bluuebunny/crossref_metadata_2025 huggingface dataset:
The prevention of nickel contact dermatitis
Authors: Gawkrodger D. J. , Healy J. , Howe A. M.
Published: April 2006

Chelating agents and other substances can be used to bind nickel or reduce its penetration through the skin, and hence to reduce the symptoms in subjects with nickel sensitivity. Topical usage is mostly described but, in some studies, chelating agents have been given systemically. The most effective ligand for nickel so far described is 5‐chloro‐7‐iodoquinolin‐8‐ol. Although normally regarded as safe, its usage in some situations may be limited by concerns about its toxicity. Other ligands with demonstrable effect include ethylenediaminetetraacetic acid in various forms, diphenylglyoxime and dimethylglyoxime. Cation exchange resins can effectively bind nickel and work both in vitro and in vivo. Propylene glycol, petrolatum and lanolin reduce the absorption of nickel through the skin. Corticosteroids and cyclosporin work in nickel dermatitis by suppressing the immunological reaction rather than through an effect on nickel. Studies of the oral administration of ligands such as tetraethylthiuram disulphide have given conflicting results but the use of these agents is limited by hepatotoxicity in any case. Some compounds offer potential for use in the prophylaxis of nickel dermatitis. Further work is required to develop the existing agents and to look at the use of novel combinations, such as that of a cation exchanger with a ligand.
Testing with fragrance mix
Authors: Frosch Peter J. , Pilz Beate , Burrows D. , Camarasa J. G. , Lachapelle J.‐M. , Lahti A. , Menné T. , Wilkinson J. D.
Published: April 2006

In a multicentre study, the value of adding sorbitan sesquioleate (SSO) to the constituents of the 8% fragrance mix (FM) was investigated. In 7 centres, 709 consecutive patients were tested with 2 types of FM from different sources, its 8 constituents with 1% SSO, its 8 constituents without SSO, and 20% SSO. 5 patients (0.71%) reacted to the emulsifier SSO itself, read as definitely allergic on day 3/4. 53 patients reacted to either one of the mixes with an allergic type of reaction. When tested with the constituents without SSO, 41.5% showed an allergic reaction versus 54.7% with SSO. If both types of reactions were considered (allergic and irritant) 38.3% of 73 patients showed a positive “breakdown” result without SSO, versus 54.8% with SSO. The differences were statistically significant. Reactivity to FM constituents was changed in a specific pattern by addition of SSO‐irritant reactions increased, particularly for cinnamic alcohol, eugenol, geraniol, oak moss and hydroxycitronellal, whereas others showed only a slight change. Allergic reactions were also increased by SSO, but the rank order of the top 3 sensitizers (isoeugenol, oak moss and eugenol) did not change. Cinnamic alcohol was the only constituent with decreased reactivity after addition of SSO. A positive history of fragrance sensitivity (HFS) was clearly associated with a positive allergic reaction to either the mix or 1 of its constituents (51% versus 28.6% with a negative HFS). Irritant reactions were linked to a negative HFS in a high proportion (64.3%). In 17 patients, a repeated open application test (ROAT) was performed with a total of 43 patch‐test‐positive materials. The ROAT was positive in 20/31 (64.5%) tests in 11 patients with a positive HFS, but negative in all 6 patients with a negative HFS (0/12 tests). In conclusion, addition of SSO to the constituents of FM increases both irritant and allergic reactions, though the difference from the results obtained without SSO is not as high as previously reported. The ROAT is a valuable tool in validating such patch test results.
Concomitant positive patch test results with standard screening tray in North America 1985–1989
Authors: Holness D. L. , Nethercott J. R. , Adams R. M. , Belsito D. , Deleo V. , Emmett E. A. , Fowler J. , Fisher A. A. , Larsen W. G. , Maibach H. I. , Marks J. , Reitschel R. L. , Rosenthal L. E. , Schorr W. F. , Storrs F. J. , Taylor J. S.
Published: April 2006

Responses to patch test substances may occur contemporaneously. Such simultaneous reactions may reflect concomitant sensitization to 2 dissimilar allergens to which concurrent exposure has taken place (e.g., ethylenediamine dihydrochloride and neomycin). It may occur when the individual has been exposed to only 1 of the substances and exhibits a response to other substances of similar chemical structure (i.e., cross‐sensitization such as between para‐phenylenediamine and benzocaine). Such simultaneous responses may also be chance occurrences, reflecting multiple sensitization or the result of altered response due to the “angry back syndrome”. This investigation established that such concurrence of response is not uncommon and adds further documentation to the literature of these associations in patch test responses.
Detection of IgE antibodies to latex allergens in human serum
Authors: Alemohammad Mohammad M. , Malki Janette , Foley Thomas J.
Published: April 2006

