bluuebunny/crossref_metadata_2025 huggingface dataset:
Differences between the sexes with regard towork‐related skin disease *
Authors: Meding Birgitta
Published: March 2003

Work‐related skin disease is common and usually presents as hand eczema. From the Occupational Injury Information System in Sweden, as well as from registers of industrial injuries in other countries, it is evident that females report skin disease more often than males. Epidemiological studies of hand eczema also show that women are more often affected than men, in particular young women. The most common type of hand eczema is irritant contact dermatitis, which is often caused by wet work. Many female‐dominated occupations involve extensive wet work, e.g., hairdressing, catering, cleaning and health‐care work. These occupations are also high‐risk occupations for hand eczema. Experimental studies of skin irritation have not confirmed differences between the sexes; thus, the higher prevalence of irritant contact dermatitis among females is most likely due to exposure, occupational and non‐occupational. Nickel allergy is the most common contact allergy, which is most frequent in young females, and in 30–40% results over time in hand eczema. Hand eczema has an impact on quality of life and females seem to report a higher degree of discomfort than males. To achieve the optimal effect of preventive efforts regarding occupational skin disease, the focus for prevention should aim at reducing wet exposure.
Expression of metallothioneins‐I and ‐II isoforms at positive patch‐test sites
Authors: Santucci B. , Amantea A. , Giuliano M. C. , Valenzano C. , Cristaudo A.
Published: March 2003

The expression and the distribution of metallothioneins (MT)‐I and II isoforms were evaluated in 5 healthy volunteers and in 16 subjects with positive patch test reactions to various compounds. Skin specimens taken both from the healthy skin of the back and at positive patch test sites (at 48 h), were treated using a 3‐step indirect immunoperoxidase procedure with a mouse monoclonal IgG1 antibody reactive against I and II isoforms of human, rat and horse MT. MT were expressed in the basal layer of the healthy skin of both controls and sensitive subjects, without any significant difference. At positive patch test sites, there was an overexpression of MT in basal and suprabasal layers of the epidermis. Overexpression of MT, related to the degree of the inflammatory reactions elicited by the penetrating compounds was observed in the dermis. The cells expressing MT in the dermis were mostly T lymphocytes and cells with dendritic morphology which positively stained in part for CD34 and in part for XIIIa markers and negatively for KP1, S100 and HLA‐DR. Taken together, these results seem to indicate that MT represent a constitutive mechanism of defence expressed by different types of cells in the skin, which is triggered by contact with both metallic and non‐metallic compounds. The biological significance of MT in the skin remains to be elucidated. Our preliminary findings do not permit evaluation of whether these nearly ubiquitous proteins exert their cytoprotective effects in the skin acting simultaneously as antioxidant, metal binding or zinc suppliers, or if they display these activities mainly depending on the nature of the penetrating substances.
Results of patch testing with lavender oil in Japan
Authors: Sugiura Mariko , Hayakawa Ritsuko , Kato Yoshimi , Sugiura Keiji , Hashimoto Rika
Published: March 2003

We report the annual results of patch testing with lavender oil for a 9‐year period from 1990 to 1998 in Japan. Using Finn Chambers and Scanpor tape, we performed 2‐day closed patch testing with lavender oil 20% pet. on the upper back of each patient suspected of having cosmetic contact dermatitis. We compared the frequency of positive patch tests to lavender oil each year with those to other fragrances. We diagnosed contact allergy when patch test reactions were + or <+ at 1 day after removal. The positivity rate of lavender oil was 3.7% (0–13.9%) during the 9‐year period from 1990 to 1998. The positivity rate of lavender oil increased suddenly in 1997. Recently, in Japan, there has been a trend for aromatherapy using lavender oil. With this trend, placing dried lavender flowers in pillows, drawers, cabinets, or rooms has become a new fashion. We asked patients who showed a positive reaction to lavender oil about their use of dried lavender flowers. We confirmed the use of dried lavender flowers in 5 cases out of 11 positive cases in 1997 and 8 out of 15 positive cases in 1998. We concluded that the increase in patch test positivity rates to lavender oil in 1997 and 1998 was due to the above fashion, rather than due to fragrances in cosmetic products.
Immediate contact hypersensitivity induced by repeated hapten challenge in mice
Authors: Natsuaki Masaru , Yano Noriko , Yamaya Kyoko , Kitano Yukio
Published: March 2003

An immediate reaction was investigated during repeated challenge testing for contact hypersensitivity to dinitrofluorobenzene ( DNFB) in BALB/c mice. The mice were sensitized to DNFB on back skin and repeatedly challenged with the same hapten on the left ear at 1 week intervals. The ear after the 5th challenge showed biphasic responses which consisted of an immediate and a delayed‐type reaction. The reactions were hapten specific. Mast cell‐deficient WBB6F1 W/WV mice did not show any immediate reaction, while congenic normal mice showed both immediate and delayed‐type reactions. Histologically, numerous dermal mast cells were found in the left ear of repeatedly challenged BALB/c and WBB6F1 normal mice, while there were few mast cells in the ear of WBB6F1 W/WV mice. Anti‐
DNP IgE antibodies were detected in BALB/c, WBB6F1 normal and W/WV mice after repeated challenge with DNFB. Intradermal injection of anti‐IgE antibodies in the repeatedly DNFB‐challenged ear elicited an immediate reaction. These results suggest that immediate contact hypersensitivity develops through the production of anti‐ DNP IgE antibodies and an increase in dermal mast cells after repeated challenge with DNFB.
Effect of test techniques on perfusion of neomycin sulfate patch tests
Authors: Bjarnason Bolli , Flosadóttir Ellen
Published: March 2003

