bluuebunny/crossref_metadata_2025 huggingface dataset:
The influence of shaving method on perfume allergy
Authors: Edman Björn
Published: April 2006

Among men, the most frequent contact allergens are perfumes (fragrance mix and balsam of Peru). Considering that the main cause of nickel allergy is ear‐piercing, shaving with a razor blade might be the cause of perfume contact allergy, by creating small wounds that increase the penetration of applied perfume substances derived from soaps, shaving foams and after‐shave lotions. 19 males with contact allergy to fragrance mix and/or to balsam of Peru were interviewed about their shaving habits by letter. 17 responded (89%), of whom 12 (71%) had been using razor blades continuously for a period of at least 1 year. At our clinic, the frequency of razor blade usage was found to be 45% in patch tested men without perfume contact allergy. When comparing the frequencies of razor blade usage among patch tested men with and without perfume contact allergy, there was a statistically significant over‐representation (p= 0.047) among those with perfume allergy. The risk of perfume allergy when using razor blades was found to be 2.9 (odds ratio).
Metal allergy in north Norwegian schoolchildren and its relationship with ear piercing and atopy
Authors: Dotterud Lars Kare , Falk Edvard S.
Published: April 2006

In 424 schoolchildren (223 boys and 201 girls) aged 7–12 years undergoing routine patch tests, 21.0% (89 children), 38.8% (78/201) of girls and 4.9% (11/223) of boys, had had their ears pierced. 18.6% (79 children, 55 girls and 24 boys) gave a history of cutaneous reactions to metallic jewellery, and in 17.2% (73 children, 49 girls and 24 boys), sensitivity to one or more metals was confirmed. Metal allergy was confirmed by patch testing in only 34.2% of the children with a history of metal dermatitis, and 13.3% of those without a history of metal reactions had, in fact, positive patch tests to 1 or more metals. The low sensitivity (37.0%) and low positive predictive value (34.2%), together with high specificity (85.2%) and high negative predictive value (86.7%), seem to justify dermatological examination of individuals with a positive symptom‐based diagnosis only. Nickel sensitivity was found in 14.9% (63 children, 44 girls and 19 boys). There is clearly a relationship between ear piercing and induction of nickel allergy in girls, as nickel sensitivity in girls with pierced ears was 2 × (30.8%) that found in those without (16.3%) pierced ears. In boys, nickel sensitivity was much less frequent and few cases were related to ear piercing. Atopy appeared to influence the propensity for developing metal sensitivity in girls, as atopic girls showed positive metal tests 2xas frequently (30.8%) as non‐atopic (17.0%). No such differences were found in boys. Girls with a combination of atopy and ear piercing showed the highest frequency of positive metal tests (45.5%). The frequency of metal allergy increased with increasing number of holes in the ear lobes. Symptoms of nickel allergy were reported in 30.2% (19/63) of mothers whose children had nickel allergy, compared to 16.3% (59/361) of mothers whose children had negative nickel tests. Only 4 children reported symptoms of nickel allergy in their father. The high frequency of nickel sensitivity in all children tested may indicate an influence of sources other than ear piercing.
The sodium lauryl sulfate model: an overview
Authors: Lee Cheol Heon , Maibach Howard I.
Published: April 2006

Irritant contact dermatitis is a complex entity with several clinical forms (acute, cumulative, etc.) and multiple mechanisms. Sodium lauryl sulfate (SLS), the most widely utilized model for studying acute and cumulative irritation, has proved highly practical and informative for such studies. This article summarizes several decade of investigation, and provides details of dosing, application method (closed versus open), and biologic endpoints (visual grading, transpidermal water loss) that may be utilized in future studies.
Surfactants and experimental irritant contact dermatitis
Authors: Effendy Isaak , Maibach Howard I.
Published: April 2006

Surface‐active agents (surfactants) are characterized by the possession of 2 different moieties, both polar and non‐polar regions on the same molecule. Surfactants are broadly classified as anionic, cationic, amphoteric, or non‐ionic, according to the nature of the hydrophile yielded in aqueous solution. In currently marketed household, personal, and industrial cleaners, anionic surfactants are the most common class because of their relative ability to solubilize fats is and oils, lower the surface tension of aqueous solutions, or form microemulsions. Many surfactants elicit irritant reactions when applied to the skin, partially due to their relative ability to solubilize lipid membranes. Hence, surfactants have become important implements in skin irritation investigations. In general, the physicochemical properties of surfactants are a crucial factor in eliciting skin irritation. Anionic surfactants are broadly accepted as potent irritants to human and animal skin. Cationic surfactants are reputedly at least equally irritating, but more cytotoxic than anionic, while the irritation potential of non‐ionic surfactants is considered the lowest. Such classification of innumerable surfactants is convenient and held in high practical esteem. However, the categorization does not permit the exact determination of irritation and cytotoxicity potential of each surfactant. Ranking of surfactant skin irritancy and cytotoxicity obtained by both in vitro and in vivo assays provides a helpful orientation for future Work.
Effect of occlusion on human skin
Authors: Matsumura H. , Oka K. , Umekage K. , Akita H. , Kawal J. , Kitazawa Y. , Suda S. , Tsubota K. , Ninomiya Y. , Hirai H. , Miyata K. , Morikubo K. , Nakagawa M. , Okada T. , Kawai K.
Published: April 2006

