bluuebunny/crossref_metadata_2025 huggingface dataset:
Dynamic patterns of allergic patch test reactions to 10 European standard allergens
Authors: Brasch Jochen , Geier Johannes , Gefeller Olaf
Published: April 2006

Insight into the dynamic time courses of patch test reactions may be useful for patch test evaluation. To put this to the proof, we have analysed the time courses of allergic patch test reactions that were filed between 1990 and 1994 by the Information Network of Departments of Dermatology in Germany (IVDK). Based on reaction strength at days 1 to 3, each allergic patch test was assigned to 1 of 5 distinct dynamic reaction patterns: crescendo, plateau, decrescendo, crescendo/decrescendo, or decrescendo/crescendo. The frequencies of these patterns were determined for those 10 standard allergens yielding the highest numbers of allergic reactions (n between 180 and 1240), and dynamic patterns were classified as type 1 (crescendo or plateau patterns) or type 2 (other patterns). Influences of population characteristics upon the classification of patterns were evaluated by logistic regression analyses. Different frequencies of reaction patterns were found for distinct allergens. For all 10 allergens, type‐1 patterns were significantly more often observed for allergic reactions assessed as clinically relevant. For 5 allergens, female sex of patients was associated with a lower frequency of type‐2 patterns. A history of atopic dermatitis and the age of patients were only weakly associated with a certain classification of reaction patterns in some of the allergens. In a comparison of reaction patterns obtained with different allergens in the same population, we found that nickel sulfate elicited type 1 reaction patterns more often than fragrance mix. We conclude that the dynamic reaction patterns should be taken into account in the evaluation of patch tests. The relation of type‐1 patterns to clinical relevance of the reaction needs further attention.
Contact allergy to aeroallergens in children with atopic dermatitis: comparison with allergic contact dermatitis
Authors: Cabon N. , Ducombs G. , Mortureux P. , Perromat M. , Taieb A.
Published: April 2006

Immediate and delayed cutaneous hypersensitivity are believed to be implicated in the physiopathology atopic dermatitis (AD). The purpose of this study was to evaluate Type I and Type IV allergy to aeroallergens in children with AD. 59 children (mean age 5.2 years), presenting with AD according to Hanifin and Rajka's criteria, were skin tested (patch and corresponding prick tests) with common environmental aeroallergens and a restricted panel of the European standard series over a 1‐year period. History and clinical data were carefully recorded using a standardized evaluation sheet: total and specific IgE serum levels were evaluated 17 of 59 patients (28.8%) had at least 1 positive patch test, 32 of 59 patients (54.2%) had at least 1 positive prick test. Corresponding patch and prick tests were observed in 8 out of 17 patients. 5 children with positive patch tests had negative prick tests. Irritant pustular reactions (2/59, i.e. 3%), “angry back” reactions (6/59, i.e. 10%) and doubtful reactions (3/59, i.e. 5%) were excluded from the positive group. Positive patch tests observed included, in decreasing order: D. pteronyssinus and D. farinæ (26.8%) garden trees (12.2%), plantain (9.8%), timothy grass, mugwort and damp area trees (4.9% each), and orchard grass (2.44%). 6 children with positive aeroallergen patch tests and 11 children with negative aeroallergen patch tests had at least 1 positive patch test to standard allergens. All children with an irritant reaction to aeroallergens had no reaction to standard patch tests. The relevance of aeroallergens in upgrading the severity of AD lesions has still to be explored by challenge studies and by long‐term follow‐up.
Tolerance to intravenous admiration of heparin and heparinoid in a patient with delayed‐type hypersensitivity to heparins and heparinoids
Authors: Boehncke Wolf‐Henning , Weber Lutz , Gall Helmut
Published: April 2006

Delayed‐type hypersensitivity reactions ot subcutaneously (s.c) injected heparins are common. Since similar reactions usually occur to different heparin preparations, semisynthetic heparinoids might be a therapeutic alternative. We report a patient exhibiting eczematous reactions to heparins as well as heparinoids; delayed‐type hypersensitivity was demonstrated by intracutaneous (i.c.) and patch tests, as well as by s.c. provocation. Remarkably, intravenous (i.v.) administration of heparin as well as heparinoid was well‐tolerated.
Chromium allergy in consecutive patients in a country where ferrous sulfate has been added to cement since 1981
Authors: Zachariae C.O.C. , Agner T. , Menné T.
Published: April 2006

Cement eczema used to be a common occupational disease in Denmark. Since 1981, ferrous sulfate has been added to all cement produced in Denmark to reduce the amount of soluble hexavalent chromate to below 2 mg/kg (2 ppm). The aim of the study was to analyse a material of consecutive chromate‐sensitive patients in an urban tertiary referral centre with respect to primary cause of sensitization, in a geographical area where the risk of chromate exposure from cement had been reduced. In the 6‐year period January 1989 to December 1994, a total of 4511 patients were patch tested with the European standard series, including chromate. 79 patients, 31 male and 48 female, were diagnosed as chromate sensitive. Relevant chromate exposure was established in 34 of these 79 patients. Leather was the most frequent source of chromate sensitization (19 out of 34) (47%). Chromate sensitization from cement was considered likely in 10 out of 34 subjects. Of these, 7 had been sensitized before 1981, 2 had been sensitized by non‐occupational exposure to cement, and only 1 had been sensitized from occupational cement exposure in the 6‐year period.
Sodium lauryl sulfate (SLS) induced irritant contact dermatitis: a correlation study between ceramides and in vivo parameters of irritation
Authors: di Nardo A. , Sugino K. , Wertz P. , Ademola J. , Maibach H. I.
Published: April 2006

