bluuebunny/crossref_metadata_2025 huggingface dataset:
FC04.5 Influence of ambient meteorological conditions (temperature and absolute humidity) on a routine NaOH‐irritation test in occupational dermatology
Authors: John Swen Malte , Schwanitz Hans‐Joachim , Uter Wolfgang
Published: August 2010

Dry air and cold weather have been shown to influence skin irritability. We have recently proposed a routine irritant patch test to assess skin irritability in a standardised fashion in occupational dermatology. The effects of local meteorological parameters on this test were studied.

In 556 consecutive persons (276 female [median age: 36], 280 male [median age: 42]) with former occupational skin disease, who were seen for medico‐legal evaluation from Feb. 2000 to Aug. 2003, a swift modified alkaline resistance test (SMART) was conducted simultaneously in the volar forearm and the dorsum of the hand. The test comprises a 0.5 M NaOH‐challenge for 2 × 10 minutes with intermediate TEWL‐measurements and a clinical assessment with an NaCl 0.9% control site. TEWL was measured according to current guidelines. The outcome of each patient was related to standardised data on the local temperature [T] and absolute humidity [aH] on the day of examination, obtained by the German Meteorological Service.

There was no relevant correlation between ‘basal TEWL’ or ‘TEWL after NaOH’ and ‘aH’ or ‘T’, respectively. There was no association between meteorological conditions and demographic characteristics potentially relevant for susceptibility to irritants and, hence, no indication of confounding. In a logistic regression model increasing ‘aH’(OR 0.91, 95% CI: 0.87–0.96 per 1 mg/l humidity) and ‘T’(OR 0.94, 95% CI: 0.81–0.97 per ° C) were associated with a decreasing likelihood of a clinically positive reaction to irritation.

Although there are only slight seasonal effects detectable, they should be taken into consideration when interpreting the test.
Gene expression profiling in allergic contact dermatitis
Authors: Kimber Ian , Dearman RJ , Ryan CA , Gerberick GF
Published: August 2010

The successful acquisition of skin sensitisation requires orchestrated cellular and molecular interactions that collectively result in the induction of a cutaneous immune response of the required quality and vigour. Pivotal roles are played by epidermal Langerhans cells (LC), and by the mature immunostimulatory dendritic cells (DC) into which they mature. LC serve as sentinels of the adaptive immune system with responsibility for surveying changes in the local microenvironment and for processing antigen (and chemical allergens) encountered at skin surfaces. Following such encounters LC are mobilised and stimulated to migrate, via afferent lymphatics, to regional lymph nodes. While in transit they lose the properties of antigen processing cells and acquire instead the characteristics of mature DC that are able to interact effectively with, and present antigen to, T lymphocytes. To gain a greater understanding of the molecular events that induce and regulate cutaneous immune responses to chemical allergens, we have used microarray transcript profiling and related experimental approaches to characterise changes in gene expression and protein production associated with the development of skin sensitisation. Our attention has focused particularly on changes in the expression of mRNA and protein resulting from the interaction of chemical allergens with DC, and associated with the presentation of antigen to T lymphocytes.
FS13.1 How to change habits at wet work – an implementation research study
Authors: Mygind Karen , Borg V , Jepsen K Frydendall , Flyvholm M‐A
Published: August 2010

Skin problems are often regarded as part of the job in wet occupations. Bad habits as not using protective gloves and moisturizers are often justified by the workers and ignored by the management. To change habits at the shop floor, involvement of the whole organisation is necessary. The objective of an intervention in 6 gut‐cleaning departments was to implement good habits by establishing a safety management system to manage skin risk. Local teams with representatives from all levels of the organisation were trained to run the process. Each team included 2–5 gut‐cleaners, who should embody good habits and supervise their colleagues. Implementation research studies evaluate the understanding and acceptance of the intervention at the workplace and the association of the implementation and the reduction of work related diseases. Data are collected from questionnaires, interviews, written documents, etc. The change after one year in the frequency of eczema on hands and forearms within the past 3 months, varied in the 6 departments from a minor increase to a 2/3 reduction. 3 months after the start of the intervention the gut‐cleaners in the team were asked to grade their expectations for success on a scale from 1 to 10; 10 being the optimum. The average grade varied from 4,8 to 10, indicating very different local expectations to the colleagues’ acquisition of new habits. Further data and analysis will show if there is a covariance between the local changes in eczema frequency and the degree of implementation.
FS13.3 Development of risk reduction strategies for preventing dermatitis
Authors: Brown Terry , Rushton L , Williams W , English J
Published: August 2010

Introduction:  A recent survey of the UK printing industry found a prevalence of 11% of occupational contact dermatitis (OCD), much higher than previously identified.

Objective:  This pilot study aimed to evaluate risk reduction strategies derived from recommendations of a literature review of preventive intervention studies and a series of focus groups of printers and observations of printers undertaking their normal duties.

Methods:  Four interventions were evaluated: (1) Provision of gloves of the correct size/type, plus use of an after‐work skin cream; (2) Provision of information; (3) Provision of skin checks; (4) Development of best practice skin care policy. Each intervention was evaluated in two companies over a three‐month period, at the end of which printers and managers were interviewed as to the effectiveness and acceptability of each intervention.

