bluuebunny/crossref_metadata_2025 huggingface dataset:
Diazolidinyl urea: incidence of sensitivity, patterns of cross‐reactivity and clinical relevance
Authors: Hectorne Kathleen J. , Fransway Anthony F.
Published: April 2006

Diazolidinyl urea (DIAZ) is a formaldehyde‐releasing preservative used in cosmetics and personal‐care products, which has been identified as a sensitizing agent in contact dermatitis. To determine whether DIAZ sensitization is secondary to formaldehyde release or due to its own allergenic properties, we reviewed 708 consecutive patch tests of patients with various dermatologic complaints. Profiles of the 58 individuals (8%) with DIAZ sensitivity were analyzed with respect to sex, age, exposures, and chronicity of dermatitis. Significant coexistent biocide reactivity was demonstrated for DIAZ and formaldehyde (81%); 12% reacted to DIAZ alone. We conclude that the primary mode of sensitization of DIAZ is via formaldehyde release and that independent contact allergy is less frequent.
Skin irritant reactivity following experimental cumulative irritant contact dermatitis
Authors: Widmer Janine , Elsner Peter , Burg Günter
Published: April 2006

Despite the frequency of irritant contact dermatitis, very little is known about the duration of barrier function impairment following cumulative irritant contact dermatitis. We studied post‐irritation irritant reactivity by assessing the response to SLS irritation in previously irritated sites. Cumulative irritant contact dermatitis was induced on the forearms of 15 volunteers aged 18 to 50 years by repeated occluded application of 0.5% SLS I h per day over 3 weeks. 3, 6 and 9 weeks later, previously irritated and unirritated control sites were challenged with 2% SLS under occlusion for 23 h. Irritation was assessed by visual scoring, transepidermal water loss (TEWL) as an indicator of epidermal barrier function, and capacitance as a parameter of epidermal water content. While no difference in irritant reactivity between pre‐irritated and unirritated sites was observed 3 weeks following irritant contact dermatitis, there was a significant hyporeactivity of previously irritated skin as expressed by clinical scores, TEWL and capacitance at 6 and 9 weeks. Our results indicate that epidermal barrier function remains altered even 9 weeks after cumulative irritant contact dermatitis. With regard to patch testing, post‐irritation hyporeactivity might be a cause of false‐negative tests on previously irritated sites.
Rubbing test responses of the skin to man‐made mineral fibres of different diameters
Authors: Stam‐Westerveld E. B. , Coenraads P. J. , Valk P. G. M. Van Der , Jong M. C. M. De , Fidler V.
Published: April 2006

The irritant potency of 5 types of insulation wools (2 types of rockwool and 3 types of glass wool) were studied on the basis of their differences in diameter by a standardized rubbing test. Assessment was done by laser Doppler flowmetry (LDF) and erythema scores. Insulation wools show a wide distribution of the diameter around the mean. Of the rockwool material, 30% consisted of small grains, called “shot”. The control test site did not change over time; thus, the rubbing procedure itself does not seem to contribute to the skin reactions. All fibre types proved to be irritant to the skin. The irritant reactions did not correspond with the mean diameter, although the fibre type with the smallest diameter was the least irritant and the fibre type with the largest diameter the strongest. The presence of “shot” had a significant effect on the LDF responses. “Shot” and the distribution around the mean diameter may play a role in eliciting the skin irritation by insulation wools.
Topical provocation of fixed drug eruption A study of 30 patients
Authors: Alanko Kristiina
Published: April 2006

Topical provocation with the causative agent was performed in 30 patients with fixed drug eruption (FDE). The epicutaneous open test method was used on inactive sites of old FDE lesions. Drugs at 10% in the vehicles petrolatum, alcohol and dimethylsulfoxide (DMSO) were used as test preparations. Positive reactions were always seen with phenazone salicylate (16 patients) and carbamazepine patients (3 patients), and in an individual case from chlormezanone. Both positive and negative reactions were seen with trimethoprim (3 and 2, respectively), doxycycline (2 and 1) and sulfadiazine (1 and 1). Control tests on unaffected skin with drug preparations and pure vehicles remained negative. The present results confirm our previous observation that topical provocation is a reliable test method in FDE caused by phenazone salicylate. The present study also shows that topical provocation may be useful in FDE caused by carbamazepine. In FDE caused by trimethoprim, doxycycline and sulfonamides, a positive, but not a negative, skin reaction is informative.
Allergenicity and tolerogenicity of amlexanox in the guinea pig
Authors: Hariya Takeshi , Ikezawa Zenro , Aihara Michiko , Kitamura Kazuko , Osawa Junko , Nakajima Hiroshi
Published: April 2006

Amlexanox (AMLX), an anti‐allergic agent, is available in Japan as Elics® opthalmic solution, Solfa® nasal douche and Solfa® tablets. Cases of allergic contact dermatitis induced by Elics® ophthalmic solution, which contains 0.25% AMLX, were reported within a year of its introduction. We therefore examined the contact sensitizing potency of AMLX. Guinea pigs sensitized to 0.25% AMLX exhibited a strong positive patch test reaction. Further, AMLX‐sensitized animals developed rashes following oral and systemic challenge with AMLX. This animal model reflected the clinical experience of systemic contact dermatitis due to AMLX. The non‐responsiveness induced by oral administration of AMLX to AMLX‐induced animals was transient, and clinical prophylaxis by desensitization with oral AMLX may only increase the risk of systemic contact dermatitis. On the other hand, there have been few reports of drug eruption from oral Solfa® tablets in spite of their wide use. Therefore, we also examined the induction of tolerance by oral administration of AMLX. Oral administration of AMLX before sensitization resulted in complete non‐responsiveness. It seems likely that a substantial reduction in the risk of AMLX sensitization by Elics® may be achieved by prior oral administration of Solfa® tablets containing AMLX.
Aluminium allergy in patients hyposensitized with aluminium‐precipitated antigen extracts
Authors: Lopez S. , Peláez A. , Navarro L. A. , Montesinos E. , Morales C. , Carda C.
Published: April 2006

