Showing papers in "Contact Dermatitis in 1992"

Air oxidation of d-limonene (the citrus solvent) creates potent allergens.

Abstract: Products containing as much as 95% of d-limonene are used for, e.g., degreasing metal before industrial painting and for cleaning assemblies. Experimental studies on the sensitizing potential of limonene show diverging results. In a previous study, we found that the sensitizing potential of d-limonene increased with prolonged air exposure. The aim of this study was to make further chemical analyses, to identify compounds formed by air exposure of d-limonene and to study their allergenic potential. d-limonene was found to be a sensitizer after prolonged exposure to air according to 2 Freund's complete adjuvant test (FCAT) experiments and 1 guinea pig maximization test (GPMT) study. No significant response was obtained to d-limonene not air exposed, even if the animals were sensitized to oxidized d-limonene. 5 main oxidation products of d-limonene were identified. (R)-(-)-carvone and a mixture of cis and trans isomers of (+)-limonene oxide were found to be potent sensitizers, while no significant reactions were obtained in the animals induced with a mixture of cis and trans isomers of (-)-carveol. It can be concluded that air oxidation of d-limonene is essential for its sensitizing potential, and that potent allergens are created.

Results of routine patch testing with corticosteroid series in 2073 patients.

Abstract: The patch test results of hi patients allergic lo at least 1 corticosteroid molecule are presented. These contact allergies were detected by testing with several corticosteroid s included in our standard patch test series between February 1988 and December 1990. Whenever possible, further investigations were conducted by means of a more complete corticosteroid series. We (mind corticosteroids to be the 7th most frequent allergen, positive results being obtained in 2.9% of all patients referred to our contact dermatitis unit. In this series, budesonide was the most common allergen and often gave simultaneous reactions with other corticosteroids.

Evaluation of a self‐administered questionnaire on hand dermatitis

Abstract: The purpose of the study was to evaluate a self-administered questionnaire on hand dermatitis that was developed to identify persons with hand dermatitis in epidemiological studies. A total of 109 nurses were subject to dermatological examination of the hands within 1 month of returning the questionnaire. 2 types of questionnaire diagnoses were made: a 'symptom-based' diagnosis and a 'self-reported diagnosis'. These were compared to the medical diagnosis of hand dermatitis. The prevalence of hand dermatitis in the 12 months before the study, based on the medical diagnosis, was 18.3%. The prevalence according to the symptom-based diagnosis and the self-reported diagnosis was 47.7% and 17.4%, respectively. The sensitivity and specificity of the symptom-based diagnosis were 100% and 64%, respectively. It is concluded that the symptom-based diagnosis can be used as screening instrument for the detection of cases in large study populations, if followed by dermatological examination of persons with a positive diagnosis. The sensitivity and specificity of the self-reported diagnosis were 65% and 93%, respectively. It is concluded that the self-reported diagnosis can be used to obtain a rough estimate of the prevalence, although comparison of prevalence figures between study populations may be distorted due to a difference in reporting of hand dermatitis. The results of the study illustrate the size of the differences in prevalence estimates that may arise as a result of differences in the definition and method of diagnosing hand dermatitis.

Propolis allergy (IV). Studies with further sensitizers from propolis and constituents common to propolis, poplar buds and balsam of Peru.

Abstract: 26 different compounds have been investigated experimentally for their sensitizing capacity in guinea pigs. 19 of these occur in propolis as well as in poplar bud exudates, and 14 of them are also found in balsam of Peru. 4 caffeates and benzyl isoferulate were found to be strong sensitizers. 7 compounds were moderate, and 13 compounds showed only weak sensitizing potency. Methyl cinnamate was negative. Patch tests in 11 propolis-sensitive patients once more revealed 3-methyl-2-butenyl caffeate and phenylethyl caffeate as the major sensitizers. In addition to the 8 compounds already known to occur in propolis as well as in balsam of Peru, we detected 5 further substances that both materials have in common. Among these, benzyl isoferulate is considered a noteworthy sensitizer. Coniferyl benzoate, which was shown to be a moderate sensitizer, is present in fresh samples of balsam of Peru, while in propolis it has been detected only once so far. The flavonoid aglycones occurring in poplar bud exudates, and hence also in propolis, are weak sensitizers which play only a minor role in propolis hypersensitivity.