Sodium lauryl sulfate (SLS), a surfactant frequently used in the induction of experimental irritant contact dermatitis in animals and in humans, characterstically induces a dose‐related increase in TEWL (transepidermal water loss). Ceramides are considered to be important in the regulation of the skin barrier. We therefore examined the relationship between initial ceramide content of stratum corneum and induced changes in skin color (erythema) and barrier function, after SLS application under occlusion (1% and 3% in water) to the forearm of 14 volunteers. Stratum corneum sheets were removed, stratum corneum lipids extracted, and ceramide composition determined from chromatograms (TLC) using densitometry. After determining baseline skin color and TEWL at each area. 2 samples of stratum corneum were obtained from each volunteer. Clinical and instrumental controls of the SLS‐induced irritation were performed at 24, 48, 72 and 96 h. Erythema was evaluated by colorimetry; barrier impairment by changes in TEWL. We found inverse correlations between baseline ceramide 61 (weight) and the 24 h erythema score for SLS: between ceramide I and 24 h TEWL, and between ceramide 611 and 72 h TEWL for SLS 3%. Our findings suggest that low levels of these ceramides may determine a proclivity to SLS‐induced irritant contact dermatitis.
Effect of barrier creams: human skin in vivo
Authors: Zhai Hongbo , Maibach Howard I.
Published: April 2006

An in vivo method was developed to measure the effectiveness of skin protective creams against 2 dye indicator solutions: methylene blue in water and oil red O in ethanol, representative of model hydrophilic and lipophilic compounds, 3 representative barrier creams commercialized as effective against lipophilic, hydrophilic, or lipophilic and hydrophilic substances were assayed by measurements of the dye in cyanoacrylate strips of protected skin samples after various application limes. The flexural surfaces of the forearms of 6 normal volunteers (3 female and 3 male, mean age 26.8±4.1 years) were treated. The method was as follows: solutions of 5% methylene blue in water and 5% oil red O in ethanol were prepared, and applied to untreated skin and protective‐cream‐pretreated skin with the aid of aluminum occlusive chambers, for 0 h and 4 h, respectively. At the end of the application time, the creams were removed. Consecutive skin surface biopsies (SSB) from 1 to 4 strips were taken. The amount of stain in each strip was determined by colorimetry, and the cumulative amount of stain from 1 to 4 strips in each measurement was calculated. The cumulative amount represents the amount of permeation of each solution at each time point, and the efficacy of skin barrier cream. The results showed one formulation at both 0 h and 4 h reduced the amount of permeation of melhylene blue (p<0.0l) and oil red O (p<0.01) compared with the control group. Another formulation was protective against the permeation of oil red O (p < 0.0l). but not against methylene blue at 0 h and 4 h; it was not significantly different at 0 h versus 4 h. The 3rd formulation produced increased cumulative amounts to oil red O at both 0 h and 4 h (p<0.05); it also increased permeation amounts to methylene blue (p<0.05) after 4 h. This model appears a facile, rapid and objective early screen to evaluate the efficacy of skin barrier creams in vivo, as well as their individual ingredients.
Contact allergy and exposure patterns to thiurams and carbamates in consecutive patients
Authors: Knudsen B. B. , Menne T.
Published: April 2006

Sensitization to rubber is must often due to sensitization to thiurams. Positive patch test reactions to carbamates are less frequent, and usually only diagnosed in patients with positive patch test reactions to thiurams as well. The aim of the present study was to describe the relative frequency of sensitization to thiuram mix (TH mix) and zinc diethyldithiocarbamate (ZDC) in a population where the exposure to these chemicals from rubber gloves was previously studied and considered to be of approximately the same order of magnitude. The thiuram derivatives seemed to be the most important sensitizers (frequency 2.8%) compared to ZDC (frequency 0.5%) which has been the most frequently reported sensitizer among the carbamates in rubber gloves. An interesting observation was that the probability that the patient was reacting to ZDC was strongly associated with the strength of the patch test reaction to TH mix. This observation may add a new aspect to the discussion about cross‐reactivity versus concomitant sensitization of thiurams and carbamates.
Occupational allergic contact dermatitis from spices
Authors: Kanerva Lasse , Estlander Tuula , Jolanki Riitta
Published: April 2006

About 1000 patients were investigated at our clinic during 1991 for occupational skin disease. and 5 had occupational allergic contact dermatitis from spices. The patients were chefs, or kitchen, coffee room, and restaurant workers. All patients had hand (or finger) dermatitis. The causative spices were: garlic, cinnamon, ginger, allspice and clove, The same patients also had allergic patch test reactions to foods: tomato, lettuce and carrot. Paprika elicited a weak allergic patch test reaction in 2 patients. Occupational allergic contact dermatitis from spices is relatively rare, but needs to be taken into consideration in patients who have hand dermatitis, and work with spices and foods, Patch testing with spices as is useful, but testing with dilutions in pet, may be needed to confirm that the patch test reactions are allergic. Patients also need to be prick tested with spices and foods.
Skin permeability barrier and occlusion: no delay of repair in irritated human skin*
Authors: Welzel J. , Wilhelm K.P. , Wolff H.H.
Published: April 2006