Reports indicate increasing incidence of Type I allergic reactions to latex allergens. The proteins that act as allergens and produce such allergic reactions are found in the natural latex sap of Hevea brasiliensis. All those who are exposed to latex products, particularly healthcare workers, are potentially at risk. The lack of qualified allergen extracts makes it difficult to perform skin testing on individuals who are at high risk. Therefore, a reliable in vitro test system for the detection of IgE antibodies to latex would be of considerable utility. We have developed a serological test for the qualitative determination of specific IgE antibodies to latex. In our study, 75 sera from individuals with a history of latex allergy and 29 serum samples from healthcare workers were tested by both radioimmunoassay (RIA) and enzyme immunoassay (EIA). The allergen bound to paper discs was the same solid phase for the RIA and EIA assays. The allergen preparation used for coating the paper discs was a mixture of proteins obtained from raw latex. The data show a good correlation between the results of RIA and EIA methods with data obtained using an RIA assay at an independent laboratory and by skin prick testing. Comparing the performance of our test using our latex material with that of the latex material obtained from the Food and Drug Administration (FDA), along with results of other tests including skin tests, we found that the specificity and sensitivity of our assay method approaches 100%. The data show no significant cross‐reactivity between latex and banana. A low level of cross‐reactivity between latex and avocado was observed. We conclude that, by using correct selection of proteins, the detection of specific IgE to latex may be a valuable assay method for screening individuals and for the diagnosis of allergy to latex.
Patch test results with serial dilutions of nickel sulfate (with and without detergent), palladium chloride, and nickel and palladium metal plates
Authors: Uter W. , Fuchs Th. , Häusser M. , Ippen H.
Published: April 2006

Clinical experience suggests the existence of different degrees of sensitivity in nickel‐allergic patients. For quantification of this phenomenon, 462 consecutive patients with previously diagnosed or strongly suspected nickel allergy were tested with serial dilution patch tests with 5 ppm to 5% nickel sulfate in pet. (Ni), and 5 ppm to 1% nickel sulfate in pet. with 1% detergent (Ni/D). Additionally, nickel and palladium metal plates were tested in 103, and cobalt salts, dichromate and palladium chloride (PdCl2) in most patients. 332 patients reacted positively to Ni or Ni/D. The influence of a concomitantly administered detergent was not significant. A significant correlation was found between positive reactions to low concentrations of Ni (or Ni/D), i.e., 0.1% or less (N=166), and concomitant reactions to nickel metal plates, cobalt salts and PdCl2 and a history of ear piercing with metal intolerance. The clinical relevance of reactions to PdCl2 is at present not clear. A subgroup of nickel‐allergic patients with “high sensitivity” can be defined. In future studies further addressing the clinical relevance of high versus low sensitivity, patch testing with 0.01, 0.1, 1.0 and 5% nickel sulfate in pet is recommended instead of routine tests with 5% only.
Contact allergy to gold sodium thiosulfate
Authors: McKenna K. E. , Dolan O. , Walsh M. Y. , Burrows D.
Published: April 2006

278 consecutive patients with suspected contact dermatitis were patch tested with the European standard series and gold sodium thiosulfate (0.5% pet.): 13 patients (4.6%) had a positive allergic response to gold sodium thiosulfate (GST). All of these patients were female, with a mean age of 37 years. The most frequent site of eczema in these patients was the head and neck (62%). A seborrhoeic distribution of eczema was common. 46% had involvement of the limbs, 15% had a perianal or perivulval rash. The mean duration of eczema in this group of patients was 15.8 months. 54% of patients allergic to gold were also allergic to nickel. Biopsy of positive patch test reactions to GST were consistent with allergic contact dermatitis.
Allergic contact dermatitis from the newly introduced fungicide fluazinam
Authors: van Ginkel C. J. W. , Sabapathy N. N.
Published: April 2006

In spring 1992, several farmers in the western part of The Netherlands developed dermatitis on their hands, forearms and face. In some, the legs, trunk and genitals were also affected. Complaints ranged from a mildly itchy, papular rash to a painful, weeping and blistering dermatitis. Medical aid was needed by 5/9 of them. Some of the farmers grew seed potatoes, the others cultivated lilies. All of them had in common that their complaints emerged after repeated application of a new fungicide over several weeks. The fungicide was Shirlan®, with fluazinam as its active ingredient. 9 farmers were patch tested with a concentration range of the whole formulation (aq.) and of the active ingredient (pet.). In 7 of 9 farmers, positive patch tests were scored with both the whole formulation (down to 0.01% (aq.) and fluazinam itself (down to 0.1% pet.). Patch tests in consecutive control patients (n=10) were all negative. As it was impossible to substitute fluazinam as the active ingredient, farmers are now supplied with detailed information as to how to avoid skin contact as much as feasible.
Irritant effects of a detergent in wash and chamber tests
Authors: Hannuksela Anna , Hannuksela Matti
Published: April 2006

Irritant properties of detergents can be tested by using patch and chamber tests and various kinds of use tests. The aim of the present study was to compare the results of use and 12 mm Finn Chamber® tests. Study subjects (10 atopic and 11 non‐atopic medical students) washed the outer aspect of 1 upper arm with liquid detergent for 1 minute 2x daily for 1 week. 48‐h chamber test with 5 concentrations of the same detergent in water were concurrently applied to upper back skin. Transepidermal water loss (TEWL), electrical capacitance and skin blood flow were measured to quantify reactions on days 0, 2, 5 and 7. Irritant contact dermatitis developed equally in atopics and non‐atopies in the wash test, whereas in the chamber test with a 10% aq. solution of the detergent, increase in TEWL was significantly higher in atopies than in non‐atopies. The chamber test results thus predicted poorly the result of the wash test. This might indicate that the wash test and the chamber test measure different aspects of skin barrier function.
The influence of patch tests with clobetasol propionate on adjacent patch test reactions
Authors: Bruze M. , Isaksson M. , Dooms‐Goossens A.
Published: April 2006

Contact allergy to corticosteroids now seems frequent among patients being patch tested. As corticosteroids are intrinsically anti‐inflammatory, we investigated whether patch tests with a potent corticosteroid might suppress simultaneous adjacent patch test reactions to another allergen. Nickel‐sensitive subjects were patch tested with an aqueous dilution series of nickel in duplicate, adjacent to patch tests with clobetasol propionate 1% in ethanol and with ethanol, respectively. Statistical evaluation of the results obtained in 2 different centers, using their own patch test techniques, did not reveal any suppression of the positive nickel patch test reactions.
Contact urticaria with anaphylactic reactions caused by occupational exposure to iridium salt
Authors: Bergman Anita , Svedberg Urban , Nilsson Eskil
Published: April 2006

