (N.S.) It was 46.5% (593/1274) in Chinese, 52.8% (151/286) in Malays, and 48.3% (48.3%) in Indians, there was no significant difference among these 1 races in Singapore. Prevalence among foreigners in Singapore was high (82.3% (65/79)) compared to the 3 major races. This may be due to a higher % of foreigners engaged as construction workers who are considered lo run a greater risk of contact allergy. The prevalence was significantly higher in those above 40, (60.9% (290/476)) compared to those under 40 (45.2% 1632/1397)).
79 citations
TL;DR: The contact sensitizing potential of various compounds was tested in mice maintained on a did supplemented with vitamin A acetate and including Dowicil® 200, einnamaldehyde, hydroxycitronellal and Kathon® CG gave positive sensitivity responses.
Abstract: The contact sensitizing potential of various compounds was tested in mice maintained on a diet supplemented with vitamin A acetate. Substances were applied epicutaneously. After challenge, increases in ear thickness were measured and the differences in response between control and treated groups determined by the Mann Whitney test. A number of sensitizers, including Dowicil 200, cinnamaldehyde, hydroxycitronellal and Kathon CG gave positive sensitivity responses.
70 citations
TL;DR: A case of an urticarial rash from delayed‐type allergy to orally administered codeine is presented and the rôle of patch testing in drug eruptions discussed.
Abstract: A case of an urticarial rash from delayed-type allergy to orally administered codeine is presented. The literature on contact allergy to codeine is reviewed, and the role of patch testing in drug eruptions discussed.
TL;DR: The cause of the rapid increase of Kathon® CG allergy in Finland during the winter of 1985–1986 was the use of a popular moisturizing cream containing first 19 ppm, then 7 ppm of a mixture of 2 isothiazolinones (Euxyl® K 100).
Abstract: In unselected eczema patients subjected to routine patch testing, the number with positive reactions to Kathon CG 100 ppm increased from none in 1983 to 0.7% in January-August 1985, and to 4.6% in September 1985 to March 1986. Repeated open application tests (ROAT) with creams containing 7-15 ppm of the isothiazolinones were positive in 12 of 24 patients tested. 2 of the ROAT-positive cases had negative patch tests to 100 ppm Kathon CG, but 1 was positive with 200 ppm. Atopic dermatitis, chronic hand dermatitis and lower leg dermatitis were the most common disorders in the positive patients. The cause of the rapid increase of Kathon CG allergy in Finland during the winter of 1985-1986 was the use of a popular moisturizing cream containing first 19 ppm, then 7 ppm of a mixture of 2 isothiazolinones (Euxyl K 100).
TL;DR: Limited patch testing revealed a majority positive to nickel, but a third were negative, indicating that jewellery reactions often but not invariably predict nickel sensitivity, and that most workers were able to carry on in their Occupations despite having hand dermatitis.
Abstract: Skin disorders were reported in 33% of catering staff and 35% of women cleaners who returned a questionnaire, and were employed in a large hospital. Hand dermatitis occurred in 15% of the caterers and 12% of the cleaners. In the majority, the dermatitis was irritant in origin and related to their wet work occupations. Cleaners had a high prevalence of jewellery dermatitis. Limited patch testing revealed a majority positive to nickel, but a third were negative, indicating that jewellery reactions often but not invariably predict nickel sensitivity. Few subjects were atopic, but some psoriatic patients with hand problems were encountered. Most workers were able to carry on in their occupations despite having hand dermatitis.
TL;DR: Information as to previous contacts with nickel suggested that development of nickel allergy had been promoted by ear‐piercing, and a lower incidence of nickel hypersensitivity was observed if this potentially sensitizing event had been proceeded by orthodontic treatment with nickel‐containing materials.
Abstract: A prospective study of the development of hand eczema was initiated in 86 junior hairdressers and 217 junior nurses. Data obtained at the start of their apprenticeships are presented. None of the junior apprentices presented with hand eczema, but a history of hand eczema was reported by 22/303 (7%) of the students. Almost half of this group (10/22, 45%) could be classified as atopics. Students without a history of hand eczema showed a similar frequency of atopy (17%) as observed in the general population. History of hand eczema was not related to nickel hypersensitivity, as assessed by patch testing. The incidence of nickel hypersensitivity was high in junior hairdressers (26%), compared to junior nurses (12%). Information as to previous contacts with nickel suggested that development of nickel allergy had been promoted by ear-piercing. A lower incidence of nickel hypersensitivity was observed if this potentially sensitizing event had been proceeded by orthodontic treatment with nickel-containing materials. This phenomenon is discussed in terms of orally-induced tolerance.
TL;DR: In 6 of 15 patients with discomfort and itch produced by rubber gloves, contact urticaria was confirmed, in 3 of whom IgE antibodies to latex were demonstrated, and RAST tests were performed using an extract from the rubber tree (Hevea brasiliensis).