The reaction index: a parameter to assess the quality of patch test preparations.

Abstract: Allergic contact dermatitis might have been caused by epoxy resin 6360, the non-bisphenol-A-type epoxy resin. The hardener GY-051 and HD-electrician specialized filling powder might also have been allergens. But many of the skin and lip lesions might have been due to the other epoxy resin and to additives. These would have been mild chronic irritant reactions, such as the nail changes. It has already been reported that contact dermatitis from epoxy Contact Dermatitis 1992: 27: 203

The value of the local lymph node assay in quantitative structure-activity investigations.

Abstract: The development of quantitative correlations between the physicochemical properties of compound and its ability to act as a skin sensitizer is complicated by the number of variables associated with the current sensitization lest data, combined with the absence of truly objective end point. Recently, however, a novel approach to die assessment of skin sensitization potential, the local lymph node assay (LLNA). has been described, which determines the skin sensitization by measuring lymphocyte proliferation in lymph nodes draining the site of chemical exposure. The assay offers several advan-tages over traditional methods in the context of quantitative structure-activity relationship studies. In the present work, H range of bromoalkanes has been employed which demonstrate the robustness and reproducibility of the LLNA. Sensitizing activity increased with chain length up to a maximum at C15/C116. whereafter the response declined. The data were modelled against hydrophobicity. expressed as Clog P and (ClogP)2 to fit the biphasic nature of the results. The results dermonstrate the utility of LLNA data for interpretation in the context Off quantitative: structure-activity relationships, the limited number of variables, inter-test reproducibility and quantitative end point, lending themselves to mathematical interpretations.

Permeation of chromium salts through human skin in vitro.

Abstract: Chromium permealation studies were performed on full thickness human skin in diffusion cells. AH samples were analysed for the total chromium content by graphite furnace Zeeman-corrected atomic absorption spectrometry. Some samples were analysed by an ion chromatographic method permitting the simultaneous determination of Cr(VI) and Cr(III) as well. The amounts of chromium found in all skin layers were significantly higher when potassium dichromate was applied lo the skin compared with chromium chloride or chromium nitrate. Chromium could only detected in the recipient phase after application of the dichromate solution. Chromium skin levels increased with increasing concentrations of applied chromium salts up to 0.034 M Cr. The amount of chromium in recipient phase and skin layers increased with increasing pH when the applied solution contained potassium dichromate. This was ascribed to a decreased skin barrier function of the skin. The amount of chromium found in all skin layers after application of chromium chloride decreased with increasing pH due to lower solubility of the salt. The % of chromium found in the recipient phase us chromium VI)increased with increasing total chromium concentration indicating a limned reduction ability of the skin in vitro.

Textile dye dermatitis.

Abstract: The study population was 3336 patients investigated for contact dermatitis in our department from 1987 to 1991. All were patch tested with the European standard series (Trolab). 159 were also tested with a series of 15 textile dyes (Chemotechnique) with paminoazobenzene (0.25% pet.) added, and 5 with a shorter series of 4 textile dyes: p-aminoazobenzene, Disperse Orange 3, Disperse Yellow 3, and Disperse Blue 106. Patch tests were applied with Vander Bend square chambers fiXed with Micropore® (3M) and covered with Mef!X (Smith & Nephew). Readings were performed after 2 and 4 (exceptionally 3) days, following ICDRG guidelines. Doubtful reactions were excluded.

Shiitake (Lentinus edodes) dermatitis.

