bluuebunny/crossref_metadata_2025 huggingface dataset:
The reliability of interview data for age at which infants' toothcleaning begins
Authors: Kwan Stella Y. L. , Williams Sonia A.
Published: February 2007

Abstract –

A number of studies have reported on the age at which toothbrushing started and drawn important conclusions. Such studies often relied on parental recall of a particular event that occurred some years previously, assuming the quality of retrospectively reported data. The present study aimed to investigate consistency of reporting the age at which toothcleaning began. Mothers from two different cultural backgrounds, 100 Caucasian and 150 Asian living in a deprived inner city area, were interviewed in their homes on two separate occasions, when the sample child was 6–24 months old and again at 3–4 years. Of the 39 Caucasian and 31 Asian mothers who specified an age at which toothbrushing commenced at both interviews, complete agreement occurred among 4 (10%) Caucasian and 2 (6%) Asian mothers, with a variation of +/– 2 months among 12 (31%) and 5 (16%) respectively. Intraclass correlation coefficients s were –0.01 for Caucasian and −0.46 for Asian mothers. Kappa values were 0 and –0.09 respectively. Of the 139 mothers who stated that their children's teeth were not cleaned at the time of the first interview, 17 claimed an earlier age than this at the second interview. It was concluded that there was little agreement between the two interviews, although the extent of the variation differed between the two cultural groups. Although these findings represent relatively deprived population groups, caution is recommended in unquestioningly accepting the accuracy of retrospective re‐porting of oral hygiene practices in dental surveys until evidence of better reliability is available.
Risk revisited
Authors: Beck James D.
Published: February 2007

Abstract– As our knowledge of dental caries and periodontal diseases has increased, our perspective has changed from viewing these diseases as ubiquitous to one which sees a variety of risk profiles in a population. Now, from a perspective of assigning risk, caries and periodontitis can be thought to be more like some of our common medical conditions, i.e., certain people or subgroups of the population are at higher risk than others and that prevention and intervention involve a combination of personal behaviors and professional practices. Research into risk assessment, however, is often hampered by confusing and ambiguous use of terminology. This commentary proposes some specific denifitions s for terms used in risk assessment in dentistry. These terms include risk factor, risk indicator, demographic risk factor, risk predictor (risk marker), prognostic factor, risk model, and prediction model.
Evaluation of a dental benefit plan for children conducted in Auvergne, France, since 1992
Authors: Tubert‐Jeannin Stéphanie , Morel‐Papernot Annick , Woda Alain
Published: February 2007

Abstract– Usually, the French dental insurance system covers the cost of restorative treatment but does not reimburse the cost of preventive therapies. A French sick‐fund covering self‐employed persons tested a new dental benefit plan for children intended to provide an incentive to develop office‐based preventive activities. The programme, which started in 1992, concerns all 4‐year‐old children of self‐employed workers in a single French region (Auvergne). Participants undergo an annual examination by the dentist of their choice until their 15th birthday. If the child is seen every year, all services related to dental caries (preventive and restorative) are provided free of charge. An ongoing evaluation of the programme was necessary to determine its influence on the development of office‐based preventive activities and the dental health of the participants. A cohort of children enrolled in the programme in 1992 was followed over 4 years to examine the patterns of service use. In addition, a cross‐sectional study comparing the caries experience of all 8‐year‐old children participating continuously in the programme (test sample) with that of a sample of control children (n=90) was conducted in 1996. Data from the longitudinal follow‐up indicate that 43.37% of the 551 children to whom the programme was offered in 1992 underwent an annual examination in the first year. Of the children enrolled in 1992, 55.2% were still participating in the programme in 1996. Results showed that independent practitioners continued to focus on restorative treatment rather than preventive therapy. Results from the cross‐sectional study are in accordance with this trend. The number of caries‐free children was identical in test and control samples and the mean dft, DMFT, DT and dt did not vary between the two groups (Student's t‐test, P > 0.05). However the mean number of filled teeth was significantly higher in the test children than in the controls (P < 0.01). For children with caries, the mean dft was 23.5% greater in the test group than in the control group (P < 0.05). In Auvergne, a large number of families were not ready to participate in a plan that required them to take their child to the dentist every year. There was not a perceived need for regular preventive dental care, an attitude probably reinforced by the interventionist approach undertaken by the dentists over the survey period. Moreover, the plan did not provide an incentive for dentists to develop office‐based preventive activities.
Dental caries and changes in dental anxiety in late adolescence
Authors: Kruger Esther , Thomson W. Murray , Poulton Richie , Davies Simon , Brown R. Harvey , Silva Phil A.
Published: February 2007

