bluuebunny/crossref_metadata_2025 huggingface dataset:
Chlorothalonil, a possible cause of erythema dyschromicum perstans (ashy dermatitis)*
Authors: Penagos Homero , Jimenez Victor , Fallas Victor , O'Malley Michael , Maibach Howard I.
Published: April 2006

We studied 39 patients with erythema‐dyschromicum‐perstans‐like dermatitis seen at Changuinola Hospital in Panama. They were compared with 41 controls. The 2 groups were native field workers of the banana plantations exposed to many pesticides. In 34 patients, there was a positive patch test reaction to 2,4,5,6‐l, 3‐tetrachloroisophlhalonilnitrile (chlorothalonil. TCPN) 0.001% in acetone. In 39 cases, biopsies showed a lichenoid tissue reaction compatible with a chronic pigmented dermatitis or erythema‐dyschromicum‐perstans‐like dermatitis, Chlorothalonil is possibly the cause of the pigmented dermatitis observed in the 39 banana farm workers studied. Until additional studies are carried out. We consider this a possible rather than definite cause‐and‐effect relationship.
Water protective effect of barrier creams and moisturizing creams: a new in vivo test method
Authors: de Fine Olivarius Frederik , Hansen Alice Brinch , Karlsmark Tonny , Wolf Hans Christian
Published: April 2006

Frequent exposure to water is an important risk factor for the development of irritant hand eczema. Evaluation of cream efficacy in protecting against water is difficult. A new non‐irritant, non‐invasive method is introduced, based on evaluation of colour intensities when an aqueous solution of crystal violet is applied to the skin, after pretreatment with different creams. By skin reflectance measurement, differences in colour intensity were objectified. Measurements of transepidermal water loss were also performed. 2 barrier creams and a moisturizer were tested on the dorsal and volar aspects of the handy One barrier cream contained silicone the other solid particles. The moisturizer had a high content of lipid. In one experiment, the immediate effect of the cream in protecting against water was evaluated. In a second experiment, the water resistancy of the creams was tested, using a standard water immersion procedure (4X20 min). The barrier cream with particles gave the best immediate protection (dorsal 76% volar 69%). The moisturizer was intermediately protective (dorsal 57% volar 34%) while very link protection was found for the silicone‐containing cream (dorsal 16% volar 10%). The water immersion procedure resulted in only minor changes in protection for each cream. When comparing transepidermal water loss in the treated areas with pretreatment values, a reduction was recorded only for the particle‐containing barrier cream. The colour method described may be used as a quick and easy test of the protective effect of creams against water.
Can pre‐employment patch testing help to prevent occupational contact allergy?
Authors: Milković‐Kraus Sanja , Magan Jelena
Published: April 2006

175 subjects (157 female. 18 male) were patch tested with a standard series of allergens (Epipharm Allergy Service, GmbH, Linz, Austria), during pre‐employment Examinations in the pharmaceutical industry, considered an industry at risk for the development of contact sensitization. None of those examined had contact dermatitis prior to testing and none gave a positive history of hand ecczema. Patch testing was positive in 12 (7%) subjects, of whom 7 showed a positive reaction to only 1 contact allergen and 5 reacted to several contact allergens. 5 subjects (2.9% reacted positively to metal salts (nickel, cobalt, chromium), 5 (2.9%) had a positive skin reaction to mixtures of rubber additives, and the remaining 2 to other allergens.
Statistical data on occupational contact urticaria
Authors: Kanerva Lasse , Toikkanen Jouni , Jolanki Riitta , Estlander Tuula
Published: April 2006

Data on occupational contact urticaria (protein contact dermatitis included) in Finland during 1990–1994 were analyzed. Altogether 815 cases were reported to the Finnish Register Occupational Diseases during this period, compared with l944 cases of occupational allergic contact dermatitis. Accordingly, the total number Of Occupational allergic contact derma loses was 2759. 29.5% being contact urticaria and 70.5% being allergic contact dermatitis. Occupational contact urticaria was much more common in women 70%) than in men (30%). The 6 most common causes of contact urticaria were (1) cow dander (362 cases=44.4%) (2) natural rubber latex (193 cases ‐23.7%), (3) Hour, grains and Iced (92 cases=113%), (4) handling of foodstuffs (25 cases=3.1 %), (5) industrial enzymes 14 cases = 1.7%) and (b) decorative plants l3 cases=1.6%), The occupations with the highest numbers occupational contact urticaria were farmers (341 cases), domestic animal attendants (61). bakers (140.5). nurses (42) chefs (40) and denial assistants (28) The ranking list of the most common occupations with occupational contact urticaria per 100,000 employed workers was as follows: (I) bakers (140.5 cases per 10(1,000 employed persons), (2) prepares of processed food. (3) dental assistants. (4) veterinary surgeons. (5) domestic animal attendants. (i) fanners and silviculturalists (7) chefs, cooks and cold buffet managers. (S) dairy workers. (9) horticultural supervisors. (10) laboratory technicians and radiographers, (II) physicians. (12) butchers and sausage makers. (1.1) laboratory assistants, (14) dentists and (15) nurses(121.2 cases per 100.000 employed person). Low‐molecular‐weight chemicals caused very few cases of occupational contact urticaria, the most common being 2‐ethyhexyl very late (5 cases)‐ To Summarize occupational contact urticaria forms a large group of occupational contact dermatoses. and dermatologists need to he able to diagnose IgE‐mediated immediate skin allergic diseases.
Patch testing in severe cutaneous adverse drug reactions, including Stevens‐Johnson syndrome and toxic epidermal necrolysis
Authors: Wolkenstein Pierre , Chosidow Oliver , Fléchet Marie‐Laure , Robbiola Odile , Paul Muriel , Dume Laurence , Renuz Jean , Roujeau Jean‐Claude
Published: April 2006