Abstract: Shiitake (Lentinus edodes) is a mushroom which is eaten in Chinese and Japanese meals and is nowadays the second most commonly produced edible mushroom in the world. Shiitake dermatitis was first described by Nakamura in 1977. This disease presents with very characteristic skin manifestations. From April 1974 to April 1991, I have observed 51 patients with shiitake dermatitis. The following description reviews the clinical manifestations, laboratory investigations and sources of shiitake dermatitis.

Clinical, immunological and bacteriological evaluation of adverse reactions to skin-penetrating titanium implants in the head and neck region.

Abstract: Between 1977 and October 1989, 445 patients have been treated with bone-anchored skin-penetrating titanium implants for anchorage of facial prostheses or bone-conducting hearing aids, at the Ear, Nose and Throat Department at Sahlgren's Hospital in Gothenburg. The majority of patients had no adverse skin reactions, while a few patients were responsible for the majority of the adverse reactions. The aim of our study was to analyse differences between these groups. We started a clinical study on 9 patients with a clinical history of adverse skin reactions around the titanium implants and 9 patients without adverse skin reactions were used as controls. None of the patients had delayed hypersensitivity to titanium. Microbiological analyses showed that when there was clinical irritation, Staphylococcus aureus could be isolated.

Possible origin of the skin sensitization potential of isoeugenol and related compounds : (I) Preliminary studies of potential reaction mechanisms

Abstract: Although many simple chemicals can give rise to the phenomenon of allergic contact dermatitis, it is rare that the mechanism of reaction between the chemical hapten and skin protein is known. A further complication is that metabolic processes may produce substantial changes to a chemical penetrating skin. Thus the skin contactant may be regarded as a prohapten which will give rise to the true hapten in vivo. In this study, the possible reaction mechanisms for a number of related simple aromatic chemicals have been investigated. The approach taken was to evaluate potential reaction mechanisms by assessing the degree to which chemicals could cross-react in sensitization tests. By careful choice of chemicals, it was then possible to confirm (or reject) options. Using this approach, a number of reaction schemes were investigated for eugenol, isoeugenol, dihydroeugenol, anethole and several related chemicals. The patterns of sensitization obtained and the cross-reactions observed indicated clearly that electrophile/nucleophile interactions were unlikely to provide a complete explanation of the sensitization processes. Eugenol and isoeugenol are not mutually cross-reactive, yet both cross-reacted with dihydroeugenol. Examination of the possible reaction mechanisms allows the speculation that eugenol reacts in part via a phenolic radical mechanism, whilst isoeugenol reacts largely via formation of an orthoquinone. Both reaction mechanisms are proposed for dihydroeugenol.

Eyelid dermatitis: an evaluation of 150 patients.

Abstract: This study was performed to evaluate eyelid dermatitis in a group of patients of our Allergy Unit between January 1990 and April 1991. Among the 1158 patients seen during this period, 150 had eyelid dermatitis: 135 females and 15 males, with a mean age of 35 years. Of the 150 patients with eyelid dermatitis, 54 had eczema localized to the eyelids only, 49 to the eyelids and face, 19 to the eyelids and hands, and 28 to the eyelids and other sites. 98 patients (65.3%) were diagnosed as having allergic contact dermatitis, 25 (16.6%) irritant contact dermatitis, 21 (14%) atopic dermatitis, and 6 (4%) seborrhoeic dermatitis. Patch test reactions to nickel sulphate, Kathon CG and fragrance-mix occurred more frequently in patients with eyelid dermatitis than in those without.

Prognosis of occupational chromate dermatitis.

Abstract: To elucidate further the natural history and prognosis of occupational chromate dermatitis, 120 affected patients, diagnosed between 1980 and 1989, were reviewed. The incidence of chromate dermatitis in Western Australia appeared to remain unchanged over the decade. 65% of patients were construction workers with cement-induced chromate dermatitis. Workers at greatest risk of sensitization were those mixing bagged cement at the work site. The median age at onset of symptoms was 34 years, with 48% having been exposed to chromate for 5 years or less. Only 37% presented to the dermatologist within 12 months of developing symptoms. 76% of patients had ongoing dermatitis at the time of review. Although 48% of the study population had completely changed their occupation to avoid chromate exposure, symptoms persisted in 69%. A delayed diagnosis of chromate sensitivity was noted to be a predictor of chronicity. In view of the potential chronicity of chromate dermatitis and its associated social and occupational impairment, we recommend the addition of ferrous sulphate while mixing bagged cement at the work site. This simple technique targets the workers at greatest risk of becoming sensitized.