Abstract –

Little is known about changes in dental anxiety with ageing and their association with changes in oral health. This study examined the relationship between changes in dental caries experience and dental anxiety from 15 to 18 years of age among adolescent participants in the Dunedin Multidisciplinary Health and Development Study. Dental anxiety was estimated using the Corah Dental Anxiety Scale (DAS), and individuals with a DAS score of 13 + were identied as being dentally anxious. Dental examinations were performed on 649 individuals at ages 15 and 18, and a DMFS score was computed for each. Caries prevalence among those who were dentally anxious at both 15 and 18 years was signicantly higher than for those who were not at either age. Regression analysis revealed that dental anxiety predicted caries incidence between ages 15 and 18 years. Dental anxiety is likely to be a signicant predictor of dental caries experience, and may be a risk factor for dental caries incidence.
Caries prediction: a review of the literature
Authors: Powell L. Virginia
Published: February 2007

Abstract –

For over a decade researchers have been looking for the formula that will allow caries prediction. The purpose of this summary is to review recent multi‐factorial prediction models for adults and children with the aim of identifying the most successful and consistent methods. Conclusions from this review include the following: Clinical variables, especially past caries experience, are confirmed as the most significant predictors of future caries development. The status of the most recently erupted/exposed surface is the most successful measure of past caries experience. Bacterial levels are included in the most accurate prediction models. Sociodemographic variables are most important to caries prediction models for young children and older adults.
Perceptions of dental aesthetics in the United States and Nigeria
Authors: Otuyemi Olayinka D. , Ogunyinka Adeola , Dosumu Oluwole , Cons Naham C. , Jenny Joanna , Kohout Frank J. , Jakobsen Jane
Published: February 2007

Abstract –

The standard dental aesthetic index (DAI) is an orthodontic treatment need index based on perceptions of dental aesthetics in the United States. It is a regression equation that links perceptions of the social acceptability of dental aesthetics with the objective intraoral measurements of ten occlusal traits. For the index to be universally acceptable, the perceptions of dental aesthetics in other countries must be similar to those of the United States. This study was designed to determine whether the perceptions of dental aesthetics of Nigerian students are similar to those of different groups of the US population. The same 25 stimuli (photographs of dental configurations, a subset of the 200 stimuli used in deriving the standard DAI equation) were rated for dental aesthetics by Nigerian students. Their ratings were compared with ratings of the same 25 stimuli by US parents, students and orthodontists. Spearman rank‐order correlations ranged from 0.75 to 0.84. These correlations were highly significant (P < 0.0001), and showed that the perceptions of dental aesthetics of Nigerian students were very similar to those of the US groups. The study therefore concluded that standard DAI could be used as a screening tool and without modification in epidemiological surveys among Nigerians.
Biological mechanisms of dental fluorosis relevant to the use of fluoride supplements
Authors: DenBesten P. K.
Published: February 2007

Abstract –

Fluorosis occurs when fluoride interacts with mineralizing tissues, causing alterations in the mineralization process. In dental enamel, fluorosis causes subsurface hypomineralizations or porosity, which extend toward the dentinal‐enamel junction as severity increases. This subsurface porosity is most likely caused by a delay in the hydrolysis and removal of enamel proteins, particularly amelogenins, as the enamel matures. This delay could be due to the direct effect of fluoride on the ameloblasts or to an interaction of fluoride with the proteins or proteinases in the mineralizing matrix. The specic mechanisms by which fluoride causes the changes leading to enamel fluorosis are not well dened; though the early‐maturation stage of enamel formation appears to be particularly sensitive to fluoride exposure. The development of fluorosis is highly dependent on the dose, duration, and timing of fluoride exposure. The risk of enamel fluorosis is lowest when exposure takes place only during the secretory stage, but highest when exposure occurs in both secretory and maturation stages. The incidence of dental fluorosis is best correlated with the total cumulative fluoride exposure to the developing dentition. Fluoride supplements can contribute to the total fluoride exposure of children, and if the total fluoride exposure to the developing teeth is excessive, fluorosis will result.
International fluoride supplement recommendations
Authors: Banting David W.
Published: February 2007