In order to investigate the el led of occlusion on the skin, the flexor sides of both upper arms were covered with column‐shaped closed chambers, 30 mm in outer diameter. 20 mm in inner diameter. and 5 mm in height, which were made of polyethylene loam. The tops of the chambers were sealed be plastic films with various levels of water vapor permeability to control moisture in each chamber. The raised chamber walls prevented direct contact between the skin and the plastic film. After 24 h of application, morphological changes of the skin surface were observed microscopically by the nitrocellulose‐replica method. Although no visual alterations were found on all areas of occluded skin, microscopic evaluation showed that simple occlusion by films induced an increase in the number of deepened skin furrows on the skin surface. This increase was associated with lower water vapor permeability of the films, as well as with higher values of both temperature and humidity on the test day. Thus, since conditions which facilitate perspiration from the skin lend to cause skin irritation, prolonged exposure of the skin to sweat by simple occlusion may act as a primary skin irritant
Corticosteroid allergy
Authors: Freeman Susanne
Published: April 2006

Allergy to corticosteroids is becoming increasingly recognized. Diagnosis is difficult because of frequently false‐negative patch tests. The optimum concentration and vehicle for patch testing with pure corticosteroid has still not been established. The patch test results of 19 patients with allergy to corticosteroids seen at the Skin and Cancer Foundation in Sydney, Australia, were analysed. It was found that patch testing with the patient's corticosteroid in the commercial cream base gave a greater yield of positive results than testing with the commercial corticosteroid ointment or with the pure corticosteroid in either petrolatum or in alcohol. Tixocortol pivalate, and lo a lesser extent budesonide, were useful for detecting allergy to hydrocortisone, but not necessarily other corticosteroids. Delayed positive patch tests were often seen, showing the importance of carrying out a late reading. The repeal open application test (ROAT) with the patient's own corticosteroid was found lo be a simple, useful diagnostic test.
No evidence of contact sensitization to acyclovir in acute dermatitis of the lips following local application of Zovirax cream
Authors: Koch Patrick
Published: April 2006

We report 4 patients with acute contact dermatitis of the lips following application of Zovirax cream. Patch tests with pure acyclovir, and combinations of the ingredients of the cream base, with and without acyclovir, provided no evidence of sensitization to any constituent of the cream.
Double‐blind placebo‐controlled peroral challenges in patients with delayed‐type allergy to balsam of Peru
Authors: Niinimäki Aila
Published: April 2006

Patch tests (PTs) with spices, such as clove, cinnamon, Jamaica pepper and vanillin sugar, and with balsam of Peru were made on 29 patients 0.8–2.9 years after an allergy to balsam of Peru had been detected. Positive reactions to balsam of Peru were seen in 17 patients, and to clove, Jamaica pepper or cinnamon in 5. Double‐blind placebo‐controlled peroral challenges (DBPCPCs) with balsam of Peru and spices (active substances) were performed on 22 patients. A substantial increase (30–280%) in the number of palmar vesicles after the DHPCPC with the active substances, but not with placebo, was seen in 8 patients, an increase with both the acme substances and placebo in 3. and with placebo but not the active substances in 1 patient. 4 of the 8 patients with positive DBPCPCs with the active substances were negative to balsam of Peru in the 2nd PT. No other objective symptoms were seen after the DBPCPCs. Balsam of Peru and the spices were retested 3 months after the DBPCPC. Both alleviation and aggravation of the PT reactions were seen. It is concluded that ingested flavoured foods might cause systemic contact reactions in some patients with allergy to balsam of Peru, but the benefits of a flavour‐avoiding diet are questionable in all of them.
Prevalence of contact allergy to non‐disperse azo dyes for natural fibers: a study in 1814 consecutive patients
Authors: Seidenari S. , Manzini B. M. , Schoiavi M. E. , Motolese A.
Published: April 2006

5 non‐disperse azo dyes, used for colouring natural fibers, were added to the standard patch test series, as 5% pet. Preparations, 1814 consecutive patients attending the patch test clinic were patch tested, of whom 16 (0.88%) reacted to the newly added dyes: 8 to Direct Orange 34. 5 to Acid Yellow 61. 2 to Acid Red 359 and 1 to Acid Red 118. On the basis of clinical history and results of patch tests with pieces of rubrics, contact sensitization to non‐disperse azo dyes seemed to be related to the appearance of skin lesions at least in 8 subjects. We conclude that systematic exploration of the sensitizing potential of textile dyes, selected after careful investigation, can provide additional information on the frequency of occurrence of textile dye dermatitis, supporting individual investigation in sensitized subjects.
Pretreatment of the test area with 1‐day occlusion improves the response rate to NiSO4 5% pet. Patch tests in subjects with a positive history of nickel allergy
Authors: Seidenari Stefania , Manzini Bianca Maria , Belletti Barbara
Published: April 2006