Occupational dermatitis from exposure to polyurethane chemicals

Abstract: In addition to asthma, contact dermatitis may also develop from occupational contact with polyurethane (PU) chemicals. 6 cases of allergic contact dermatitis from exposure to PU chemicals were diagnosed in 1974-1990. The present paper summarizes the results and gives detailed descriptions of 3 such patients. 3 patients were allergic to 5 different diisocyanates (DICs), including 4,4'-diphenylmethane DIC (MDI), toluene DIC (TDI), 1,6-hexamethylene DIC (HID), and furthermore to diaminodiphenylmethane (MDA). 3 patients were sensitized by exposure to MDI. 2 of these reacted to MDI and MDA, and 1 to TDI in addition. 1 of the 3 patients reacted only to MDA, possibly formed by hydrolysis of MDI. Primary sensitization to MDA and cross-allergy to MDI could explain the reactions of the patients exposed to MDI, but separate sensitization may also be possible. Patch tests with fresh petrolatum (pet.) mixtures were first made and a 2% concentration was recommended for MDI and TDI. In order to determine the stability of DIC test substances, the last 2 patients were tested with old test substances. Tests with MDI 1.5% pet. and TDI 1.5% pet., 5.5 months and 15.5 months old, were positive. The results suggest that, when allergy to PU chemicals is suspected, patch tests should include, in addition to MDA, at least MDI and TDI 1.5-2% pet. They also suggest that test substances can be used for over a year, and that allergy to MDA may point to MDI exposure contained in PU chemicals.

Patch test reactions in atopic patients

Abstract: Patch testing was carried out in 851 atopic patients; 181 atopic dermatitis (AD) patients were additionally tested with 50% dilutions of the test substances. The occurrence of allergic and irritant reactions was frequent, being 57% and 33% for AD patients aged 28-41 years and 19-27 years, respectively. Among age-matched allergic rhinitis (AR)/allergic conjunctivitis (AC) or asthma (A) patients, the number of allergic reactions varied from 25 to 30%, and for irritant reactions was 24%. In all groups, nickel, fragrance-mix, balsam of Peru and neomycin were the commonest allergens. Contact allergy to ingredients of topical medicaments was common among AD patients and patients with severe and long-lasting dermatitis were most frequently sensitized. However, sensitivity to multiple substances was not common among those patients. The number of irritant reactions was considerable, but 50% dilution of the test substances did not solve the problem.

Contact dermatitis in hairdressers: the Italian experience. Gruppo Italiano Ricerca Dermatiti da Contatto e Ambientali.

Abstract: A multicenter study was performed in 9 Italian centers by members of the GIRDCA, to evaluate the frequency and source of contact sensitization in a group of 302 hairdressers with dermatitis. Occupational habits and use of preventive measures were specifically investigated both in these 302 hairdressers and in a further group of 240 hairdressers who answered a questionnaire. The results showed the presence of an occupationally relevant sensitization in 60.9% of the 302 hairdressers. This proportion included 52 hairdressers who had negative patch tests to the hairdressers' series but showed positive reactions to other allergens, such as nickel, rubber additives, preservatives and fragrances, which were judged relevant to their occupation. Among hair dyes, PPD caused 73 reactions (24.2%), PAP 32 reactions (10.6%), ONPPD 24 reactions (7.9%), and PTD 40 reactions (13.2%). A low incidence of sensitization was detected in our hairdressers to resorcinol and pyrogallol (1.3% for each substance). Among permanent wave allergens, positive reactions to GMTG were found in 11.3% of patients, while ATG gave a lower rate of positive reactions (5.0%). Allergic contact dermatitis due to APS was also relatively common (11.3%). 4 hairdressers in this study gave a positive reaction 30 min after a provocative test with latex gloves, patch testing to the rubber series being negative. Enquiry regarding preventive measures revealed that the majority of hairdressers use gloves when doing hair dyeing, but rarely use them for washing dyed hair or for doing permanent waving. The infrequent use of preventive measures by Italian hairdressers was confirmed by the results of the questionnaire, and possibly explains the high frequency of skin problems (12.5%) in the hairdressing population that was specifically interviewed.