Abstract –

A telefax survey was conducted to determine the current and past recommended schedules for fluoride supplementation using tablets, salt or milk. Twenty‐one of 90 countries listed in the 1997 FDI directory responded. Information on additional countries was gathered from a recent textbook on fluoride and a dental health survey report. The summary table provided is far from comprehensive but it represents the best data available at this time. The conclusions are limited to the information received but there is a clear trend to lower dosage recommendations and no fluoride supplementation to very young children. Several issues are identied which should be addressed whenever fluoride tablet supplementation schedules are being considered.
A re‐examination of the pre‐eruptive and post‐eruptive mechanism of the anti‐caries effects of fluoride: is there any anti‐caries benefit from swallowing fluoride?
Authors: Limeback Hardy
Published: February 2007

Abstract –

The belief that fluoridated water reduces caries incidence by half stems from years of fluoridation studies where the caries rates of people in various fluoridated and non‐fluoridated communities were compared. By their nature, the water fluoridation trials were not able to distinguish between the topical effects of the fluoride in the water and the systemic effects of the fluoride that is inevitably swallowed and incorporated into developing teeth. Some attempts have been made to estimate the contribution of systemic fluoride to the control of dental caries but researchers are discovering that the topical effects of fluoride are likely to mask any benefits that ingesting fluoride might have. In this updated review of the pre‐eruptive vs post‐eruptive benefits of fluoride in the prevention of dental caries, a re‐examination of the literature, which is often cited to support the notion that swallowing fluoride, either in water or in pill form, was done in recognition of the mounting evidence for the topical mechanism as being the primary mechanism for the prevention of dental caries. Maximum benefits from exposing newly erupted teeth to topical fluoride in the oral cavity may have been seriously under‐estimated. This has obvious implications for the use of systemic fluorides to prevent dental caries and forces everyone working in the field to examine more closely the risks and benefits of fluoride in all its delivery forms.
Is atopic dermatitis a predisposing factor for experimental acute irritant contact dermatitis?
Authors: Gallacher G. , Maibach H. I.
Published: February 2007

Proclivity to acute irritant contact dermatitis has been reviewed by comparing the response in patients with atopic dermatitis to controls. Although several controlled studies demonstrate such a proclivity, others do not, suggesting that the mechanisms involved are complex.
Formaldehyde concentration in diagnostic patch testing: comparison of 1% with 2%
Authors: Trattner A. , Johansen J. D. , Menne T.
Published: February 2007

Exposure to formaldehyde is common from both consumer products and industry. The reliability of the patch test is essential for the diagnosis of formaldehyde allergy as it is difficult to suspect from the patient's history. The recommended formaldehyde patch test concentration has been reduced over the last decades from 4–5% to 2% and is currently 1%. The changes have not been based upon formal studies, but driven by an intention to reduce irritancy and false‐positive results. The aim of the present study was prospectively to compare the outcome of simultaneous testing with formaldehyde 1% and 2% in consecutively patch‐tested patients, with respect to frequency of positive patch test reactions, strength of patch test reactions to different formaldehyde test concentrations, irritancy and relevance. The study included 3734 consecutively patch tested patients. 121 gave a positive reaction to 1% and/or 2% formaldehyde in water. There was no statistically significant difference between 1 and 2% with respect to allergic reactions, but 2% gave significantly more irritant reactions. Doubtful, positive and follicular reactions at day (D) 2 frequently developed into true positive reactions at D 3 to 4. Reading at D 7 gave few additional positive cases compared to D 3/4. Problems related to relevance are discussed. Based on present knowledge, a 1% patch test concentration for formaldehyde is recommended.
Severe allergic contact blepharoconjunctivitis from phenylephrine in eyedrops, with corresponding T‐cell hyper‐responsiveness in vitro
Authors: Thomas Peter , Rueff Franziska , Przybilla Bernhard
Published: February 2007

Causes of allergic contact reactions of the eye region include topical medicaments, contact lens solutions, eye cosmetics and contaminated towels, pillows or fingers (1–3). Lesions may also arise from airborne or systemic contact, as well as photocontact dermatitis (4, 5). Ophthalmic drugs contain a wide range of potential allergens (6, 7).
Erythema‐multiforme‐like eruption following photoallergic contact dermatitis from oxybenzone
Authors: Zhang Xiao‐Min , Nakagawa Mikio , Kawai Keiichi , Kawai Kyozo
Published: February 2007