Patch testing may help to assess the culpability of a drug in an adverse reaction. Our aim was to study patch testing in severe cutaneous ad verse drug reactions [ADRs] (Stevens‐Johnson syndromeitoxic epidermal necrolysis (SJS/TEN). acute genera exanthematous pustulosis (AGEP), and other cutaneous ADRs). 59 patients with cutaneous ADRs were included: 22 had SJS/TEN. 14 AGEP, and 23 other cutaneous ADRs. Patients were patch tested with the suspect drug and with H standard series of drugs. 2 patients among the 22 SJSTEN cases had a relevant positive test. 7 patients among the 14 AGEP cases had a relevant positive test. 6 patients among the 23 other cutaneous ADRs had a relevant positive test. Our results suggest that patch testing has a weak sensitivity in SJS'TEN and is not appropriate in these diseases. Patch testing seems more adapted to other cutaneous ADRs, such as AC it: P. in which the proportion of positive patch tests was significantly higher (P<0.02). Nevertheless, the difference of sensitivity of patch testing in SJS TEN, AGEP or other cutaneous ADRs could be linked not only to the clinical type of eruption, but also lo the different spectrum of culprit drugs in each type of eruption.
Studies on non‐immune immediate contact reactions in an unselected population
Authors: Basketter D. A. , Wilhelm K.‐P.
Published: April 2006

Non‐immune immediate contact reactions (NIICR) arising from skin contact with a wide range of chemicals have been well described. There is evidence that many, if not all, individuals are susceptible to this effect: it may be just a matter of applying a higher dose to the most resistant types of skin. In this work, we chose to evaluate susceptibility to development of NIRCR in a large unselected population. Skin tests were made with 1 known unlearns (benzoic acid, trans‐cinnamic acid and methyl nicotinate). each al 2 concentrations. In a group of 200 volunteers, it was demonstrated that all 3 chemicals induced NIICR in the majority of people. Approximately 10%. of the volunteers appeared particularly sensitive, reacting fairly strongly to 2/3 urticants. In contrast, another subset, also about 10% failed to respond significantly to any of the chemicals at any dose. However, strong reactivity to one urticant was not predictive of the reaction to the other urticants. In a number of cases, individuals reacting strongly to one urticani reacted very little it' at all to the other unlearns. Also, the type of response, erythema or oedema, was specific to an individual. There was no significant correlation with age or sex on the degree of NIKR. In conclusion, it has been demonstrated that there is a wide interindividual variation in the response to chemical urticants. which cannot be predicted on the basis of age or sex. The prospect of identifying y panel of individuals generally sensitive to non‐immune immediate contact reactions seems limited
Airborne contact dermatitis from unexpected exposure to rosin (colophony)
Authors: Karlberg Ann‐Therese , Gäfvert Elisabeth , Meding Birgitta , Stenberg Bernot
Published: April 2006

We report 3 cases of contact dermatitis in rosin‐sensitive individuals caused by exposure to airborne rosin components from different sources. Case no. 1 was a female office worker with a facial dermatitis caused by rosin components which emanated from the linoleum floor covering in her office. Floor material containing wood flour and rosin was released into the air, causing a facial dermatitis in the rosin‐sensitive subject. Case no. 2 involved a woman who worked in a factory producing dairy product cartons and had a dermatitis on her lower legs, lower arms and upper chest. Her dermatitis was caused by dust from the paper cartons and contact allergy to rosin components probably aggravated her dermatitis. Case no. 3 was a female office worker with a relapsing dermatitis on her eyelids. Her dermatitis was caused by a rosin‐containing floor polish, which was seen as a powder on the office floor. Extracts of suspected material and products were patch tested and analysed for the presence of rosin components with HPLC and GC techniques. A discussion and recommendations on chemical analyses of rosin components follow. We conclude that a thorough investigation, including chemical analyses, can rule out non‐specific diagnoses and offer a solution to the patient's skin problems.
Multiple sensitivities to transition metals: the nickel palladium reactions
Authors: Santucci B. , Cannistraci C. , Cristaudo A. , Picardo M.
Published: April 2006

Patch test data of 1000 consecutive patients sensitive to at least 1 substance of our standard series showed that transition metals gave associated reactions amongst themselves more frequently than they did with the remaining substances. The responses to transition metals were largely variable and seemed dependent not only upon the associated exposure to different metals or the concomitant responses of the T cell clones, as reported by others, but also upon the chemical properties of the metals and the consequent interactions inside the skin. Concomitant reactions to nickel sulfate and palladium chloride were the most frequently found associated positivities and occurred in a minority of nickel‐sulfate‐sensitive subjects. In 43 out of 45 of these subjects, patch tests to mixed solutions containing nickel sulfate, plus sulfates of magnesium, zinc, and manganese at higher doses, were not able to reduce the nickel sulfate reactions. This behaviour contracted with that found in the majority of subjects sensitive only to nickel sulfate. These findings seem to demonstrate that, whilst in subjects with positive reactions to nickel sulfate alone antigen formation involves biomolecules containing ions, in those with concomitant reactions to palladium chloride, other structures are involved.
Patch testing with allergens from modified rosin (colophony) discloses additional cases of contact allergy
Authors: Gäfvert Elisabeth , Bordalo Olivia , Karlberg Ann‐Therese
Published: April 2006