Abstract: Rubber glove intolerance is a common dermatological problem and hypersensitivity of both delayed and immediate types occur. In order to study immediate skin reactions induced by rubber gloves, 15 patients with discomfort and itch produced by rubber gloves were examined. The patients were provoked by wearing rubber gloves, scratch tested with gloves, rubber chemicals and powders. RAST-tests were performed using an extract from the rubber tree (Hevea brasiliensis). In 6/15 patients, contact urticaria was confirmed, in 3 of whom IgE antibodies to latex were demonstrated.
TL;DR: Follow‐up revealed that hand dermatitis often resulted in the worker not continuing 10 work in the hairdressing trade, and the prognosis in the former group of workers with respect to continued employment in the trade tended to be poorer than the latter.
Abstract: 18 cases of hand dermatitis in hairdressers seen over a 5-year period are reviewed. The diagnoses in these patients are discussed with reference to other studies of hand dermatitis in hairdressers. Contact allergy due to paraphenylenediamine and related hair dyes was the presenting complaint in younger hairdressers, while formaldehyde allergy occurred in those who were older. The prognosis in the former group of workers with respect to continued employment in the trade tended to be poorer than the latter. Follow-up revealed that hand dermatitis often resulted in the worker not continuing to work in the hairdressing trade.
TL;DR: Several of the difficulties involved in the detection of corticosteroid allergy are illustrated by the problems encountered in a patient sensitive to a preparation containing hydrocortisone and miconazole nitrate.
Abstract: Several of the difficulties involved in the detection of corticosteroid allergy are illustrated by the problems encountered in a patient sensitive to a preparation containing hydrocortisone and miconazole nitrate. The importance of appropriate concentrations and vehicles for patch testing, the possible role of impurities, and cross-sensitivity of corticosteroid molecules are discussed.
TL;DR: The clinical symptoms of both irritant and allergic airborne contact dermatitis are reviewed.
Abstract: Industrial airborne irritant or allergic contact dermatitis is commonly observed in many factories. Examples of airborne irritants include fibres (such as fibreglass or rockwool), various kinds of dust particles (such as cement, slag, sludge, insulating foam, wood chips), acids and alkalis, gasses and vapours. Airborne contact allergens are unequivocally numerous. The clinical symptoms of both irritant and allergic airborne contact dermatitis are reviewed.
TL;DR: Chemicals used on fabrics to improve 10 different performance characteristics have resulted in irritant or allergic contact dermatitis, the most significant problem is due to formaldehyde and N‐methylol compounds to produce durable press fabrics.
Abstract: Chemicals used on fabrics to improve 10 different performance characteristics have resulted in irritant or allergic contact dermatitis. The most significant problem is due to formaldehyde and N-methylol compounds to produce durable press fabrics. Little is known about incidence of finish dermatitis or mode and amount of transfer of chemicals from fabric to skin.
TL;DR: Among patients with a history of metal sensitivity, 50 were patch‐test‐negative to nickel, cobalt and chromate and most patients in this category were found to be atopic.
Abstract: Among patients with a history of metal sensitivity, 50 were patch-test-negative to nickel, cobalt and chromate. 20 of them were further examined epicutaneously and intracutaneously. They were also studied with a clinical diagnostic method for symptoms and signs of atopy. Most patients in this category were found to be atopic.
TL;DR: The results indicated that the experimental cream “Water harrier” reduced the absorption of water and benzene but not formaldehyde Kerodex 71 cream slightly reduced theabsorment of benzene and formaldehyde.
Abstract: The effect of 4 barrier creams on the absorption of (3H)-water (14C)-benzene and (14C)-formaldehyde into excised human skin was studied. The control skin and the barrier cream treated skin were exposed to the test substance for 0.5 hr, whereupon the amount absorbed was determined. The results indicated that the experimental cream "Water barrier" reduced the absorption of water and benzene but not formaldehyde. Kerodex 71 cream slightly reduced the absorption of benzene and formaldehyde. The barrier creams Petrogard and "Solvent barrier" did not affect the absorption of any of the substances studied. The use of these creams against percutaneous absorption is questioned.
TL;DR: Male sex, jewellery contact and wetwork occupations all predispose to the development of nickel sensitivity, and the prevalence of a personal history of atopy was not raised.
Abstract: Data on 134 consecutive nickel-sensitive subjects attending our contact dermatitis clinic were analysed. The female to male ratio was 8 to 1, with a mean age at presentation of 35 years for women and 53 years for men. Hand dermatitis occurred in 49% of patients and in 70% of men. It was usually preceeded by jewellery or metal contact dermatitis for some months or years. Although office workers made up the largest occupational group, cleaners, housewives, catering staff, nurses and hairdressers were represented among the women. Several of the men had had heavy occupational exposure to nickel. Cobalt co-sensitivity occurred in 29% of subjects. Sensitivity to 3 or more allergens was found in 32% of those studied but was seen in 2/3 of the men. The prevalence of a personal history of atopy was not raised. A majority of women had had their ears pierced: in 2/3 the nickel dermatitis followed this procedure but in a third it had occurred before. Female sex, jewellery contact and wetwork occupations all predispose to the development of nickel sensitivity.
TL;DR: Further support use the previously reported conclusion that use of this new biocide at the very low concentrations required for effective preservation of rinse‐off products involves an extremely low risk of clinical derma loses.