Many contact allergens can cause an erythema‐multifor‐me (EM)‐like or urticarial papular and plaque eruption (UPPE) (1–6). Although numerous topical medicaments have been reported as causing UPPE, oxybenzone (2‐hydroxy‐4‐methoxy benzophenone, benzophenone 3, Eusolex 4360) has not.
Contact pemphigus vulgaris?
Authors: Stransky L.
Published: February 2007

A 52‐year‐old woman developed a bullous eruption on the oral mucosa at the site of contact with a nickel‐con‐taining tooth filling. The lesion was resistant to treat‐ment and persisted long after removal of the contact. Patch tests with the European standard series were posi‐tive to nickel. Biopsy and immunofluorescence indicated definite pemphigus vulgaris.
Occupational dermatoses in a plant producing binders for paints and glues
Authors: Gruvberger Birgitta , Bruze Magnus , Almgren Goran
Published: February 2007

A survey of occupational dermatoses, based on a questionnaire, clinical examination and patch testing, was carried out among present and former employees in a plant producing binders for glues and paints. The binders are chemically based on vinyl acetate and/or acrylates. Preservatives are needed and those based on methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) are the most commonly used. The questionnaire was answered by 83 out of 85 present employees (97.6%) and 12 out of 15 former employees (80.0%). 76 of the present (89.4%) and 11 of the former employees (73.3%), respectively, participated in the clinical examination and patch testing, which was conducted with a standard test series and chemicals from the work environment. Occupational dermatosis was diagnosed in 22 present workers (28.9%). Irritant and allergic contact dermatitis was demonstrated in 9 (11.8%) and 13 (17.1%) employees, respectively. Occupational contact allergy to acrylates and formaldehyde was detected in 3 workers and 1 worker, respectively. 12 individuals (9 present and 3 former production workers) had an occupational contact allergy to MCI/MI. 4 of the present workers had spilled Kathon LX on their skin resulting in chemical burns and allergic contact dermatitis. In total, the figure for occupational skin diseases among all present production workers was 40.4%.
Susceptibility to skin stinging, non‐immunologic contact urticaria and acute skin irritation; is there a relationship?
Authors: Coyerly J. , Peters L. , Whittle E. , Basketter D. A.
Published: February 2007

Adverse skin reactions cover many types of response: toxic, irritant, allergic, urticarial, sensory, etc. The relationships between an individual's tendency to develop different types of skin response are not well‐described. We examined whether those who perceive stinging might be more likely to experience urticarial, sensory and irritation reactions in skin. A panel of 86 volunteers was tested with 10% lactic acid in the nasolabial fold to assess their ability to perceive stinging. At the same time, their capacity to develop non‐immunologic contact urticaria was evaluated using chemicals of different structural type and urticant ability: methyl nicotinate, benzoic acid, cinnamic acid, cinnamaldehyde and dimethyl sulfoxide (DMSO). DMSO was also used to assess sensory effects and skin irritation. 44 were classed as “stingers” and 42 as “non‐stingers”. The pattern of urticant reactivity in the stingers and non‐stingers was essentially the same, with neat DMSO generating the strongest reactions in both groups. Sensory reactions to DMSO (stinging, itching, tingling or burning) were similar in stingers and non‐stingers; although the former may have reacted more quickly, a smaller proportion reacted (64% versus 76%). The skin irritation response to DMSO was also identical in stingers and non‐stingers and the intensity of the urticant response in an individual did not correlate with the intensity of their subsequent irritant reaction. In conclusion, this study demonstrated that an individual's ability to perceive skin stinging does not give a general indication of their susceptibility to other types of non‐immunologic skin response. Indeed, there appeared to be little evidence of correlations between any of the skin effects studied.
Common contact sensitizers in Chandigarh, India
Authors: Sharma V K. , Chakrabarti A.
Published: February 2007