During hyposensitization therapy with aluminium‐precipitated antigen solutions, a small % of patients develop persistent subcutaneous nodules at the injection site; the existence of delayed sensitivity to aluminium has been implicated in the pathogenesis of these nodules. We studied the prevalence of aluminium sensitivity (using patch, prick and intradermal tests) and common contact allergens (TRUE Test™) in 20 healthy subjects, and in 40 patients treated with aluminium‐containing extracts, 20 of whom had persistent subcutaneous nodules that remained for more than 2 months, the other half having no nodular reactions or nodules that remained for less than 2 months. Aluminium sensitivity was found only in those patients of the treated group who had persistent nodular reactions, 4 cases of positivity to an aluminium chloride patch test being found. All 4 cases were women, nodules remained for more than 6 months, and intracutaneous tests were negative. 3 of them also had contact sensitivity to nickel. In 2 cases, nodules were removed for histological and histochemical examination, showing non‐specific inflammatory granulomas, and aluminium crystals being found in only 1 case. It is concluded that delayed sensitivity to aluminium appears to be implicated in the pathogenesis of persistent nodular reactions, but sensitivity to aluminium was not found in patients treated with aluminium‐precipitated extracts without persistent nodular reactions.
Allergic contact dermatitis from ethyl chloride and sensitization to dichlorodifluoromethane (CFC 12)
Authors: Bircher Andreas J. , Hampl Karl , Hirsbrunner Piroschka , Buechner Stanislaw A. , Schneider Markus
Published: April 2006

Despite the widespread use of ethyl chloride as a local anesthetic and chlorofluorocarbons as propellants in medical and cosmetic aerosols, contact allergy to these 2 gases is rare. In a 30‐year‐old woman, an unusual itchy dermatitis appeared at all skin sites where a medical aerosol containing ethyl chloride had been briefly applied. Subsequent re‐exposure to the spray and patch tests revealed contact sensitization to ethyl chloride and dichlorodifluoromethane (CFC 12). Histologic and immunohistochemical examinations of the test reaction were consistent with a T‐cell‐mediated allergic reaction. The low incidence of contact allergy to ethyl chloride and chlorofluorocarbons may be due to the rapid evaporation of these volatile gases, thus preventing intense and prolonged contact with the skin and consequently contact sensitization. A modified patch test procedure using perforated plastic chambers to allow gas evaporation is necessary to test volatile agents.
Identification of causative chemicals of allergic contact dermatitis using a combination of patch testing in patients and chemical analysis Application to cases from rubber gloves
Authors: Kaniwa Masa‐aki , Isama Kazuo , Nakamura Akitada , Kantoh Hiromi , Hosono Kumiko , Itoh Masatoshi , Shibata Keiko , Usuda Toshikazu , Asahi Kunihiko , Osada Tomoko , Matsunaga Kayoko , Ueda Hiroshi
Published: April 2006

5 cases of allergic contact dermatitis from rubber gloves were investigated by our recommended procedures using a combination of patch testing in patients and chemical analysis of causative rubber products by gas chromatography (GC) and high‐performance liquid chromatography (HPLC). We previously confirmed that zinc ethylphenyldithiocarbamate (ZEPC), a dithiocarbamae‐type accelerator (DTC), was causative in a case of allergic contact dermatitis from rubber work gloves. Subsequently, we have clarified that DTCs such as zinc dimethyldithiocarbamate (ZDMC), zinc diethyldithiocarbamate (ZDEC) and zinc dibutyldithiocarbamate (ZDBC) and amines such as dimethylamine (DMA), diethylamine (DEA) and piperidine (PIP) were also causative in cases from surgical rubber gloves. Thus, our investigative studies revealed that, although thiurams have been taken much more notice of as allergenic compounds than their corresponding DTCs and amines, not only DTCs such as ZDMC, ZDEC, ZDBC and ZEPC, but also amines such as DMA, DEA and PIP were noteworthy causative candidates of allergic contact dermatitis from rubber gloves.
Contact dermatitis from a textile flame retardant
Authors: Moreau A. , Dompmartin A. , Castel B. , Remond B. , Michel M. , Leroy D.
Published: April 2006

We report a case of contact sensitivity to Flammentin ASN®, a flame retardant used on cotton and wool. The patient was a painter who was protecting his face with a white cotton cap. He presented with eczema of the forehead and face at the sites of cap contact. Patch tests with the treated cap and flame retardant were positive; a formaldehyde patch test was negative. Flame retardants are used in construction, materials and textiles. Contact sensitivity is rarely described and we compare our case to those published in the literature.
Echographic evaluation with image analysis of irritant reactions induced by nonanoic acid and hydrochloric acid
Authors: Seidenari Stefania
Published: April 2006