Most rosin (colophony) used today is chemically modified. Will contact allergy 10 modified rosin be overlooked when testing is performed with only unmodified rosin in the standard series? 2 components from modified rosins. maleopimaric acid (MPA) and glyceryl 1‐monoahietale (GMA), earlier identified us contact allergens, were added to the patch lest standard series. Some commonly‐used modified rosin products were also tested. Positive reactions were observed to the modified components MPA and GMA. Of the patients with positive reactions to MPA and GMA. several did not react to unmodified rosin in the standard series. No reaction was observed to the modified rosin products without a concomitant reaction to unmodified rosin. The positive reactions observed to the modified rosins may be due to residual unmodified material in the product, but a possible contribution from allergenic modified rosin components cannot be disregarded. When u patient's history indicates a rosin allergy, but a negative response to unmodified rosin in the standard series is observed, additional testing with GMA and MPA or, second best, with glycerol‐esterified rosin and maleic‐anhydride‐modified rosin is recommended. Some modified rosin products, which could be used for additional testing, are suggested.
Olaquindox‐induced airborne photoallergic contact dermatitis followed by transient or persistent light reactions in 15 pig breeders
Authors: Schauder Silvia , Schröder Werner , Geier Johannes
Published: April 2006

There have been no previous reports of photosensitivity following photoallergy to airborne olaquindox in a large group. 15 pig breeders, with photo‐distributed dermatitis related to olaquindox dust, were investigated lo study the nature, promoting factors, and course of this disease. Minimal erythema doses for UVA and UVB were established before photopatch testing and at intervals thereafter. AM patients presented with olaquindox‐induced photoallergy. In 14 cases, this was followed by prolonged increased sensitivity to UVA, 7 patients also displayed an increased sensitivity to UVB. 13 farmers came into contact with olaquindox in mineral feed (1000 mg/kg) and only 2 in final feed (50 mg/kg). S patients avoided further contact with olaquindox because of warnings in the media. Allergies and photoallergies to other occupational substances preceded or followed olaquindox (photo)allergy. Because of their increased sensitivity to light, most of these farmers used sunscreens, and 2 of them developed (photo(allergy to UV‐absorbers. As a result of our studies, we recommend photopatch testing for olaquindox in pig breeders with photo‐distributed dermatitis. This would enable the early recognition of photoallergy to olaquindox and the prevention of persistent light reaction.
Different pathways in irritant contact eczema?
Authors: Grängsjö A. , Leijon‐Kuligowski A. , To̊mä H. , Roomans G. M. , Lindberg M.
Published: April 2006

The epidermal response to 2 different irritants, nonanoic acid (NAA) and sodium lauryl sulfate (SLS), was investigated with 2 different methods. NAA 80% and SLS 4% were applied under occlusion for up to 24 h. Elemental changes were determined in cryosections by x‐ray microanalysis. Compared to unexposed skin a significantly higher sodium/potassium ratio was found after 6 h in NAA‐exposed skin and a lower ratio in SLS‐exposed. At 24 h both substances had induced similar changes, compatible with a cell injury. The findings demonstrate a time‐dependent NAA and SLS response, With reverse transcription potymerase chain reaction, the mRNA expression of interleukin‐1 alpha (IL‐1α;), ‐1beta (IL.‐1β), ‐6 (1L‐6), and ‐8 (IL‐8). tumor necrosis factor alpha (TNFα) and granulocyte macrophaye colony stimulating factor (GM‐CSF) in shave biopsies from irritated and unexposed skin was studied at 0. 4, 8 and 24 h NAA, but not SLS. induced an increase in mRNA expression for IL‐6. mRNA‐expression for GM‐CSF was increased after SLS exposure, but not after NAA. These findings indicate a time and substance dependent different in the up‐regulation of m‐RNA different cytokines in epidermis during the first 24 h of the irritant reaction. This might he the effect of differences in the irritants action on the cell membranes, which is also reflected by the differences found in the elemental content at 6 h.
The efficacy of different moisturizers on barrier recovery in hairless mice evaluated by non‐invasive bioengineering methods
Authors: Mortz Charlotte G. , Andersen Klause E. , Halkier‐Sorensen Lars
Published: April 2006

Moisturizers (emollients) are used frequently on normal and diseased skin. However, only few studies have examined their effects in dynamic situations and in more clinically relevant settings. We evaluated the effect of 4 commonly used products in a hairless mice model after acute skin barrier perturbation with acetone. The efficacy was evaluated by measurement of the transepidermal water loss (TEWL) and electrical conductance at various time intervals during barrier repair. The test products were compared with acetone‐treated air‐exposed controls allowed to recover otherwise normally and with a known irritant product, chlorhexidine cream 1%. Locobase® was the most effective product in correcting barrier function and significantly improved barrier function during early stages of barrier recovery (<6 h) with out interfering with late stages of barrier recovery (>6 h). The irritant control product, chlorhexidine cream 1%, delayed barrier recovery in the late stages. The model makes it possible to evaluate the combined effects of exogenous and endogenous components on barrier repair and to select the potentially most effective products before perforating more cumbersome and time‐consuming field studies.
Guidelines on sodium lauryl sulfate (SLS) exposure tests
Authors: Tupker R. A. , Willis C. , Berardksca E. , Lee C. H. , Fartasch M. , Atinrat T. , Serup J.
Published: April 2006