Effects of test techniques on neomycin patch test results have not been thoroughly investigated. This study focuses on effects of dose and application time of neomycin sulfate patch tests on test results. The effects are assessed both visually and by perfusion. 16 subjects positive to neomycin are retested with neomycin sulfate in various doses and vehicles applied with different application devices for variable time intervals. All subjects were tested with a serial‐dose series for time intervals ranging from 3 to 96 h (4 days [D]). The results show very good agreement between perfusion assessments and positive and negative visual assessments of reactions; however, a gray zone was detected where reactions with variable perfusion were associated with visually questionable test responses. 1:27 serial dilutions and wide application time intervals show a positive response with perfusion assessments and partly with visual assessments. Regardless of reading technique, highest reactivity of reactions was detected at either 96 h (day [D] 4) or 168 h (D7) in each subject with minor exceptions, regardless of dose, vehicle, application device or application time. Some findings of the study support the idea that reactions with papules alone are positive tests. Possible effect of tapes and foils on test results are discussed.
Nickel release from coins
Authors: Lidén Carola , Carter Stephen
Published: March 2003

Nickel allergy is the most frequent contact allergy and is also one of the major background factors for hand eczema. The clinical significance of nickel release from coins was discussed when the composition of euro coins was decided. Current European coinage is dominated by cupro‐nickel coins (Cu 75; Ni 25); other nickel‐containing and non‐nickel alloys are also used. Nickel release from used coinage from the UK, Sweden and France was determined. It was shown that nickel ions are readily available on the surface of used coins. After 2 min in artificial sweat, approximately 2 μg of nickel per coin was extracted from cupro‐nickel coins. Less nickel was extracted from non‐nickel coins. Nickel on the surface was mainly present as chloride. After 1 week in artificial sweat approximately 30 μg/cm2 was released from cupro‐nickel coins: less nickel was released from coins made of other nickel alloys. Theoretically, several μg of nickel salts may be transferred daily onto hands by intense handling of high‐nickel‐releasing coins.
Skin occlusion and irritant and allergic contact dermatitis: an overview
Authors: Zhai Hongbo , Maibach Howard I.
Published: March 2003

Occlusion, widely used to enhance percutaneous absorption of drugs, also increases penetration of other chemicals and antigens, and hence may exacerbate irritant and allergic contact dermatitis. This overview summarizes the adverse effects of occlusion.
Occupational allergic contact dermatitis caused by wood dusts
Authors: Estlander T. , Jolanki R. , Alanko K. , Kanerva L.
Published: March 2003

Exposure to wood dusts may cause various skin and mucosal symptoms. Allergic dermatoses, caused by wood dusts, diagnosed at the Finnish Institute of Occupational Health during 1976–1999 are reported here. 16 had allergic contact dermatitis and, 2 had contact urticaria. 9 men (3 cabinet makers, 3 joiners, 1 carpenter, 1 knifemaker and 1 machinist) were mainly exposed to tropical hardwoods. 1 man had dermatitis caused by western red cedar. 5 patients, 3 men and 2 women, were exposed to Finnish pine or spruce dusts, and 1 man to aspen. 7 also had rhinitis, 4 asthma or dyspnoea and 3 conjunctivitis. On patch testing, 10 men reacted to 9 different wood dusts, including teak (5), palisander (3), jacaranda (2), mahogany (2), walnut (2) and obeche (1). Reactions to wood allergens, including lapachol (2), deoxylapachol (1), (R)‐3,4‐dimethoxydahlbergione (2), 2,6‐dimethoxy‐1,4‐benzoquinone (1), mansonone A (2) and salicyl alcohol (1), were noted in 4 cases. All but 1 of 5 patients exposed to pine or spruce dusts reacted to the sawdusts, all 5 to colophonium, 3 to abietic acid, 2 to tall oil resin, 3 to wood tar mix and 4 to other wood gum resins. Of the 2 CU patients, 1 was prick and RAST positive to obeche, 1 reacted with urticarial dermatitis to punah wood dust on chamber exposure. Occupational allergic dermatoses are mainly caused by the dusts of hardwoods, mostly due to Type IV allergy, but may also be caused by softwood dusts. Patch tests can be done with wood dusts, but should be confirmed by patch testing with wood allergens if possible.
Effect of different moisturizers on SLS‐irritated human skin
Authors: Held Elisabeth , Lund Henrik , Agner Tove
Published: March 2003

Moisturizers are widely used to treat irritant contact dermatitis (ICD). Their use is, however, not well‐documented and standardized models for testing skin care products are needed to acquire documentation of their efficacy. The present study was undertaken to evaluate the effect of 6 commonly‐used moisturizers on the recovery of irritated human skin. No commercial interests were involved in the study. 36 healthy volunteers had patch tests with SLS 0.5% applied on their forearms/upper arms for 24 h. After irritation of the skin, all volunteers had a moisturizer applied on one forearm/upper arm, respectively, 3 × daily for the following 5 days. The other forearm/upper arm served as an untreated control. Each moisturizer was tested on 12 volunteers and each volunteer tested 2 moisturizers at the same time. Evaluation was done on days 1, 3 and 8 by transepidermal water loss, electrical capacitance, laser Doppler flowmetry, DermaSpectrometry and clinical scoring. All 6 moisturizers were found to accelerate regeneration of the skin barrier function when compared to irritated non‐treated skin. The most lipid‐rich moisturizers improved barrier restoration more rapidly than the less lipid‐rich moisturizers. We suggest this experimental model for further moisturizer efficacy testing.
Validity of self‐reports of hand eczema
Authors: Meding Birgitta , Barregård Lars
Published: March 2003