Skin reactions to 40% nonanoic acid in propanol (NON) and to 4% hydrochloric acid were evaluated by image analysis of 20 MHz B scan recordings (Dermascan C, Cortex Technology). 18 women, aged 18 to 45, were patch tested with 24‐h application time, and clinical and instrumental evaluations were performed at the beginning of the experiment, and 24 and 48 h after patch testing. To check possible regional variations in reactivity to NON and HC1, both substances were applied 2 × on the same forearm. As control tests, saline solution, propanol and sodium lauryl sulfate (SLS) 3% were applied. Echographic images were processed by a program enabling numerical representation of picture data, based on attribution of fictional values to the echoes' amplitudes, selection of amplitude bands of interest, binary transformation of the image, and calculation of the extension of areas reflecting within the same amplitude range. Sonographic recordings were evaluated by an amplitude interval marking hyporeflecting parts of the dermis (corresponding to edema and inflammatory infiltration), and by a band highlighting the entrance echo (epidermis). Our evaluations showed that extension of the hypoechogenic area of the dermis increases according to intensity of inflammatory reaction for all irritant substances. A clear decrease in reflectivity of the epidermis echo at 24 h was visible at SLS patch test test sites, whereas at patch test sites performed with NON and HCl, there was a trend towards an increase in values of hyperreflecting pixels. No significant variations between data recorded at proximal compared to distal skin sites were observed for NON and HCl. In conclusion, the echographic technique provides a method for quantification of the dermal inflammatory reaction, and also for description of skin reactions induced by irritant substances, according to their specific epidermal effects.
Sensitization to epoxy resin systems in special flooring workers*
Authors: Condé‐Salazar L. , de Domingo M. A. Gonzalez , Guimaraens D.
Published: April 2006

The use of new products in building and public works is increasing, among them being special floor coverings containing epoxy resins and derivatives. These are used principally in heavily frequented areas, such as shopping precincts, hospitals, civic centres, etc., due to their high resistance to wear and tear, environmental factors, etc. In the last 2 years, we have studied 15 cases of men sensitized to epoxy resin, or derivatives, who worked with special floorings. Speed of sensitization, severity of lesions, and localization to the hands, face and legs were characteristic.
Hypertrophic allergic contact dermatitis from hair dye
Authors: Santucci B. , Cristaudo A. , Cannistraci C. , Amantea A. , Picardo M.
Published: April 2006

We report a case of hypertrophic allergic contact dermatitis probably due to p‐phenylenediamine (PPDA) in a 26‐year‐old female, which developed at the sites of application of a black hair dye to the skin. Histological examination revealed an eczematous process. The lesions subsided completely except for leukoderma that remained on the leg. Patch tests showed positive reactions to PPDA, p‐aminophenol and Disperse Orange 3. PPDA, which was one of the components of the dye, was considered to be the primary sensitizer because it was the only substance able to reproduce at the patch test site both the hypertrophic pattern and the permanent leukoderma found in the patient's lesions. To explain the difference in reaction between PPDA and the other 2 para‐group substances, we speculate that they are due to different quantities of reactive intermediates, oxidation products and free radicals, produced by these substances.
Sulfite contact allergy
Authors: Vena Gino A. , Foti Caterina , Angelini Gianni
Published: April 2006

In the last 2 years, 2,894 consecutive eczematous patients were patch tested with sodium metabisulfite 1% pet. Positive reactions were elicited in 50 subjects (1.7%). All 50 patients were also positive to potassium metabisulfite 1% pet. and sodium bisulfite 1% and 5% pet., while only 2 of them were positive to sodium sulfite 1% pet. Prick tests and intradermal tests with a sodium metabisulfite solution (10 mg/ml) were negative. No flare‐ups of dermatitis or patch test were provoked by oral challenge with 30 mg and 50 mg of sodium metabisulfite. The dermatitis was taken to be occupational in 7 cases. In only 5 out of 43 non‐occupational cases was the positive reaction considered relevant.
Mite‐antigen‐stimulated cytokine production by peripheral blood mononuclear cells of atopic dermatitis patients with positive mite patch tests
Authors: Kubota Y. , Koga T. , Imayama S. , Hori Y.
Published: April 2006

To investigate possible involvement of Th1‐type immunoreaction in the development of skin lesions of atopic dermatitis (AD), we measured mite‐antigen‐stimulated production of IL‐2, IL‐4 and IFN‐γ, using peripheral blood mononuclear cells (PBMC) obtained from 23 patients with AD who developed positive patch test reactions to house dust mite antigens extracted from Dermatophagoides pteronyssinus (Dp). Incubation of these PBMC with the Dp antigen for 72 h produced marked secretion of IL‐2 and IFN‐γ, but not IL‐4, indicating that Dp‐specific T cells were found in these patients' circulating peripheral blood and were capable of producing IL‐2 and IFN‐γ, known as major mediators of the delayed‐type allergic reaction. Our study suggests that Thl‐type cells may be involved in the development of skin lesions of AD patients with positive patch test reactions to house dust mite antigen.
A single accidental exposure may result in a chemical burn, primary sensitization and allergic contact dermatitis
Authors: Kanerva Lasse , Tarvainen Kyllikki , Pinola Anne , Leino Timo , Granlund Håkan , Estlander Tuula , Jolanki Ritta , Förström Lars
Published: April 2006