Vaccination granulomas and aluminium allergy: course and prognostic factors

Abstract: 21 children who had cutaneous granulomas following immunization with a vaccine containing aluminium hydroxide, and who had positive patch tests to aqueous aluminium chloride and/or to a Finn Chamber, were followed for 1 to 8 years. During the period of observation, the symptoms cleared in 5 children, improved in 11, and remained unchanged in 5. The course of the granulomas could not be correlated with sex or atopy, nor with intensity of the initial aluminium patch test. 4 children were patch tested again with aluminium.

Compositae dermatitis: a survey.

Abstract: Compositae dermatitis in an allergic contact dermatitis, frequently chronic, triggered by plants of the Compositae family. The condition, which is seen, in particular, in middle-aged and elderly persons, typically starts in the summer months with an acute eczema either corresponding to areas exposed to light and air, or corresponding to areas of plant contact; it disappears spontaneously during the fall of the year. Repeated exposure over a number of years may cause severe intractable dermatitis affecting the patient throughout the year. The responsible allergens are sesquiterpene lactones, and investigations to date indicate that the frequency of the allergy is similar to that seen with some of the contact allergens of the standard patch test series. The diagnosis, however, is difficult, partly due to the fact that the clinical picture may be mistaken for a photodermatosis, and partly owing to the difficulty in obtaining commercially available allergens for patch testing. The diagnosis is therefore based on testing with plant extracts, which can cause pronounced local reactions and possibly active sensitization. A survey is given of the possible modes of sensitization, sex and age distribution, the relationship to photosensitivity and atopy, as well as the possible treatment. It is concluded, on the basis of the chronic nature of the disease, and the diagnostic and treatment problems, that continued intensive research into the condition is urgently needed.

Allergic contact dermatitis from triphenyl phosphate.

Abstract: A 29-year-old man, with no previous allergic or atopic history, had a 6-month history of an itchy fissured psoriasiform dermatitis of both palms. He was a carpenter but tolerated woods well. Asked about hobbies, he described making special figures, such as animals, that would participate in festivals at carnival time. For the last few months, he had been constructing a big bird, the feathers of which were applied meticulously one by one. He used natural feathers of different colours, which he attached carefully with a plastic glue. Positive patch test results of a standard series, balsams, plastics and lacquers (Henna!-Trolab®) were as follows at 4 days. paraben-mix 15% pet. + + cobalt chloride 1% pet. + potassium dichromate 0.5% pet. + + formaldehyde 1% aq. + triphenyl phosphate 5% pet. + + Discussion

Allergic contact dermatitis from formaldehyde. A case study focussing on sources of formaldehyde exposure.

Abstract: Formaldehyde is a common contact allergen. The prognosis of formaldehyde-sensitive patients is generally considered to be bad because of widespread exposure to formaldehyde. 11 patients with eczema and a positive patch test to formaldehyde were interviewed by a dermatologist and a toxicologist/chemist and instructed to fill in a questionnaire on exposure to chemical products. The content of formaldehyde and formaldehyde releasers in such products was examined using the database of the Danish Product Register (PROBAS) and by supplemental inquiries of manufacturers or importers. All the patients used one or more products containing formaldehyde or formaldehyde releasers. Sources of exposure were cosmetics and personal care products, dishwashing liquids, water-based paints, photographic products, etc. Patients were advised to use alternatives to those products containing formaldehyde or formaldehyde releasers. The status of 10 out of the 11 patients' eczema at follow-up was about 1/3 healed, 1/3 improved and in 1/3 no change. When the relevance of positive patch test reactions to formaldehyde was based on information obtained on exposure, a very high rate of current relevance was found. Computerized data on product composition allows the screening of products for contact allergens and also generates lists of contact allergens indicated for patch testing, based on the patients' own products.