200 patients (122 male, 78 female) with suspected allergic contact dermatitis were patch tested with the European standard series (ESS) and the results compared with other Asian centres. 131 (65.5%) patients showed 1 or more patch test positives to the ESS. Patch tests were positive to all allergens except primin. Potassium dichromate was the most common allergen (20.5%) followed by nickel sulfate (16.5%), SQL mix (14%), PPD (11.5%), cobalt (8%), fragrance mix (7.5%), formaldehyde (6.5%), colophony (5.5%), neomycin sulfate and mercapto mix (5% each). In women, nickel sulfate was the commonest allergen (30.8%) followed by SQL mix (16.7%) and potassium dichromate (15.4%). In men, potassium dichromate was the commonest sensitizer (23.8%) followed by SQL mix and PPD (12.3% each). Our results are at variance with other centres in Asia. SQL mix was able to detect less than ½ (42.2%) of patients allergic to ethanolic dilutions of ether extracts of parthenium. We conclude that the European standard series, with exclusion of primin, is suitable for detection of allergic contact dermatitis in India. However, SQL mix is not a adequate screen for parthenium sensitivity and patch testing with extracts of the plant should be continued, wherever indicated.
A controlled study of gold contact hypersensitivity
Authors: Fleming C. , Lucke T. , Forsyth A. , Rees S. , Lever R. , Wray D. , Aldridge R. , MacKie R.
Published: February 2007

1203 patients attending for routine patch testing at 3 hospitals and 105 volunteers were tested with 0.5% and 0.05% gold sodium thiosulfate (GST). 38 patients (3.2%) and 5 volunteers (4.8%) had positive patch tests to GST. There were no significant differences between volunteers and patients with respect to age, sex, atopy or exposure to gold in dental restorations, jewellery or through occupation. There were no significant differences in prevalence of GST hypersensitivity in the 3 hospitals, or between patients and controls. This is the 1st controlled study of hypersensitivity to GST, and suggests that routine patch testing to gold is of limited clinical benefit.
Reliability of diagnostic tests for contact allergy to mydriatic eyedrops
Authors: Villarreal O.
Published: February 2007

Adverse reactions due to the administration of mydriatic eyedrops are not uncommon. In Spain, the most commonly used are phenylephrine, tropicamide and cyclopentolate hydrochloride. In this study, 37 patients with adverse reactions to the administration of mydriatic eyedrops were investigated from January 1993 to June 1997. The aim was to assess the reliability of the diagnostic methods used, particularly the adequate concentration of allergens and the introduction of conjunctival challenge as a safe and accurate diagnostic tool in those patients who could not be diagnosed by other methods. Phenylephrine was the drug most frequently causing sensitization (93.5%) among the 31 allergic patients. Preservatives were the cause in only 1. Patch testing detected allergy in 68.5% of the subjects. 2 concentrations (1% and 10%) and vehicles (pet. and aq.) were used for phenylephrine. The most reliable was 10% aq. Reading at D4 was more useful than at D2. The sensitivity of the patch test was low (72.4%) and its negative predictive value (NPV) poor (42%). In 24%o f patients, allergy to phenylephrine was detected only by conjunctival challenge test. This diagnostic method is safe and helpful and has not previously been used to diagnose adverse reactions due to mydriatic eyedrops.
Foot dermatitis in children: causative allergens and follow‐up
Authors: Cockayne Sarah E. , Shah Manu , Messenger Andrew G. , Gawkrodger David J.
Published: February 2007

Allergic contact dermatitis from shoes may have a typical pattern of presentation, but we have found that the distribution of dermatitis is often unhelpful in establishing the diagnosis. In this study, we aimed to define the features of foot dermatitis in children and to assess its outcome, in comparison to adults with foot eruptions. Relevant allergens were found in 15 out of 29 children and 26 out of 57 adults with foot eruptions. The most common allergens in children were rubber chemicals and topical medicaments. Adults showed a similar pattern, but also reacted to clothing dyes. The prognosis in both groups was good, with the dermatitis improving or resolving in 2/3.
Comparison of simultaneous patch testing with parthenolide and sesquiterpene lactone mix
Authors: Orion E. , Paulsen E. , Andersen K. E. , Menne T.
Published: February 2007