Results:  Although this pilot study was short, all interventions were acceptable to some extent. The prevalence of frank dermatitis fell over the study period, particularly in intervention (3). Intervention (1) achieved an improvement of awareness in both management and workforce and an increase in the use of both gloves and cream. Intervention (2) highlighted problems of dissemination and the need for relevant information in an appropriate format. However. no single intervention was completely effective.

Conclusions:  This qualitative research approach forms an essential first stage to improving understanding of ways in which OCD may be reduced among workers in the printing industry, and points towards the need for further testing of preventive strategies in larger‐scale intervention trials, in printing and other industries.
FS13.5 Occupational contact dermatitis: printer worker’s viewpoints
Authors: Brown Terry , Rushton L , Williams H , English J
Published: August 2010

Introduction:  Occupational contact dermatitis (OCD) is very common in the printing industry due to contact with chemicals, paper, and wet work. It can be avoided by adequate protective measures, but the effectiveness of intervention depends heavily on the employer’s and employee’s awareness of this health risk.

Objectives:  The study aimed to collect information on the knowledge, attitudes and beliefs of print workers about the risk of OCD and methods of prevention.

Methods:  A series of focus groups were held with print workers, health and safety officers and managers to discuss their awareness of dermal risk factors, risk behaviour at work, attitudes to health and safety and options on possible preventive measures. A number of companies were also visited to observe, overtly and covertly, the normal work practices.

Results:  OCD was not perceived to be either a major problem or a health and safety priority. There was general agreement about the processes and work practices that could cause skin problems. However, work practices varied considerably and did not always reflect this awareness. There was general concern about the type and availability of personal protective equipment, especially gloves and after‐work skin cream. The provision of an occupational health service was generally felt to be inadequate, and no company had a policy in place that specifically addressed skin care.

Conclusions:  These findings highlight the urgency to intensify health and safety education on skin care within the printing industry. Recommendations were developed for the evaluation of a series of risk reduction strategies.
FS13.6 Risk management for workplace dermal exposure – a practical approach
Authors: Packham Christopher Leonard
Published: August 2010

Contact dermatitis remains one of the most common forms of occupational ill health in most industrial countries. Eliminating or minimising contact can significantly reduce the incidence and prevalence of occupational contact dermatitis. However, this is often believed by managers to be associated with either expensive measures, such as constly changes in the process or in the need for expensive new equipment, or with the provision of personal protective equipment such as gloves. Frequently, however, an analysis of the actual source of exposure can lead to a simple change that can have a significant effect in elimninating or controlling exposure. In many cases not only has this led to the elimnination of the skin problems, but also to a reduction in operating costs and/or an improvement in productivity. A structured approach to the elimination or adequate control of exposure will be explained and its benefits illustrated by a number of case studies where simple intervention methods have achieved the desired results.
P26 An epidemiological study of the relevance of the allergens of the standard series of the Spanish Group for the study of contact dermatitis (Grupo Español para la Investigación de la Dermatitis de Contacto, GEIDC)(2001)
Authors: Rodríguez‐Serna Mercedes , Silvestre JF , De la Cuadra J , Garcia‐Bravo B
Published: August 2010

An epidemiological study is made to evaluate the present or past relevance of positivity to the allergens pertaining to the GEIDC standard series. A retrospective study was made of patients evaluated with patch tests corresponding to the GEIDC standard series by 14 GEIDC dermatologists in the course of 2001. The following parameters were evaluated: age, sex, positive allergens, and present, past and total relevance. A total of 3343 patients were studied, of which 1892 had at least one positive test (56.59%). The most relevant allergens were mercaptobenzothiazole (93,93%), thiuram mix (93%) and nickel sulfate (92.33%). In women, paraphenylenediamine was moreover also very relevant, while in males epoxy resin, butylphenol formaldehyde resin and colophony were particularly relevant. Among the less relevant allergens in both sexes, we found the following in relation to the total: quinolein (44.44%), lactones (45.45%) and caine mix (48.07%). In 1783 patients with at least one positive test, an evaluation was made of whether allergen relevance was past or present. In 60.78% of the positive tests present relevance was established. The allergens of greatest present relevance were ethylenediamine (100%), budesonide (100%), euxyl K 400 (96.96%), epoxy resin (93.33%), and Quaternium 15 (92.85%). The allergens of least present relevance were nickel sulfate (36.38%), caine mix (40%), and neomycin (41.37%).

Determination of the relevance of positive patch test is fundamental in all cases. In our study nickel and rubbers were the most relevant allergens, though nickel was essentially of past relevance. Few studies have addressed the present or past relevance of the standard allergen series.
P32 Dexamethasone inhibits dendritic cell activation by skin sensitizers
Authors: Gonçalo Margarida , Vital AL , Cruz MT , Figueiredo A , Lopes MC
Published: August 2010

Objective:  Evaluate activity of a corticosteroid on dendritic cell (DC) activation induced by skin sensitizers.

Methods:  Using a fetal mouse skin derived dendritic cell line (FSDC) stimulated by Nickel sulphate (50–100 ìg/ml) and DNFB (1–2.5 ìg/ml), we studied the effect of dexamethasone (DEX)(0.01–1 ìM) on nitric oxide (NO) production (by the Griess reaction), on nitric oxide synthase type II expression (iNOS)(by immunocytochemistry and western blot) and on the activation of the nuclear factor‐kappaB pathway (NF‐êB)(by electrophoretic mobility shift assay – EMSA), pathways that we have previously shown to be activated by these sensitizers.