The validity of questionnaire answers with respect to hand eczema was investigated. Car mechanics, dentists and office workers answered a questionnaire on the occurrence of hand eczema on any occasion during the past 12 months. “Yes”‐responders and a random sample of “no”‐responders were subsequently interviewed and examined by a dermatologist. 10.0% of the car mechanics, 12.0% of the dentists and 12.5% of the office workers were found to have hand eczema despite previous “no”‐answers. In the same populations, 81%, 94% and 80% of the “yes”‐answers were confirmed at the clinical examination. Considering false‐negative and false‐positive answers, the sensitivity was 53–59% and the specificity 96–99% in the 3 groups. The 1‐year prevalence changed from self‐reported 15% to estimated 21% in the car mechanics, from 15% to 24% in the dentists and from 15% to 23% in the office workers. It is concluded that self‐reported 1‐year prevalence of hand eczema considerably underestimates the true prevalence.
Occupational dermatitis in dental personnel: contact dermatitis with special reference to (meth)acrylates in 174 patients
Authors: Wrangsjö K. , Swartling C. , Meding B.
Published: March 2003

Between 1995 and 1998, 174 dental personnel were referred as patients to the Department of Occupational and Environmental Dermatology, Stockholm. After clinical examination, 131 were patch tested with the Swedish standard series and 109 with a dental screening series. Furthermore, 137 were tested for IgE‐mediated allergy to natural rubber latex (NRL). Hand eczema was diagnosed in 109/174 (63%), 73 (67%) being classified as irritant contact dermatitis and 36 (33%) as allergic. Further diagnoses included other eczemas, urticaria, rosacea, psoriasis, tinea pedis, bullous pemphigoid or no skin disease. 77/131 (59%) had positive reactions to substances in the standard series and 44/109 (40%) to substances exclusive to the dental series. 24/109 (22%) patients had positive reactions to (meth)acrylates, the majority with reactions to several test preparations. Reactions to HEMA (2‐hydroxyethyl methacrylate), EGDMA (ethyleneglycol dimethacrylate) and MMA (methyl methacrylate) were most frequent. 9 of the 24 were positive only to (meth)acrylates, the remaining 15 also had reactions to allergens in the standard series. 23 of these had hand eczema and 1 facial eczema. In 17 of the 24 allergic to (meth)acrylates, the dermatitis had started in 1995 or later, in 15 within the previous 12 months. Of 8 who had been sick‐listed, 7 also had a history of atopy and 6 were allergic to nickel. The most frequent allergens besides (meth)acrylates were nickel, cobalt, palladium, fragrance mix, colophonium and thiuram mix. Allergy to natural rubber latex was diagnosed in 14/137 (10%). In conclusion, irritant hand dermatitis was the dominant diagnosis. Contact allergy to (meth)acrylate was seen in 22% of the patch tested patients, with reactions to 3 predominant test substances. 1/3 of the patients with allergy to (meth)acrylates had been sick‐listed for dermatitis, but in all these cases the (meth)acrylate allergy was seen together with atopy and/or further contact allergies.
An update on airborne contact dermatitis
Authors: Huygens S. , Goossens A.
Published: March 2003

This review is an update of 2 previously published articles on airborne contact dermatoses. Because reports in the literature often omit the term ‘airborne’, 18 volumes of Contact Dermatitis (April 1991–June 2000), 8 volumes of the American Journal of Contact Dermatitis (1992–1999) and 4 volumes of La Lettre du Gerda (1996–1999) were screened, and the cases cited were classified as to history, lesion locations, sensitization sources, and other factors. Reports on airborne dermatitis are increasingly being published, sometimes in relation to specific occupational areas.
Nickel on the Swedish market before the Nickel Directive
Authors: Lidén Carola , Johnsson Stina
Published: March 2003

Nickel allergy is by far the most frequent contact allergy, affecting 10–15% of women in the general population, and causing dermatitis and hand eczema. The EU Nickel Directive, aimed at the prevention of nickel allergy, comes fully into force by July 2001. The Directive covers piercing materials, items in contact with the skin, and requirements on resistance to wear. We carried out a study of the prevalence on the market, before the Nickel Directive, of items that release nickel and of nickel in piercing posts. Nickel release, as shown by a positive dimethylglyoxime (DMG) test, was detected in 25% of 725 items intended for direct and prolonged contact with the skin. Of 15 posts intended for use during epithelialization after piercing, 60% contained more than 0.05% nickel. These products do not comply with the requirements of the EU Nickel Directive. It is suggested that experts in contact dermatitis participate in the prevention of nickel allergy by explaining its effects: the rôle of skin exposure and which parts of an item are in contact with the skin, and the crucial question of nickel release versus nickel content.
Occupational skin diseases in national servicemen and military personnel in Singapore, 1989–1999.
Authors: Goon Anthony Teik‐Jin , Goh Chee‐Leok
Published: March 2003