It has been reported that occlusive treatment of irritated skin results in a reduction of barrier repair activities in hairless mice. In contrast, the clinically observed benefit of occlusion in the treatment of hand eczema and other chronic skin diseases with a perturbed barrier function is well–known. While the beneficial effect of occlusion has been proven for the treatment on psoriasis there are no controlled clinical studies of the effect of occlusion on irritated human skin. We have therefore evaluated the effect of various occlusive treatments on repair of the human skin permeability barrier under controlled experimental conditions. Barrier perturbation was induced either by application of sodium lauryl sulfate (SLS) or by repeated tape stripping. This was followed by treatment with different occlusive and semipermeable dressings, partly alter pre‐treatment with petrolatum. Repair of water barrier function was evaluated by daily measurements of transepidermal water loss (TEWL) for 1 week. SLS irritation and tape stripping led to a 6‐fold increase in TEWL as a sign of severe water barrier perturbation, followed by a stepwise decrease over the following days. Occlusion did not significantly delay barrier repair as measured by TEWL. Only in tape‐stripped skin did TEWL stay at high levels during treatment with self‐adhesive dressings. This may be explained by damage of newly formed stratum corneum caused by changing of these membranes. Our results indicate that, in contrast to earlier observations in hairless mouse skin, permeability barrier repair activities are not significantly delayed by occlusive treatment in human skin.
Isolated colophony allergens as screening substances for contact allergy
Authors: Karlberg Ann‐Therese , Gäfvert Elisabeth
Published: April 2006

Rosin has a complex chemical composition. The aim of this study was to investigate if it is possible to define 1 or 2 compounds as the rosin allergens. 2 compounds, 13, 14(β)‐epoxyabietic acid and 7‐oxodehydroabietic acid, identified in gum rosin and tall oil rosin, were used as screening substances for patch testing in addition to the standard series. The rosin patch detected more cases of contact allergy than the isolated allergens did. Our suggestion is to patch test with a preparation of gum rosin, as well‐defined as possible, for screening. The content of oxidation products should be kept at a constant and rather high level, since these are the main allergens. A rosin series for additional testing of patients with allergic contact dermatitis suspected to be caused by rosin could he a valuable tool. Gum rosin and tall oil rosin from different countries should be included, since the amounts of allergens in rosin varies due to source and mode of production. Testing with identified allergens from modified rosin products and with modified rosins could also be performed.
Contact dermatitis due to rubber boots worn by Japanese farmers, with special attention to 6‐ethoxy‐2,2,4‐trimethyI‐,1,2‐dihydroquinoline (ETMDQ) sensitivity
Authors: Nishioka Kazue , Murala Masko , Ishkawa Takehito , Kaniwa Masa‐Aki
Published: April 2006

An investigation was conducted as follows in 9 farmers with contact allergy due to rubber boots: (i) patch tests with 19 rubber additives: (ii) chemical analysis of additives in 6 pairs of rubber bouts: (iii) use tests on a hypoallergenic trial product in 5 patients. The following results were obtained: (i) in the patch tests, all 9 patients showed positive reactions to 1 or more of the nitrogen(N)‐containing antioxidants (IPPD. DMRPPD. ETMDQ): (ii) ETMDQ was detected in 1 pair rubber boots, and IPPD and DMBPPD in another pair: (iii) no patient using hypoallergenic boots during rice‐planting had recurrent dermatitis. N‐containing antioxidants. such as IPPD. DMBPPD and ETMDQ, were thus considered as the main causative agents and the trial product was found useful for managing contact dermatitis. Contact allergy due to ETMDQ in rubber is reported here for the 1st time.
Nickel dermatitis: how much nickel is safe?
Authors: Gawkrodger David J.
Published: April 2006

The Nickel Directive will become law in the countries of the European Union in 1996. This directive slates that the concentration of nickel in post assemblies (used after ear piercing) may not exceed 0.05% that products which come into direct and prolonged contact with the skin. e.g. earrings, watchstraps or zippers, may not release greater than 0.5 μg/cm2/week, and that nickel release from coated products will not exceed this level after 2 years of normal use. The data relating to the threshold for reacting to nickel and the levels of nickel release from nickel‐containing objects, are considered in this review. Although the level of 0.5 μg/cm2/week is one below, which a minority of nickel‐allergic subjects will react, it is not safe in every nickel‐sensitive individual, This level of nickel release is currently exceeded by many nickel‐containing alloys and jewellery items that are made from high‐sulfur stainless steel, and manufacturers are going to have to change the composition of jewellery to comply with the directive.
The influence of hard water (calcium) and surfactants on irritant contact dermatitis
Authors: Warren Raphael , Ertel Ketth D. , Bartolo Robert G. , Levine Mark J. , Bryant Paula B. , Wong Louis F.
Published: April 2006

Although the induction of irritant contact dermatitis has been extensively studied for surfactants, the role of the environmental factor water hardness (i.e., calcium content) on the induction process has not received attention. Our objective was 10 investigate differences in surfactant‐induced irritant skin reactions from cumulative exposure to 3 different personal cleansing agents and determine whether the irritation potential can be affected by the hardness of the water. 2 commonly used exaggerated washing procedures were variously employed lo evaluate representative sodium‐soap, triethanolamine‐soap, or synthetic detergent cleansers under conditions where the water hardness varied from 0‐grain to 11‐grain (gr). Subjects were clinically evaluated for skin dryness, skin redness, and instrumentally for hydration. Soap binding to skin was quantified using Fourier transform infrared reflectance spectroscopy. Using the more mild wash procedure, skin sites treated under conditions of hard. 11 gr water, were significantly drier, had more erythema, and were less hydrated than corresponding sites treated with deionized 0 gr water. All 3 surfactant cleansers behaved similarly. We also found the hardness of the rinse water to be the more significant factor, versus that of the wash water. Effect of water hardness on soap binding to skin revealed a similar outcome. Under a more exaggerated wash condition the relationship between water hardness and irritation broke down.
An evaluation of the relationship between ‘atopic skin’ and skin irritability in metalworker trainees
Authors: Stolz Rahel , Hinnen Urs , Elsner Peter
Published: April 2006