This report reviews the clinical and hisiopathological reactions caused by sodium lauryl sulfate (SLS), and the non‐invasive methods that can characterize these reactions. Furthermore, SLS exposure techniques and factors that may influence the outcome of these exposures are discussed. Finally, guidelines are introduced for each exposure technique in order 10 have a uniform approach to SLS jesting in man. Since different study aims warrant different testing conditions, we have proposed 2 categories, namely susceptibility testing and provocative testing, tailored to the aim with which the study is performed.
Is patch testing necessary in vulval vestibulitis?
Authors: Nunns D. , Ferguson J. , Beck M. , Mandal D.
Published: April 2006

Allergic contact dermatitis has been suggested as a possible cause of vulval vestibulitis, a condition of unknown aetiology characterized by burning, stinging and dyspareunia, with symptoms localised to the vestibule. To examine this relationship, 30 women with vulval vestibulitis were patch tested using a standard series of contact allergens and a special series relevant lo perianal and vulval disorders. Other potential allergens identified by the patients as causing aggravation were also included. There were 5 positive reactions, 4 to nickel and 1 to fragrance mix, though none of these reactions were considered relevant. Our results suggest that allergic contact dermatitis is unlikely to be a primary factor in the development or persistence of vulval vestibulitis. Patch testing patients with vulval vestibulitis cannot routinely be recommended.
Influence of temperature on irritation in the hand/forearm immersion test
Authors: Clarys P. , Manou I. , Barel A. O.
Published: April 2006

As indicated by in vitro experiments the penetration of irritants through the skin is significantly influenced by the temperature of the solution. In vivo experiments, demonstrated equally a significant influence of temperature in surfactant‐induced skin irritation. In order to evaluate the irritant potential of detergent solutions under normal user conditions. we used the hand/forearm immersion test. We compared to detergents with different anionic character in a repetitive immersion protocol (30 min immersion on 4 consecutive days). The solutions were tested at 2 temperatures (37°C and 40°C). The irritation was quantified by assessment of the stratum corneum barrier function (transepidermal water loss), skin redness (a* colour parameter) and skin dryness (capacitance method). Both detergents affected the integrity of the skin in a significant way. The anionic content as well as the temperature of the solutions were found to be determinative for the irritant potential, with a stronger response for higher anionic content and temperature, respectively.
Shoe dermatitis
Authors: Freeman Susanne
Published: April 2006

Chronic foot dermatitis can be disabling and footwear allergy is not always excluded as a partly because patch testing to shoes and their components can he daunting. Once the diagnosis of shoe allergy is made, the difficult problem of finding suitable footwear remains. There is a lack of literature regarding the follow‐up of these patients. We analysed the data on 55 patients with allergic contact dermatitis from their shoes and followed them up to see whether knowledge of the allergen had enabled them to find suitable footwear and to improve their dermatitis. The files of 55 patients with shoe allergy were analysed, and 4K were followed up. Rubber was the commonest allergen, followed by chromate. P‐tertiary‐butylphenol‐formaldehyde resin and colophony. All parts of the feet were affected, except the interdigital areas. The majority of patients suffered from hyperhidrosis, 43% were atopics, who had a super‐added shoe allergy. The mean duration of the foot dermatitis before patch testing was 4 years 8 months. Follow‐up of 48 cases showed that 87.5% had either improved or resolved completely. Most of our patients were successful in finding suitable footwear and many differing strategies were used. All patients with foot dermatitis which does not respond to treatment should be patch tested to exclude shoe allergy.
The major allergen of Dendropanax trifidus Makino
Authors: Oka Keiko , Saio Fumio , Yasuhara Ta ashi , Sugimoo Akiko
Published: April 2006

Dendropanax trifidus Makino (family Araliaceae, syn. Gilibertia trifida Makino) has been reported as causing allergic contact dermatitis in Japan. To identify the major allergen, fractionated extracts of fresh leaves of Dendropanax trifida were patch tested on 2 patients with hypersensitivity to the plant. Cis‐9,17‐octiidecadiene‐12,14‐diyne‐1,16‐diol (I), an analog of falcarinol, was identified as an active component. 18 normal control subjects were patch tested with the leaf of Dendropanax trifidus and I diluted to 0.05% in pet. 4 of them showed active sensitization to the leaf of Dendropanax trifidus and I. Our results suggest that I is the major allergen of Dendropanax trifidus and is a strong sensitizer. The results of patch testing on patients and control subjects with the leaves of Fatsia japonica Decne. et Planch, and Hedera helix L. which also belong to the Araliaceae family, and urushiol are also shown.
Compound allergy
Authors: Bashir Saqib J. , Maibach Howard I.
Published: April 2006

This review defines the term “compound allergy” in the context of new findings, and discusses evidence that allergenic reaction products have been identified. Material was gathered by searching Index Medicus and the Science Citation Index, and reviewing several standard texts. Issues regarding the validity of patch lest results are addressed and we introduce the term “pseudcompound allergy” to cover cases of false‐negative patch tests. We present new theories regarding the mechanisms by which new allergens arc formed and a means of classification.
Topical D‐vitamins: multiparametric comparison of the irritant potential of calcipotriol, tacalcitol and calcitriol in a hairless guinea pig model
Authors: Fullerton Ann , Serup Jorgen
Published: April 2006