Abstract: Biocidal preservative agents are important in preventing the growth of pathogenic and nonpathogenic organisms in a variety at personal care, household and industrial products. Nearly all effective. Commonly used preservative materials possess skin sensitization potential. In a Series of 13 prophetic human repeat instill patch tests involving a total of 1450 subjects, no skin sensitization was induced at conclusion of 10 ppm. and 6 ppm or 5 ppm (1121 subjects) or at 15 ppm (200 subjects) of a new isothiazolinone preservative mixture (Kathon® CG). Delayed contact hypersensitivity was induced in I of S4 subjects at 12.5 ppm and in 2 of 45 subjects at 20 ppm. These results add Further support use the previously reported conclusion that use of this new biocide at the very low concentrations required for effective preservation of rinse-off products involves an extremely low risk of clinical derma loses.
TL;DR: Falcarinol, but not faicarindiol, falcarinone and dehydrofalcarin one, elicited allergic contact dermatitis in a 38–year‐old female plant‐nursery worker.
Abstract: From the plant Schefflera arboricola, which has been reported to cause allergic contact dermatitis, we have isolated and determined the elicitor of allergic contact dermatitis as falcarinol, heptadeca-1,9(Z)-diene-4,6-diyne-3-ol. Three polyacetylenes closely related to falcarinol, namely falcarindiol, falcarinone and dehydrofalcarinone were tested simultaneously. Falcarinol, but not falcarindiol, falcarinone and dehydrofalcarinone, elicited allergic contact dermatitis in a 38-year-old female plant-nursery worker.
TL;DR: The patient is a 29-year-old male nurse who occasionally had a mild dermatitis, who worked in the intensive care department of the authors' hospital, and 1 h after starting work, erythema and swelling of both hands developed extending to his thorax and the head and neck.
Abstract: The patient is a 29-year-old male nurse who occasionally had a mild dermatitis. He worked in the intensive care department of our hospital. 1 h after starting work, erythema and swelling of both hands developed extending to his thorax and the head and neck. The reaction was violent; he had a speech disturbance leading to aphonia with glottal edema and dyspnoea, in the course of which an inspiratory and expiratory stridor was observed. He had tachycardia, but the blood pressure did not decrease alarmingly. He was treated with an anti-histamine, clemastine 2 mg i.v.
TL;DR: A dental assistant developed sensitivity to denial restorative materials within 3 months of starting to use them, and was also allergic to the disinfectant Desimex i® containing dodecyl diaminoethyl glycine.
Abstract: A dental assistant developed sensitivity to denial restorative materials within 3 months of starting to use them. They contained the epoxy acrylate BIS-GMA, which is the most commonly used dimethacrylate monomer in dental composite restorations. She was positive to a patch test with BIS-GMA, which was the probable allergen, and epoxy resin, but this substance was not present in the materials used, LIS shown by high performance liquid chromatography. The patient was also allergic to the disinfectant Desimex i® containing dodecyl diaminoethyl glycine.
TL;DR: The incidence of positive patch test reactions to Quaternium 15 has increased by a factor of 3 within a relatively stable population over 2 years, while the incidence of reactions to Bronopol and Germall 115 has remained static.
Abstract: The incidence of positive patch test reactions to Quaternium 15 has increased by a factor of 3 within a relatively stable population over 2 years, while the incidence of reactions to Bronopol and Germall 115 has remained static. The problem of interpreting an apparent positive reaction to a formaldehyde-releasing preservative in a formaldehyde-sensitive patient is discussed.
TL;DR: A positive patch test reaction to 100 ppm does not initiate eczema alter use of products preserved with Kathon CG in the low Concentrations (3–15 ppm) used in final products.
Abstract: Among 1511 consecutive patients patch tested with Kathon CG at 100 ppm active ingredient, 13 (0.8%) gave a positive reaction. Use test with a lotion containing Kathon CG (8.6 ppm) revealed no reaction in 11 patients with a positive patch test. It is concluded that a positive patch test reaction to 100 ppm does not initiate eczema after use of products preserved with Kathon CG in the low concentrations (3-15 ppm) used in final products.
TL;DR: Fungus infection as a cause or complication in hand eczema should not be left out of consideration: in 2 persons, a mycosis of hands and or fingernails was diagnosed.
Abstract: Hospital cleaning personnel were examined for occupational dermatoses. 356 persons were included in the study. The UJJC ranged from 20 to 63 years with a mean of 40.1 years. The period prevalence rate of moderate and severe eczema was 12% (10% in men and 19% in women). In 88%, the eczema was of a duration longer than 2 years. Positive patch tests were found in 10% of men and 53% of women with eczema. The main allergens were nickel, cobalt, chromate and rubber chemicals. Positive tests to cleaning agents were rare. One case of contact allergy to sodium dichloroisocyanurate and one to lysol were, diagnosed. Irritant factors played: a major role in most cases (92%). Fungus infection as a cause or complication in hand eczema should not be left out of consideration: in 2 persons, a mycosis of hands and or fingernails was diagnosed.