Skin hyperirritability to irritants as well as atopy are considered to be predisposing factors for contact dermatitis. The aim of the study was to evaluate whether these predictive factors are independent or whether they are so closely related that one could possibly replace the oilier. 205 metalworker trainees underwent skill examination for skin atopy, including standardised questionnaire, clinical examination of the skin and a series of skin irritability tests. These tests included measurements of transepidermal water loss (TEWL) before and after irritation with 3 different irritants: sodium lauryl sulfate (SLS), dimethylsulfoxide (DMSO) and sodium hydroxide (NaOH). The results of the linear regression analysis demonstrate that skin atopy is not associated with increased skin irritability, as assessed by the irritability testing methods presented.
Acute irritant contact dermatitis: recovery time in man
Authors: Lee Jun Young , Effendy Issac , Maibach Howard I.
Published: April 2006

Our understanding of the details of the recovery time of acute irritant contact dermatitis (ICD) is limited. We examined skin reactivity to a model surfactant, sodium lauryl sulfate (SLS). on previous acute ICD and normal sites over time with visual grading and noninvasive instruments. Acute ICD was induced on the upper arms of 18 volunteers (aged 30 to 51 years) by occluded application of 1% SLS for 24 h. Previous ICD and normal sites were provoked by occluded application of 2% or 7.5% SLS 30 min daily 4 consecutive days. Skin reactivity was assessed daily by visual erythema scoring (VES), transepidermal water loss (TEWL), skin color reflectance (SCR) and electrical capacitance (EC). Skin function of previous ICD sites assessed, by VES, TEWL. SCR, and EC did not normalize until 2 weeks later: all parameters of previous ICD returned to normal after 3 weeks. While skin reactivity to 2% und 7.5% SLS showed no differences between previous ICD and normal sites at 4 weeks, differences of irritant reactivity especially 7,5% SLS between previous ICD and normal sites were significant at 3 weeks post‐provocation. Our results demonstrate that irritation evaluated with irritant provocation was long‐lasting, even though skin functional parameters assessed by various bioengineering instruments returned to normal. Complete recovery of skin function including irritability after acute ICD induced by 1% SLS was achieved approximately 4 weeks later. The date were generated with a model surfactant: it remains to be determined whether similar responses will be noted with chemicals of different physicochemical properties.
Prevalence of gold contact hypersensitivity in the West of Scotland
Authors: Fleming Colin , Forsyth Angela , Mackie Rona
Published: April 2006

373 patients unending for routine patch testing were tested with 0.5% gold sodium thiosulfate (GST), 8(2.1%) patients had a positive patch test, and a further 4 (1.0%) patient reactions which were interpreted as irritant. 2 out of 8 patients with a positive patch test to GST suspected gold allergy prior to testing, and both of these patients reported that their eczema resolved if they avoided gold jewellery. This is the lowest prevalence of hypersensitivity to GST reported and suggests that gold contact allergy may not he as widespread as has been recently proposed.
Bulb dermatitis
Authors: Bruynzeel Derk P.
Published: April 2006

The irritant and allergenic properties of the most important flower bulbs are described, as well as the clinical symptoms they cause. The tulip contains the allergen tulipalin A: sensitization and irritation are responsible for the development of tulip fingers. The same clinical picture can be caused by Alliums like the onion and garlic. The narcissus causes lily rash, a dermatitis rarely caused by sensitization. The hyacinth evokes itching in practically everyone: an irritant reaction caused by calcium oxalate crystals. Patch testing is complicated as the allergens are not all identified.
Contact allergy to gold sodium thiosulfate
Authors: Solva Raquel , Pereira Fåtima , Bordalo Olivia , Silva Elvira , Baarros Antónia , Gonço Margarida , Correla Teresa , Pessoa Graça , Baptista Armando , Pecegueiro Manuela
Published: April 2006

During 1995, we added gold sodium thiosulfate and potassium dicyanoaurate to the patch test standard series. Our purpose was to compare the reactivity of the gold salts, to determine the frequency of contact allergy to gold in our country, to compare our results with those of the Malmö group and, finally, to try to clarify the clinical relevance. 2853 patients were routinely tested and 168 patients answered a questionnaire similar to that used by the Malmö group. Contact allergy to gold was found in 23 patients; all women: 22 to gold sodium thiosulfate (0.78%). only 1 to potassium dicyanoaurate and 2 to both salts. All reactors had their ears pierced and were exposed to gold jewellery (mainly earrings). Simultaneous allergies to nickel and cobalt were statistically significant in patients with positive patch tests to gold sodium thiosulfate. Atopy was no more common among these patients.
Conversion of common names of cosmetic allergens to the INCI nomenclature
Authors: de Groot Anton C. , Weijland J. Willem
Published: April 2006