Results:  NO production induced by Ni was significantly inhibited by DEX in a dose dependent way. Future studies using 0.5 ìM of DEX, showed a significant reduction of iNOS expression at 24 h induced by both sensitizers. This effect occurred in parallel with the inhibition of NF‐êB activation, which was most evident at 45 min.

Conclusions:  These results suggest that dexamethasone inhibits intracellular events that are relevant for DC activation induced by skin sensitizers during antigen presentation. Therefore, besides the anti‐inflammatory activity of DEX usually used for the treatment of ACD, this drug can also interfere with the initial steps of skin sensitization. This work was supported by FCT (Portugal).
P33 Patch testing an extended standard series
Authors: Hervella Marcos , Yanguas JI , Iglesias ME , Larrea M , Cascante L , Gállego M
Published: August 2010

Objective:  To examine the usefulness of the standard allergen series as a sole tool in the diagnosis of allergic contact dermatitis and consider the diagnostic benefits yielded by the routine use of an extended standard series in general dermatology practice.

Methods:  From January 1, 2003, to December 31, 2003, one hundred patients attended in a general dermatology unit were recruited for patch testing. Every patient underwent testing with the standard tray recommended by the Spanish Contact Dermatitis Research Group, and simultaneously, with a supplementary series of 35 allergens. Other specific series were performed in some cases, but their results have been omitted in this study. Patients with positive allergic reactions were divided into two groups based on the clinical relevance of their reactions. These groups were subsequently stratified in four subgroups: (1) reactions only to allergens in the standard series; (2) reactions only to additional allergens; (3) reactions to both standard and additional allergens; and (4) reactions to own substances or allergens in other series.

Results:  Of patients tested, 62 had at least 1 positive allergic reaction, and among these, 44 had reactions deemed clinically relevant. Of all the patients with relevant positive tests, 70.5%(31/44) reacted only to allergens in the standard tray; 11.4%(5/44) reacted to supplementary allergens exclusively; 4.5%(2/44) reacted to both standard and supplementary allergens. Finally, 6 more patients (13.6%) reacted to other sensitizers.

Conclusion:  In our study, 15.9% relevant allergies would have been missed by the standard series alone. Patch testing an extended standard series increased our diagnostic capability, and might be a useful screening tool in those dermatology offices where other series are lacking.
P37 Autoxidation of the fragrance caryophyllene forms contact allergens
Authors: Börje Anna , Sköld M , Matura M , Karlberg A‐T
Published: August 2010

This is part of an ongoing effort to investigate how autoxidation affects the sensitzing potential of terpene‐based fragrances. We have previously shown that terpenes such as abeitic acid (diterpene), limonene and linalool (monoterpenes) form stable hydroperoxides when oxidized. These hydroperoxides have proved to be strong allergens. Its therefore of special interest to study the connection between formation of hydroperoxides caused by autoxidation of fragrance chemicals during handling and storage and an increased allergenic effect.

Objective:  To investigate the autoxidation of caryophyllene (sesquiterpene) and study its effect on the sensitizing capacity.

Methods:  Caryophyllene was exposed to air and the autoxidation was monitored by GC and HPLC. The major oxidation products were isolated and their structure determined. The allergenic activity of pure caryophyllene and its oxidation products was investigated in animal assays and clinical testing.

Result:  Only 10% of the staring material remained after 20 weeks of air exposure. The major oxidation product was caryophyllene oxide. Substantial amounts of formaldehyde were found in the oxidation mixture. Little or no hydroperoxides were detected in the total oxidation mixture. Caryophyllene oxide and oxidized caryophyllene showed a low sensitizing capacity in animals and very few positive reactions at patch testing.

Conclusion:  Caryophyllene is easily oxidized at air exposure. A low allergenic effect is observed in both sensitization studies and clinical testing. This is consistent with our earlier findings that the amount of hydroperoxides is important for the allergenic activity of autoxidized terpenes.
P38 Quantitative structure activity relationships for fragrance aldehydes
Authors: Basketter DA , Patlewicz Grace , Gimenez‐Arnau E , Lepoittevin J‐P
Published: August 2010

Fragrance substances represent a diverse group of chemicals, some being associated with the ability to cause allergic skin reactions. In recent work, we evaluated two groups of fragrance chemicals, saturated aldehydes (aryl substituted and aliphatic aldehydes) and ?,?‐unsaturated aldehydes. QSAR models relating the LLNA EC3 values to a measure of the lipophilicity of a chemical (log P) and s*(a measure of reactivity) were developed for both sets of aldehydes. The outcome was consistent with ?,?‐unsaturated aldehydes reacting via Michael addition, whilst saturated aldehydes formed Schiff bases with proteins. In the present study we evaluated further aldehydes to test the robustness and extend the scope of the QSARs. The QSAR models were used to predict EC3 values for 4 new Michael addition aldehydes and 6 new Schiff base formers. LLNA data generated for these compounds demonstrated the original QSARs were fairly accurate but still required improvement. Development of the QSAR models has provided us with a better understanding of the potential mechanisms of action for aldehydes and hence how to avoid or limit allergy. Knowledge generated from this project is being incorporated into new/improved rules for sensitisation in the expert toxicity prediction system Deductive Estimation of Risk from Existing Knowledge (DEREK).
P43 Acute urticaria to infliximab
Authors: Giménez‐Arnau Ana , Gilaberte M , Perez M , Pujol‐Vallverdú RM
Published: August 2010