Several studies have pointed out that the sesquiterpene lactone (SL) mix is a safe, though inadequate, screen for Compositae allergy. To test the usefulness of the sesquiterpene lactone parthenolide as a supplementary Compositae screening test to the mix, both were included in the standard series in 2 Danish dermatology departments. Among 2244 patients tested, 46 (2%) were positive to SL mix and 73–75% of these were positive to parthenolide. The results demonstrate that parthenolide is not suitable as a supplementary screening agent to SL mix, but may be a fairly good screen on its own if the mix is not available.
Genotype and phenotype of N‐acetyltransferase 2 (NAT2) polymorphism in patients with contact allergy
Authors: Schnuch A. , Westphal G. A. , Müller M. M. , Schulz T. G. , Geier J. , Brasch J. , Merk H. F. , Kawakubo Y. , Richter G. , Koch P. , Fuchs Th. , Gutgesell T. , Reich K. , Gebhardt M. , Becker D. , Grabbe J. , Szliska C. , Aberer W. , Hallier E.
Published: February 2007

We investigated whether patients with contact allergy differed from non‐contact‐allergic, non‐atopic controls with regard to genotype and phenotype of the polymorphic enzyme N‐acetyltransferase 2 (NAT2). 55 contact‐allergic patients recruited from the Information Network of Departments of Dermatology (IVDK) were compared to 85 controls from among local health care personnel. NAT2 activity was calculated from HPLC analysis of the ratio of the caffeine metabolites 5‐acetylamino‐6‐formylamino‐3‐methyluracil (AFMU) and 1‐methylxanthine (1MX) in the urine. NAT2 genotype was determined by polymerase chain reaction (PCR). A statistically significantly increased proportion of rapid acetylators was found in contact‐allergic patients. This may have 2 possible implications: acetylation may enhance contact sensitization; or NAT2 status may be a genetic marker for contact sensitizability.
Lack of antagonism to Ni2+ and Co2+ contact allergy from other essential divalent metal ions
Authors: van den Broeke Leon T. , Nilsson I Lars G. , Scheynius Annika , Wahlberg Jan E. , Karlberg Ann‐Therese
Published: February 2007

The potential antagonistic effects of Ca2+, Cu2+, Fe2+, Mg2+, Mn2+ and Zn2+ on contact allergy to Co2+ and Ni2+ were studied. The immune response was characterized by the Co2+ or Ni2+ mediated cellular [methyl‐3H]thymidine uptake in peripheral blood mononuclear cell (PBMC) cultures from 6 subjects contact‐allergic to Co2+ and Ni2+ and 6 non‐allergic control individuals. Results from the in vitro experiments were further evaluated with Co2+‐sensitized guinea pigs according to the modified Freund's complete adjuvant test. Ni2+ and Co2+ (10–50 μM) significantly increased the lymphocyte proliferation in PBMC cultures from contact‐allergic subjects in comparison with those from control individuals. Pretreatment of the PBMCs with Ca2+, Fe2+, Mg2+ (10–100 μM) or Mn2+ (1–10 μM) did not influence, while Zn2+ (100 μM) enhanced, and Cu2+ (5 and 10 μM) markedly reduced the Ni2+ and Co2+ mediated cellular [methyl‐3H]thymidine uptake. The inhibition of the Ni2+‐ and Co2+‐induced cell proliferation by Cu2+ in vitro was probably related to toxicity, since the viability of the cells was significantly reduced by applied combinations of Ni2+ or Co2+ with Cu2+. Topical pretreatment of Co2+‐sensitized guinea pigs with maximum non‐irritating doses of CuCl2· 2H2O (0.8%) did not affect the challenge testing to CoCl2· 6H2O (0.1 and 0.3%). In conclusion, our combined in vitro and in vivo results indicate that Ca2+, Cu2+, Fe2+, Mg2+, Mn2+ and Zn2+ are not able to antagonise the formation of Ni2+ and Co2+ antigens.
Contact sensitization in chronic venous insufficiency: modern wound dressings
Authors: Gallenkemper Georg , Rabe Eberhard , Bauer Ralf
Published: February 2007