We have made a list of substances that can be present in cosmetics and have been described as allergens, and compared their formerly more familiar names with International Nomenclature Cosmetic Ingredient 11 NCI) nomenclature, when different. The list should assist dermatologists in advising their patients allergic to cosmetic ingredients.
Allergenic ingredients in nail polishes
Authors: Sainio Eeva‐Liisa , Engström Kerstin , Henriks‐Eckerman Maj‐Len , Kanerva Lasse
Published: April 2006

It has been known since the 1940s that nail polishes contain allergenic ingredients. The aim of this study was to clarify whether the nail polishes on the market today contain significant amounts of allergens, and what the solvents are. The following ingredients were determined: toluene, toluene sulfonamide formaldehyde resins, free formaldehyde, acrylates, methacrylates and certain organic‐solvents. The study comprised 20 brands and 42 samples. All the nail polishes analyzed contained allergenic toluene sulfonamide formaldehyde resins (TSFR), in concentrations from 0.08 to 11.0%. The concentration of total formaldehyde varied from O.12% to 0.5%. The more TSFR a nail polish contained, the higher was its formaldehyde content. Probably not only TSFR‐allergic but also formaldehyde‐allergic persons may get dermatitis from many of the nail polishes studied. The concentrations of acrylates and methacrylates were so small that they are of practical significance only to those previously sensitized lo acrylates. Of the organic solvents, toluene was still widely used, whereas xylene was found in only 1 product. The nail polishes on the market today are not safe for all consumers. However, according to the regulations of the European Union, the packaging labeling of all cosmetic products must be supplied with a list of ingredients from the beginning of 1998. This will help the consumer to avoid allergenic products. A better alternative could, however, be to substitute the most allergenic ingredients with substances possessing minor allergy potency.
Adhesion molecules in atopic dermatitis: patch tests elicited by house dust mite
Authors: Jung K. , Linse F. , Pals S. T. , Heler R. , Moths C. , Neumann C.
Published: April 2006

Different T‐helper subsets, which are characterized by the secretion of distinct cytokines (Th1, Th2), have been found in house dust mite‐exposed skin of sensitized individuals and in nickel‐specific T lymphocytes from nickel contact allergic and non‐allergic individuals. In order to evaluate the role which adhesion molecules may play in the homing of different T‐cell subsets into allergen‐exposed skin of atopic and normal individuals, we compared the expression pattern of adhesion molecules in patch test reactions to house dust mite antigen (D.pt.), nickel sulfate (Ni) and the irritant anthralin. Biopsies were taken al various time points after application of these agents and studied by immuncytochemistry. To exclude an endogenous difference in adhesion molecule expression in atopic and non‐atopic skin, sequential biopsies from Ni patch tests of 2 normal individuals were also included in this study. The expression of E‐selection. P‐selection. CD31, VCAM‐1 and ICAM‐1 on endothelial cells and other cells in the skin was quantified by microscopic evaluation. Skin homing T cells were also quantified using antibodies toCD3, CD4, CDS, UCHL‐I, L‐selection and the cutaneous lymphocyte antigen (CLA). Independent of the eliciting substance, all lesions showed an up regulation of all adhesion molecules tested, with the exception of CD62. The appearance of E‐selection and an increase in ICAM‐1 and VCA M‐1 expression were first observed at 12 h after application of the various agents. In parallel, the number of CLA+ and L‐selection+ lymphocytes increased steadily. No principle differences could be established between the various types of skin reactions in atopic individuals, nor did the skin of patients with AD differ from normal controls. Our results provide evidence that differential expression of adhesion molecules does not play a major part in observed differential homing of Th1 and Th2‐cell subsets into patch test sites provoked by house dust mite and nickel sulfate in atopic and non‐atopic individuals.
Conformability and irritancy of adhesive tapes on the skin
Authors: Tokumura F. , Ohyama K. , Fujisawa H. , Matsuda T. , Kitazaki Y.
Published: April 2006

The relationship between the conformability of adhesive tape, the mechanical property of the adhesive tape not to interfere with skin movement, and irritation of the skin was investigated. In order to assess the conformability of adhesive tape to the skin, a uniaxial method employing film strips connected to a strain gauge was used to measure the elastic properly of the skin, with or without application of various elastic tapes. The tension loaded on the strain gauge was measured while the skin was extended by 15% of its original length in a direction across the humeral axis on the flexor side of the upper right arm. The most elastic adhesive tape showed the best conformity to the skin. The same adhesive tapes were applied on the flexor side of both upper arms so that the tape held a piece of sanitary cotton in place for 24 h. Dermal irritation was not so remarkable in the skin under the inner part of the tapes. On the other hand, the skin reaction was much more severe on the skin under the edge portion of the applied tape which showed poor conformability to the skin. These findings seemed to indicate that the skin reaction was caused by localized distortion of the skin under the edge portion of the applied tapes, during movement of the underlying muscle. Actually, the distortion of the skin surface was great in the areas immediately outside the edge of the applied tape. In conclusion, adhesive tape conformable to skin movement reduced localized distortion of the skin during application, resulting in low irritation at the edge of the applied tape.
Rôle of ear piercing in metal allergic contact dermatitis
Authors: Nakada Tokio , Iuima Masafumi , Nakayama Hideo , Maibach Howard I.
Published: April 2006