The irritant potential of calcipotriol. 1α.24‐diliydroxy vitamin D3, (tacalcitol) and 1α, 25‐dihyd rosy‐vitamin‐ D3 (calcitriol) was compared in a hairless guinea pig model. Randomized, occlusive patch testing for 2 days was used. Each group of X animals was tested simultaneously with the 3 substances and a placebo vehicle. 3 dose levels i.e. 500 μg/ml, 50 μg/ml and 5 μg/ml were used, Test sites were evaluated at day 2 (2 h after removal of the patches) and again at day 3. Evaluation was blinded and based on a multiple parameter assessment of skin irritancy. comparing clinical scoring. skin perfusion using high resolution laser Doppler image scanning, skin colour (a*, Minolta ChromaMeter) and skin thickening (20 MHz ultrasound) indicating oedema. Skin biopsies were taken for histological preparation and assessment of epidermal hyperplasia. No difference was observed between the irritant potential of calcipotriol, tacalcitol and calcitriol bused on clinical scoring as well as objective non‐invasive measuring techniques. All 3 substances showed a dose‐dependent and equal increase in clinical irritation score. cutaneous blood flow, skin colour and epidermal hyperplasia. The cutaneous inflammatory reaction was dominated by vasodilation and increased cutaneous perfusion. Oedema formation was only seen ill the highest dosages tested. Skin barrier damage was not induced as TEWL remained unaffected. The hairless guinea pig appears a valid model to test irritancy of topical D‐vitamins since the same profile of irritancy was previously established in humans for 2 of the compounds tested. calcitriol and calcipotriol.
Skin disorders in ship's engineers exposed to oils and solvents
Authors: Svendsen Kristin , Hilt Bjorn
Published: April 2006

Ship's engineers are exposed to mineral oil and solvents in their work. This study was intended to investigate if ship's engineers had an increased prevalence of skin disorders and whether any such increased risk could be linked lo exposure to mineral oils and solvents. A self‐administered questionnaire was sent to 700 male seamen from 3 Norwegian ferry companies. Of the 492 respondents. 169 were currently working as ship's engineers and 295 had never worked as ship's engineers, The outcomes eczema, acne, dry skin, a in dermatitis and hand dermatitis were defined from the questionnaire. Prevalences of these skin disorders were compared between the groups. Logistic regression was used to elucidate explanatory variables further. When comparing current ship's engineers with those who had never worked as ship's engineers, the crude prevalence ratios were 1.7 (95% CI 1.1–2.7) for dry skin. 1.7 (95%CI 1.1 2.5) for any dermatitis. 1.3(95%CI 0.66–2.67) for acne and 1.2 (CI 0.61–2.27) for eczema. The risk of these symptoms increased for the engineers in the regression analysis, after controlling for age, self‐reported use of Stoddard solvent, and the use of fuel oil as a hand cleansing agent. The increased prevalence of skin disorders found among ship's engineers in this investigation may be explained by direct contact with mineral oils and solvents.
Nickel release from stainless steels
Authors: Haudrechy Pascale , Mantout Bernard , Frappaz Anne , Rousseau Daniel , Chabeau Guy , Faure Michel , Claudy Alain
Published: April 2006

In 1994, a study of nickel release and allergic contact dermatitis from nickel‐plated metals and stainless steels was published in this journal. It was shown that low‐sulfur stainless steel grades like AISI 304, 316L or 430 (S≤0.007%) release less than 0.03 μg/cm2/week of nickel in acid artificial sweat and elicit no reactions in patients already sensitized to nickel. In contrast, nickel‐plated samples release around 100/μg/cm2week of Ni and high‐sulfur stainless steel (AISI 303 ‐ S =0.3%) releases about 1.5 μug/cm2/week in this acid artificial sweat. Applied on patients sensitized to nickel, these metals elicit positive reactions in 96% and 14%, respectively, of the patients. The main conclusion was that low‐sulfur stainless sleets like AISI 304, 316L or 430, even when containing Ni, should not elicit nickel contact dermatitis, while metals having a mean corrosion resistance like a high‐sulfur stainless steel (AISI 303) or nickel‐plated steel should be avoided. The determining characteristic was in fact the corrosion resistance in chloride media, which, for stainless steels, is connected, among other factors, to the sulfur content. Thus, a question remained concerning the grades with an intermediate sulfur content, around 0.03%, which were not studied. They are the object of the study presented in this paper, 3 tests were performed: leaching experiments, dimethylglyoxime and HNO3 spot tests, and clinical patch tests: however, only stainless steels were tested: a low‐sulfur AISI 304 and AISI 303 as references and 3 grades with a sulfur content around 0.03%: AISI 304L, AISI 304L added with Ca. AISI 304L + Cu. Leaching experiments showed that the 4 non‐resulfurised grades released less than 0.5 μg/cm2/week in acid sweat while the reulfurized AISI 303 released around or more than 0.5 μug/cm2/week. This is explained by the poorer corrosion resistance of the resulfurized grade. Yet all these grades had the same reaction to the DMG test (negative result), which shows again its lack of sensitivity. In contrast, the HNO3 spot test distinguished AISI 303 from the non‐resulfurized grades. Clinical patch tests again showed that some patients (4%) were intolerant to AISI 303, while none were intolerant to the other grades. Thus, this study confirms that non‐resulfurized stainless steels (S≤0.03%) like Ni‐containing 304 and 3D4L should not elicit Ni contact dermatitis, while the resulfurized grades (5 > 0.1%) should be avoided.
Is it possible to improve the prognosis in nickel contact dermatitis?
Authors: Kalimo Kirsti , Lammintausta Kaija , Jalava Jaana , Niskanen Tuulikki
Published: April 2006