It is known from experimental studies that antigenic potency and the concentration of antigen determine whether exposure to an antigen will result in sensitization. A single accidental exposure to concentrated antigen may therefore induce primary sensitization. The purpose of this report was to collect clinical cases in which a single exposure had resulted in contact dermatitis suspected to be allergic. Only patients without previous relevant skin symptoms were included. Patch testing was used to demonstrate sensitization. 6 patients developed occupational allergic contact dermatitis from accidental exposure. Patch testing revealed allergy to diglycidylether of bisphenol A epoxy resin, poly functional aziridine hardener, methyl acrylate, phenol‐formaldehyde resin, and methylchloroisothiazolinone/methylisothiazolinone (Kathon LX), respectively. Furthermore, 2 patients developed allergic contact dermatitis from their first exposure to tear gas chemicals, namely omega‐chloroacetophenone and ortho‐chlorobenzylidene malonitrile. A single exposure can therefore induce both sensitization and subsequent allergic contact dermatitis without further exposure. The allergens described must be considered strong allergens. The skin should immediately be cleaned if an accidental splash with such an allergen has taken place.
Propylene glycol dermatitis: re‐evaluation of an old problem
Authors: Funk Jens O. , Maibach Howard I.
Published: April 2006

Evaluation of dermatitis associated with propylene glycol application or ingestion remains a challenge. The research dealing with skin reactions to propylene glycol is revisited and new aspects for future research are outlined. Based on literature review and our own observations, we propose classifying skin reactions to propylene glycol into 4 mechanisms: (a) irritant contact dermatitis, (b) allergic contact dermatitis, (c) non‐immunologic contact urticaria, and (d) subjective or sensory irritation. This concept allows a partial explanation of effects observed by different authors. Despite attempts to define objective criteria, biologically, histopathologically, or clinically, the distinction between irritant and allergic reactions remains unclear. Furthermore, the irritation threshold of propylene glycol, and likewise the optimal standard concentration in patch tests, is subjudice. Future studies on propylene glycol dermatitis should include repeated patch tests with serial dose dilutions, repeated open application tests/pro vocative use tests, oral challenge tests, and biopsies for a more complete evaluation of mechanisms and clinical significance.
Occupational allergic contact dermatitis caused by thiourea compounds
Authors: Kanerva Lasse , Estlander Tuula , Jolanki Riitta
Published: April 2006

Thiourea compounds are mainly used as accelerators in the rubber industry, but also in other industries, e.g., as antioxidants in the graphics industry. Thiourea compounds may provoke allergic contact dermatitis, although the number of reported cases is relatively low. During 1985–1991, we had 5 patients with allergic patch test reactions caused by thiourea compounds. 1 of our patients had to use a knee brace after an occupational accident. He developed allergic contact dermatitis caused by the knee brace, probably because he had become sensitized to diethylthiourea. 2 patients were probably sensitized by diphenylthiourea in neoprene gloves. A florist had an allergic patch test reaction to diphenylthiourea and might have been sensitized by fungicides or pesticides, which break down into thioureas. It is often difficult, however, to detect the source of thiourea compound sensitization. If the patient has contact dermatitis and has been exposed to products that may contain thiourea compounds (or compounds that break down into thiourea compounds), such as rubber, PVC plastic or adhesive, diazo paper, paints or glue remover, anticorrosive agents, fungicides or pesticides, patch testing with a series of thiourea compounds needs to be performed. If patch testing with thiourea compounds is not performed, allergic contact dermatitis caused by thiourea compounds is not likely to be diagnosed.
Allergic contact dermatitis from the synthetic fragrances Lyral and acetyl cedrene in separate underarm deodorant preparations
Authors: Handley J. , Burrows D.
Published: April 2006

The case is reported of a 28‐year‐old man who developed allergic contact dermatitis from 2 synthetic fragrance ingredients, Lyral (3‐ and 4‐(4‐hydroxy‐4‐methylpentyl)‐3‐cyclohexene‐1‐aldehyde) and acetyl cedrene, in separate underarm deodorant preparations. The implications of the patient's negative patch test reactions to the European standard series (Trolab) and cosmetics and fragrance series (both Chemotechnique Diagnostics) are discussed. The importance is stressed of patch testing with the patient's own preparations when cosmetic dermatitis is suspected, and of identifying and reporting offending fragrance ingredients, with a view possibly to updating the European standard series and commercially available cosmetics and fragrance series.
Nickel release from metals, and a case of allergic contact dermatitis from stainless steel
Authors: Kanerva Lasse , Sipiläinen‐Malm Thea , Estlander Tuula , Zitting Antti , Jolanki Riitta , Tarvainen Kyllikki
Published: April 2006

The prevalence of allergic contact dermatitis (ACD) caused by nickel is increasing. The probable cause is the increased use of nickel‐containing metals in intimate contact with the skin. The critical factor is the amount of nickel released from these metals (bioavailable nickel) onto the skin. In the present study, we determined, with flame atomic absorbtion spectrometry, the amount of nickel released into synthetic sweat from metal samples. The results of this method were compared with the results of the dimethylglyoxime (DMG) test, which is considered to be a reliable means of identifying whether nickel‐containing metals may cause allergy symptoms in sensitive individuals. Out of 10 samples studied, only small amounts (< 0.5 μg/cm2/week) were released from 2 samples, and the DMG test was negative. From 5 samples, more than 0.5 μjg/cm2/week was released, and the DMG test was positive. For 3 samples, however, the DMG test was negative, though the flame atomic absorption spectrometry test showed considerable release of nickel. Therefore, although the DMG test can be used as a first line test for determining nickel release, some DMG‐negative metal materials probably induce nickel sensitization, and should by no means be advertised as safe in this respect. We also report a nickel‐allergic patient who developed ACD from stainless steel, indicating that some types of stainless steel release enough nickel to elicit allergic symptoms.
Structure‐activity relationships in allergic contact dermatitis
Authors: Hausen B. M. , Hettsch H. , Borrman B. , Koch D. , Rathmann R. , Richter B. , König W. A.
Published: April 2006