This is a study of occupational skin disease among military personnel and conscripts in Singapore. All military personnel and conscripts diagnosed with occupational dermatoses in the National Skin Centre, Singapore, between 1989–1999 were studied retrospectively. Conscripts and regulars comprised 7.3% of all occupational skin disease patients seen. All were male, with a mean age of 23 years. Irritant contact dermatitis was more common than allergic contact dermatitis, by 4.4:1. The most common vocations associated with occupational skin diseases are those involving vehicle repairs and maintenance (48%) and food handling (19%). The most common irritants were oil/grease (66%), wet work (23%) and solvents (18%). The most common allergens were food (40%) and chromates (20%). Military personnel and conscripts make up a significant proportion of occupational skin disease patients seen in Singapore.
Photopatch test method: influence of type of irradiation and value of day‐7 reading
Authors: Pollock B. , Wilkinson S. M.
Published: March 2003

118 consecutive patients were photopatch tested with 5J UVA and 10mJ UVB. In addition, day 7 readings were taken. Testing with UVB and performing late readings conferred no advantage. The current recommendations of the British Photodermatology Group regarding photopatch testing remain the most recent guide to photopatch test methodology.
Sensitization and cross‐reaction patterns in Danish Compositae‐allergic patients
Authors: Paulsen E. , Andersen K. E. , Hausen B. M.
Published: March 2003

Results of aimed patch testing with constituents of sesquiterpene lactone (SL) mix, Compositae mix (CM) and other Compositae extracts and allergens in 190 Compositae‐allergic patients detected in an 8‐year period are presented. Feverfew of CM elicited positive reactions most frequently, followed by tansy, wild chamomile, yarrow and arnica, whereas dehydrocostus lactone of SL was the most frequent elicitor of positive reactions, followed by alantolactone and costunolide. Chrysanthemum (Dendranthema) and marguerite (Argyranthemumfrutescens) were the most important suspected sensitizers in both occupationally and nonoccupationally exposed, and cross‐reactions between chrysanthemum and feverfew/tansy/chamomile may partly explain the high prevalence of positive reactions to the 3 last mentioned. In the nonoccupationally sensitized group, garden plants such as feverfew, blanket flower (Gaillardia), elecampane (Inula helenium), large yellow ox‐eye (Telekia speciosa) and cosmea (Cosmos) were additional important allergenic plants. The 3 last mentioned were picked up by SL mix. Most of the lettuce‐sensitized persons were CM‐positive. 19% of the occupationally sensitized group were negative to both SL and CM, making very aimed patch testing necessary, notably when suspecting rare sensitizers such as Gerbera and star of the veldt (Osteospermum). The significance of the weeds dandelion, dog fennel and ox‐eye daisy as sensitizers is not clarified, but they are probably less important than cultivated plants.
Self‐diagnosed dermatitis in adults
Authors: Meding Birgitta , Lidén Carola , Berglind Niklas
Published: March 2003

In a population‐based survey of public health issues in Stockholm, Sweden, self‐reported hand eczema, history of childhood eczema, nickel allergy, occurrence of skin symptoms on the face and intolerance to cosmetics and hygiene products, were investigated. A postal questionnaire was sent to 15,000 inhabitants aged 19–80 years. The response rate was 73%. The 1‐year prevalence of hand eczema was 8% (females 10%, males 6%). History of childhood eczema was reported by 15% and, of these, 42% also stated positively that they had had hand eczema at some time. Hypersensitivity to nickel was owned to 15% of the females and 3% of the males. Of the nickel‐sensitive, 30% reported ever having had hand eczema. The combination of nickel allergy and history of childhood eczema resulted in a cumulative prevalence of hand eczema of 56%. Females reported more hand‐washings per day than did males, and a relation between number of hand‐washings and hand eczema was found. Self‐reported 1‐year prevalence of skin symptoms on the face was 14% and, of these, 33% also owned to hypersensitivity to cosmetics. Dermatitis appears to be a common health problem. This fact should be made clear to those who give priority and allocate resources to health problems, e.g., by participation of dermatologists in performing population‐based surveys.
Persistence of contact allergy among Danish adults: an 8‐year follow‐up study
Authors: Nielsen N. H , Linneberg A , Menné T , Madsen F , Frølund L , Dirksen A , Jørgensen T
Published: March 2003

In 1990, a random sample of 567 persons of the 15–69‐year‐old population living in the Western part of Copenhagen County, Denmark, was patch tested in a cross‐sectional study. In 1998, a follow‐up study was performed. Out of 540 invited, 365 (68%) were re‐patch tested. In the follow‐up study, the persistence of allergic contact sensitivity, defined as 1 or more positive patch tests in both surveys, was 71% (37 out of 52 subjects). Nickel allergy persisted in 79% (19 out of 24 subjects), while 60% (21 out of 35 subjects) had a positive patch test reaction to 1 or more allergens, other than nickel, in both surveys. The lowest persistence was 50% (5 out of 10 subjects) and this was found for patch test reactivity to 1 or more of the cosmetic ingredients included in the patch test series. 8 years after the baseline study had demonstrated allergic contact sensitivity, 71% of the subjects still had at least 1 positive patch test. Nickel allergy persisted in 79%. Allergen avoidance should probably be lifelong to prevent elicitation of contact dermatitis.
Allergic contact dermatitis: the cellular effectors
Authors: Kimber Ian , Dearman Rebecca J.
Published: March 2003