This paper presents the case of a non‐smoking and non‐atopic male, exposed to indium chloride at work, who developed respiratory tract symptoms and contact urticaria. Application of indium salt to normal skin caused contact urticaria. An iridium chloride prick test showed a positive reaction and a scratch test produced anaphylactoid reactions. Platinum salt allergy was excluded through prick testing with hexachloroplatinate solution. There is no previous report describing a case where an individual has a positive prick test reaction to iridium salts and simultaneously a negative one to platinum salts. The results are interpreted as immediate‐type hypersensitivity (Type I allergy?) to iridium salt. The route of sensitization was probably through the airways. Further testing showed that iridium salt allergy could persist for at least 18 months after exposure ceases. 14 employees at the same factory were prick tested with iridium and platinum salts with negative results. Prick testing is recommended as a method of first choice when investigating a person with suspected indium salt allergy.
Occupational allergic contact dermatitis from alkanolamineborates in metalworking fluids
Authors: Bruze Magnus , Hradil Eva , Eriksohn Inga‐Lill , Gruvberger Birgitta , Widström Lena
Published: April 2006

Alkanolamineborates are extensively used in coolants as corrosion inhibitors. In this paper, 3 machinists with contact allergy to alkanolamineborates are reported. To avoid false‐positive test reactions due to the alkalinity of the alkanolamineborates, they should be tested when dissolved in an acidic buffer. When various alkanolamineborates were tested in dilution series in the 3 patients, 2 types of reactivity patterns emerged, indicating the existence of at least 2 separate sensitizers in alkanolamineborates. The raw materials, ethanolamines and boric acid, did not yield any positive patch test reactions. Thin‐layer chromatography investigations demonstrated that each alkanolamineborate consists of many substances, which differed in part between different alkanolamineborates. The present study shows that it is not possible to use 1 particular alkanolamineborate for tracing contact allergy to alkanolamineborates in general.
Factors associated with skin irritation of the hands experienced by general dental practitioners
Authors: Burke F. J. T. , Wilson N. H. F. , Cheung S. W.
Published: April 2006

Practising dental surgeons are now wearing gloves for longer periods of time than any other comparable group. As part of a study to assess dentists' attitudes to cross‐infection, a questionnaire was sent to 1950 randomly selected general dental practitioners in England and Wales, with information being requested concerning the incidence of skin irritation of the hands considered to be associated with glove wearing. The response to the questionnaire was 61%, with 29% of respondents indicating that they had experienced skin irritation. A strong association was identified between pattern of glove wearing and incidence of skin irritation, with routine glove wearers being more likely to suffer skin irritation than occasional glove wearers. Female respondents were also more likely to have experienced skin irritation than male respondents. No association was identified between reported incidence of skin irritation and practising arrangements, years since graduation and number of years of glove wearing.
Two‐dimensional blood flow determinations in allergic reactions using laser Doppler scanning
Authors: Stücker Markus , Auer Thorsten , Hoffmann Klaus , Altmeyer Peter
Published: April 2006

The new technique of laser Doppler scanning (LDS) provides a 2‐dimensional pattern of cutaneous microcirculation, which offers a visual image and can quantify the intensity and expansion of perfusion. With the help of this technique, we examined the microcirculatory pattern of Type IV reactions to recall antigens, which were applied using a test stamp (Multitest Merieux). The measurements were performed before application of the test stamp as well as 10 min, 24, 48 and 72 h afterwards. The inflammatory hyperemia was evaluated using LDS and unidimensional laser Doppler fluxmetry. The diameter of the inflammatory infiltrate was quantified by means of palpation, the thickness by means of high‐resolution 2U MHz sonography. The clinically visible erythema was measured planimetrically. An unspecific hyperemia resulting from the trauma of the stamp revealed no evident infiltrate under sonography 10 min after the test application. Depending of the individual reaction, the mean flux and the expansion of the hyperemia were at their peak after 48 h. The flux values were at a maximum in the center of the inflammatory reaction and dropped continuously toward the periphery. The area of the hyperemia seen in the LDS image was significantly larger than the expansion of the erythema measured planimetrically, but there was a significant correlation. The perfusion correlated significantly with the infiltration diameter (24 h, 48 h, 72 h) and the infiltration thickness 48 h after testing. All in all, it was possible to measure directly and without touching the skin and to quantify a subclinical pattern of skin perfusion as a response to and inflammatory reaction on a 2‐dimensional display.
Is the European standard series suitable for patch testing in Riyadh, Saudi Arabia?
Authors: El‐Rab Mohamed Osman Gad , Al‐Sheikh Omar Abdulaziz
Published: April 2006