Primin (2‐methoxy‐6‐pentyl‐1,4‐benzoquinone)is a naturally‐occurring strong sensitizer from Primula obconica (Primulaceae), To determine the effect of side‐chain length on senstizing potency 15 analogues with linear side chains from to from C1, to C15 and 4 C6‐ analogues with branched side chains were prepared synthetically and devoted to experimental sensitization in guinea pigs The results showed an increase of the sensitizing capacity with increasing length of the alkyl side chain from C1 to C10, reaching a maximum at C11 and C12. On further elongation the senstizing potency decreased beyond C13 reaching values which finally were as low as those of the C1 and C3 derivatives. The results mirror finding which finally were as low as those of the C1 and C3 derivatives. The results mirror findings which formerly have been obtained with other non‐quinonoid compounds like catechols, phenols hydroquinones and gallates. In the plant kingdom. Compound approximating an “ideal allergen” consisting of a quinonoid ring with a 10 or 11 carbon‐remarkably strong sensitizer found in Wigandia caracasana (Hydrophyllaceae)
Butenylbithiophene, α‐terthienyl and hydroxytremetone as contact allergens in cultivars of marigold (Tagetes sp.)
Authors: Hausen Björn M. , Helmke Burkhard
Published: April 2006

Ornamental cultivars of Tagetes sp., commonly named marigold, are one of the presently most popular pot, and garden plants. Sensitizing experiments in guinea pigs with short ether extract and isolated compound‐ repealed the presence of 3 constituents that must be considered as contact allergens. They were identified as 5‐(3‐buten‐1‐ynyl)‐2.2′‐bithiophene, α‐terthienyl and hydroxytremetone. In sensitized animals, butenylbithiophene showed moderate to strong Sensitizing potency while α terthienyl was less strong and hydroxytremetone weak. The results demonstrate, for the first time, that at least some of the thiophenes abundantly occurring in many species of the Composite family possess not only phototoxic activity but also sensitizing properties.
Comparison of in vitro predictive tests for irritation induced by anionic surfactants
Authors: Goffin Veronique , Paye Marc , Piérard Gérald E.
Published: April 2006

Skin compatibility of anionic surfactants may often but not always he predicted by vitro tests. For instance, the correlation between in vivo and in vitro data is classically hampered in the presence of magnesium. This ion is known to interfere with in vitro skin irritation predictive test based on protein denaturation. This study was conducted to compare a recently introduced assay, corneosurfametry, with other in vitro tests including the pH‐rise of bovine serum albumin, collagen swelling, and zein solubilization tests. Corneosurfametry entails collection of eynoacrylate skin surface strippings and short contact time with surfactants, followed by staining samples with toluidine blue and basic fuchsin dyes. Measurements are made by reflectance colorimetry. Data show that irritation potentials predicted by corneosurfametry agree with those obtained by established in vivo and in vitro irritation tests. Moreover, corneosurfametry data are not artificially lowered by addition of magnesium in surfactant solutions. In conclusion, corneosurfametry should be viewed as one of the realistic predictive tests for surfactant irritancy.
Occupational allergic contact dermatitis in construction workers
Authors: Condé‐Salazar L. , Guimaraens D. , Villegas C. , Rumero A. , Gonzalez M. A.
Published: April 2006

We report the patch test results of 449 con in met ion workers who came as patients to tine Occupational Dermatology Service of the Instituto National de Medicina y Seguridad del Trabajo in Madrid between 1989 and 1993. 90.8%. of them were patch tested, because they had cutaneous lesions or a clinical history suggestive of occupational dermatitis. 65.5% (268) of those patch tested showed one or more reactions connected with their work. Chromate at 411 was the main allergen. followed by cobalt, 20.5% nickel. 10%, and epoxy resin. 7.5%. 25.9% (106) of patients showed sensitization to rubber components, the majority at 20.7%, to thiuram mix, with TETD being the main allergen.
Contact allergy to Dermatophagoides in atopic dermatitis patients and healthy subjects
Authors: Manzini Bianca Maria , Motolese Alberico , Donini Massimo , Seiwinari Stefania
Published: April 2006

To compare different house‐dust‐mite‐derived allergenic materials and to correlate the presence of IgE LO Dermatophagoides with patch test results, 313 atopic dermatitis (AD) patients and 100 healthy volunteers (HV) underwent patch tests with: Dermatophagoides Pteronyssimus (DPT) lyophilized purified alpha fraction in buffered saline/glycerol 50% and or in petrolatum (Bayropharm); 540% DPT and 50%Dermatophagoides farinae (DF) whole bodies in petrolatum and petrolatum oil (Allergopharma‐Bracco); DPT and DF whole bodies in petrolatum and petrolatum oil (Lofarma). We found 39% positive reactions among AD subjects and 13% in HV The presence of serum‐specific IgE did not influence the patch test results. with of AD patch‐lest‐positive patients and 5 of 13 HV respectively, showed a positive prick less and or RAST lo Dermatophagoides. Similar sensitization rates were observed with the allergenic material from Bayropharm (54% positivities) and Allergopharma‐Bracco (51% positivities), whereas the preparations from Lofarma gave a 20% response rate.
In vivo cytokine profiles in allergic and irritant contact dermatitis
Authors: Hoefakker S. , Caubo M. , van 't Erve E. H. M. , Roggeveen M. J. , Boersma W. J. A. , van Joost Th. , Notten W. R. F. , Claassen E.
Published: April 2006