To evaluate the effect of ear piercing on sensitization to gold and other metals, diagnostic patch testing with metals was performed. 377 patients 18 (65 men and 312 women. ranging in age from 15 to 78 years: mean 34.2 S.D±15.1 years) were patch tested; 107 had pierced earlobes. Metals were applied on the hack for 2 days, and the results read with the ICDRG scoring system 3 days after application. Reactions of + to +++ were regarded as positive. There were significantly more patients reacting to gold chloride (P < 0.001), mercuric chloride (P < 0.001). and nickel sulfate (P < 0.05) in patients with pierced ears than in those without. Statistical issues included: (iii) a significant number of patients without referred because of earring dermatitis; (ii) those with pierced ears represented a different age group from those without; (iii) a significant number of patients without eczema in the non‐pierced ear group. However, our data suggests that ear piercing is a risk factor not only for nickel but also for gold sensitization. Gold was the second most frequent metal allergen after nickel in the pierced group.
Patch test materials for mercury allergic contact dermatitis
Authors: Nakada Tokio , Higo Naotaka , Lijima Masafumi , Nakayam Hideo , Maibach Howard I.
Published: April 2006

The objective of this study was to define adequate patch test materials to evaluate mercury allergic contact dermatitis. We applied 0.1% and 0.05% mercuric chloride, and 0.5% and 0.2% mercury in petrolatum to systemic eczematous contact‐type dermatitis (baboon syndrome), and gold‐dermatitis patients. All baboon‐syndrome patients reacted not only to mercuric chloride but also to metallic mercury. In gold‐dermatitis patients, significantly more patients reacted to mercuric chloride than to metallic mercury (21 of 35, 60%, versus 2 of 19, 10.5%, p < 0.0005). We speculated that sensitization to mercury may be of 2 types: one a reaction to ionized mercury only, the other to both ionized mercury and non‐ionized mercury. The possibility that the phenomenon is caused by differences in bioavailability or percutaneous penetration between ionized and non‐ionized mercury cannot be ruled out, but could be explored by penetration measurement. For the evaluation of mercury hypersensitivity it may be more reliable to apply both ionized and non‐ionized mercury rather than only mercuric chloride or ammoniated mercury.
Occupational allergic contact dermatitis from 2,3‐epoxypropyl trimethyl ammonium chloride (EPTMAC) and Kathon® LX in a starch modification factory
Authors: Estlander Tuula , Jolanki Ritta , Kanerva Lasse
Published: April 2006

2.3‐epoxypropyl trimethyl ammonium chloride (EPTMAO is used in the production of cationic starch (CS) for the paper industry. It has been shown to be a sensitizer in guinea pigs, but eases of human sensitization are few. 4 workers were previously sensitized to the substance in a Finnish plant. This report describes 3 process men from another plant examined because of recurring dermatitis. IS workers were involved in production, and had free access in ill work sites. 3 process men. whose work involved drying the CS, had dermatitis, although they had only occasional contact with the cationizing chemical. 2 were already verified to be allergic to EPTMAC' and had had variable dermatitis for 8–12 years. One had had dermatitis on his lace for 1 year. Patch testing with a dilution series (1%, 0.5%. 0.2%, 0.1% pet.) confirmed their allergy to the cationizing chemical containing EPTMAC, but tests with CS were negative. In addition, 2 had contact allergy to C1+ Me‐isothiazolinone from contact with Kathon® LX used us a slimicide in the process. In longstanding (years) recurrent dermatitis, re‐examination of patients with verified exposure history and skin tests is necessary. In line with our previous study, sampling the process materials, maintenance work and contamination of work sites and gloves caused sensitization. The results also confirm that EPTMAC is a strong human contact sensitizer. 0.2%–0.5% pure EPTMAC in pet. seem to be the optimal patch test concentration.
Allergic contact dermatitis from pyoctanin
Authors: Schoppelrey Hans‐Peter , Mily Hilde , Agathos Monika , Breit Reinhard
Published: April 2006

Although pyoctanin is widely used in medicine, there are hardly any reports of contact allergy to it. Most reports of side‐effects refer to irritant reactions after topical application. We describe 2 patients who developed pyoctanin contact dermatitis after long‐term application on damaged skin, Positive patch test results down to concentrations of 0.0025% and 0.05% aqueous pyoctanin solution, respectively, were found.
Occupational allergic contact dermatitis from carnosol, a naturally‐occurring compound present in rosemary
Authors: Hjorther A. B. , Christophersen C. , Hausen B. M. , Menné T.
Published: April 2006

A 56‐year‐old man, working in a food processing factory, developed contact dermatitis of his hands, forearms, and face after the introduction of a new herb extract (Rosmanox®) made from the leaves of rosemary (Rosmarinus officinalis). He reacted to carnosol, the main constituent of Rosmanox®, 226 controls were negative. To our knowledge, this is the 1st reported case of contact dermatitis from carnosol.
Further evaluation of the quantitative structure‐activity relationship for skin‐sensitizing alkyl transfer agents
Authors: Roberts D. W. , Basketter D. A.
Published: April 2006