Contact hypersensitivity reactions are mediated by lymphocytic effector cells. Until recently it was believed that the most important of these were CD4+ T lymphocytes. However, there is growing evidence that in many instances the predominant effector cell may be a CD8+ T lymphocyte, with in some instances CD4+ cells performing a counter‐regulatory function. Here we review the roles of CD4+ T helper (Th) cells and CD8+ T cytotoxic (Tc) cells, and their main functional subpopulations (respectively, Th1 and Th2 cells and Tc1 and Tc2 cells) in the elicitation of contact hypersensitivity reactions and consider the implications of effector cell selectivity for the biology of allergic contact dermatitis.
Population differences in acute skin irritation responses
Authors: Robinson Michael K.
Published: March 2003

The variability in human skin irritation responses has been well documented and can confound our ability to accurately assess differences in skin reactivity between human subpopulations. In the current analysis, results were compiled from nine acute irritation patch test studies, conducted at three test facilities over a 5‐year period. Four irritant test chemicals, 20% sodium dodecyl sulphate, 100% decanol, 100% octanoic acid and 10% acetic acid, were tested in sufficient numbers of test subjects to enable the stratification of results for different human subpopulations. An increased reactivity was noted for Asian versus Caucasian subjects for each of three test chemicals, in contrast to the previously described individual study results from which these data were drawn. Male subjects were directionally or significantly more reactive to each of the test chemicals than female subjects. The oldest age cluster of subjects (56–74 years of age) was directionally or significantly less reactive than younger age clusters. There was virtually identical reactivity between self‐assessed ‘sensitive’ and normal skin groups. Lastly, there was little correlation between the results from individual subjects tested in two or more studies with the same chemicals. These results add to our general understanding of population differences in skin reactivity and the potential implications for ingredient and product skin safety testing and risk assessment.
Oak moss extracts in the diagnosis of fragrance contact allergy
Authors: Johansen Jeanne Duus , Heydorn Siri , Menné Torkil
Published: March 2003

Oak moss absolute is one of the eight ingredients of the fragrance mix (FM) used for diagnosing perfume allergy. Oak moss absolute is an extract prepared from the lichen Evernia prunastri growing on oak trees. It has been shown that the oak moss patch test material from one producer contained resin acids which are ingredients of another lichen, tree moss. Resin acids, e.g. abietic acid and dehydroabietic acid, are also the main allergens in colophonium. The aim of the study was to assess whether the contamination of oak moss absolute and thus the FM with resin acids had affected their diagnostic value so that they, instead of indicating fragrance allergy, had become indicators of allergy to resin acids and thus colophonium. Two studies were undertaken. First the relationship between patch test reactions to FM, oak moss absolute, both with contents of resin acids, and colophonium were assessed in 885 consecutive patients. A significant relationship between reactions to colophonium and FM was seen (p < 0.001) as well as a significant relationship between oak moss absolute and colophonium (p < 0.001). The relationship between colophonium and FM was still significant when all reactions to oak moss absolute were disregarded (p < 0.001), showing a relationship also between colophonium and fragrance ingredients other than oak moss absolute. Second, 119 consecutive patients were tested with an old and a new version of oak moss absolute containing resin acid (0.05%) and no measurable resin acid, respectively, and with the corresponding FM. No overall difference in reactivity to the old and new version of oak moss absolute/FM was seen. It is concluded the diagnostic value of oak moss absolute as indicator fragrance contact allergy has been and is unaffected by the resin acid contamination.
Ethnic variations in self‐perceived sensitive skin: epidemiological survey
Authors: Jourdain R. , Lacharrière O. de , Bastien P. , Maibach H. I.
Published: March 2003

To examine possible ethnic variations in perception of sensitive skin, an epidemiological survey was performed in the San Francisco area. Approximately 800 telephone interviews were conducted with women from four different ethnic groups (Afro‐Americans, Asians, Euro‐Americans, Hispanics; approximately 200 women per group). In addition to sensitive facial skin assessments, age and other general skin condition data were collected. 52% of the subjects identified themselves as having sensitive facial skin. There was no statistical difference between the ethnic groups in terms of sensitive skin prevalence. Nevertheless, some differences were noted between ethnic subgroups of sensitive skin. Euro‐Americans were characterized by a higher skin reactivity to wind and tended to be less reactive to cosmetics. Afro‐Americans presented diminished skin reactivity to most environmental factors and a lower frequency of recurring facial redness. Asians appeared to have greater skin reactivity to spicy food, to sudden changes in temperature and to wind, and tended to suffer from itching more frequently. Hispanics presented a lower incidence of skin reactivity to alcohol. The differences in skin sensitivity between ethnic groups concerned mostly factors of skin reactivity and, to a lesser extent, its symptomatology. But, taken together, we note the similarities in comparing how women of varying ethnic backgrounds perceive the sensitive skin condition.
An epidemic of allergic contact dermatitis due to epilating products
Authors: Goossens A. , Armingaud P. , Avenel‐Audran M. , Begon‐Bagdassarian I. , Constandt L. , Giordano‐Labadie F. , Girardin P. , Coz C. J. L. E. , Milpied‐Homsi B. , Nootens C. , Pecquet C. , Tennstedt D. , Vanhecke E.
Published: March 2003