Local cytokine profiles in skin biopsies from allergic and irritant patch test reactions were determined by in vivo immunohistochemistry to differentiate between these 2 clinically identical afflictions especially at the time of final reading in diagnostic patch testing. Biopsies were taken from established allergic persons after specific allergic patch test.‐, to epoxy resin (1%) and formaldehyde (1%) and from non‐allergic individuals with irritant patch tests to sodium lauryl sulfate (10%) and formaldehyde (8%). At 72 h after application of the agents, significantly enhanced frequencies of dermal infiltrating cells, producing IL‐1α, TNF‐α. IL‐2. and IFN‐γ per 100 infiltrating cells in the dermis. were observed in allergic as well us irritant patch test reactions, as compared to normal skin. Significantly higher frequencies of IL‐ Iα‐producing cells were observed in biopsies from epoxy resin (1%) allergen‐affected and sodium lauryl sulfate (10%) irritant‐affected skin as compared to formaldehyde (1%) allergen‐affected skin. In addition, significantly higher frequencies of TNF ‐α reproducing cells were observed in epoxy resin allergen‐affected skin us compared to Formaldehyde (1%) allergen‐affected and formaldehyde (8%) irritant affected skin. The allergic and irritant patch test reactions showed similar levels of expression of the Thl cytokines IL‐2 and IFN‐γ in the dermis. confirmed by probe based detection of IL‐2 mRNA and IFN‐γ‐ mRNA, In conclusion, the described similarity shows that allergens and irritants can induce the same profile of IL‐la. TNF‐α. IL‐2. and IFN‐γ production, resulting in the near impossibility of discriminating between allergic and irritant contact dermal is at the lime of patch test reading.
Contact allergy to imidazoles used as antimycotic agents
Authors: Dooms‐Goossens A. , Matura M. , Drieghe J. , Degreeef H.
Published: April 2006

The present article reviews the literature (up to 1994) on contact sensitivity to imidazoles and presents the results obtained from 15 patients observed at the Contact Allergy Unit in Leuven. The frequency as well as the cross‐reaction patterns described are analyzed. Although allergic contact reactions may have been missed in the past (mainly because of problems with the correct choice of vehicle for patch testing), they seem to be relatively infrequent in view of their widespread use. The imidazole derivatives most frequently reported 10 be allergens are miconazole, econazole, tiocanozole, and isoconazole. As far as cross‐reactivity is concerned, statistically significant associations were found in the patient data between miconazole, econazole, and isoconazole: between isoconazole and miconazole and econazole: and also between isoconazole and tioconazole. Patients sensitive to phenylethyl imidazoles (except ketoconazole) needing antimycotic therapy should be advised to use ketoconazole, clotrimazole, bifonazole, or, perhaps, the new flutrimazole. Clearly, non‐imidazole antifungals can also be used.
Occupational allergic contact dermatitis caused by epoxy diacrylate in ultraviolet‐light‐cured paint, and bisphenol A in dental composite resin
Authors: Jolanki Riitta , Kanerva Lasse , Estlander Tuula
Published: April 2006

Allergic contact dermatitis (ACD) caused by epoxy di(meth)acrylates or bisphenol A is rare. Here 2 such cases are reported. A dental assistant had allergic contact dermatitis (ACD) caused by bisphenol A contained in denial composite resin (DCR) products based on epoxy dimethacrylate. The contact allergy was verified by allergic patch lest reactions to bisphenol A and 2 DCRs. The OCRs giving allergic reactions were analyzed, and 0.014–0.015% of bisphenol A was detected. Occupational ACD caused by bisphenol A in dental composite resins has not been described before. The other patient was a male process worker in a paint factory. He was sensitized by an epoxy diacrylate, 2.2‐bis[4‐(2‐hydroxy‐3‐acryloxypropoxy)pheny]‐propane (BIS‐GA), and other acrylate compounds contained in raw materials of ultraviolet‐light‐curable paint. The epoxy diacrylate gave an allergic patch test reaction down to 0.016% in pet. He also had an allergic patch lest reaction to several other acrylate compounds. 2‐hydroxypropyl acrylate, 2‐hydroxypropyl acrylate, 1,4‐butanediol diacrylate, 1,6‐hexanediol diacrylate, diethyleneglycol diacrylate, triethylene glycol diacrylate, and tripropylene glycol diacrylate, indicating cross and/or concomitant sensitization.
Streptozotocin: inherent but not expressed skin sensitizing activity
Authors: Ashby John , Hilton Jennifer , Dearman Rebecca J. , Kimber Ian
Published: April 2006

We have shown previously that the alkylating agent streptozotocin (STZ) fails to induce responses in the murine local lymph node assay, a predictive test for contact sensitizing potential. In the present study we demonstrate that this same compound when injected intradermally into the ears of mice provokes a dose‐dependent induction of draining lymph node cell proliferation. These data indicate that the intrinsic immunogenicity of STZ is not displayed in the local lymph node assay under conditions of conventional topical exposure, secondary to a failure to cross the lipophilic stratum corneum in sufficient, quantities. This finding has implications for the discernment of structure‐activity relationships in contact sensitization.
Occupational hand dermatitis in hospital environments
Authors: Stingni Luca , Lapomarda Vincenzo , Lisi Palo
Published: April 2006