Due to the lack of a regional patch test series in our geographical area, the suitability of the European standard series was evaluated by patch testing dermatitis patients in Riyadh, Saudi Arabia. Of 240 consecutive patients with various forms of dermatitis, 136 (57%) showed 1 or more positive patch tests, women, 74 (54%), slightly outnumbering men, 62 (46%), Positive reactions were found to 21 of the 22 items in the test series. Sensitization was most common to nickel sulfate (51=37.5%), potassium dichromate (48=35%) and cobalt chloride (43 = 32%). The frequency of sensitization to nickel was higher in women (41=30%) while that to dichromate was higher in men (39=29%). Less reactions were found to fragrance mix (21 = 15%). formaldehyde (15=11%) and neomycin sulfate (15=11%). Sensitization to other allergens ranged between 10 and 1%. Less than 1% of patients (0.7%) reacted to benzocaine and none to primin. The frequency of occurrence of multiple sensitivities is also presented. We conclude that the European standard series is suitable for patch testing dermatitis patients in our region, with the exception of benzocaine and primin. The addition of 3 allergens that could be of local relevance is discussed.
Skin irritation in man: a comparative bioengineering study using improved reflectance spectroscopy
Authors: Andersen P. H. , Maibach H. I.
Published: April 2006

Variable types of skin irritation were induced in 8 human female volunteers, ranging from subclinical to visible erythema with slight oedema. Skin reactions were graded clinically and objectively using transepidermal water loss (TEWL), laser Doppler flowmetry (LDF) and improved reflectance spectroscopy. This last technique enables separation of in vivo erythemas into relatively deoxygenated (venous‐deoxy hem) and oxygenated (arterial oxy hem) haemoglobin components. Compared to uninvolved skin, an empty patch increased oxy hem by 197%± 121%(p < 0.05). Exposure to vehicles also changed skin biophysics. At sodium lauryl sulfate (SLS) and hydrochloric acid (HCL) exposed sites, a linear correlation between concentration and oxy hem. LDF and TEWL was found. These chemicals predominantly increased TEWL values. Nonanoic acid (NON) and imipramine (IMI) also raised oxs hem, LDI and TEWL values linear at increasing concentrations. Although IMI 2.5% clinically was graded as a type ++ response, no significant increase in TEWL was found. The improved reflectance spectroscopic technique proved valid in skin irritation studies, with a higher sensitivity than laser Doppler flowmetry, and allowed irritant vascular reactions to be discriminated into arterial and venous components. Furthermore, our observations clearly demonstrate that clinical indistinguishable skin irritation reactions induce significantly different changes in barrier function (disruption) and vascular status.
Atopic dermatitis, nickel sensitivity and xerosis as risk factors for hand eczema in women
Authors: Nilsson Eskil J. , Knutsson Anders
Published: April 2006

Knowledge of the relationship between a history of atopic dermatitis and nickel sensitivity as risk factors for hand eczema is limited. Our objective was to study the relative importance of atopic manifestations and nickel sensitivity as risk factors for hand eczema in women. From women referred for patch testing with a dental series. 100 consecutive nickel‐positive and 95 nickel‐negative patients were studied. A history of atopic manifestations and a history of 5 symptoms of hand eczema, i.e., dry erythemas, maculopapules, vesicles, erosions and hyperkeratoses were recorded. A history of atopic dermatitis was found lo increase the risk of the 5 symptoms of hand eczema and sick leave due to hand eczema highly significantly. Nickel sensitivity increased only the risk of vesicles and erosions, Xerosis increased the risk of dry erythemas and vesicles. We concluded that a history of atopic dermatitis was more important than nickel sensitivity as a risk factor for hand eczema in women.
Sensitization of mice to paraphenylenediamine and structurally‐related compounds: adjuvant effects of vitamin A supplementation
Authors: Kalish Richard S. , Wood Jonathan A.
Published: April 2006

Allergic contact dermatitis from moderate and weak contact sensitizers is generally studied with guinea pigs, since they are readily sensitized to contact allergens. Mice, by contrast, are poor responders to weak contact allergens. However, the variety of in vitro murine systems us well, is murine specific reagents make mice the preferable species, with the use of vitamin A supplementation, 2 protocols were developed which sensitized CBA/J female mice to paraphenylenediamine, Mice were sensitized by 5 daily topical applications to shasen dorsal skin. Alternately mice were sensitized by 2 intraperitoneal infections of antigen pulsed spleen cells. Sensitization to paraphenylenediamine was determined by ear swelling following topical application. Vitamin A supplementation was found to be essential for optimum response. Lymph node and spleen cell from sensitized mice were capable of proliferating to paraphenylenediamine in vitro. With the use of Vitamin A supplementation and intraperitoneal injection, CBA/J mice were also sensitized to a number of compounds structurally related to paraphenylenediamine, including the ortho‐ and meta‐derivatives of paraphenylenediamine, as well as hydroquinone and resorcinol. These new protocols, combined with vitamin A supplementation, expand the use of mice to study moderate sensitizers with minimal animal utilization.
Contact allergy to cocamidopropyl betaine
Authors: de Groot Anton C. , van der Walle Henk B. , Weyland J. Willem
Published: April 2006

Cocamidopropyl betaine is an amphoteric surfactant used increasingly in cosmetic products. We describe 20 cases of cosmetic allergy to cocamidopropyl betaine; all were caused by shampoo or shower gel. 8 patients were hairdressers, who had occupational allergic contact dermatitis from shampoos. We recommend patch testing cocamidopropyl betaine 1%. aq. routinely in hairdressers with dermatitis of the hands, and in all patients suspected of suffering from cosmetic allergy.
Prognosis of occupational hand dermatitis in metalworkers*
Authors: Shah Manu , Lewis Fiona M. , Gawkrodger David J.
Published: April 2006