The biological activity of skin‐sensitizing chemicals can be expressed in terms of physicochemical properties which relate to the propensity of those chemicals to behave as electrophiles and which describe their ability to partition into the epidermis and between compartments within it, For defined series of chemicals, it has proved possible to express such structure‐activity relationships quantitatively. Such quantitative relationships can provide valuable insights into the mechanisms of skin sensitization and/or are of use in predictive toxicology. In the present work the quantitative structure‐activity relationship (QSAR) previously derived for a series of alkyl transfer agents based on alkanesulfonate leaving groups has been critically examined in the light of skin sensitization data obtained for new members of that series and also for alkyl transfer agents based on different leaving groups. The QSAR predictions were broadly accurate, but demonstrated that further refinement was both necessary and possible. In particular, the physicochemical parameters which relate to the disposition of the chemical in the epidermis, i.e., its penetration through the stratum corneum, cell surface/ cytoplasmic distribution and the associated dynamics, will need to be understood more fully in order to enhance the precision of the QSAR and its predicitve power.
More positive patch test reactions with larger test chambers?
Authors:   Results from at study group of the German Contact Dermatitis Research Group (DKG), Brasch Jochen , Szliska Christiane , Grabbe Jürgen
Published: April 2006

Test chambers of various sizes are commercially available for patch testing. Therefore, we asked the question whether the size of patch test chambers may affect allergic patch test reactions. A total of 495 patients were doubletested synchronously with small and large Finn Chambers containing standard preparations of fragrance mix, wool wax alcohols. Kathon CG and formaldehyde, Double tests in 217 patients who had reacted with at least 1 allergic, questionable, or irritant reaction to 1 of these allergens were statistically evaluated. For each of the 4 allergens, a significantly higher number of stronger reactions was seen with the large chambers as compared to the small ones. It is concluded that large test chambers may be useful for detection of weak sensitizations to particular contact allergens.
Contact allergenic activity of Tween® 80 before and after air exposure
Authors: Bergh Margarita , Magnusson Kirstin , Nilsson J. Lars G. , Karlberg Ann‐Therese
Published: April 2006

Tween 80 is an ethoxylated hydrophilic non‐ionic surfactant, which is used for the preparation of oil‐in‐water emulsions in pharmaceutical products, cosmetics, and industrial detergents, Ethoxylated surfactants are polyethers and are thus easily oxidized by atmospheric oxygen to u variety of hydroperoxides. peroxides and carbonyl compounds. The aim was to investigate the formation of oxidation products and the allergenic potential of Tween 80 before and after air exposure. The formation of peroxides and formaldehyde was followed with chemical analyses during air and pure oxygen exposure of water solutions of Tween 80 of technical quality. A complex mixture of compounds was formed when Tween 80 was oxidized. Formaldehyde was detected in amounts that may be eliciting in allergic individuals. Acetaldehyde was identified in Tween 80 before oxygen exposure, where after the amount gradually decreased. The contact allergenic activity was determined in experimental sensitization studies in guinea pigs. Non‐oxidized as well as oxidized Tween 80 of technical quality showed allergenic activity. The results indicate that allergens are present in Tween before oxidation and that new allergens arc formed in the oxidation process. No obvious dose‐response relationship was found in the sensitization studies. The possibility that allergenic compounds can be formed during storage and handling of products containing ethoxylated surfactants should be taken into consideration.
Allergic contact dermatitis from grasses
Authors: Koh D. , Goh C. L. , Tan H. T. W. , Nge S. K. , Wong W. K.
Published: April 2006

This study attempts to demonstrate the existence of allergic contact dermatitis from grass, and to develop a patch test series to screen patients with grass intolerance. 6 common grass species from lawns and military training areas were collected. Solvent extracts of polar. non‐polar and volatile fractions were prepared and used for patch testing in 20 control subjects and 46 patients with a history of grass intolerance. The 20 control had negative responses to patch testing. 5 out of 46 patients had positive patch tests to Axonopus compressus (carpet grass). Ischaenmum muticum (sea‐shore centipede grass). Imperata evlindrica (lalang). Panicum maximum (Guinea grass) and Pennisetum purpureum (elephant grass). Reactions to the non‐polar fraction for all 5 species were noted. This study demonstrates the existence of allergic contact dermatitis from various common species of grass. In our series, this is seen in 11% of those with a history of grass intolerance.
Proposal for a revised international standard series of patch tests
Authors: Lachapelle J.‐M. , Ale S. I. , Freeman S. , Frosch P. J. , Goh C. L. , Hannuksela M. , Hayakawa R. , Maibach H. I. , Wahlberg J. E. ,   The International Contact Dermatitis Research Group
Published: April 2006

Worldwide, there are 3 major standard series of patch tests, the European, North American and Japanese, together presenting 32 allergens, the differences between them being the result of regional variation in allergen distribution as well as differences in dermatological opinion. We propose a “minimal” international standard series of 20 allergens, together with an “extended” international standard series of 14 allergens.
Exposure of nickel in used and unused gold‐plated earrings: a study using scanning electron microscopy and X‐ray microanalysis
Authors: Ishikawaya Yayoi , Suzuki Hiroyki , Kullavanija Preya
Published: April 2006

Nickel is the most common contact sensitizer in the female population. The aim of the present study was to examine closely the surface of both used and unused gold‐plated earrings by scanning electron microscopy, and to ascertain the distribution of nickel on the surface of these earrings qualitatively and quantitatively by X‐ray microanalysis. The claps of 4 sets of used earrings causing nickel dermatitis and of the 3 sets of unused earrings were examined. In backscattered electron images obtained by scanning electron microscopy, a large number of scratches and pits were found on the surface of the used earrings. Cross‐sections of the surfaces confirmed that the gold plating was defective in some areas, exposing the nickel. Nickel was readily detected and quantitatively determined in the scratches and pits by X‐ray microanalysis. We also found that, even in unused earrings, numerous scratch marks and pits Acre present, again exposing the nickel. Clearly, even in unused earrings, nickel exposed at the surface sensitizes the skin and causes contact dermatitis
Purpura caused by Emla® is of toxic origin
Authors: de Waard‐van der Spek Flora B. , Oranje Arnold P.
Published: April 2006