Over a period of 19 months, 33 cases of acute allergic contact dermatitis from Veet® epilating waxes and/or the accompanying tissue (Reckitt Benckiser, Massy, France) were observed in France and Belgium. The lesions started on the legs and spread to other parts of the body, especially the face, and were sometimes so severe that hospitalization and/or systemic corticosteroids were required. Primary sensitization occurred as early as after the first application in several patients. Patch tests were performed in 26 of the patients and produced strong positive reactions to the tissue (25 times) and/or the wax (13 times). The allergenic culprits in the wax were modified‐colophonium derivatives (colophonium in the standard series testing negatively in all except 4 patients), while methoxy PEG‐22/dodecyl glycol copolymer and to a lesser degree lauryl alcohol turned out to be the main causal allergens in the tissue.
The association between contact allergy and hand eczema in 2 cross‐sectional surveys 8 years apart
Authors: Nielsen Niels Henrik , Linneberg Allan , Menné Torkil , Madsen Flemming , Frølund Lars , Dirksen Asger , Jørgensen Torben
Published: March 2003

Hand eczema is a recurrent chronic skin disease related to contact allergy and atopic dermatitis. When possible, efforts should be redoubled to eliminate provoking factors. Our objective was to assess changes in the prevalence of self‐reported hand eczema and to evaluate the association between contact allergy and hand eczema among adult Danes before and after nickel exposure regulation in Denmark. In 1990 and 1998, random samples of 15–41‐year‐old persons were examined in 2 cross‐sectional studies of the general population in Copenhagen, Denmark. The studies included questionnaires, patch and prick testing. From 1990 to 1998 the prevalence of a history of hand eczema increased significantly. This increase did not appear to be fully explained by changes in the prevalence of flexural eczema, prick test reactivity, patch test reactivity, and nickel allergy. In 1990, nickel allergy and allergic nickel contact dermatitis were significantly associated with a history of hand eczema among women. In 1998, these associations were not found. It can be concluded that, from 1990 to 1998, the prevalence of a history of hand eczema rose significantly. It was indicated that it might be possible to prevent the hand eczema related to nickel allergy by exposure regulation, public education or both.
Hand dermatitis as an unsuspected presentation of textile dye contact sensitivity
Authors: Giusti Francesca , Mantovani Lucia , Martella Alessandro , Seidenari Stefania
Published: March 2003

The aim of this study was to evaluate disperse dye sensitization in patients with hand dermatitis. From January 1996 to December 2000, we identified 130 patients with hand dermatitis reacting to one of the 7 dyes included in our standard series. In 82 subjects the dermatitis was localized to the hands alone, whereas 48 patients had lesions both on the hands and on other skin sites. Disperse Blue dyes, and Disperse Orange 3 were the most common sensitizers. Among the 13 subjects allergic to disperse dyes alone, we found 3 cases of occupational allergic contact dermatitis, 1 child with atopic dermatitis worsening after the use of synthetic fibre garments, 4 subjects affected by clothing dermatitis, and 5 individuals occupationally exposed to irritants with a dermatitis involving the hands alone. In the latter, the hands may represent a ‘locus minoris resistentiae’, and both induction and elicitation of contact sensitization could be caused by impaired barrier function at a skin site repeatedly exposed to sensitizing garments.
Latex sensitization in dental students using powder‐free gloves low in latex protein:a cross‐sectional study
Authors: Schmid Klaus , Christoph Broding Horst , Niklas Dietrich , Drexler Hans
Published: March 2003

In Germany, employers must provide low‐protein, powder‐free gloves. This study was carried out to determine the current prevalence of latex sensitization in dental students using these gloves and to compare our results with a study of the same design dating from 1990/1991 at our university. A cross‐sectional study was performed by questionnaire, prick testing and determination of specific IgE antibodies. 226 of 403 dental students underwent prick testing with a panel of 8 aero‐allergens, 1 commercially available latex extract and 5 high‐ammonia accelerator‐free latex fluids. 39 of 226 dental students (17.3%) had a positive prick test response to at least 1 of the 6 latex substances tested. The prick test positivity was similar in preclinical education (semester 1–6) and in clinical education (semester 7–10), at 17.1% and 17.4%, respectively. In 9 of 32 persons with positive prick tests, specific IgE antibodies to latex could be detected. Within the past 10 years, prick test positivity increased from 8.7% to 17.3%. 14 students (6.2%) reported a history of glove intolerance, 3 of them (1.3%) showing a positive prick test to latex. By the use of low‐protein, powder‐free gloves less students with glove intolerance were observed. The observed reactions to between 1 and 3 of 6 latex substances tested may indicate a decrease in intensity and spectrum of sensitization. Additionally non‐occupational sensitization may be of importance.
Occupational allergic contact dermatitis caused by isocyanates
Authors: Goossens A. , Detienne T. , Bruze M.
Published: March 2003

Between 1978 and 2001, 22 patients were diagnosed with occupation‐related allergic contact dermatitis from isocyanates and/or polyurethanes in our clinic. 13 had a positive reaction to the isocyanates, of whom 10 also reacted to diaminodiphenylmethane (MDA), which is used in the production or processing of isocyanates and polyurethanes; 9 reacted only to MDA. The object of the present study was to identify the trades and industries responsible for the development of contact allergy to these resins. Such patients must be patch tested with the isocyanates contacted at work, and account must be taken of positive reactions to MDA as a marker for isocyanate sensitivity.
A quantitative genetic study of cephalometric variables in twins
Authors: Carels C. , Van Cauwenberghe N. , Savoye I. , Willems G. , Loos R. , Derom C. , Vlietinck R.
Published: March 2003