Hand dermatitis is common in workers employed in the cutting and grinding of metals. Previous studies have given conflicting results on the prognosis of this common occupational disease. This study was designed to determine the prognosis of hand dermatitis in metalworkers and the responsible allergens. A questionnaire survey was conducted on 64 patients seen between 1 and 5 years previously in the contact dermatitis clinic. Of the 51 patients responding, 82% still had hand dermatitis. There was no difference in outcome between those who continued to work with metals and oils, and those who had changed their occupation. Hand dermatitis in metalworkers carries a poor prognosis, with most workers remaining symptomatic even if they no longer had occupational exposure to metals or oils. This study also demonstrates that biocides are the most important allergen group in the aetiology of hand dermatitis in metalworkers.
Delayed hypersensitivity at the injection sites of a low‐molecular‐weight heparin
Authors: Moreau A. , Dompmartin A. , Esnault P. , Michel M. , Leroy D.
Published: April 2006

We report a case of delayed hypersensitivity to a low‐molecular‐weight heparin. The patient presented with eczema at the site of subcutaneous injections and allergy testes confirmed the clinical diagnosis. There were positive tests with 3 low‐molecular‐weight heparins and unfractionated subcutaneous calcium heparin but negative with intravenous sodium heparin. Although delayed hyper‐sensitivity to low‐molecular‐weight heparins is rare, the possibility of cross‐allergy to unfractionated heparin could be a therapeutic problem for some patients.
Long‐lasting allergic patch test reactions to nickel sulfate: analysis by nickel quantification and immunocytochemistry
Authors: Handley J. , Todd D. , Dolan O. , McMaster D. , Walsh M. , Allen G. , Burrows D.
Published: April 2006

We previously showed the median duration of positive patch test reactions to nickel sulfate(5% pet) was 9 days, and defined as long‐lasting (LLAPTR) the 14.3% of reactions that persisted for 17 Days or longer. The pathomechanisms of LLAPTR are unclear, but may involve either localized antigen persistence or abnormal down regulation of the cellular immune response. In this study, we compared (a) the nickel concentration and (b) the immunocytochemical nature of the local immune reaction, between biopsies from LLAPTR (n= 8) and normally resolving allergic patch lest reactions (NRAPTR) (n= 8) to nickel sulfate. The concentration of nickel in LLAPTR (median 0.8μg/g, μg/g, range 0.25–3.87 μg/g, mean 0.83μg/g, 95% CI 0 35–1.31) and NRAPTR (median 0.58 μg/g, range 0.2 1.85 μg/g, mean 0.88 μg/g, 95% CI 0.02 1.74) was similar. Activated T lymphocytes, expressing surface IL‐2 receptor, HLA DR, DR alpha 1, DP, DQ, and CD2>CD8>CD4 antigens, were seen throughout the dermis and occasionally infiltrating the suprabasal layer of the epidermis in all biopsies. CDI and HLA DR, DR alpha 1, DP, and DQ‐expressing Langerhans cells were present throughout the epidermis and occasionally seen in the papillary dermis. HLA DR, DR alpha 1, DP, and DQ antigen expression were also seen on the surface of non‐dendritic cells in the epidermis (probably either keratinocytes or T lymphocytes) and vascular endothelial cells in the papillary dermis. There were no significant qualitative or quantitative differences in the immuno‐cytochemical nature of the localized immune reaction between LLAPTR and NRAPTR. These findings suggest that the pathomechanism of LLAPTR to nickel sulfate is unlikely to be explained simply on the basis of nickel concentration or the nature of the localized immune reaction at the patch test site.
Variation in response of human skin to irritant challenge
Authors: Judge M. R. , Griffiths H. A. , Basketter D. A. , Whitte I. R. , Rycroft R. J. G. , McFadden J. P
Published: April 2006

A major obstacle to the establishment of a protocol for in vivo irritant skin testing in humans is the apparent variability of responses between individuals. This study of the threshold response of normal human skin to a standard irritant (sodium lauryl sulfate 0.3–10%), in a group of 22 subjects, revealed a marked interindividual variation in their threshold reaction. The results demonstrate that this phenomenon does exist and that it will have to be allowed for in future human irritant test systems or assays.
Methyldibromoglutaronitrile is an important contact allergen in The Netherlands
Authors: de Groot Anton C. , de Cock Paul A. J. J. M. , Coenraads Pieter Jan , van Ginkel Cornelis J. W. , Jarman Berend A. , an Joost Theodoor , van der Kley A. M. Joost , Melnardi Marcus M. H. M. , Smeenk Gerard , van der Valk Pieter G.M. , van der Walle Henk B. , Weyland Jan Willem
Published: April 2006

From 15 May to 15 December 1994, 2943 patients sunspected of having contact dermatitis(1955 women, 988 men) were patch tested with methyldibromoglutarorutrile 0.3%, 0.1% and 0.05% pet. 119 patients (4.0%: women 4.1%, men 3.8%) proved to be allergic, 71% of the reactions were considered to be relevant. In 2/3 of the patients, causative products were cosmetics, in 1/3 moistened toilet tissues. Testing with methyldibromoghitaronitrile at lower concentrations (0.05% and 0.1%) commercial allergens (Euxyl® K 400 and methyldibromoglutaronitrile, both containing methyldibromoglutaronitrile 0.1%). resulted in a number of falsc‐negative reactions. All preservatives in the European standard series had lower scores than the 4% positive reactions to methyldibromoglutaronitrile (formaldehyde 2.0% MCI/MI (Kathon® CG) 3.2% parabens 1.0% quaternium‐15 1.3%). It is concluded that methyldibromoglutaronitrile (present in the commercial preservative Euxyl® K 400) is an important contact allergen in the Netherlands in cosmetics and moistened toilet tissues. It should be added to cosmetics series and to proctological series. The optimal test concentration is unknown, but may be 0.3% pet. The concentration of 0.1% methyldibromoglutaronitrile in the currenttly available commercial allergens appears to be too low. resulting in a number of false‐negative reactions.
Allergic and irritant patch test reactions and atopic disease
Authors: Klas P. A. , Corey G. , Storrs F. J. , Chan S. C. , Hanfin J. M.
Published: April 2006