Influence of area of application of allergen on sensitization in contact dermatitis.

Abstract: There are at least 2 quantitative variables when applying allergens to obtain sensitization: the absolute amount of allergen and the surface concentration. This review analyzes the limited studies on surface concentration and determines surface area threshold levels for the allergens documented in the literature.

Changes in transepidermal water loss and cutaneous blood flow during the menstrual cycle.

Abstract: This study quantified irritant susceptibility and blood vessel reactivity in normal women over the course of the menstrual cycle. Such alterations were studied by observing vasodilation from topical application of methyl nicotinate (MN) on the following days of the menstrual cycle: (i) the day of putative maximal estrogen secretion; (ii) the day of maximal progesterone secretion; (iii) the day of minimal estrogen/progesterone secretion. These responses were evidenced by changes in the following dose response characteristics: the initial response (IR), the peak response (PR) and the area under the curve (AUC). Baseline laser Doppler velocimetry (LDV) blood flow values and transepidermal water loss (TEWL) values on normal skin were also obtained. No significant differences existed for any of the dose-response characteristics (IR, PR, AUC) when the values for the 3 testing days were compared to one another. Significant differences did exist for baseline TEWL values when comparing the day of maximal estrogen secretion to the day of minimal estrogen/progesterone secretion. TEWL was higher on the day of minimal estrogen/progesterone secretion as compared to the day of maximal estrogen secretion on both back (p = 0.037) and forearm (p = 0.021) sites, suggesting that the skin barrier function is less complete on the days just prior to the onset of the menses as compared to the days just prior to ovulation. Significant differences in baseline blood flow also existed for the day of maximal estrogen secretion as compared to the day of maximal progesterone secretion, with higher baseline blood flow recorded on the day of maximal progesterone secretion on both the back (p = 0.021) and forearm (p = 0.009) sites.

Allergic contact dermatitis in children. A multicenter study of the Portuguese Contact Dermatitis Group (GPEDC).

Abstract: The authors report a study of allergic contact dermatitis in 329 Portuguese children of 14 years or younger. 170 children (64 male and 106 female) reacted to 1 or more allergens. Most of these were in the 11-14 years group. The main allergens were nickel, thimerosal, cobalt, mercury, fragrance-mix and potassium dichromate. Nickel reactivity predominated in females over the whole group, but a greater number of males younger than 5 years reacted to nickel. The number of positive reactions increased with age, but this was not accompained by an increase in the % of relevant tests. 12 children, all of them 13 or 14 years-old, had an occupational allergic contact dermatitis.

Epidemiological, clinal and allergological observations on pompholyx

Abstract: We have studied a group of 104 patients with pompholyx, to investigate the relationship between allergological factors and its etiopathogenesis. The following examinations were performed: blood sampling (routine tests and IgE levels), allergological tests (patch, prick, intradermal, and oral provovation tests with nickel sulphate), skin biopsy to exclude pemphigus vulgaris or bullous pemphigoid. An accurate history of familial and personal allergic diathesis was enquired for and various possible aggravating factors (season, microclimate, perspiration and emotional stress) were considered. The results were age and sex-matched with a healthy control group (208 subjects). We found familial and personal atopic diathesis in 50% of patients versus 11.5% of controls (p less than 0.001); 39 patients (37.49%) also had high levels of IgE. Nickel sulphate was the allergen with the highest positivity on patch testing: 20.19% versus 6.25% of the control group (p less than 0.001). The % of patients allergic to nickel reached 26%, including those (6 patients) reacting to the oral provocation test. Season (43 patients) and hyperhidrosis (38) were the aggravating factors most commonly claimed. We detected no correlation between age, sex, grading of pompholyx and the allergological parameters investigated. Though several different allergological findings have previously been reported in dyshidrosis, their role in its pathogenesis has not yet been fully explained. We think that different haptens or antigens can produce the same clinical and histological picture of pompholyx in predisposed subjects.