A questionnaire was sent to 143 patients who had shown a positive patch test reaction to nickel sulfate more than 10 years earlier. 91 patients returned the questionnaire, revealing that after the testing, 73 had suffered from dermatitis, 61 especially from hand dermatitis, 37 of these patients were clinically examined and patch tested with standard series and in addition, 12 patients were tested with nickel sulfate and nickel chloride with different occlusion times. At the clinic visit, 23 patients had dermatitis, 16 hand dermatitis, and 11 were symptom‐free, 26 of the patients had metal items close to their skin and 21 of them had current dermatitis, 14 hand dermatitis. Of the 11 patients who had no metal exposure, 9 were symptom‐free. The association of dermatitis with exposure to metal objects was statistically significant (p < 0.001). Those patients who had current dermatitis had also developed multiple allergies and reacted to nickel with shorter application times in patch tests, as compared to those who were symptom‐free. It seemed possible that the prognosis for nickel dermatitis could be improved if nickel‐allergic patients would strictly avoid metal contact, especially in clothing and jewelry.
Effect of a topical corticosteroid, a retinoid and a vitamin D3 derivative on sodium dodecyl sulphate induced skin irritation
Authors: Le T. K. M. , de Mon P. , Schalkwuk J. , van der Valk P. G. M.
Published: April 2006

Exposure of the skin to sodium dodecyl sulfate (SDS) leads to disruption of barrier and skin irritation. We used repetitive short exposure to a low molarity SDS solution as an in vivo model to mimic the development of irritant contact dermatitis. In this model, we studied clinical (erythema), functional (transepidermal water loss(TEWL)) and cell biological changes, 24 healthy volunteers were patch tested with SDS (0.2%) for 4 h a the day for 5 consecutive days. After removal of the patches, the exposed sites were treated 1 × daily either with a topical corticosteroid (triamcinolon acetoide cream 0.05%). a retinoid (tretinoin cream 0.025%). or a vitamin D3 derivative (calcipotriol ointment 50 microgram/g). Irritant reactions were assessed by erythema scoring and measurement of barrier function with TEWL up to 14 days after the first challenge. Skin biopsies were taken for cell biological changes at day 4. Vehicle‐treated sites served as controls. Repetitive exposure of human skin to SDS resulted in a gradual increase in erythema scoring and TEWL associated with the upregulation of proliferative cells as measured by the expression of Ki‐67‐antigen and of differentiation markers, visualized by increased expression of involucrin and epidermal‐fatty‐acid binding protein (E‐FABP). Skin irritation as assessed by erythema scoring and TEWL was not significantly suppressed by triamcinolone cream. However, a significant reduction of the number of cycling keratinocytes and a decrease in involucrin positive cell layers was observed in this group. Neither treatment with calcipotriol ointment nor with tretinoin cream induced improvement of skin irritation as judged by visual scoring and TEWL. In contrast to steroid treatment no significant elf eel of calcipotriol ointment or tretinoin cream treatment was observed with regard to the number of cycling cells and differentiation markers. Further studies are needed to assess whether treatment with topical corticosteroids is an effective modality in skin irritation and irritant contact dermatitis.
Contact reactions to the jellyfish Carybdea marsupialis: observation of 40 cases
Authors: Peca Giampiero , Rafanelli Silvia , Galassi Giancarlo , Bartolo Paolo Di , Bertini Sauro , Alberani Maurizio , Beccari Giampiero
Published: April 2006

The clinical characteristics of 40 patients seen in an accident and emergency department after Contact with jellyfish while bathing in the sea are described.
Patch testing to detect corticosteroid allergy: is it adequate?
Authors: Seukeran D. C. , Wilkinson S. M. , Brck M. H.
Published: April 2006

Whilst patch testing with corticosteroids in ethanol is more sensitive than either petrolatum or the cream formulation, the frequency of false‐negative reactions is not known. We have compared patch testing with corticosteroids at 1% in ethanol with intradermal (i.d.) tests using Img cortico‐steroid suspended in normal saline. Patch tests with tixocortol pivalate and budesonide detected all patients allergic to hydrocortisone and budesonide, respectively. For other corlicosteroids, the use of ethanol as a vehicle resulted in both false‐positive and false‐negative reactions. In particular, patch tests with hydrocortisone‐17‐butyrate missed 30% of all positive reactions detected by i.d. testing. There may be a case for advising the avoidance of this steroid in all patients who are positive on patch testing to tixocortol pivalate and budesonide.
1,2‐benzisothiazolin‐3‐one (Proxel®): irritant or allergen?
Authors: Chew A.‐L. , Maibach H. I.
Published: April 2006

The isothiazolinone, 1,2‐benzisothiazolin‐3‐one (Proxel®), is a popular preservative, as well as a skin sensitizer and irritant. Patch test studies have been performed with different concentrations and vehicles. The current suggested patch test concentration is 0.1% BIT in petrolatum (pet). This article evaluates the effects of patch testing at this concentration and reviews the current literature. An irritancy patch test was performed on 56 controls, using BIT in concentrations of 0.002% and 0.05% in aqueous dipropylene glycol (Proxel® GXL) and 0.1% in pet. 10 had positive readings at 4 days with 0.1% BIT in petrolatum. 9 of which were negative at retest. 0.1% BIT is, therefore, irritant and not a suitable concentration for patch testing. Literature review revealed 15 patch test studies, with varying testing techniques. Additional studies with adequate controls and experimental tests should be invaluable in furthering our insight into BIT sensitization and irritation.
Hand dermatitis and allergic patch test reactions caused by nickel in electroplaters
Authors: Kanerva Lasse , Kiilunen Mirja , Jolanki Riitta , Estlander Tuula , Aitio Antero
Published: April 2006