This study presents a profile of patients with chronic recalcitrant eczematous disease referred by dermatologists for contact allergy evaluation. Allergic contact dermatitis (ACD) and irritant responses were carefully defined, as was the presence or absence of atopy obtained by history. Of 410 patients studied, 44% had no history of atopic disease and 46% were classed as definitely atopic. Among relevant ACD patch lest reactors (n= 198). 51.5% had atopy, compared with 40.9% with no atopy but this difference was not significant. Likewise, among atopics (n= 189). 54% had definite, relevant ACD patch test responses while 33.9% had negative ACD (again not significant). Significance was seen in the higher mean number of positive allergic patch tests in the atopic group (2.7 versus 2.0. p=0.0223). Irritant patch tests were highest among patients with both ACD and atopy (p= U.0308) and the proportion of irritant responses correlated with increasing numbers of positive ACD tests. We conclude that atopics are at least as likely to have ACD as are non‐u topics. Irritancy is increased in these patients with chronic dermatitis and the frequency of irritant reactions correlates with both greater numbers of ACD responses and with presence of atopy.
Occupational skin diseases in dental laboratory technicians
Authors: Rustemeyer T. , Frosch P J.
Published: April 2006

In Germans, occupational skin disease (OSD) in dental technician (DT) has been steadily rising in recent years and causing considerable costs for medical care and rehabilitation. Our objective in this study was to: (i) examine affected workers: (ii) perform patch tests to identify causative agents; (iii) develop strategies of prevention. 7 dental laboratories were inspected as to materials used, working habits, safety regulations, etc. A computer data base was developed for products (trade name, active ingredient, additives, etc.). A questionnaire regarding development of OSD was sent out to 1132 dental technicians (45 questions). 55 DT with suspected OSD were examined and patch tested with the standard series, an extensive series of methacrylates, and own materials. Working conditions and knowledge of potential hazards. varied greatly in the laboratories visited. The safety data sheets of working materials were of with use and required supplementation by the computer data base. which provided rapid access to allergological information (e.g., and of aerylate. concentration). In the questionnaire (173 answers). 36% reported skin lesions attributed to work and 1/3 suspected plastic materials as their primary cause. Among the 55 DT examined, allergic contact dermatitis diagnosed in 63.6% and irritant contact dermatitis in 23.6%. Most of the allergens identified (74%) were found in plastic materials (methyl methaerylale (MM A). 9 patients (16%); 2‐hydroxyethyl methacrylate (2‐HEMA). 18 patients (33%); ethyleneglycol dimethacrylaie (EGDMA), 15 patients (27%)). In 16 patients, multiple sensitizations to various methacrylates were found. The fingertips were primarily involved in allergic contact dermatitis (93%). whereas in irritant contact dermatitis, the dorsa of the fingers (especially of the dominant hand) were affected (80%). 9 patients also showed lesions on the face, neck and forearms. The main irritant factors included wet work, contact with plaster, mechanical friction and thermal changes. Based on experience with DT, various preventive measures have been tried and found to be effect five (reduction of skin contact. 4H Gloves, etc.). In conclusion, better knowledge of OSD in dental laboratories (in physician. D T and their employers) would lead lo a reduced rate of new cases.
Reproducibility of the chamber scarification test
Authors: Andersen Klaus Ejner
Published: April 2006

The chamber scarification test is a predictive human skin irritation test developed to rank the irritation potential of products and ingredients meant for repealed use on normal and diseased skin. 12 products or ingredients can he tested simultaneously on the forearm skin of each volunteer. The test combines with the procedure scratching of the skin at each test site and subsequent closed patch tests with the products, repeated daily for 3 days. The test is performed on groups of human volunteers: a skin irritant substance or products is included in each lest as a positive control, and a compound with low irritant potential as a negative control, to obtain relative characterization of the irritant potential of the unknown products. The outcome of tests with a positive and negative control product used repeatedly in 13 chamber scarification tests over a 7–year period is reported, and shows high reproducibility of the test. Further intra‐individual variation in skin reaction to the 2 control products in 26 volunteers, who participated 2x, is shown, which supports the conclusion that the chamber scarification lest is a useful short‐term human skin irritation test with high reproducibility.
Hypersensitivity to thimerosal: the sensitizing moiety
Authors: Gonçalo Margarida , Figueiredo Américo , Gonçalo Saudade
Published: April 2006

There has been increasing interest in characterizing the sensitizing moiety of thimerosal [TIM]. following the finding that patients with photosensitivity to piroxicam arc allergic to the thiosalicylic acid [TIO] moiety of TIM. For this purpose, the authors have conducted 2 studies in TIM‐sensitive patients. In the 1st. of 175 patients tested with TIO and ammoniated mercuric chloride [HGAM|, 45.7% reacted only to TIM, whereas 45. 7%. reacted also to TIO and 17.7%. also to HGAM: 9.1% reacted to both TIO and HGAM. In the 2nd. of 47 patients tested with TIO and ethylmercuric chloride [F.THG], 87.2% reacted to ETHG. 44.7% to TIO and 31.9% reacted to both. None of the patients reacted only to TIM. The authors conclude that thimerosal allergy is due either to the mercuric moiety or to thiosalicylic acid, with no cases of sensitivity only to the whole molecule of TIM. TIM‐sensitive patients are mainly allergic to the mercuric moiety. but among them there are a large number of TIO‐sensitive patients, and these should be advised to avoid piroxicam.
Patch test reactions in children, adults and the elderly, A comparative study in patients with suspected allergic contact dermatitis
Authors: Wantke F. , Hemmer W. , Jahisch R. , Götz M.
Published: April 2006