Infliximab is a chimeric antitumor necrosis factor‐alpha monoclonal antibody used to treat Crohn’s disease and rheumatoid arthritis. Acute infusion reactions, headache, fever, chills, urticaria and chest pain were seen in 17% of patients with infliximab compared with 7% of those receiving placebo. Other adverse cutaneous reactions are fungal dermatitis, eczema, seborrhoea, hordeolum, bullous eruption, furunculosis, periorbital oedema, hyperkeratosis, rosacea, verruca, skin pigmentation, alopecia, leukocytoclastic vasculitis, lichenoid drug eruption, erythema multiforme, perniosis‐like eruption, granuloma annulare and acute folliculitis. Any pathogenic mechanism has been suggested. Patch test with infliximab can induce flare‐up of lesions, nausea and malaise and suggest a percutaneous absortion. A sixty years‐old man with atopy background and rheumatoid arthritis treated with Remicare®, infliximab who developed a severe acute urticaria with angioedema is presented. The lesions appearance after previous endovenous administrations and the worsening spreading wheals days after the injection clinically suggested an hypersensitivity mechanism. The protocolized study drug hypersensitivity performed showed only the Prick Test positivity with infliximab at 30/60 minutes. Patch test with infliximab was negative and any adverse event was reported. Actually the patient is treated with etanercept and this drug is well tolerated. This result suggested a type I hypersensitivity mediated reaction. Urticaria could be induced as immunologic reaction of the host against the murine part of infliximab, just as it hapens with other antichimeric antibodies.
PCS.07 Establishment of safe exposure limits for the elicitation of allergy – hair dyes
Authors: Basketter David A
Published: August 2010

It is well known that a subtle balance exists between consumer desire to use hair dyes of various kinds and the sensitizing effects of particular dye ingredients. Of these, p‐phenylenediamine (PPD) is the mostly commonly reported contact allergen and which serves as a general model for hair dye allergy. PPD is reported as a strong sensitizer in all predictive tests; it is fairly commonly identified as a contact allergen in diagnostic patch testing, with relevance to hair dye ACD being about 50%. Whilst it may not be possible always to eliminate, or even greatly reduce, the extent to which sensitisation is induced, a final opportunity for limiting the degree of ACD occurs at the elicitation phase. Here, ensuring the extent of skin exposure is below the level at which all except the most strongly sensitized will react can provide clear consumer benefits. To achieve this aim, it is necessary to ensure a full appreciation of the variables impacting the elicitation of ACD exist. To this end, series of investigations of the elicitation of p‐phenylenediamine (PPD) sensitization has been conducted. In particular, the impact of duration and frequency of exposure on elicitation has been studied. Using groups of PPD sensitized volunteers, in patch tests and repeated open application tests, we have shown that exposures of only a few minutes are often without consequence in such individuals, except where the exposure is often repeated and/or the individual is highly allergic. With volunteers who were 1+ or 2+ positive to the diagnostic patch test, and where exposure to PPD was at 0.5%–1.0% in a short contact rinse‐off hair colouring product, no scalp reactions were experienced. It is our view that the establishment of safe exposure limits to contact allergens should be based wherever possible on a detailed assessment of the risk to sensitized humans.
P49 Occupational dermatoses of machinists – Finnish statistics
Authors: Suuronen Katri Maria , Alanko K , Tuomi T , Jolanki R
Published: August 2010

Objective:  In this study the statistical data on occupational dermatoses of Finnish machinists in 1992–2001 were analysed.

Methods:  The data were collected from the Finnish Register of Occupational Diseases (FROD) to which physicians are obligated to report all cases of occupational disease. Each case record consists of information on the patient and the employer, date and diagnosis, causative agents, etc.

Results:  During the 10‐year period, a total of 281 occupational dermatoses of machinists were diagnosed. Dermatoses consisted mostly of irritant contact dermatitis (N = 144), allergic contact dermatitis (N = 108) and unspecified contact dermatitis (N = 21). Only few cases of protein contact dermatitis and contact urticaria as well as occupational acne were reported. The main causes of irritant contact dermatitis were cutting oils and fluids, oils and lubricants, and organic solvents; the commonest inducers of allergic contact dermatitis were formaldehyde, cutting oils and fluids, metals (nickel, chromium and cobalt) and various antimicrobial agents.

Conclusion:  Dermatoses were the second commonest occupational diseases of machinists, after hearing loss, and they accounted for 27% of all occupational diseases within the profession. Machinists are a large occupational group (about 19 000 employees; 0.8% of the work force) in Finland, and their dermatoses formed a noteworthy proportion (about 2.6%) of the occupational skin diseases reported during the study period.
P51 Occupational contact dermatitis among operating room nurses
Authors: Stoskute Laura , Dubakiene R , Glumbakaite E
Published: August 2010

Background:  Occupation related dermatitis is a common problem in health care workers, especially in nurses, who are exposed to a wide variety of allergenic and irritant substances. The aim of this study was to assess the prevalence rate of skin symptoms among personnel handling chemical disinfectants and to examine which allergens were important.