A worksite survey was conducted in all 38 Finnish electroplating plants. All workers (n=163) who worked with nickel plating (bath workers, hangers and solution makers) were interviewed with a questionnaire about symptoms of nickel dermatitis, hand dermatitis, and about protective measures, atopy, etc. Patch testing with nickel sulfate was done with the TRUE TestTM method. All the workers, 94 men and 69 women, answered the questionnaire. The mean age of women was 41.1 years, and of men 43.1 years, respectively. Men had longer occupational exposure to nickel (14 years) than women (10 years). Most workers used protective gloves. 35% of women and 30% of men reported present or past hand dermatosis. 19% reported a history of atopic dermatitis. 15% of women (n= 8) and 4% (n= 2) of men had an allergic patch test reaction to nickel sulfate. 70% of those with an allergic patch test reaction to nickel reported past or present hand eczema. The prevalence of nickel allergy among the electroplaters was similar to that of patients in patch test clinics in Finland. An allergic patch test reaction to nickel sulfate does not necessarily oblige an electroplater to change jobs.
Discrepancy in patch test results with wool wax alcohols and Amerchol® L‐101
Authors: Matthieu L. , Dockx P.
Published: April 2006

Wondering why Amerchol® L‐101 (containing wool wax alcohols obtained from the hydrolysis of wool fall appears as a test material (100%) in a cosmetics series (Chemotechnique Diagnostics AB). as wool wax alcohols were already tested in the European standard series, we added Amerchol®L‐101 (100%) systematically to the standard series, From 8 April 1991 to 28 February 1992. a total of 393 patients were tested: 3.05% (n= l2) showed positive test results (+, ++, +++) for wool wax alcohols as well as Amerchol® L‐101 (100%.), only and 11.1% (n= 44) for Amerchol® L‐101 (100%) only. Thus, the positive tests for Amerchol® L‐101 (100%) had a higher frequency of 3.4 compared to those for wool wax alcohols. In the meantime, we also added Amerchol® L‐101 50% (Trolab) to the standard series. Of all patients tested (n=223) 2.7% (n=6) had positive reactions to wool wax alcohols and 12.1% (n=27) to Amerchol® L‐101 100% and or 50%. Thus, positive reactions to Amerchol® L‐101 (100% and 50%) were 45 higher, whereas the rate of concordancy decreased. It is remarkable that 8 patients only had a positive reaction to Amerchol® L‐101 50% and 9% only to Amerchol® L‐101 1005. It seems that we miss many diagnoses in contact allergy by using only the standard wool wax alcohols test (30%)
pH measurements during lactic acid stinging test in normal and sensitive skin
Authors: Issachar N. , Gall Y. , Borfll M. T. , Poelman M. C.
Published: April 2006

Because of the lack of objective signs, the phenomenon of sensitive skin is hard to document. The measurement of the skin pH Variations in the nasolabial fold, and on the forearm, after a single application of lactic acid on a preselected sensitive skin population, versus a control one, is proposed as a useful test to detect this kind of population.
Iodopropynyl butylcarbamate: a new contact allergen
Authors: Bryld Lars Erik , Agner Tove , Rastogi Suresh C. , Menné Turkil
Published: April 2006

Iodopropynyl butylcarbamate (IPBC) has been used for years as a fungicide and bactericide for wood and paint preservation without any reports of cutaneous side‐effects. During the last few years, it has entered cosmetic products and is temporarily permitted in the EU Cosmetics Directive in a use concentration of 0.1%. In the present study, we report our preliminary experience with patch testing consecutive contact dermatitis patients with IPBC. A patch lest concentration of 0.1% seems appropriate for initial screening but deserves further evaluation. Among 311 consecutive patch lest patients. 3 patients with a positive patch lest to IPBC have been identified. Contact allergy is Likely in at least 1 case, based on clinical history, exposure history, patch testing with dilution series. ROAT and chemical analysis.
Adverse reactions to fragrances
Authors: de Groot Anton C. , Frosch Peter J.
Published: April 2006

This article reviews side‐effects of fragrance materials present in cosmetics with emphasis on clinical aspects: epidemiology, type, of adverse reactions, clinical picture, diagnostic procedures, and the sensitizers. Considering the ubiquitous occurrence of fragrance materials, the risk of side‐effects is small. In absolute numbers, however, fragrance allergy is common, affecting approximately 1% of the general population. Although a detailed profile of patients sensitized to fragrances needs to be elucidated, common features of contact allergy are: axillary dermatitis, dermatitis of the face (including the eyelids) and neck, well‐circumscribed patches in areas of “dubbing‐on” perfumes (wrists, behind the ears) and (aggravation of) hand eczema. Depending on the degree of sensitivity, the severity of dermatitis may range from mild to severe with dissemination and even erythroderma. Airborne or “connubial” contact dermatitis should always be suspected. Other less frequent adverse reactions to fragrances are photocontact dermatitis, immediate contact reactions and pigmentary changes. The fragrance mix, although very useful for the detection of sensitive patients, both causes False‐positive and false‐negative reactions, and detects only 70% of perfume‐allergic patients. Therefore, future research should be directed at increasing the sensitivity and the specificity of the mix. Relevance is said to be established in 50–65% of positive reactions, but accurate criteria are needed. Suggestions are made for large‐scale investigation of several fragrances on the basis of literature data and frequency of use in cosmetics. The literature on adverse reactions to balsam of Peru (an indicator for fragrance sensitivity), essential oils (which currently appear to be used more in aromatherapy than in perfumery) and on fragrances used as flavours and spices in foods and beverages is not discussed in detail, but pertinent side‐effects data are tabulated and relevant literature is provided.
Study of persistence and loss of patch test reactions to dichromate and cobalt*
Authors: Katsarou A. , Baxevanis C. , Armenaka M. , Volonakis M. , Balamotis A. , Papamihail M.
Published: April 2006