A group of 58 women, aged 18 to 51 years, with a clinical history of nickel allergy, who exhibited equivocal or negative reactions to nickel sulfate 5% pet, patch tests performed on the skin of the back, were recruited consecutively from the patch test clinic from September 1993 to June 19944. In order to improve the response rate to NiSO4 5% pet, patch tests, a testing procedure utilizing pretreatment of the test area by 1‐day (24‐h) occlusion was introduced. Patients underwent 2 patch tests on adjacent sites of the volar surface of both forearms. 3 of the patch tests were performed with 40 mg nickel sulfate 5% pet., whereas a control test was carried out by occluding with an empty chamber. 2 of the nickel sulfate test sites were pretreated with 1‐day occlusion performed with an empty chamber. A visual grading system and echographic measurement were used to quantify the responses 30–40 min after patch test removal. Echographic evaluations were carried out using a 20 MHz B‐scanner. Measurement of skin thickness and determination of the hypoechogenic dermal area, both considered to be parameters of inflammation, were used to evaluate the intensity of the allergic reaction. At the 3‐day (72‐h) evaluation. 19 subjects out of 58 clearly showed positive reactions to nickel sulfate 5% pet, at pre‐occluded skin sites. Moreover, values of skin thickness and of 0–30 areas at positive pre‐occluded nickel test areas were higher in respect to control test areas, confirming clinical evidence of increased response to NiSO4, after occlusion.
Immediate irritant reactions to benzoic acid are enhanced in washed skin areas
Authors: Lahti Arto , Pylvänen Virpi , Hannuksela Matti
Published: April 2006

Factors affecting immediate irritant skin reactions are poorly understood. Our purpose was to study the effect of washing on reactions to benzoic acid, a well‐known immediate‐type irritant. 12 test subjects washed their left upper arms with a diluted dishwashing liquid 2× daily for 6 days. Benzoic acid in a dilution series was tested on both upper arms on days 0, 3 and 6. The reactions were graded visually, and the blood flow, skin color, transepidermal water loss and electrical capacitance of the test sites were measured. On days 3 and 6, the benzoic acid reactions were stronger on the washed arm than on the control arm. This was clinically visible and was associated with changes in blood flow and skin color measurements. Washing itself did not ususally cause visible erythema, but transepidermal water loss increased and electrical capacitance decreased. Low concentration of irritant substances, such as benzoic acid, may cause clinically relevant reactions in repeatedly washed skin. This should be taken into consideration in assessing product safety in the cosmetic, medical and household chemical industries, and when tests for chemical skin irritancy are designed and the results of such tests interpreted.
An outbreak of occupational dermatosis in an electronics store
Authors: Koh David
Published: April 2006

An outbreak of skin disorders was noted by the primary care physician responsible for the health care of 52 employees in an electronics store. The cases occurred after termite treatment of the store, and the breakdown of the air‐conditioning system in several areas in the store. Investigations were initiated to allay worker concern that the chemicals used for termite treatment (in particular, arsenic trioxide) were responsible for the outbreak. 9 of the 52 workers were found to have heat rash (miliaria rubra). 21% (7) of workers who worked in non‐air‐conditioned areas had heat rashes, as compared to 11% (2) of workers who worked in air‐conditioned work zones. 2 workers had contact dermatitis due to exposure to greaseless lubricant, and 8 other workers had a non‐work‐related skin disorder. Indoor wet bulb globe temperature index measurements in the non‐air conditioned areas were within threshold limit values, but ventilation in these areas was very poor. 2 environmental samples had non‐detectable limits of arsenic.
Analysis of patients with allergic patch test reactions to a plastics and glues series
Authors: Tarvainen K.
Published: April 2006

839 patients were patch tested with a series of 31 plastics and glues allergens at a dermatologic clinic over a period of 7 years. 52 (6%) had a positive patch test reaction to 1 or more such allergens. Clinic charts of 47 patients (out of 52) were available for the study. All but 3 patients had dermatitis on their hands: 17 had only hand dermatitis. 25 (53%) patients' test results were of present or past relevance to their skin diseases. 11 patients (68%) with occupational allergic contact dermatitis (ACD) and 14 (45%) with non‐occupational dermatitis had relevant reactions. p‐tertiary‐butylphenol‐formaldehyde resin was the most common allergen (9 cases). 7 patients reacted to diaminodiphenylmethane. 5 patients, who had colophony allergy, reacted to abietic acid and 4 to abitol. There was no reaction to 14 test substances. Special series, such as this plastics and glues series, reveal the cause of ACD less frequently than standard series. However, there is no other way to confirm allergy to these usually industrial allergens, which can also sensitize through non‐occupational exposure during hobby working or through unpolymerized monomer left in the finished plastic product.
Damage to the skin by repetitive washing
Authors: Grunewald A. M. , Gloor M. , Gehring W. , Kleesz P.
Published: April 2006

Damage to the skin following the repeated use of 2 different wash solutions was investigated. Stratum corneum capacitative resistance, stratum corneum lipids, transepidermal water loss, skin surface pH, laser Doppler flow and skin reddening were determined. All skin function parameters already showed a marked change after a single wash (e.g., the median of TEWL values increased by more than 0.5 g/m2 h). Repetitive washing for 1 week led to a further deterioration of TEWL and corneometry values (e.g., TEWL increased for about 2.9 g/m2 h after repetitive washing with sodium lauryl sulfate). The rate of skin function regeneration after repetitive washing was unaltered compared to regeneration after a single wash. The surfactants used showed quantitatively differing effects on corneometry, TEWL and laser Doppler flow (e.g., after repetitive washing with Geli‐derm, the median of TEWL values increased only up to 1.55 g/m2 h). However, damage arising from repetitive washing could not be completely prevented by the selection of a mild surfactant. Skin function regeneration showed no difference with the 2 surfactants used.
Experimental study of cutaneous tolerance to glycol ethers
Authors: Zissu Danièle
Published: April 2006