Patch tests with an expanded European standard series and 20 different wound dressings revealed sensitization in 78% of all (36) patients. The charts of allergens were headed by ointment bases (wool wax alcohols sensitization in 33% of all patients; Amerchol L‐101 19.4%; cetearyl alcohol 13.9%; propylene glycol 8.3%), followed by plant resins/ethereal oils (balsam of Peru 22.2%; colophony 13.9%, fragrance mix 8.3%; propolis 5.6%) and topical antibiotics (neomycin sulfate 16.7%, chloramphenicol 13.9%), while usually common sensitizers like metal salts were not found as often (nickel sulfate 16.7%; potassium dichromate 13.9%; cobalt chloride 5.6%). Sensitization to modern wound dressings was found in 8.3% (3 cases) and was caused by propylene glycol as an ingredient of hydrogels; no sensitization was found to hydrocolloids, alginates or polyurethane foams. The overall sensitization rate in 2nd degree CVI was nearly as high as in 3rd degree CVI, but sensitization to ointments, their additives and topical antibiotics was significantly higher in 3rd degree CVI. Significant differences in sensitization frequencies to individual allergens were found between male and female patients. Our investigation points out the high risk of sensitization in 2nd as well as 3rd degree CVI, especially to ointment bases and active principles of topical drugs. Even wound dressings may cause allergic contact reactions.
Phototoxic contact dermatitis from 5‐methoxypsoralen in aromatherapy oil
Authors: Clark S. M. , Wilkinson S. M.
Published: February 2007

Bergamot (Citrus bergamia) oil is obtained from the rind of small orange‐like fruits native to Italy. It is obtained by expression when the fruits have almost yellowed. Its light citrussy aroma, in addition to long‐standing use in the cosmetic industry and to flavour tea, is used in aromatherapy. The essential oil of bergamot contains various compounds, including the furocoumarins citropten (5,7‐dimethoxycoumarin (5,7‐DMC)) and bergapten (5‐methoxypsoralen (5‐MOP)) (1). In combination with exposure to sun, bergamot oil stimulates melanogenesis (2), hence potentially protecting the skin against erythema and even cutaneous cancers (photo‐chemoprotection) (3). However, both citropten and bergapten are known to be photomutagenic (4, 5) and phototoxic, bergapten being the more toxic.

Until recently, 5‐MOP was frequently used in suntanning preparations. The status of 5‐MOP in the EU is currently being discussed, though there is already an un‐official ban in the UK on its use in sunscreen products. IFRA recommends in its code of practice that, when used for application on areas of skin exposed to sunshine, excluding bath preparations, soaps and other products that are washed off the skin, bergamot oil should not be used in consumer products at above 0.4%. Major manufacturers of perfumes comply with the IFRA code of practice which limits 5‐MOP to 75 ppm in perfume, and distil oil of bergamot to substantially remove 5‐MOP (6). 8‐MOP is prohibited in cosmetic products except the natural content of essences.
Perioral contact dermatitis caused by L‐carvone in toothpaste
Authors: Worm M. , Jeep S. , Sterry W. , Zuberbier T.
Published: February 2007

Contact sensitivity to toothpaste is rare and usually due to preservatives or flavourings, of the latter, mint components being the most important sensitizers (1).
Adverse skin reactions to vitamin K1: report of 2 cases
Authors: Balato N. , Cuccurullo F. M. , Patruno C. , Ayala F.
Published: February 2007

Vitamin K is essential to the biosynthesis of prothrombin and other clotting factors (VII, IX and X), and is mostly used for the prophylaxis of bleeding disorders, mainly in patients with hepatic disfunction (1). 4 different pharmacological forms exist: the natural form K1 (phytomenadione); K2 (menaquinone), which is derived from intestinal bacterial action; K3 (menadione); and K4 (menadiol). The latter 2 are synthetic products. In Italy, only vitamin K1 is marketed (2).

Adverse cutaneous reactions to vitamin K are rare; 2 are mainly reported: an erythematous plaque (3, 4) or pseudo‐scleroderma (5) at the injection site. Contact dermatitis and localized urticarial lesions have also been described (2).
Photocontact dermatitis from UV filters
Authors: Ricci Cinzia , Pazzaglia Massimiliano , Tosti Antonella
Published: February 2007

UV filters are currently the most common photoallergens (1, 2), particularly the benzophenones (2–7). Recently, the concentration of UV filters in the GIRDCA photopatch test series has been increased from 2% to 10% pet.
Allergic contact dermatitis from dioctyl sodium sulfosuccinate in a topical corticosteroid
Authors: Lee Ai‐Young , Lee Ki‐Hyun
Published: February 2007

Contact dermatitis from topical corticosteroids should be considered if an existing dermatitis resists treatment or becomes worse (1).
Occupational heat contact urticaria
Authors: Miranda‐Romero Alberto , Navarro Lourdes , Pérez‐Oliva Narciso , González‐López Antonio , García‐Muñoz Miguel
Published: February 2007