This study aimed at determining the relative genetic and environmental impact on a number of well‐known cephalometric variables in twins. In order to find a clue in the heritability pattern of some dentofacial characteristics and on the expected limits of the therapeutic impact on the dentofacial subparts they are representing. Cephalograms were collected from 33 monozygotic and 46 dizygotic twins, who did not undergo any orthodontic treatment. Nineteen linear and four angular variables were selected all representing a different definite subpart of the dentofacial complex. The reproducibility of the measurement of most of the linear variables was very high.  A genetic analysis using model fitting and path analysis was carried out. First, data were checked on the fulfilment of the conditions for genetic analysis in twins reared together.  The results show that the genetic determination is significantly higher for vertical (72%) than for horizontal (61%) variables. As far as the genetic component is concerned, all variables selected seem to be inherited by additive genes, except for mandibular body length, which was determined by dominant alleles. Sex differences in genetic determination were found for the anterior face height, showing a significantly higher genetic component for boys (91%) than for girls (68%). For the angular measurements, no genetic influence was found: only environmental influences common to both members of each pair could be demonstrated.
Glomeruloid hemangioma in POEMS syndrome shows two different immunophenotypic endothelial cells
Authors: Kishimoto Saburo , Takenaka Hideya , Shibagaki Ryo , Noda Yosuke , Yamamoto Mari , Yasuno Hirokazu
Published: March 2003

The case of a Japanese woman with glomeruloid hemangioma, an initial marker for POEMS syndrome, is reported. Her cutaneous lesions were multiple and consisted of glomeruloid hemangiomas, cherry‐type capillary hemangiomas, and a mixture of both. The specimens of glomeruloid hemangiomas were studied by paraffin section immunohistochemistry with a large panel of antibodies and electron microscopy, respectively. The lesions, whose size ranged from minute foci to large nodules, were composed of anastomosing vascular channels resembling renal glomeruli and had irregular lumina, often featuring capillaries and sinusoid‐like spaces. The vascular channels were lined by a single layer of endothelial cells, which showed two types of cells. The capillary‐type endothelium possessed large vesicular nuclei with open chromatin and large amount of cytoplasm. The sinusoidal endothelium possessed small basal nuclei with dense chromatin as well as scant amount of cytoplasm. The former cells had a characteristic CD31+/CD34+/UEA I +/CD68− phenotype. Some of these cells ultrastructurally showed intracytoplasmic lumen formation. The latter cells had a characteristic CD31+/CD34−/UEA I−/CD68+ phenotype. The present study shows that glomeruloid hemangioma has unique morphologic and immunologic features that differ from the traditional hemangiomas as well as littoral cell angioma of the spleen.
Expression of the pro‐apoptotic caspase 3/CPP32 in cutaneous basal and squamous cell carcinomas
Authors: Cousin Florence , Baldassini Sylvie , Bourchany Dominique , Claudy Alain , Kanitakis Jean
Published: March 2003

Apoptosis, a process of programmed cell death, plays an important role in normal and pathologic tissue homeostasis. The apoptotic cascade is triggered by caspases, a family of cystein proteases, among which caspase 3 (CPP32) seems to be the most directly related to apoptosis. Until now, few, if any, data exist on the role of CPP32 in skin tumors. We studied by immunohistochemistry, Western blot and reverse transcriptase‐polymerase chain reaction (RT‐PCR) the expression of CPP32 in specimens of normal human skin, basal and squamous cell carcinomas. CPP32 (both at the protein and mRNA level) was detected within epidermal and adnexal keratinocytes. CPP32 was also expressed in tumor masses of squamous cell carcinomas and more weakly in basal cell carcinomas; no correlation was found between CPP32 expression and depth of tumor invasion. CPP32 was occasionally expressed in tumor‐infiltrating lymphocytes and peritumor endothelial cells. The expression of CPP32 in normal skin and in tumors arising from it suggests that this enzyme is involved in their homeostasis; its precise functional significance awaits further investigation ( Note).
Multiple infundibulocystic basal cell carcinomas in association with human immunodeficiency virus
Authors: Kagen Mark H. , Hirsch Ranella J. , Chu Paul , McCormack Patricia C. , Weinberg Jeffrey M.
Published: March 2003

Infundibulocystic basal cell carcinoma (IBCC) is a relatively recently described variant of basal cell carcinoma that is controversial and not universally accepted. Excluding cases of nevoid basal cell carcinoma syndrome, IBCC usually presents as a small, solitary, superficial lesion on the face of older persons. There have been previous reports of diffusely distributed, multiple similar lesions, but there is disagreement about the diagnosis in these cases. We present a case of a 43‐year‐old man with multiple papular lesions which we believe represent IBCC in the setting of infection with the human immunodeficiency virus (HIV).
Cytokeratin expression of apocrine and eccrine poromas with special reference to its expression in cuticular cells
Authors: Yamamoto Osamu , Hisaoka Masanori , Yasuda Hiroshi , Kasai Takahiko , Hashimoto Hiroshi
Published: March 2003

Background: There are no immunohistochemical studies on cytokeratin (CK) expression in large series of cases of apocrine poroma. In addition, detailed immunohistochemical analysis of cuticular cells, a specific type of constituent cells of poromas, has not been reported.