We tried out the potential irritant and sensitizing effect of the main glycol ethers found in industrial and consumer products. Cutaneous irritation was determined in the rabbit following the EEC method (European Economic Communities) and the Draize protocol, and the sensitizing effect was evaluated in the guinea pig by the maximized Magnusson and Kligman method. The results showed no delayed cutaneous hypersensitivity, and all glycol ethers studied were classified from slightly irritant to severely irritant according to the Draize protocol, though only 2–butoxyethanol and isopropoxyethanol were classified as skin irritants with the EEC method. Glycol ethers should be handled with all the care that should be taken in the safe use of organic solvents.
Effects of water temperature on surfactant‐induced skin irritation
Authors: Berardesca Enzo , Vignoli Gian Piero , Distante Fernanda , Brizzi Pietro , Rabbiosi Giacomo
Published: April 2006

Surfactant‐induced irritant reactions may be elicited by several endogenous and exogenous factors. Among these, surfactant concentration, and duration and frequency of exposure play important rotes. The study focuses on the influence of water temperature in determining damage of the skin barrier. 10 subjects of both sexes entered the study. 4 areas (4×4 cm2) were randomly selected on the volar forearm and were treated with a daily open application of 5% sodium lauryl sulphate for 4 days. The solutions were at 3 temperatures: 4®, 20® and 40 ®C. One site served as untreated control. On the 5th day, skin irritation was evaluated using transepidermal water loss (TEWL) measurements, erythema (a* value), skin reflectance (L* value), hydration (capacitance) and desquamation (stripping). The results show a significant effect of the solution's temperature in determining skin irritation (P < 0.001), Skin damage was higher in sites treated with warmer temperatures and a highly significant correlation (P < 0.001) between irritation and temperature was found. In conclusion, the study shows that water temperature during washing has an important effect on the onset of irritant contact dermatitis.
The clinical effect of percutaneous histamine on allergic contact dermatitis elicited to fragrance mix
Authors: Lijnen R. L. P. , van Joost Th.
Published: April 2006

Histamine (2‐(4‐imidazol)ethylamine) has been shown to downregulate cell‐mediated reactions in vitro. However, the role of such downregulation in vivo has not yet extensively been studied in humans. In an attempt to gain more insight into this, we studied in vivo the effect of percutaneous histamine on an allergic contact reaction elicited to fragrance mix in 28 human volunteers with previously‐known sensitization (patch tests) to this allergen. Histamine (0.1 mg/ml) was administered either via subcutaneous injections or by scratching at the site of patch tests to one concentration (8% pet.) of fragrance mix at different times. Histamine and control solution were administered immediately before patch testing (0 hours) or 2 × at 0 and 24 h (after application). No significant differences were observed in the grade of delayed‐type hypersensitivity reaction (DTHR) to fragrance mix (8% pet.) by visual reading when histamine or control solution was administered. This study did not exclude the possibility that histamine could inhibit DTHR to lower concentrations of the allergen used, and therefore additional in vivo studies are required.
Allergic contact dermatitis from purified eosin
Authors: Koch P. , Bahmer F. A. , Hausen B. M.
Published: April 2006

We report on a patient, seen in 1993, who developed sensitization to eosin from topical preparations. The patient had a positive patch test reaction to pure tetrabromofiuorescein but not to its impurities separated by thin‐layer chromatography. Our findings suggest that the allergen was eosin itself.
Airborne irritant contact dermatitis from metal dust adhering to semisynthetic working suits
Authors: Hafner Jüer , Rüegger Martin , Kralicek Petra , Elsner Peter
Published: April 2006

2 workers at an aircraft factory were employed in a plasma sparying unit. Soon after they were equipped with new semisynthetic working suits, they started to complain of pruritic eruptions after heavy exposure to metal dust. They noted that the dust was not as easily blown off the clothes by pressurized air as previously. Clinical findings consisted of discrete macular and papular lesions, partly follicular, on the ventral and medial thighs. Atopy score, IgE level and a standard series of prick tests ruled out atopic disposition. Patch tests revealed no reactions. A diagnosis of occupational airborne irritant contact dermatitis from metal dust was therefore made. To elucidate the role of the working suit, extensive physical investigations of the physical properties of the textile were performed. Microscopic pictures at low magnification showed more dust particles on the semisynthetic working suit, compared to the former pure cotton suit. This impression could not be confirmed by particle count because of too uneven particle distribution at higher magnification. Hairiness of the 2 textiles was low and ruled out irritation by the semisynthetic textile itself. No difference in electrostatic properties between the 2 working suits could be established either. Both textiles showed high static electrical propensity. When use of the semisynthetic overall was discontinued, the patients reported no recurrence. The 2 reported cases show that the physical properties of the textiles of working suits can be of interest and should be considered in the management of dust‐induced irritant contact dermatitis. Extended physical examinations of textile failed to explain the clinical observation; further investigations might establish physical characteristics of textiles for such adhesion qualities.
A critical commentary and updating of the guinea pig maximization test
Authors: Kligman A. M. , Basketter D. A.
Published: April 2006