Methods:  We investigated 460 randomly selected health care workers (HCW), who had constant contact with chemical disinfectants during their work. The study was performed by means of a questionnaire, a medical examination, skin patch test using Finn chambers and glutaraldehyde, benzalkonium chloride, hydrogen peroxide and chlorine compounds at 0,1, 0,5 and 1,0% wat.

Results:  241 HCW (52,5%) described various skin symptoms they attributed to disinfectant exposure. Generally, these symptoms were mild and ranged from pruritis to hand eczema. Of these 66 (14,4%) tested were skin patch test positive. Of the 460 HCW tested, 37 (8%) had positive patch test reactions to benzalkonium chloride, 22 (4,8%) to chlorine compounds, 18 (4%) to glutaraldehyde, 6 (1,2%) to hydrogen peroxide. 5 HCW (7,6%) testing positive to disinfectants gave no history of reactivity to them. History of atopic dermatitis was found in 50 (10,9%) and it was associated with diagnosis of allergic contact dermatitis and positive patch test reactions to benzalkonium chloride. Also positive patch tests reactions were associated with frequent use of latex gloves in contrast to those, which used latex gloves while working constantly or didn’t use them at all.

Conclusions:  1. Skin symptoms related to work with chemical disinfectants are common, but mostly mild. 2. Benzalkonium chloride is one of the strongest sensitizing disinfectants used in health care professions, especially for atopic persons who do not take measures of protection during exposure to it.
P54 Prevalence of skin changes in the cleaning industry
Authors: Anna Schuttelaar Marie‐Louise , Coenraads PJ
Published: August 2010

Background:  In the cleaning industry, the hands are exposed to water and irritants, resulting in dry skin and hand eczema. The prevalence and severity of skin changes is unknown.

Objectives:  To quantify the prevalence and the severity of skin changes of the hands. To compare questionnaire‐based self‐reported signs of hand eczema (both current and at any occasion during the last 12 months), with skin changes revealed by clinical examination.

Methods:  A random sample of 231 employees in the cleaning industry participated in the study. Most of them were immigrants. They had to answer a (translated) questionnaire about signs of hand eczema. Then all of them were examined and the severity of hand eczema was graded by a scoring system1. In the comparison only objective subvariables (desquamation, erythema, fissures, infiltration, vesicles) were used.

Results:  Clinical examination of the hands detected desquamation in 38%; erythema in 29%; fissures in 24%; infiltration in 12%; vesicles in 4%.

Severity scoring of hand eczema: one point in 21%; two points in 18%; three points in 9%; four points in 4%.

Signs of hand eczema reported in the questionnaire based on the current situation: desquamation in 17%; erythema in 20%; fissures in 20%; infiltration in 10%; vesicles in 12%.

Signs of hand eczema reported in the questionnaire based on any occasion during the last 12 months: desquamation in 18%; erythema in 17%; fissures in 22%; infiltration in 11%; vesicles in 15%.

False negative self‐reporting by the questionnaire: desquamation in 26%; erythema in 18%; fissures in 14%; infiltration in 11%; vesicles in 3%.

False positive self‐reporting by the questionnaire: desquamation in 5%; erythema in 10%; fissures in 10%; infiltration in 8%; vesicles in 11%.

Conclusions:  Desquamation and erythema were the most common signs both in clinical examination and in questionnaire. The self‐reported prevalence (both current and over the last 12 months) of erythema and desquamation is an underestimation of the true prevalence. Scoring hand eczema revealed that most of the employees scored one or two points; indicating that most of the clinical signs of hand eczema are minor. False negative self‐reporting by questionnaire was high; indicating that these minor symptoms of hand eczema were probably not recognized by the employees. False positive self‐reporting was also high; probably because they misunderstood the questions. This study illustrates the need for a consensus about the distinction between “minor skin damage” and “true eczema”.
P56 Occupational protein contact dermatitis from shiitake mushrooms
Authors: Kaminska Renata , Aalto‐Korte K , Alanko K
Published: August 2010

Case report:  A 54‐year‐old woman, with no family or personal history of atopy, developed skin symptoms and cough after she had been cultivating shiitake mushrooms for 12 months. The patient reported dermatitis on the backs of her hands, fingers and on her wrists, after 1 or 2 days of being in contact with shiitake mushrooms. The skin lesions and cough disappeared entirely during the holidays. Result: Prick tests to common inhalant allergens, molds and flours were negative, with the exception of D. farinae (3 mm). The prick‐to‐prick test was positive for shiitake gill (3 mm), shiitake stalk (3 mm) and dry shiitake (8 mm ps). The histamine wheal was 5–7 mm. Control prick tests with shiitake on 5 nonexposed subjects were negative. An open test was performed with shiitake on the flexor side of the upper arm. Within 20 minutes a positive reaction appeared comprising two wheals and flare reactions. Patch test with shiitake gave a strong toxic reaction in 2 days, which continued to diminish on days 3 and 4. Conclusion: Contact urticaria is the clinical skin symptom of immediate allergy, but repeated exposure may lead to protein contact dermatitis. However, our patient has not had urticaria symptoms from shiitake, although the prick‐to‐prick and open tests were positive. To our knowledge, this is the first report of protein contact dermatitis from shiitake in a patient with a positive immediate skin reaction and negative patch test result.
P60 Permeability of gloves to plant allergens
Authors: Gonçalo Margarida , Mascarenhas R , Vieira R , Figueiredo A
Published: August 2010

Objective:  Study permeability of gloves to plant allergens, therefore evaluating glove efficacy for hand protection.

