Showing papers on "Hand eczema published in 1992"

Noninvasive measuring methods for the investigation of irritant patch test reactions. A study of patients with hand eczema, atopic dermatitis and controls.

Abstract: The aim of the study was to assess the susceptibility of clinically normal skin to a standard irritant trauma under varying physiological and patophysiological conditions. Evaluation of skin responses to patch tests with sodium lauryl sulphate (SLS) was used for assessment of skin susceptibility. The following noninvasive measuring methods were used for evaluation of the skin before and after exposure to irritants: measurement of transepidermal water loss by an evaporimeter, measurement of electrical conductance by a hydrometer, measurement of skin blood flow by laser Doppler flowmetry, measurement of skin colour by a colorimeter and measurement of skin thickness by ultrasound A-scan. The studies were carried out on healthy volunteers and patients with eczema. In the first studies the standard irritant patch test for assessment of skin susceptibility was characterized and validated. SLS was chosen among other irritants because of its ability to penetrate and impair the skin barrier. The implications of use of different qualities of SLS was investigated. The applied noninvasive measuring methods were evaluated, and for quantification of SLS-induced skin damage measurement of TEWL was found to be the most sensitive method. Application of the standard test on clinically normal skin under varying physiological and patophysiological conditions lead to the following main results: Seasonal variation in skin susceptibility to SLS was found, with increased susceptibility in winter, when the hydration state of the stratum corneum was also found to be decreased. A variation in skin reactivity to SLS during the menstrual cycle was demonstrated, with an increased skin response at day 1 as compared to days 9-11 in the menstrual cycle. The presence of active eczema distant from the test site increased skin susceptibility to SLS, indicating a generalized hyperreactivity of the skin. Taking these sources of variation into account healthy volunteers and patients with hand eczema and atopic dermatits were studied and compared. In healthy volunteers increased baseline TEWL and increased light reflection from the skin, interpreted as "fair" skin, was found to be associated with increased susceptibility to SLS. Hand eczema patients were found to have fairer and thinner skin than matched controls. Increased susceptibility to SLS was found only in patients with acute eczema. Patients with atopic dermatitis had increased baseline TEWL as well as increased skin susceptibility as compared to controls. Skin susceptibility is thus influenced by individual- as well as environment-related factors. Knowledge of determinants of skin susceptibility may be useful for the identification of high-risk subjects for development of irritant contact dermatitis, and may help to prevent the formation of the disease.

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.

Hydrocortisone sensitivity: clinical features of fifty-nine cases.

Abstract: Background : Hypersensitivity to topical steroids is becoming increasingly recognized. Objective : Our purpose was to establish factors associated with allergy to topical hydrocortisone. Methods : Data from 59 consecutive patients allergic to hydrocortisone were compared with 199 consecutive patients who were not allergic to hydrocortisone. Results : Patients with stasis dermatitis and leg ulceration were significantly more likely to be allergic to hydrocortisone. In patients with hand eczema, in whom hydrocortisone sensitivity was less common, hydrocortisone was still a common allergen, occurring as frequently as wool alcohols and colophony. In four patients with atopic eczema, hydrocortisone was the only allergen. Duration of dermatitis was not important in determining the presence of hydrocortisone allergy. However, patients allergic to hydrocortisone were more likely to have multiple allergies when compared with control subjects. Conclusion : Allergy to topical hydrocortisone is associated with stasis dermatitis and multiple positive patch test reactions.

Cyclosporin A responsive chronic severe vesicular hand eczema.

Abstract: A patient with an otherwise recalcitrant chronic vesicular hand eczema responded with a dramatical improvement within 2 weeks of cyclosporin A (CsA) therapy 5.0 mg/kg daily. The patient was still free of eczema in spite of reducing the CsA dose to 2.5 mg/kg daily. CsA therapy was finally stopped due to a moderate increase in blood pressure, resulting in rapid recurrence of the hand eczema. The case report clearly demonstrates that oral CsA should be considered in patients with severe hand eczema that cannot be controlled on conventional immunosuppressive treatments.