The guinea pig maximization test (GPMT) of Magnusson and Kligman was published in 1969. Since then, a vast body of practical experience with the test has been accumulated. New information requires that certain aspects of the procedure be reevaluated, especially with regard to the interpretation of challenge results. In particular, awareness of the phenomenon of hyperirritable skin (the ‘angry back’ phenomenon) suggests that presently used controls are not always adequate and may overstate allergenicity owing to false‐positive reactions. The control group should be exposed to a chemical insult at induction which provokes an inflammatory reaction comparable to the test substance. We present strategies to distinguish irritant from allergic responses. Allergic reactions should persist on rechallenge weeks later, while nonspecific irritant reactions generally fade and are irreproducible in particular animals. Finally, when a chemical is identified as a contact sensitizer of risk is necessary to estimate the relevance of the test result to usage in the real world.
Ear piercing, and nickel and cobalt sensitization, in 520 young Swedish men doing compulsory military service
Authors: Meijer Claes , Bredberg Marja , Fischer Torkel , Widström Lena
Published: April 2006

Piercing the earlobes has increased in popularity among males in recent years. This habit would be expected to increase the incidence of nickel and cobalt sensitization. Patch testing with nickel sulfate and cobalt chloride was performed in 520 young Swedish men doing compulsory military service. The overall frequency of nickel/cobalt positive tests was 4.2%, The prevalence of nickel/cobalt positive tests was significantly higher (p < 0.05) in 152 men with pierced earlobes (7.9%) than in those 368 with unpierced earlobes (2.7%). A history of hand eczema (7/152=4.6%) or other types of eczema (22/152=14.5%) in individuals with pierced earlobes was no more common than in those with unpierced earlobes: 24/368=6.5% and 51/386=13.9%, respectively (n.s.). Hand eczema was no more common in sensitized (1/22=4,5%) than in nonsensitized individuals (32/498 = 6.4%) (n.s.)
Hand eczema in Finnish farmers
Authors: Susitaival P. , Husman L. , Hollmén A. , Horsmanheimo M. , Husman K. , Hannuksela M.
Published: April 2006

In a population of 2005 Finnish farmers, 172 (8.6%) reported hand or forearm dermatoses in a self‐administered questionnaire. 138 (80%) of them attended a clinical examination. Skin prick tests (SPTs) were done to 80% and patch tests (PTs) to 77% of the examined farmers. 93% of hand dermatoses were eczema and 70% were considered work‐related. Cow allergy was found in 41 of 104 prick‐ and patch‐tested farmers (39%). Immediate allergy to cow epithelium was encountered in a total of 28/41, in 20 with SPTs, and in 8 only with 20 min PTs. Delayed contact allergy to cow dander was found in 27/41. The result suggests that in addition to SPTs using commercial cow epithelium extract, PTs using fresh cow dander should also be done, and both immediate and delayed responses should be read.
Contact allergy to kojic acid in skin care products
Authors: Nakagawa Mikio , Kawai Keiichi , Kawai Kyozo
Published: April 2006

Kojic acid (5‐hydroxy‐2‐(hydroxymethyl)‐4‐pyrone), a fungal metabolic product, has increasingly been used as a skin‐depigmenting agent in skin care products marketed in Japan since 1988. In order to determine its frequency of sensitization, during 1 year from October 1992 to September 1993, we performed patch testing with it in 220 female patients with suspected cosmetic‐related contact dermatitis. Of the 220 patients, 8 used at least 1 skin care product containing kojic acid, 5 of whom reacted to kojic acid as well as to 1 or more their own products containing 1% kojic acid, but not to their other products not containing it, and 3 of whom were negative to kojic acid and all their own products. Patch testing with kojic acid in the remaining group of 212 patients, who had not previously used skin care products containing it, was negative without exception. The 5 kojic‐acid‐sensitive patients, aged 34 to 58 years, developed facial dermatitis 1–12 months after starting application of kojic‐acid‐containing products. Kojic acid is considered to have high sensitizing potential, as a comparatively high frequency of contact sensitivity was observed in patients using products containing it (5 out of 8).
The fragrance mix and its constituents: a 14‐year material
Authors: Johansen Jeanne Duus , Menné Torkil
Published: April 2006

Results from 14 years of patch testing with the fragrance mix and its constituents are reviewed. From 1979–1992, 8215 consecutive patients were patch tested with the fragrance mix and 449 (5.5%) had a positive reaction. An increase in the frequency of reactions to fragrance mix was seen from the first 5‐year period to the last. Only 54.4% of the patients tested in the last 5‐year period with the individual constitutents of the mix had at least 1 positive reaction. The results of testing with the constituents are the basis for a discussion of methodological problems. A significant decrease in the frequency of reaction to cinnamic aldehyde was registered, at the same time as the test concentration was reduced from 2% to 1% pet. However, no significant variations in the frequency of reactions to oak moss were seen, notwithstanding a similar reduction in test concentration.
Sulfur spring dermatitis
Authors: Sun Chee‐Ching , Sue Ming‐Shen
Published: April 2006

44 cases of an unusual condition, designated hot spring dermatitis, have been studied. Patients usually presented during the winter months with a history of having taken green sulfur spring baths within the previous 2–20 days. Skin lesions developed about 24 h after bathing and were distributed generally over the trunk and limbs, especially in the skin folds. No micro‐organisms were found in either hot spring water specimens or skin lesions. Patch tests showed no positive reactions. Investigations were undertaken to determine the physicochemical characteristics of the hot spring. In its extreme acidity and high content of soluble sulfur and chloride, it differed from other nearby hot springs.
Occupational allergic contact dermatitis and contact urticaria caused by polyfunctional aziridine hardener
Authors: Kanerva Lasse , Estlander Tuula , Jolanki Riita , Tarvainen Kyllikki
Published: April 2006