Changing trends in the epidemiology of contact dermatitis in Singapore.

Abstract: All patients seen in the Contact Dermatitis Clinic of the National Skin Centre, Singapore (and the former Middle Road Hospital) between January 1986 and December 1990 were analysed retrospectively. 5557 patients comprising 2934 (47.4%) males and 2923 (52.6%) females were patch tested, 3154 (56.8%) patients had 1 or more positive reactions. The majority of the patients wore Chinese (78.0%), followed by Malays (11.5%), Indians (8.1%) and other minority races (2.4%). The majority of positive reactions belonged to the 21.40 age group. The incidence of Positivity decreased after 61) years. The commonest allergens responsible were nickel (17.7%), fragrance (13.3%); neomycin (6.9%), colophony (6.6%)and proflavine (6.5%). Both neomycin mid proflavine were commonly used as over-the-counter medicaments. Compared loan earlier report in 1988, there were differences in the incidence of contact sensitivity to some allergens. Potassium dichromate. which used to be a common allergen, was less common. Some allergens (carba-mix, naphthyl-mix, caine-mix and PCMX) have been removed from our standard series as they were uncommon causes of contact allergy. Thimerosal and Amerchol L-101 were added in their place.

Electrical impedance applied to non-invasive detection of irritation in skin.

Abstract: Healthy volunteers were subjected to irritation by sodium lauryl sulphate at concentrations in the range 0.002% to 5.0% applied in Finn Chambers for 24 h. Test sites were visually assessed 1 h and 24 h after cessation of exposure. At the same times electrical impedance was measured with a new impedance device which allows non-invasive local measurements to a controlled depth. Close agreement between concentration and an irritation index calculated from electrical impedance parameters was found over the whole concentration range for most test persons. At concentrations below 0.2%, visual scores were zero. These results suggest that electrical impedance can be used as an objective tool to record irritation, and further that electrical impedance might be a more sensitive method than the commonly used visual readings.

Diagnostic value of the lymphocyte proliferation test in nickel contact allergy and provocation in occupational coin dermatitis

Abstract: The lymphocyte proliferation test (LPT) was compared with the patch test in the diagnosis of nickel contact sensitivity. Of the 21 subjects with nickel contact allergy, the patch test detected 20 (95%). The subject remaining negative in the patch test was positive in the intradermal test. 18/21 subjects with nickel contact sensitivity were positive in the LPT, whereas in the control group 2/23 subjects were false positive. These results were obtained at nickel sulfate concentrations of less than 10 micrograms/ml, higher concentrations led to nonspecific lymphocyte stimulation. 3 nickel-sensitive cashiers with suspected coin contact-induced deterioration of their hand eczema were challenged by having them count nickel-containing coins daily for 15 min. 2 of them developed vesicular eczema on their palms and fingers in 2 to 3 days. The present results show that the LPT is a reliable additional test in the diagnosis of nickel contact sensitivity. Furthermore, provocation is a valuable procedure when assessing the relevance of nickel contact in occupational hand eczema in certain occupations.

Nickel in jewellery and associated products

Abstract: Nickel-sensitive patients quite often say, \"Now I cannot even wear gold or silver jewellery\": nickel exposure may not be so restricted to cheap items, so-called fashion jewellery, as often thought. Nickel is widely.used in jewellery and associated products, i.e., watches and spectacles. Its application is much broader than generally known by dermatologists, nickel-sensitive persons, customers or 'people behind the counter' (1, 2).