Material and methods:  We studied 20 female patients (aged 21–71; mean 45,1 years) with ACD from plants, 10 allergic to diallyl disulfide (DAD) from Allium sativa, 8 allergic to alpha‐methylene‐gama‐butyrolactone (AMGBL) from Alstroemeria ligtu and 2 allergic to primin from Primula obconica. Patch testing was performed applying the allergens, for 24 or 48 h, directly on the skin and over fragments of different gloves: domestic rubber gloves (RG), nitrile latex gloves (NG), vinyl gloves (VG), surgical latex gloves (LG) and polyethylene gloves (PG).

Results:  VG, PG or LG gloves offered no protection for these 3 allergens. With RG and NG gloves, DAD reactivity was abolished or significantly reduced, respectively, in 5 and 7 cases. Reactivity to AMGBL wasn’t abolished by any glove material. NG abolished skin reactivity to primin; RG was efficacious only in 1 patient.

Conclusions:  Advising gloves in patients with ACD from plants is difficult, as allergen permeability through gloves associated with occlusion may intensify the dermatitis, as occurred during skin testing. Nitrile latex gloves may protect from primin and garlic dermatitis, whereas they are not helpful for manipulating Alstroemeria. Although exposure time in this study is higher than in real life, results show interesting data on glove permeability to these plant allergens and support our patients’ complaints that gloves didn’t protect them.
P63 Prevention of occupational dermatitis in the digital age: http://www.2hands.ch
Authors: Perrenoud Daniel , Gogniat T , Tran Q‐V
Published: August 2010

In 1998 we began to develop multi‐lingual educational material for apprentice schools. This material was highly graphical, consisting of overheads with explanatory notes. The kit also included clinical slides, an introductory videotape, and handcream samples. By early 2000, 300 kits had been distributed to teachers of apprentices all over Switzerland. Teachers rapidly embraced the kit thanks to its simplicity and ease of use. Feedback was also gratifyingly high among those outside teachers per se: health professionals, safety engineers and others involved in prevention, even outside Switzerland.

By 2004, however, we had made a total paradigm shift: kits were out, the Internet was in. The advantages were obvious, both in quantity and in quality. We could reach more people and we could reach them better. When we made 300 kits our budget reached its limit, but with the virtually free Internet, using only one highly developed digital course, we can now reach a potentially limitless audience. Moreover, we can refine, update and amend our material continuously.

Our main course includes defining and preventing contact dermatitis, defining the special requirements of such varied users as hairdressers, bricklayers and machinists. It also shows how to avoid misuse of protective gloves. The course still involves an intense use of graphics, but they were redrawn from scratch for the Internet to maximize simplicity, immediacy and elegance.

Conclusions:  The risk of hand eczema is more than doubled in dental technicians. The work involves frequent and unprotected exposure to acrylates and wet work. Education regarding skin protection is important.
PCS.08 Risk assessment versus risk management – is there a role for legislation? Yes
Authors: Berggren Elisabet
Published: August 2010

Classification and labeling of substances and preparations within the EU is made in accordance with the criteria as written out in Directive 67/548/EEC (‘the substances directive’) and Directive 1999/45/EC (‘the preparation directive’ setting general concentration limits for preparations containing substances classified under 67/548). The basis for the criteria concerning hazard for skin sensitisation is based on practical experience showing that the substance or preparation is capable to induce a sensitization by skin contact in a substantial number of persons (appropriate patch testing or epidemiological data); or where positive tests from appropriate animal testing are available. Recently at the EU level and currently continued at the OECD, there is an expert discussion on the appropriateness to make potency considerations of skin sensitisers. The experts evaluate the possibility to set specific concentration limits for induction skin sensitisers contained in preparations. These limits would then give the possibility to classify such preparations better mirroring the reality than the current general limits given in the preparations directive. The first measure to prevent the hazard when a chemical or preparation fulfills the criteria to be classified as a skin sensitiser, is through the labeling indicating the standardized risk phrase: ‘May cause sensitization by skin contact’, which also must be followed with an adequate safety advice. The classification of a substance has further consequences in other legal instruments on EU level leading to additional risk management measures.
Mouse models of skin autoimmunity and peripheral tolerance
Authors: Katz Stephen I
Published: August 2010

To understand the mechanisms involved in immunological tolerance to skin‐associated proteins, we have developed trangenic (Tg) mice that express a model self antigen, membrane‐bound chicken ovalbumin (OVA), under the control of a keratin 14 (K14) promoter. We have characterized these mice and have shown that their skin serves as an excellent target for CD8+ T cells from OVA‐specific T cell receptor Tg (OT‐I) mice. When the K14 OVA transgenic mice are crossed with the OT‐I mice they no longer serve as targets for the OT‐I CD8+ T cells from the OT‐I mice. This paradox is due to peripheral tolerance that is exhibited by the double Tg mice. I will discuss these two models and describe studies that are attempting to determine the mechanism of this peripheral tolerance.
FS01.6 A 10‐rear review to determine whether exposure to p‐phenylenediamine during patch tests leads to sensitisation
Authors: Dawe Simon , White I , Ryecroft R , McFadden J
Published: August 2010