A prospective study of the development of hand eczema in an automobile manufacturing industry

Abstract: We have not been able to find any prospective study of the risk of developing occupational dermatitis in the car manufacturing industry. To try to define individual predictive risk factors for the development of hand eczema and to determine the prevalence of hand eczema within 1 year in an automobile manufacturing industry, we investigated prospectively 1564 new employees during one year of employment. Only persons with previous atopic dermatitis or hand eczema were restricted to dry and clean workplaces. The employees were personally interviewed and examined before their employment. Written questionnaires were used at 3 and 12 months to obtain information on type of work, exposure, protection and hand dermatitis. All patients developing hand eczema were examined, patch tested and followed to determine the course and consequence of their eczema. The risk turned out to be only 4% on average, but significantly higher in females (6%). Certain sections within the factory such as wet work (canteen/kitchen and cleaning) and work in the paint shop with high exposure to organic solvents carried significantly higher risks. Heavy exposure to mineral oil, a known risk factor, was effectively counteracted by the extensive use of protective gloves to yield a lower than average prevalence in the press and body shop. Individual risk factors for the development of hand eczema were previous hand eczema, atopic dermatitis, but also wool intolerance and hay fever as isolated phenomena. Most cases of hand eczema were mild, of irritant contact type and only 1 employee developed an allergic contact dermatitis due to the working environment.(ABSTRACT TRUNCATED AT 250 WORDS)

Disulfiram is Effective for Nickel Allergic Hand Eczema

Abstract: Disulfiram, a nickel chelator, has been reported to be useful in treating hand eczema in some individuals who are allergic to nickel. Nine patients with chronic hand eczema and positive patch tests to nickel completed a 2 month, randomized, double-blind, placebo-controlled, crossover study to evalua

Colophony in paper as a cause of hand eczema.

Abstract: A 36-year-old man had worked since 1976 as a mixer in a paint factory. He repeatedly dipped his index finger in paint and spread it on a piece of paper to check the colour. According to the producer, many such products contain modified colophony. One with which the patient worked frequently was analysed by us using HPLC (3) and shown to contain colophony in unmodified form. An adhesive containing modified colophony was repeatedly sprayed on his hands while he was sticking labels on tins. The patient had had moderate hand eczema since 1980. In 1988 it worsened and for 1 year it was severe. In 1989, he changed to sales work. The eczema was alleviated, but did not clear. Contact allergy to colophony was shown and extensive patch testing carried out (Table 1 ). Patch testing was positive with extracts of newspaper and newsprint paper without printing ink. The patient was advised to wear cotton gloves when reading newspapers and handling paper. The hand eczema rapidly cleared completely and he was able to handle paper \vithout wearing gloves. Temporarily, he had facial dermatitis

Compositae dermatitis presenting as hand eczema.

Abstract: A patient had a facial eczema that did not appear to be correlated with the use of any topical preparations. He also had very striking symptoms of oculorhinitis. These symptoms had been present intermittently for about 3 months, and correlated with working, with improvement away from work. There was no personal or family history of atopy. The patient had worked for many years in a pharmaceutical plant as a chemical technician. He had recently been transferred to a department that pro-

Hydrocortisone sensitivity: fifty-nine cases Clinical features of

Abstract: Background: Hypersensitivity to topical steroids is becoming increasingly recognized. Objective: Our purpose was to establish factors associated with allergy to topical hydrocortigone. Methods: Data from 59 consecutive patients allergic to hydrocortisone were compared with 199 consecutive patients who were not allergic to hydrocortisone. Results: Patients with stasls dermatitis and leg ulceration were significantly more likely to be allergic to hydrocortisone. In patients with hand eczema, in whom hydrocortisone sensitivity was less common, hydrocortisone was still a common allergen, occurring as frequently as wool alcohols and colophony. In four patients with atopic eczema, hydrocortisone was the only allergen. Duration of dermatitis was not important in determining the presence of hydrocortisone allergy. However, patients allergic to hydrocortisone were more likely to have multiple allergies when compared with control subjects. Cbnclusion: Allergy to topical hydrocortisone is associated with stasis dermatitis and multiple positive patch test reactions. (J AM ACAD DERMATOL 1992;27:683-7.)