Polyfunctional aziridine (PFA) is increasingly used as a water‐based cross‐linker in 2‐component paints, paint primers, lacquers, topcoats and other protective coatings. The cross‐linker (PFA hardener) is made by reacting multifunctional acrylic monomer with a highly reactive aziridine compound. During 1992–1993, we came across 2 patients with allergic patch test reactions provoked by PFA hardener. One of the patients was a parquet layer, and the other a printer. Allergic‐contact dermatitis (ACD) was diagnosed by positive allergic patch test reactions to PFA hardener in a dilution series in pet.: 0.3%‐1% gave ++ to +++ allergic reactions in both patients, whereas 0.1% gave a weak (+) or questionable reaction (?+), respectively. The methacrylate patch test series was negative in both patients, although gas chromatography mass spectrometry analysis showed that PFA hardener contained 0.3% of trimethylolpropane triacrylate (TMPTA), a multifunctional acrylic monomer. One of the patients also had symptoms of contact urticaria, and a prick test with PFA hardener (1% aq.) induced a histamine‐sized prick test reaction. The positive reactions with the PFA hardener and the negative reactions with the starting chemicals and additives in PFA, namely acrylates, propyleneimine and dimethylethanolamine, indicate that PFA caused ACD. This is in accordance with our previous observations, but differs from the reports of others, whose patients had been sensitized to acrylates present as remnants in the PFA hardener. As test substance, 0.5% PFA hardener in pet, is recommended for patch testing. Testing should be performed in patients with contact dermatitis if exposure to PFA has occurred. Skin prick tests may be of help to detect contact urticaria.
Erythema‐multiforme‐like eruption due to topical contactants: expression of adhesion molecules and their ligands and characterization of the infiltrate
Authors: Puig Lluis , Fernández‐Figueras María‐Teresa , Montero María‐Angeles , Ferrándiz Corlos , Alomar Augustin
Published: April 2006

Erythema‐multiforme‐like reactions are a rare manifestation of allergic contact sensitivity, the pathomechanisms of which and their possible relationship to erythema multiform: remain unclear. We present our histopathological and immunohistochemical findings regarding the expression of several adhesion molecules and inmumophenotypic markers of the infiltrate in skin biopsy specimens from 2 cases of erythema‐multiforme‐like reactions due to contact sensitizers and 3 ‐cases of typical post‐herpetic erythema multiforme. The histopathological pattern of erythema multiforme‐like reactions was characterized by an upper‐dermal perivascular tymphoid infiltrate with exocyiosis and keratinocyte necrosis: in 1 of the cases, there were foci of spongiosis and an admixture of eosinophils in the infiltrate. In comparison with biopsy specimens from cases of typical erythema multiforme, in both cases of erythema‐multiforme‐like reactions, the epidermal expression of ICAM‐I was more prominent, the % of CD4+ cells in the infiltrate was higher and the % of CD69+ cells was lower. There were no other significant differences in the cell phenotype of the infiltrate or in adhesion molecule expression in biopsy samples from both disorders.
Patch testing with fragrances: results of a multicenter study of the European Environmental and Contact Dermatitis Research Group with 48 frequently used constituents of perfumes
Authors: Frosch P. J. , Pilz Beate , Andersen K. E. , Burrows D. , Camarasa J. G. , Dooms‐Goossens A. , Ducombs G. , Fuchs T. , Hannusksela M. , Lachapelle J. M. , Lahti A. , Maibach H. I. , Menné T. , Rycroft R. J. G. , Shaw S. , Wahlberg J. E. , White I. R. , Wilkinson J. D.
Published: April 2006

The objective of this study was to determine the frequency of reactivity to a series of commonly fragrances in dermatological patients. A total of 48 fragrances (FF) were chosen, based on the publication of Fenn in 1989 in which the lop 25 constituents of 3 types (1. perfumes, 2. household products, 3. soaps) of 400 commercial products on the US market had been determined. In a pilot study on a total of 1069 patients in 11 centres, the appropriate test concentration and vehicle were examined. For most fragrances, 1% and 5% were chosen, and petrolatum proved to be the best vehicle in comparison to isopropyl myristate and diethyl phthalate. In the main study, a set of 5 to 10 fragrances at 2 concentrations was patch tested in each centre on a minimum of 100 consecutive patients seen in the patch test clinic. These patients were also patch tested to a standard series with the 8% fragrance mix (FM) and its 8 constituents. In patients with a positive reaction to any of the 48 FF, a careful history with regard to past or present reactions to perfumed products was taken. A total of 1323 patients were tested in 11 centres. The 8% FM was positive in 89 patients (8.3% of 1072 patients). Allergic reactions to the constituents were most frequent to oak moss (24), isoeugenol (20), eugenol (13), cinnamic aldehyde (10) and geraniol (8). Reactions read as allergic on day 3/4 were observed only 10 × to 7 materials of the new series (Iso L: Super® (2), Lyral® (3), Cyclacet® (1), DMBCA (1), Vertofix® (1), citronellol (1) and amyl salicylate (1)). The remaining 41 fragrances were negative. 28 irritant or doubtful reactions on day 3/4 were observed to a total of 19 FF materials (more than 1 reaction: 5% citronellol (2), 1%amyl salicylate (2), 1%isononyl acetate (3), 0.1% musk xylol (2). 1%citral (2), and 1% ionone beta (2)). Clinical relevance of positive reactions to any of the FF series was not proved in a single case. This included the 4 reactions in patients who were negative to the 8% FM. In conclusion, the top 25 fragrances commonly found in various products caused few reactions in dermatological patients and these few appeared to be clinically irrelevant, with the possible exeption of Lyral®. However, this data should be interpreted in the light of the relatively small number of patients tested (only 100 in most centres).
Immediate and delayed contact hypersensitivity to verbena plants
Authors: Potter P. C. , Mather S. , Lockey P. , Knottenbelt J. D. , Paulsen E. , Skov P. S. , Andersen K. E.
Published: April 2006