Our review aimed to answer the question of whether exposure to PPD in the European standard series could lead to subsequent sensitisation in a significant number of patients. We aimed to achieve this by comparing the frequency of PPD sensitivity in patients who had never been patch tested compared to those who were having repeat patch testing and who therefore had been exposed to PPD in patch test conditions. From January 1990 to December 1999 14,001 patient’s with suspected contact dermatitis were tested with the European standard series in St. Johns. We selected and obtained the records of all patient’s during this time period who had a positive patch test to PPD free base 1% pet. Of the 14,001 patient’s tested, 1035 had previously been patch tested on at least one occasion representing 7.4% of the population. This proportion varied from 5.6% in 1994 to 11.1% in 1991 but there was no obvious trend during the ten year period. The total number of PPD positive reactions (+ to +++) over the ten year period in the whole population was 449 (3.2%). The number of PPD positive reactions in the first time testers was 419 (3.2%) compared to 30 (2.9)% in the repeat testers. Our figures over a ten‐year period do not show an increase in the rate of PPD sensitivity in patients who have been previously patch tested. These figures suggest that PPD 1% pet. as used in the standard series is not actively sensitising patients who are repeatedly patch tested.
FS01.7 Prevalence of contact allergy in an adult Thai population
Authors: Basketter David A , Duangdeeden I , Gilmour N , Kullavanijaya P , McFadden J
Published: August 2010

There is only very limited data on the prevalence of contact allergy, as judged by a positive diagnostic patch test, in unselected, non‐clinical populations. We carried out a 48 h patch test to 7 common allergens and to the petrolatum vehicle in a total of 2545 adult volunteers in Bangkok. The patch tests were read at 48 h approximately 1 h after patch removal. Positive results were as follows Ni 27.8%, fragrance mix 2.9%, Cr 2.6%, PPD 2.3%, colophony 2.1%, MI/MCI 1.2% and formaldehyde 0.7%. No reactions were found to petrolatum. The particularly high frequency of reactions to Ni was surprising.

However, the large female bias (approximately 75:1) strongly suggested that, despite the absence of a 96 h score, that irritancy did not play a significant part in these reactions. Reaction rates to the other 6 contact allergens appeared to confirm predictions made from the extrapolation of diagnostic patch testing or from previous published studies on smaller population groups. The rates of reaction to these allergens also are likely to reflect the extent of exposure in the Bangkok region. Nevertheless, it is interesting to note that over 2% of this adult population appear to be allergic to the cosmetic related allergens PPD and fragrance.
FS02.4 Differential gene expression in allergen‐activated peripheral blood mononuclear cells from allergic patients
Authors: Hansen Malene Barré , Skov L , Menné T , Olsen J
Published: August 2010

Allergic contact dermatitis is a delayed type hypersensitivity reaction mediated by allergen specific T‐lymphocytes. Allergen exposure leads to the activation of specific T‐lymphocytes, which subsequently start to produce and release a vast array of cytokines and chemokines. However, the list of relevant genes taking part in the elicitation phase of contact dermatitis is not complete. In this study, we evaluate the use of the high‐density microarray technology, which enable us to assess the global gene expression in allergen‐stimulated peripheral blood mononuclear cells (PBMC). We included 3 chromium‐allergic patients and 3 non‐allergic controls in the study. Cultures of PBMC were established from each participant and stimulated with 100 ug/ul CrCl3 or media alone. The cell cultures were grown for 24 hours and the gene expression was analysed using an Affymetrix GeneChip(R) Array. Of the genes that exhibited differences of expression (p < 0.01) in allergen‐activated PBMC from patients compared to controls, 54%(159/294) displayed increased activity and 46%(136/294) displayed decreased activity. Of the 159 up‐regulated genes, 41 genes had a fold change above 1.50 and 30 genes among the 136 down‐regulated genes had a fold change below ‐1.5. A significant number of the genes that showed differential expression in the cell cultures established from the allergic patients are known to be involved in immune responses and inflammation. The data indicates that the method of microarrays is a valuable tool for investigating the gene expression profile in our model system for allergic contact dermatitis.
FS02.5 Nickel allergy and hand eczema – a twenty‐year follow‐up
Authors: Josefson Anna , Färm G , Meding B
Published: August 2010

Aim:  To investigate the occurrence of hand eczema after 20 years in schoolgirls previously patch‐tested to nickel.

Methods:  In 1982–83, 960 schoolgirls, aged 8, 11 and 15 years, were investigated for the occurrence of nickel allergy (Larson‐Stymne B and Widström L, Contact Dermatitis 1985:13:289–293). The girls were patch‐tested and the prevalence of nickel allergy was 9%. Twenty years later, the same individuals have received a questionnaire regarding hand eczema and factors of importance for the development of hand eczema. After two reminders, the response rate was 81%.

Results:  In total 17.5% of the girls reported hand eczema after the age of 15. The 1‐year prevalence of hand eczema was 12.6%. Of the previously patch‐tested schoolgirls who answered the questionnaire, 63 were sensitive to nickel. In this study, the prevalence of hand eczema among those 63 was 16%, compared to 17% in the non‐sensitive group (NS). Excluding persons with atopic dermatitis, the prevalence of hand eczema was 12.5% in the nickel‐sensitive group, and 10% among the others (NS). 32% of the persons who had had atopic dermatitis reported hand eczema after 15 years of age, compared to 10% of those with no history of atopic dermatitis (p < 0.001).