Health care personnel form the 5th category at major occupational risk of skin disease in Italy The aim of this study was to assess the prevalence and clinical relevance of contact dermatitis in a group of 1301 employees of the Perugia Monteluce Hospital (658 females and 643 males: mean age 39.8 years) who answered a self‐administered questionnaire elaborated by the authors. The subjects with anamnestic hand dermatitis and/or atopic mucosal reactions were clinically examined and submitted to skin tests (patch and/or prick tests). Contact dermatitis of the hands and/or forearms occurred in 21.2% and was significantly more frequent (P < 0.001) in women, subjects under 31 years of age, workers in internistic and surgical fields, cleaners and nurses. In the majority of cases (94.9%) the lesions were irritant in origin and mainly related to disinfectants (especially, chlorhexidine gluconate and glutaraldehyde) and gloves (latex proteins and starch glove powder. rather than accelerators and additives of rubber), Finally, atopy seemed to favour the onset of hand dermatitis, The importance of these results for preventive measures of contact dermatitis in hospital employees is discussed.
Euxyl K 400: incidence of sensitization, patch test concentration and vehicle
Authors: Tosti Antonella , Vincenzi Colombina , Trevisi Pomipilio , Guerra Liliana
Published: April 2006

The aim of this study was to verily the most suitable vehicle and concentration for testing Euxyl K 400 and its individual ingredients, and to evaluate the prevalence of sensitization to this preservative over the years in Italy. From January 1991 to October 1994. Euxyl K 400 2.5% pet, was positive in 99 patients (35 male. 64 female) out of 3455 (2.8%.). Of these, 22 out of 855 patients had a positive reaction during 1991 (2.6%), 29 out of 1037 in 1992 (2.8%), 28 out of 858 in 1993 (3.3%), and 20 out of 705 in 1994 (2.8%). 51 of the 99 patients with a reaction to Euxyl K 400 2.5% pet, showed a positive reaction to dibromodicyanobutane 0.5% pet, and 2 to phenoxyethanol 5% pet. The results of patch testing with serial dilutions of Euxyl K 400 in different vehicles indicate that water is a good vehicle for testing the preservative. However, since Euxyl K 400 is only hydrosoluble to a limited extent, the maximum concentration that can be tested using water is 0.5% and so with this concentration about 40% of sensitized patients are missed. The results of patch testing with serial dilutions of Euxyl K 400 in petrolatum demonstrate that concentrations lower than 2.5% are not suitable for detection of all sensitized patients. Euxyl K 400 in ethanol frequently causes irritant reactions without offering significant advantages in detecting sensitized patients.
A study on expert reading of patch test reactions: inter‐individual accordance
Authors: Bruze M. , Isaksson M. , Edman B. , Björkner B. , Fregert S. , Möller H.
Published: April 2006

To diagnose allergic or irritant contact dermatitis, a clinically relevant contact allergy has to be demonstrated or ruled out, respectively. Although patch testing has been used for 100 years, it remains the method of choice for diagnosing contact allergy. A disadvantage of patch testing is that reading is subjective, based on inspection and palpation of the test area, implying that the assessment is subject to the reader's knowledge and experience. This study was carried out to investigate the accordance in reading patch test reactions between 5 dermatologists. 4 groups, each with 10 patients, participated. Within each group, all 10 were allergic to one and the same sensitizer; nickel, epoxy resin, ethylenediamine, or Kathon CG. The sensitizers were tested in serial dilutions and applied randomly to the back. The tests were read independently by the dermatologists in a blinded fashion. A protocol was used where the dermatologists had to note the presence of the morphological features erythema, infiltration, papules, vesicles, and bullae. In this way, it was possible to allocate the various readings into 4 classification systems, 3 European and one American, although the definition of the various classifications might differ slightly. Based on the readings and classifications, it was possible to calculate the degree of accordance within the 4 systems used. It was also possible to analyze the degree of accordance for the various morphological features. Total accordance for the 5 reading dermatologists for positive and negative test reactions was noted in 36% and 46%, respectively. The 3 European systems require homogenous erythema and infiltration for a reaction to be classified as allergic, while the American system also requires the presence of papules. Therefore, a higher number of allergic reactions (9%) was obtained with the European systems. Between the 4 classification systems, there were statistically significant differences, with the highest number of deviations for the system in which papules had discriminatory significance. When looking at the various morphological features, papules were most difficult to assess, followed by vesicles. Preferably, a classification system should not depend on papules. In conclusion, there was good accordance among the dermatologists in reading patch test reactions, since the 5 dermatologists read 82% of all tests similarly.
A simple HPLC method for the isolation and quantification of the allergens tuliposide A and tulipalin A in Alstroemena
Authors: Christensen Lars P. , Kristiansen Kell
Published: April 2006

A practical, rapid, reliable and sensitive method for the isolation and determination of the allergens tuliposide A and α‐methylene‐γ‐butyrolactone (tulipalin A), by reversed‐phase high‐performance liquid chromatography (RP‐HPLC), has been developed in order to select Alstroemeria species for breeding purposes. From the aqueous extracts of flowers, stems and leaves, of several Alstroemeria species, the contents of 6‐tuliposide A and tulipalin A were determined by isocratic RP‐HPLC, using distilled water as mobile phase. The compounds were detected by an UV detector at 208 nm. Differences in 6–tuliposide A and tulipalin A content were found among the species investigated, with the highest concentrations in stems and flowers. The absence of other tuliposides (e.g., 1‐tuliposide A, 1‐ and 6‐tuliposide B) in extracts was proven by TLC, RP‐HPLC, 1H‐ and 13C‐NMR. 6‐Tuliposide A and tulipalin A were identified by 1H‐ and 13C‐NMR and comparison with authentic material, respectively. With this HPLC method, it is possible to investigate a large number of plants for their contents of tuliposide A and tulipalin A, within a minimum of time, and to isolate them directly from aqueous extracts.
Immunologic contact urticaria due to airborne methylhexahydrophthalic and methyltetrahydrophthalic anhydrides
Authors: Tarvainen K. , Jolanki R. , Estlander T. , Tupasela O. , Pfäffli P. , Kanerva L.
Published: April 2006