Plants from the Verbenaceae family may cause contact dermatitis of unknown nature. This report describes 2 cases of allergic reactions to the Verbena species. A teenage boy developed an anaphylactic allergic response following contact with the leaves of Verbena hybrida. Characterization of the patient's specific IgE response to Verbena hybrida, using Western blots and autoradiography, identified the specific 62000 Dalton allergen present in the verbena leaves to which the patient reacted. This is the first report of an IgE‐ mediated immediate contact hypersensitivity reaction to Verbena hybrida a common perennial in South African gardens. The other case was a 23‐year‐old female gardener who developed immediate and delayed‐ type contact dermatitis from Verbena elegans‘Cleopatra’ produced in a Danish nursery. Prick tests to plant material were considered positive and of an allergic nature.
Allergic contact cheilitis
Authors: Ophaswongse Suwirakorn , Maibach Howard I.
Published: April 2006

Allergic contact cheilitis describes a not uncommon inflammatory reaction of the lips. We reviewed its allergic causes, mid suspect that the literature does not adequately document the frequency and etiologic factors involved.
Evaluation of patch test results by use of the reaction index. An analysis of data recorded by the Information Network of Departments of Dermatology (IVDK)*
Authors: Brasch Jochen , Gfier Johannes , Henseler Tilo
Published: April 2006

Results of patch tests performed in 15.553 patients by IS dermatological department (members of the German Contact Dermatitis Research Group) and recorded by the Information Network of Departments of Dermatology (IVDK) were analysed by comparing recently defined reaction indices (RIs). The RIs studied were calculated from the numbers of allergic (a), questionable (q), and irritant (i) reactions (RI = (a‐q‐i/(a+q+l)), which were obtained using 13 European standard allergens. RIs were calculated for all patients and for separate subgroups defined by age, sex, history of atopic dermatitis time of allergen exposure (1 versus 2 days), and lime of patch test reading (2 or 3 days after allergen application), Higher RIs were consistently obtained when patch tests were applied for 1 day, as compared to 2 days. Readings at 3 days after allergen application resulted in higher RIs than readings after 2 days. In contrast, sex, age, and history of atopic dermatitis of patients were not found to have LI consistent influence on the RIs. We suggest that reading after 3 days should be obligatory, and that allergen exposure for 1 day instead of 2 days might make patch test evaluation easier. These suggestions need to be substantiated by data on clinical relevance.
Adverse contact reactions to sculptured acrylic nails: 4 case reports and a literature review
Authors: Freeman Susanne , Lee May‐Sen , Gudmundsen Ken
Published: April 2006

4 cases with differing presentations of contact allergy to acrylates in sculptured acrylic nails are presented. These read ions include nail fold, fingertip and hand dermatitis, face and neck dermatitis dystrophic nail changes and paraesthesia. We discuss acrylic nails and review the previously published reactions to acrylates in acrylic nails.
Rosin (colophony) and zinc oxide in adhesive bandages
Authors: Gäfvert Elisabeth , Färm Gunilla
Published: April 2006

Adhesives and bandages containing zinc oxide (ZnO) and rosin are often used for treatment of ulcers. The aim of this work was to study a possible inhibitory effect of ZnO on the eliciting of allergic contact reactions to rosin und lo determine whether such an effect might be due to the formation of zinc resinates. Patch testing in rosin‐sensitive patients was performed with mixes of ZnO and rosin. The eliciting capacities of one mix in which zinc resinates might be formed and another mix in which the formation of zinc resinates was prevented, were compared to the eliciting capacity of rosin alone. If a reduction of the allergic response was observed for the mix in which zinc resinates might form and if no reduction was observed for the mix in which formation of zinc resinates was prevented, this would support the hypothesis that the reduction in eliciting capacity was due to formation of zinc resinates. However, we could not see any difference in eliciting capacity when comparing the 2 mixes with a lest preparation of rosin. Commercial adhesives (bandages) containing ZnO and rosin were patch tested in 7 rosin‐sensitive patients. The concentration of abietic acid in the adhesives was determined with HPLC. Abietic acid was detected in all but one of those declared to contain rosin. The patients reacted to the adhesives in which abietic acid was detected. For rosin‐sensitive persons, the addition of ZnO to rosin‐containing adhesives cannot be regarded as an appropriate measure to inhibit the elicitation of allergic reactions.
Occupational hand dermatitis in a tertiary referral dermatology clinic in Taipei
Authors: Sun Chee‐Ching , Guo Yue‐Liang , Lain Ruey‐Shiung
Published: April 2006