Conclusion:  Contact allergy to nickel in early childhood (8–15 years) did not seem to increase the prevalence of hand eczema later in life. The prevalence of hand eczema was increased by a factor of three among those with a history of atopic dermatitis, which is in accordance with earlier reports.
Fragrance contact dermatitis in Korea: a joint study
Authors: An Susun , Lee Ai‐Young , Lee Cheol Heon , Kim Do‐Won , Hahm Jeong Hee , Kim Kea‐Jeung , Moon Kee‐Chan , Won Young Ho , Ro Young‐Suck , Eun Hee Chul
Published: August 2010

The purpose of this study is to determine the frequency of responses to selected fragrances in patients with suspected fragrance allergy and to evaluate the risk factors. 9 dermatology departments of university hospitals have participated in this study for the past 1 year. To determine allergic response to fragrances, 18 additional fragrances in addition to the Korean standard and a commercial fragrance series were patch‐tested in patients with suspecting cosmetic contact dermatitis. Over 80% of the patients were women, and the most common site was the face. Cinnamic alcohol and sandalwood oil (Santalum album L.) showed high frequencies of positive responses. Of the specific fragrances, ebanol, α‐isomethyl‐ionone (methyl ionone‐γ) and Lyral® (hydroxyisohexyl 3‐cyclohexane carboxdaldehyde) showed high positive responses. We compared the results obtained during this study with those of other studies and concluded that including additional fragrance allergens may be useful for the detection of fragrance allergy.
Self‐reported allergy to latex gloves among health care workers in Jordan
Authors: Khader Yousef , Abu‐Zaghlan Maisoun , Abu‐Al Rish Issam , Burgan Samar , Amarin Zouhair
Published: August 2010

The objective of this study is to determine the prevalence of natural rubber latex allergy and its associated factors among health care workers in Jordan based on a self‐administered questionnaire. In this cross‐sectional study, the data were obtained through a self‐reported hand‐delivered questionnaire that was distributed to 500 health care workers who use natural rubber latex gloves. A total of 420 (84%) health care workers responded by filling the questionnaire. Of the total number of 420 health care workers who filled the questionnaire, 57 (13.6%) reported allergy to latex gloves. The prevalence of allergy to latex gloves was significantly higher for those who had allergy to some foodstuffs (especially avocado, kiwifruits and chestnuts) or with history of eczema and hay fever. However, allergy to latex gloves was independent of gender, age, job, family history, type of gloves, hours of use/day and number of years of use. It is concluded that a high rate of allergy to latex gloves was reported among health care workers in Jordan.
The Development of the Monotremata.–Part III. The Development of the Skull of Ornithorhynchus.
Authors: de Beer G. R. , Fell W. A.
Published: August 2010

The chondrocranium and bony skull are described in five stages of development of Ornithorhynchus.

It is shown (p. 17) that Ornithorhynchus provides an intermediate condition between reptiles and higher mammals, representing a mosaic of characters some of which are typically reptilian and others equally typically mammalian.

Ornithorhynchus is definitely a mammal which has preserved a number of reptilian characters.

The pleurocentrum of the proatlas verterba fuses with that of the atlas vertebra, and forms part of the odontoid peg, as in Lacertilia, Rhynchocephalia, and higher mammals.

The cochlear capsule is not formed out of cartilage of the basal plate (contra Gaupp).

The dumb‐bell bone probably ossifies independently of the palatal processes of the premaxillæ, and represents the prevomers (supporting Wilson and Broom).

The “mammalian pterygoid” of Ornithorhynchus is the detached lateral wing of the parasphenoid of reptiles and the dorsal plate of the pterygoid of higher mammals.

The “Echidna‐pterygoid” is the pterygoid of reptiles and the secondary pterygoid cartilage (and subsequent ossification therein) of higher mammals.

The alisphenoid is present in Ornithorhynchus as a perichondral ossification in the ala temporalis.
The myelinization of the central nervous system of the American water snake (Natrix sipedon).
Authors: Warner. Francis James , Hindle Dr. Edward
Published: August 2010

Summary.

The descending fibre tracts extending from the brain to the spinal cord (the medial longitudinal bundle, the reticulo‐spinal and the direct vestibulo‐spinal tracts) become medullated earlier than the afferent fibre paths from the spinal cord to the brain.

In the brain stem the vestibular nerve, the direct vestibulo‐spinal tract, medial longitudinal bundle, and reticulo‐spinal fibres are medullated very early.

The lateral lemniscus is medullated, and can be traced to the inferior corpora quadrigemina and nucleus isthmi, at a relatively early stage of Natrix sipedon.

The tectal component of the dorsal tecto‐bulbar fibre tract does not become medullated until quite late. The dorsal tecto‐bulbar fibre tracts are medullated earlier than the ventral ones.

The fibre tracts of the spinal cord, medulla, and midbrain in Natrix sipedon become medullated in the same order as those of the opossum and the cat. The phylogenetically most ancient fibre tracts become medullated sooner than the newer tracts.

The order of medullation of the cranial nerves and fibre tracts in Natrix sipedon resembles that of amphibia.