The age‐ and sex‐related distribution of positive patch lest reactions was investigated in 234 children (0–7 years, n=72 and 8–14 years, n=162), 1200 adults (20 to 50 years) and 295 elderly patients (≥70 years) with suspected allergic contact dermatitis using a European standard series. In girls Prom 0 to 7 years, the most frequent contact allergens were thimerosal (37.5%) and nickel (27.5%), in girls from 8 to 14 years, nickel (28.7%) and thimerosal (26.6%), in women, thimerosal (25.3%) and nickel (25.2%), and in elderly women, nickel (12.6%) and balsam of Peru (9.7%). The most frequent contact allergens in boys from 0 to 7 years were ethylmercuric chloride (28.1%) and thimerosal (25.0%), in boys from 8 to 14 years, thimerosal (30.9%) and ethylmercuric chloride (14.7%), in men, thimerosal (21.1%) and ethylmercuric chloride (13.7%) and in elderly men, nickel (11.2%) and balsam of Peru (6.7%). Females showed more positive reactions than males. Whilst 0 to 7 year‐old girls and boys showed relatively more frequent reactions, the elderly of both sexes were clearly less affected. Nickel is the most frequent contact allergen in females of 8 years and more. In men, thimerosal is most frequent and reactions to balsam of Peru show a peak incidence in the elderly. Results indicate that patch testing should be considered in children and elderly patients with appropriate indications.
Occupational allergic contact dermatitis caused by decorative plants
Authors: Lammimää Anne , Estlander Tuula , Jolanki Rutta , Kanerva Lasse
Published: April 2006

12 cases of occupational allergic contact dermatitis caused by decorative plants were diagnosed in a 14‐year period. The patients were middle‐aged, and their average exposure time was 13 years. The plant families and plants causing occupational contact dermatitis were Compositae (5 patients: chrysanthemum, elecampane, gerbera, feverfew), Alstroemeriaceae (5 patients, Alstroemeria), Liliaceae (4 patients; tulip, hyacinth). Amaryllidaceae (2 patients: narcissus) and Caryophyllaceae (2 patients; carnation, cauzeflower). The known chemical allergens causing dermatitis were tuliposide‐A and sesquiterepene lactones, such as alantolactones and parthenolide, in the Liliaceae and Compositae families. 7 of the 12 patients were able to continue their work; 5 were not because of severe relapses of skin symptoms. The plant allergen and extract series currently available are of great help in the diagnosis.
Occupational dermatoses in a Swedish aircraft plant
Authors: Bruze Magnus , Edenholm Mats , Engström Krister , Svensson Göran
Published: April 2006

A survey of occupational dermatoses, based on a questionnaire, clinical examination and patch testing, was curried out among 341 workers in an aircraft plant. The questionnaire was answered by 330 workers (96.8%), Present or previous skin disease was reported by 92 employees, who were all subjected to physical examination and patch testing. Patch testing was conducted with a standard series, us well as with a series of substances and products representing the work environment. Occupational contact allergies were established in 12 employees. In total, the figure for occupational skin diseases was 16.1% (55 workers), when calculated for all employees.
Wood dust from jelutong (Dyera costulata) causes contact allergy
Authors: Meding Birgitta , Karlberg Ann‐Therese , ÅHman Mats
Published: April 2006

Jelutong is the wood from Dyera costulata growing in south‐east Asia. It is soft and easy to work and is used in. e.g., model workshops in car factories. It has also been much used in woodwork leaching in Swedish comprehensive schools. To estimate the prevalence of contact allergy to jelutong, 84 woodwork teachers and 110 consecutive dermatitis patients were patch tested with extract from wood dust of jelutong. 16/84 (19%) teachers had positive reactions. When they were tested with a dilution series, positive reactions were obtained for 6 mg and down to 0.3 mg of the extracted material. Half the test‐positive teachers had skin symptoms that, might he related to exposure to jelutong, 4/110 dermatitis patients at the clinic also had positive reactions, and possible exposure to jelutong was traced in 3 of them. 3 other dermatitis patients had flare‐up reactions after about 2 weeks, indicating patch‐test sensitization. To investigate the sensitizing capacity of the extract, the cumulative contact enhancement test was performed in guinea pigs. This confirmed that the extracted material was sensitizing, and a clear dose‐response relationship was found. The schools will be recommended to use safer wood alternatives in woodwork teaching.
Adverse effects of cosmetics and toiletries reported to the Swedish Medical Products Agency 1989–1994
Authors: Berne Berit , Bostrom ÅSa , Grahnen Anita Finne , Tammela Monica
Published: April 2006

In Sweden, a cosmetic control system was introduced in 1989 at the Medical Products Agency (MPA) It consists of a register of importers, manufacturers and their products, and a voluntary adverse reaction reporting system identical to that concerning drugs. Between 1989 and 1994, MPA evaluated 191 reports concerning adverse effects of 253 cosmetics and toiletries. 90% of the reports concerned women and the top‐ranking product category was moisturizers, followed by hair care products and nail products. The majority of the adverse effects reported involved only the skin, and 90% were eczematous reactions. 70% of the eczemas were classified as contact allergic, as patch tests were positive to the product as is, and in 1/2 of these products, 1 or more relevant allergens could be identified when tests were made with individual cosmetic ingredients. The most common offending ingredients were fragrances, toluenesulfonamide‐ formaldehyde resin and preservatives. The number of reports is small in relation to the expected number of cosmetic adverse effects, which can he explained, by under‐reporting. Efforts are being made to persuade Swedish physicians to report more often.
Occupational dermatoses from exposure to epoxy resin compounds in a ski factory
Authors: Jolanki R. , Takwinun K. , Tatar T. , Estlander T. , Henriks‐Eckerman M.‐L. , Mustakallio K. K. , Kanerva L.
Published: April 2006