Occupational skin disease is one of the most common occupational diseases. The hand is the most frequent site of involvement in occupational skin disease. We interviewed and examined patients seen in the Contact Dermatitis Clinic of the National Taiwan University Medical Center, a tertiary referral center in Taipei City. For patients suspected of having allergic skin diseases, patch testing was carried out using the, European standard series and suspected allergens. Occupational hand dermatitis (OHD) WHS diagnosed according to medical history, work exposure, physical examination, and patch lest findings. 36% of patients seen were diagnosed as having OHD. Electronics, hairdressing. medical, chemical, and construction were the most important industries causing OHD. In the 16–1 patients with OHD. 58.5%. had irritant contact dermatitis (ICD) and 41.5% allergic contact dermatitis (ACD). Dorsal fingers, nail folds, and dorsal hands were most frequently involved in patients with ACD: dorsal fingers, volar fingers and fingertips were most frequently involved in those with ICQ Using logistic regression analysis, we were able to identify the most important clinical presentations that predicted the types of OHD. ACD versus ICD. Patients with atopic history and palm involvement were more likely to have ICD, and those with nail fold involvement more likely to have ACD. In patients with ACD, the most important allergens were dichromate. nickel, cobalt, fragrance mix, epoxy resin, thiuram mix, and p‐phenylenediamine. In this study, we identified the important industries and causal agents for OHD. Future preventive measures focused on these industries and agents lo reduce OHD will be warranted.
Evaluation of human skin irritation by carboxylic acids, alcohols, esters and aldehydes, with nitrocellulose‐replica method and closed patch testing
Authors: Sato A. , Obata K. , Ikeda K. , Ohkoshi K. , Okumura H. , Ozawa N. , Ogawa T. , Katsumura Y. , Kawai J. , Tatsumi H. , Honoki S. , Hiramatsu I. , Hiroyama H. , Okada T. , Kozuka T.
Published: April 2006

Closed patch testing and the nitrocellulose replica method are performed as useful clinical methods for the evaluation of human skin irritation by cosmetics and topical medicaments. Comparison of the sensitivity between microscopic scoring by nitrocellulose‐replica method and visual scoring by closed patch test in the detection of skin irritation, however, has not been well studied with statistical analysis. Here, we evaluated human skin irritation by carboxylic acids. Alcohols, esters and aldehydes, with different chain length (C8‐C18), using both methods. The results of closed patch testing showed that, although the score of skin irritation for carboxylic acids (C8, C12), alcohols (C8) and aldehydes (C8), tested at a concentration of 0.5 m‐2.0 m. significantly increased with increasing concentration of the test compounds, ester compounds scarcely caused any irritation on the surface of the skin occluded. In addition, an increase of carbon chain length in the test compounds made it impossible to detect skin irritation. In contrast, the nitrocellulose‐replica method could evaluate skin reactions against very weak irritants that gave no macroscopic alterations on the skin surface in the closed patch test. However, the scoring system is somewhat subjective and should be improved to make the analysis more objective.
Comparison of 2 tests for clinical assessment of formaldehyde exposure
Authors: Flyvholm Mari‐Ann , Tiedemann Eva , Menné Torkil
Published: April 2006

The objective of the study was to obtain further experience on the applicability of 2 tests for clinical assessment of formaldehyde exposure. About 1300 products brought in by caosecutive formaldehyde‐sensitive eczema patients during a 2‐year period were tested with both the chromotropic acid test and the acetylacetone test. The chromotropic acid test was modified by including a 2nd reading after 2 days. The outcome was identical for about 90% of the products, and 74% of he products that were positive on day 2 were also positive on day 2. For products analyzed with both the chromotropic acid test (day 2 readings) and the acetylacetone test. About 80% gave identical results. Positive reactions were frequently found for hair shampoo, creams and lotions, soap and skin cleansers. Make‐up and dishing liquids. The samples causing discolouration or problems in the tests were mostly concentrated in specific product categories. Very few products caused problems in both test methods. Thus, the most convenient test can be used as the 1st choice and, for product categories causing discolouration or problems with a specific test, the other test method can be used.
Allergic patch test reactions to palladium chloride in schoolchildren
Authors: Kanerva Lassh , Kerosuo Heidi , Kullaa Arja , Kerosuo Eero
Published: April 2006

A study of the prevalence of allergic patch test reactions to palladium chloride compared to nickel sulfate was performed in a group of Finnish schoolchildren. All adolescents 14–18 years of age in a Finnish town with 40 000 inhabitants, who had received orthodontic treatment with metallic appliances at a municipal dental clinic, were included in the study. The selection of patients was based on patient records. A non‐treatment control group was randomly selected from the same age groups of the town population. A total of 700 subjects (77% of those invited), 417 (60%) girls and 283 (40%) boys, participated. The majority (91%) of the girls had pieced ears. Orthodontic treatment was equally common (67–70%) in the boys and the girls. The girls had a much higher frequency of allergic patch test reactions to both nickel sulfate and palladium chloride. Of the 700 adolescents tested 48 (7%) had an allergic patch test reaction to palladium chloride. Of the 417 girls, 44 (11%) were palladium‐chloride‐positive, whereas only 4 of the 283 boys tested (1%) had an allergic patch test reaction to palladium chloride 3 patients reacted to palladium chloride only, whereas all other patients with allergic patch test reactions to palladium chloride also had an allergic patch test reaction to nickel sulfate. The results support the concept of cross‐reactivity between nickel sulfate and palladium chloride. The clinical significance of the allergic patch test reactions caused by palladium chloride remains unclear.