Hyposensitization is it poorly understood phenomenon that refers to the conversion from a positive to a negative (or less positive) patch test. We studied 180 cement workers with contact dermatitis, who originally had a total of 163 positive patch test reactions to potassium dichromate and 98 positive reactions to cobalt chloride. They were patch tested a 2nd time after 2–6 years. On the 2nd patch test to dichromate. 103 (63%) remained positive, while reactivity decreased in 33 (20%) and 21(17%) had become non‐reactive. Cobalt sensitivity persisted in 47%, diminished in 13%, and 40% of the patch tests became non‐reactive. In 10 patients with persistent patch test reactions and 10 matched patients with diminished reactions or loss of reactivity, circulating T‐cell responses to dichromate and cobalt were studied in vivo. Circulating T cells that proliferated only to specific contact allergens were isolated and in all patients they were primarily CD4+. However, in patients with persistent reactions, they were CD4+ CD45RO+ (memory cells), while in the group that lost sensitivity, they were CD4+ CD45RA (suppressor ‐ inducer cells). These differences support an immunologic basis for hyposensitization.
Cross‐sensitizations between azo dyes and para‐amino compound
Authors: Seidenari Stefania , Mantovani Lucia , Manzini Bianca Maria , Pignatti Marco
Published: April 2006

Combined sensitizations to different azo dyes, probably based both on true cross‐sensitization and on simultaneous positive reactions, have frequently been described. However, since azo dyes are included in the standard series in a minority of countries, the case studies considered comprise, with few exceptions, a small number of subjects. The aim of our study was to investigate cross‐reactions between different azo dyes and para‐amino compounds in azo‐dye‐sensitive subjects, to study the clinical aspects of azo dye dermatitis, to assess the relevance of sensitization to azo dyes, and to relate the pattern of cross‐sensitizations to the chemical structure of the different dyes. Out of 6203 consecutively tested patients, 236 were sensitized to at least 1 of 6 azo compounds employed as textile dyes, included in our standard series. 107 subjects reacted to Disperse Orange 3 (DO3), 104 to Disperse Blue 124 (DB124), 76 to p‐aminoazobenzene (PAB), 67 to Disperse Red 1 (DR1), 42 to Disperse Yellow 3 (DY3), and 31 to p‐dimethylaminoazobenzene (PDAAB). Co‐sensitizations to para‐phenylenediamine were present in most subjects sensitized to DO3 (66%) and PAAB (75%), in 27% and 36% of DR1 and DY3‐sensitive subjects, and only in 16% of subjects sensitized to DB124. Apart from the hands and the face, the neck and the axillae were the most frequently involved skin sites. Whereas the involvement of flexural areas was mainly connected with sensitization to DB124, in patients with hand dermatitis and in those working as hairdressers, sensitization to DO3 and PAAB was more frequent. Moreover, in the former patient group, a history of textile dye allergy was most frequently obtained. Out of 33 patients tested with an additional textile dye series, only 5 subjects reacted to anthraquinone dyes. Cross‐sensitizations between azo dyes and para‐amino compounds can partially be explained on the basis of structural affinities.
Reproducibility of a non‐invasive skin irritancy test in a cohort of metalworker trainees
Authors: Iliev D. , Hinnen U. , Elsner P.
Published: April 2006

The identification of subjects with increased susceptibility to irritants may play an important rôle in the prevention of irritant contact dermatitis. A short and quick method of non‐invasive testing for assessing irritant sensitivity was developed by Wilhelm and coworkers in 1990, based on the alkali resistance test of Burckhardt. In order to determine the reproducibility of this screening method, 204 healthy metalworker trainees were tested 2 × according to Wilhelm within an interval of 6 months. No statistically‐significant correlation could be shown, indicating that the reproducibility of this screening method is low. Therefore, we propose applying not just a single test for the assessment of skin irritability, but a series of tests, in order to improve the reliability of this kind of testing.
Olive oil – contact sensitizer or irritant?
Authors: Kränke Birger , Komericki Peter , Aberer Werner
Published: April 2006

Adverse cutaneous reactions to topically applied olive oil are seldom reported, and positive patch tests to it are mostly regarded as allergic. To evaluate such “positive” patch test reactions. 77 female (mean age: 44 years) and 23 male eczema patients (mean age: 46 years) were prospectively patch tested with freshly prepared olive oil. Tests were performed openly (including ROAT) as well as using Al‐tests® and Finn Chambers® on Scanpor®. 5 patients (2 male) showed “positive” test reactions (all patients at the Al‐test® site. 3 at the Finn Chamber® site. I with ROAT). In only 1 patient could the reaction be classified as probably allergic, in contrast to previous reports. In conclusion, olive oil is very weakly irritant in general, but bears relevant irritant capacity when applied under occlusive conditions. Therefore, olive oil appears to be less than suitable for the topical therapy of patients with venous insufficiency and associated eczema of the lower extremities.