Of 22 workers in a ski factory, occupational allergic contact dermatitis was found in 8. 6 were sensitive to epoxy resin compounds, i.e. epoxy resins, hardeners or diluents. I to cobalt in glass‐fiber reinforcements, and I to formaldehyde in a urea–formaldehyde glue and a lacquer. 4 workers had irritant contact dermatitis from epoxy resin compounds, lacquers, sanding dust. or glass‐fiber dust. 3 had contact allergy from a new sensitizer, diethyleneglycol diglycidyl ether, in a reactive diluent. Immediate transfer of workers sensitized to epoxy resin from epoxy exposure prevents aggravation of their dermatitis and broadening of the sensitization to epoxy hardeners, diluents and other compounds.
Sodium lauryl sulfate effect on the density of epidermal Langerhans cells.
Authors: Mikulowska Anna , Andersson Anders
Published: April 2006

The effect of different test models for sodium lauryl sulfate (SLS)‐induced irritant contact dermatitis on epidermal Langerhans cells (LC) numbers was examined. Finn Chambers, 8 and 12 mm, containing 15 and 34 or 50 μl, respectively. of l% aq. solution of SLS were applied to human forearm skin for 48h as single or repeated application. The results showed a clear difference between the effects with the 2 chamber Sizes. The effect of the 8‐mm chambers could result in increased, unchanged or decreased LC numbers, while 12‐mm chambers always produced a decrease. These results seem to explain, at least partly, the discrepant results reported from various laboratories.
Allergic contact dermatitis and mercury exanthem due to mercury chloride in plastic boots
Authors: Koch Patrick , Nigkolaus Gerhard
Published: April 2006

We report a 5‐year‐old child with previous skin intolerance from Mercurochrome (merbromin). who developed a severe allergic contact dermatitis of both feet when wearing new polyvinyl chloride (PVC) boots. Within a few days, he developed a mercury exanthem involving both legs, groins and lateral parts of the trunk. Patch tests showed strong reactions to organic and inorganic mercury compounds, in particular to mercury chloride (mercuric chloride: HgCl2), 0.01% pet., which was identified by atomic absorption spectrometry and polarography in the boots worn. New hidden sources of mercury in consumer goods may represent a potential source of danger for the future, if its use is not more strictly regulated.
Quantitative aspects of isoeugenol contact allergy assessed by use and patch tests
Authors: Johassen J. D. , Andersen K. E. , Menne T.
Published: April 2006

The clinical implications of sensitization to the fragrance material isoeugenol were studied in 19 subjects. Patch testing with serial dilutions of isoeugenol and a repeated open application test (ROAT) were performed The minimum effect level under patch test conditions was below 0.01% isoeugenol in 4/19 (20%) of the test subjects. The ROAT was performed with a test solution of 0.2% isoeugenol in ethanol. which is the recommended maximum concentration used in perfumes, ethanol being applied as vehicle control. 4 weeks was the maximum exposure period. The upper arm was used as test site the 1st 14 days and the upper arm as well as the neck for the next 14 days, 12/19 (63%) of test subjects had a positive ROAT. 4 of the responders (33%) reacted beyond day 7, but none alter day 14. Use testing on the neck for 14 days did not add any further ROAT‐positive cases, compared with testing on the upper arm. The sensitivity found on patch testing may be a guidance for the outcome of use tests with the same compound. In this study, all subjects with a positive use test to isoeugenol (0.2%) in ethanol also demonstrated on patch testing a minimum effect level of 0.2% or lower. Data from serial dilution patch and use IC‐N may contribute significant information to assessment of the relationship between patch test responses and clinical contact hypersensitivity, and thus the safety of allergens used in cosmetics.
Natural ingredients based cosmetics
Authors: Rastogi Suresh C. , Johansen Jeanne D. , Menne Torkil
Published: April 2006

In the present Study, we have investigated 42 cosmetic products based on natural ingredients for content of 11 fragrance substances: geraniol, hydroxycitronellal, eugenol. isoeugenol. cinnamic aldehyde, cinnamic alcohol, α‐amylcinnamic aldehyde, eitral. coumarin, dihydrocoumarin and α‐hexylcinnamic aldehyde. The study revealed that the 91% (2O/22) of the natural ingredients bused perfumes contained O.027fi‐7.7fr of 1 to 7 of the target fragrances. Between 1 and 5 of the chemically defined synthetic constituents of fragrance mix were found in 82% (18/22) of the perfumes. 35% (7/20) of the other cosmetic products (shampoos, creams, tonics, etc.) were found to contain 0.0003‐0.0820% of 1 to 3 of the target fragrances. Relatively high concentrations of hydroxycitronellal, coumarin. cinnamic alcohol and α‐amyl cinnamic aldehyde were found in some of the investigated products. The detection of hydroxycitronellal and α‐hexylcinnamic aldehyde in some of the products demonstrates that artificial fragrances, i.e., compounds not yet regarded as natural substances, may be present in products claimed to be based on natural ingredients.