Emla® cream has been widely used as a local anaesthetic for superficial procedures. Blanching and redness are commonly observed side‐effects. We observed purpura in 5 patients after application of Emla®. Other authors have not reported this before. In 4 patients, purpura was observed after 30 min Emla® application before the treatment of mollusca contagiosa. In 1 patient, Emla® was used for 60 min before taking a lip biopsy. In these patients, patch tests were performed with the individual ingredients of Emla® cream. Emla® cream itself, placebo cream, and Tegaderm® plaster. All tests were negative at an early reading alter 30 min as well as after 2 and 3 days. We concluded that the purpuric reaction was not of an allergic nature. Possibly, it was caused by a toxic effect on the capillary endothelium.
Leukaemia inhibitory factor: induction in the early phase of allergic contact dermatitis
Authors: Szepietowski Jacek C. , Mckenzif Toderick C. , Keohane Stephen G. , Walder Craig , Aldridge Roger D. , Hunter John A. A.
Published: April 2006

It has been suggested that leukaemia inhibitory factor (LIF), may be involved in the pathogenesis of cutaneous inflammation. In 5 patients with previously proven contact allergy to nickel. LIF mRNA and protein expression were assessed by reverse transcription‐polymerase chain reaction and imnunohistochemistry in 5% nickel sulfate patch test biopsies 24 h alter application of the patch. Control specimens were obtained from non‐tested and vehicle‐tested skin from the same individuals, LIF mRNA expression was significantly increased in nickel‐tested skin compared with both vehicle‐tested (p=0,045) and non‐tested skin (p= 0,041), All biopsies showed similar patterns of LIF immunoreactivity, with no significant differences between nickel‐tested, vehicle‐tested and non‐tested skin. Immunostaining was cyoplasmic and was present in the epidermis and hair follicles. No dermal staining was observed. This study suggests that LIF may play a role in the early phase of allergic contact dermatitis.
Delayed and immediate allergy caused by methylhexahydrophthalic anhydride
Authors: Kanerva Lasse , Hyry Heli , Jolanki Riitta , Hytönen Maija , Estlander Tuula
Published: April 2006

Epoxy resin compounds (ERC) include a large number of chemicals. Such as epoxy resins (ER), reactive diluents and hardeners. Many hardeners. e.g., aliphatic polyamines. are well‐known sensitizers. Another type of ER hardeners are the phthalic anhydrides, such as methylhexahydrophthalic anhydride (MHHPA) and mathyltetrahydrophthalic anhydride (MTHPA). which have been reported as causing immunologically‐mediated respiratory diseases and contact urticaria. but not allergic contact dermatitis. Here, we present a horizontal boring‐machine worker who developed allergic contact dermatitis. as Well as allergic rhinitis and and immediate contact skin reaction from MHHPA. patch testing with a dilution series of MHHPA in pet. elicited the following results: 2%. 1% and 0.5. ++: 0.25%+ and 0.125%. + (3‐ to 6‐day readings) An immunohistochemical and electron microscopic study also indicated that the patch lest reactions were conventional‐delayed allergic reactions, Interleukin 8 was observed in the epidermal cells, whereas interleukin 4 immunoreactivity was detected in the dermal cell Immunoreactivity to interleukin 5. granulocyte/macrophage‐colophony Stimulating factor (GM‐CSF) or eosinophil cationic protein was not seen. In conclusion, the patient developed both Type I und Type IV allergy to MHHPA. The clinical data. patch lest results, immunohistochemical and electron microscopic observations indicated that the MHHPA allergy detected by the patch test reaction was a conventional delayed‐type hypersensitivity reaction. The patient also had an allergic patch test reaction to para‐phenylenediamine and diaminodiphenylmethane. possibly representing occupational sensitization.
A proposed relevance scoring system for positive allergic patch test reactions: practical implications and limitations
Authors: Lachapelle J.‐M.
Published: April 2006

A relevance scoring system for positive allergic patch test reactions is proposed. It refers to current relevance (CR) as well as past relevance (PR), The system was evaluated in adult patients between January 1 and June 30, 1996, and limited to 4 allergens: nickel sulfate, neomycin sulfate, epoxy resin and colophony Certain methods available for increasing the accuracy of relevance were used in the present study. Practical implications and limitations of using a relevance scoring system are discussed.
A case of contact dermatitis due to impurities of cetyl alcohol
Authors: Kscomamura Hiromi , Dor Toshiaki , Inui Shigeki , Yoshikawa Kunihiko
Published: April 2006

A 29‐year‐old man being treated for itchy lesions on the amputation stump of the thigh became allergic to betamethasone valerate and gentamicin sulfate cream (Rinderon VG®. Closed patch tests with all the ingredients of the cream revealed positive reactions to cetyl alcohol 30% to 5% pet. Gas chromatographic analysis of the cetyl alcohol in the cream base detected stearyl alcohol (C18), myristyl alcohol (C14) and lauryl alcohol (C12) in addition to the main component of cetyl alcohol (C16). Patch testing with 99% pure analytical reagent grade saturated alcohols. (C10, C11, C12, C13, C14, C15, C16, C17, C18, C19, C20) showed negative reactions. Thus, it is concluded that some minor impurities in cetyl alcohol not detected by gas chromatography might be the cause of this dermatitis.