Acid anhydrides are low‐molecular‐weight chemicals known to cause respiratory irritancy and allergy. Skin allergy has on rare occasions been reported. 2 workers contracted hives and itching on uncovered skin after 2 months exposure to methyltetrahydrophthalic anhydride (MTHPA) and methylhexahydrophthalic anhydride (MHHPA), to which they had airborne exposure. Later, the patients also developed conjunctivitis, rhinitis, sore throat, cough or asthma. In addition to MTHPA, 1 worker was also exposed to unsaturated polyester resin (UP). Both patients' immediate allergy to MTHPA and MHHPA was verified by positive prick tests to MTHPA and MHHPA, conjugated with human serum albumin (HSA), and positive radioallergosorbent tests (RASTs) to these anhydrides. On prick testing, both patients also reacted to a phthalic anhydride (PA)‐HSA‐conjugate and 1 of the patients to UP‐HSA‐conjugate. Specific immediate allergy to UP was shown by RAST. RAST inhibition with MTHPA, MHHPA and UP‐resin conjugates confirmed IgE‐mediated allergy and cross‐reactivity between anhydrides. Our patients had developed airborne contact urticaria caused by phthalic anhydrides, in addition to respiratory allergy. Phthalic anhydride contained in the UP resin was possibly responsible for the immediate reaction of the skin.
Chloromethylisothiazolone/methylisothiazolone (CMI/MI) use test with a shampoo on patch‐test‐positive subjects Results of a multicentre double‐blind crossover trial
Authors: Frosch P. J. , Lahti A. , Hannuksela M. , Andersen K. E. , Wilkinson J. D. , Shaw S. , Lachapelle J. M.
Published: April 2006

A randomized, multicentre, double‐blind, 2–period crossover study with 2 shampoos was performed on subjects patch‐test‐positive to 100 ppm CMI/MI. One shampoo was preserved with 15 ppm a.i. CMI/MI, the other with 0.3% imidazolidinyl urea (IU). 27 subjects from 5 European dermatology clinics participated. 1 subject discontinued use after severe adverse reactions to the CMI/MI‐preserved shampoo and did not evaluate the other shampoo. Another 2 subjects developed moderate symptoms with the CMI/MI‐preserved shampoo and discontinued its use, but tolerated the lU‐preserved shampoo for the full 2–week period. 2 subjects discontinued use after 1 or 2 washes after severe adverse reactions to the lU‐preserved shampoo. 1 of these subjects tolerated the CMI/MI‐preserved shampoo for 2 weeks without any untoward effects. However, the majority of subjects had negative findings on the scalp, face, neck, and hands for both shampoos. The physicians' global evaluation data indicated that shampoo with CMI/MI caused fewer skin problems than shampoo with IU (38% versus 27%, n.s.), with over 1/3 of the subjects (35%) having no skin problems with either preservative. The current study showed that most subjects previously sensitized to CMI/MI can successfully use shampoo preserved with CMI/MI. Since some subjects previously sensitized to CMI/MI, or possibly to IU, may develop clinical reactions, it would still be prudent for the clinician to advise alternative products to patients with sensitivity to a shampoo or cosmetic ingredient. Full ingredient labelling will ensure that this is possible. As the overall rate of adverse effects in sensitized individuals was low, studies of this nature should also be conducted for other allergens. This will be helpful in determining the relevance of patch test data.
3‐Dimethylaminopropylamine: a key substance in contact allergy to cocamidopropylbetaine?
Authors: Angelini Gianni , Foti Caterina , Rigano Luigi , Vena Gino A.
Published: April 2006

In the past year, 1200 consecutive eczematous patients were tested with cocamidopropylbetaine 1% aq. Contact allergy was evinced in 46 subjects (3.8%), while irritant reactions (slight erythema only) were observed in 15 cases (1.25%). 30 out of 46 patients with allergic reactions were subsequently tested with the substances used in the synthesis of cocamidopropylbetaine, together with a sample of cocamidopropylbetaine declared by the supplier to possess a greater purity. In all 30 subjects, positive reactions were obtained to 3‐dimethylaminopropylamine (DMPA) 1% aq., while the cocamidopropylbetaine denned of purer grade, at 0.5% and 1% aq., gave positive reactions in 10% and 53% of cases, respectively. These results suggest that the DMPA present at various levels as an impurity in the commercial product is responsible for cocamidopropylbetaine allergy. Owing to the inconsistency of positive reactions to cocamidopropylbetaine of variable purity, and to the consistency of positive reactions to DMPA, it seems likely that these reactions may also be connected with the presence in the product, defined of purer grade, of unknown amounts of DMPA as impurity. Structural similarities between the 2 molecules cannot be considered in this case, because the DMPA structure is radically changed in its transformation to the betaine structure, Further experiments with other molecules related to the above structures are in hand.