Methods: Using the avidin‐biotin method, we compared immunostaining patterns of eleven different anti‐CK antibodies in 12 cases of apocrine and 21 cases of eccrine poromas, and normal adult skin.

Results: Poroid cells were exclusively positive for CK1/5/10/14, CK5/8 and CK14, which were expressed in the outer cells of normal dermal sweat ducts. Poroid cells were heterogeneously stained with anti‐CK7, CK8/18, CK10/11 and CK19 antibodies, which reacted in the inner cells of dermal ducts and in the secretory cells of sweat glands. The cuticular cells showed constant expression of CK1/5/10/14 and CK10/11, and various expression patterns of CK5/8, CK6, CK7, CK14, CK8/18, CK17, and CK19.

Conclusions: Based on the keratin immunohistochemistry, the neoplastic cells in eccrine and apocrine poromas are considered to be closely related to the cells of dermal sweat ducts. Also the cuticular cells are considered to occupy an intermediate spectrum between the inner and outer cells of the dermal ducts. Although it is difficult to differentiate apocrine poroma from eccrine poroma by keratin expression patterns alone, the data obtained here can be helpful in differentiation of apocrine poroma from other hair follicle‐related neoplasms.
Angiocentric primary cutaneous T‐cell‐rich B‐cell lymphoma: a case report and review of the literature
Authors: Gogstetter Darin , Brown Marc , Seab James , Scott Glynis
Published: March 2003

Background: T‐cell‐rich B‐cell lymphoma (TCRBCL) is an uncommon B‐cell lymphoma, which is characterized histologically by a small number of neoplastic B cells surrounded by large numbers of nonneoplastic T cells. Diagnosis is frequently difficult because the neoplastic B‐cell population may be quite sparse, and immunohistochemical and molecular analysis to identify the B‐cell origin and clonality of the cells is necessary.

Methods: In this report we present an additional case of primary cutaneous TCRBCL with immunohistochemical and gene rearrangement studies and review the literature of this unusual entity.

Results: The patient was a 52‐year‐old woman who had a slowly growing cutaneous lymphoma which fulfills the strictest criteria initially proposed for a diagnosis of TCRBCL. This case has additional features of a prominent angiocentric/angioinvasive histology and dual clonality, showing both immunoglobulin heavy chain and T‐cell receptor gene rearrangements.

Conclusions: Controversy surrounds the notion of TCRBCL as a distinct clinicopathological entity. There have only been 14 reported cases of TCRBCL with skin involvement in the literature and only seven of these cases have arisen in the skin. To better understand the histological and clinical characterisitcs of TCRBCL we have reviewed previously reported cases of TCRBCL with skin involvement, and contrast them with the present case.
Benign keratosis with a spectrum of follicular differentiation: a case series and investigation of a potential role of human papilloma virus
Authors: Somach Stephen C. , Morgan Michael B.
Published: March 2003

Background: A variety of dermatopathologic entities are histologically defined by the presence of follicular differentiation. Follicular differentiation confined to the epidermis may follow induction from dermal mesenchymal proliferations, as in a nevus sebaceus of Jadassohn, or represent endogenous proliferations such as the tumor of the follicular infundibulum or trichilemmoma.

Methods: We report on five cases of a histologically distinct form of benign keratosis showing variable follicular differentiation. Clinicopathologic correlation and analysis of a potential human papilloma virus pathogenesis was investigated.

Results: Each of the cases arose on the trunk or extremities of three men and two women with a mean age at presentation of 66.6 years. All of the lesions showed variable follicular differentiation, with germinative basaloid cells, matrical cells with matrical keratinization, inner root sheath with trichohyalin granules, or glycogenated lower outer root sheath. Immunohistochemical staining for human papilloma virus was negative in each case.

Conclusions: There exists a distinct entity, histologically defined as a keratosis with variable follicular differentiation, which has not been previously described. These lesions do not appear to be pathogenically related to human papilloma virus infection.
Human dermal pericytes express 3G5 ganglioside – A new approach for microvessel histology in the skin
Authors: Helmbold Peter , Wohlrab Johannes , Marsch Wolfgang CH. , Nayak Ramesh C.
Published: March 2003

Background: Pericytes cover the abluminal surface of microvessels and play an important role in capillary regulation and pathology. Studies on pericytes have been hindered by the lack of specific markers with which to facilitate microscopic identification of this cell type. Expression of the cell surface 3G5 ganglioside antigen has been reported in cultured retinal and cardiac pericytes. The objective of this study was to determine the usefulness of monoclonal antibody 3G5 as a pericyte marker in human skin.

Methods: Cryosections of 21 skin biopsies were examined by direct fluorescence technique with anti‐3G5, anti‐von Willebrand factor, anti‐α‐smooth muscle actin or DNA fluorochrome.

Results: In human dermis, 3G5 expression is limited to pericytes discriminating this cell type from all other cells including smooth muscle cells, myofibroblasts and myoepithelial cells. We found a pericyte: endothelial cell ratio of 1:12.4 (±7.1), and a difference of α‐smooth muscle actin expression between the subpapillary plexus and the microvessels of the Stratum reticulare.

Conclusions: 3G5 mAB is an excellent and so far the only reported tool for identification of dermal pericytes by fluorescent light microscopy. Moreover, this is the first report of the application of 3G5 technique to the microvasculature in tissue sections at the light microscopic level.