Heat‐induced local urticaria (HLU) is a rare physical urticaria, recognizable by the formation of wheals in the areas where heat is applied. About 40 cases have been published (1), including the familiar delayed variant (2).
Formation of formaldehyde and peroxides by air oxidation of high purity polyoxyethylene surfactants
Authors: Bergh Margareta , Magnusson Kerstin , Nilsson J. Lars G. , Karlberg Ann‐Therese
Published: February 2007

Ethoxylated alcohols are non‐ionic surfactants. The majority are used in household cleaners, laundry products, toiletries and in industrial and institutional cleaners. In previous studies, an ethoxylated non‐ionic surfactant of technical quality showed allergenic activity in guinea pig experiments. Chemical analysis revealed a content of formaldehyde, a well‐known contact allergen, and peroxides in the surfactant. Most cases of occupational contact dermatitis are considered to be of irritant origin, caused by contact with water and surfactants, but if allergenic autoxidation products can be formed, allergic contact dermatitis cannot be excluded. The sensitizing potential of a chemically defined high purity ethoxylated alcohol was investigated and oxidation under various storage and handling conditions was studied for this and a homologous product. The pure surfactant showed no significant allergenic activity on predictive testing in guinea pigs. When ethoxylated alcohols were stored in the refrigerator, their deterioration was limited. At room temperature, their content of peroxides and formaldehyde increased with time. Levels of formaldehyde above those capable of causing positive patch test reactions were found. Since such surfactants have wide applications, resulting exposure to formaldehyde could be more frequent than is generally realized, contributing to persistence of dermatitis in individuals allergic to formaldehyde.
Keratin 17 is expressed during the course of SLS‐induced irritant contact dermatitis, but unlike keratin 16, the degree of expression is unrelated to the density of dividing keratinocytes
Authors: Willis C. M. , Reiche L. , Wilkinson J. D.
Published: February 2007

The aims of this study were to utilize quantitative immunocytochemical techniques to determine the densities of keratin 16 (K16) and keratin 17 (K17) expressed by keratinocytes during the course of acute patch test reactions to sodium lauryl sulfate (SLS), and to relate these to the proliferative state of the epidermis, as assessed by Ki‐67 immunolabelling. Significantly increased numbers of dividing keratinocytes were present in 48h and 96h reactions, concurrent with high levels of expression of K16 and more moderate expression of K17. Statistical analysis indicated a good correlation between K16 expression and the density of Ki‐67+ keratinocytes present in the epidermis (r=0.843). This was not the case for K17 (r=0.396). The results demonstrate that both K16 and K17 expression are features of acute irritant contact dermatitis reactions, but suggest that the factors which influence and control their expression differ.
Ethylenediamine: a possible cause of airborne urticaria and indoor air complaints
Authors: Baker Beth , Gregor Gail , Prawer Steven
Published: February 2007

Ethylenediamine, a stabilizer in topical creams and a component of aminophylline (1), causes dermatitis and is a common sensitizer. Other related amines, such as monoamylamine and para‐phenylenediamine, have caused urticaria. Except for 1 case report by Urbani (2), ethylenediamine is not a common cause of allergic urticaria (3, 4).
Allergic contact cheilitis from spearmint oil
Authors: Skrebova Natalja , Brocks Kim , Karlsmark Tonny
Published: February 2007

Allergic reactions to toothpaste flavours are infrequent: only 5 cases in a 26‐year period among 46,000 Copenhagen eczema patients (9) and 7 cases in a 6‐year period at Gentofte Hospital (3). Spearmint is used in almost every brand of toothpaste as a flavour, together with other flavouring ingredients such as menthol, peppermint, anethole, eugenol and cinnamic aldehyde. It is also used in chewing gum, medicines, etc.
Occupational dermatitis in a silk‐screen maker
Authors: Goossens A. , Coninx D. , Rommens K. , Verhamme B.
Published: February 2007

In silk‐screen printing, ink is squeezed through the open meshes of a screen carrying an image, thus transferring the image to the surface below (1, 2). Silk has been replaced by nylon, Dacron®, and polyesters (3). Previously, all the stencils were prepared manually, but now indirect photo‐mechanical processing and photo‐composition are widely used (2). Thus are printed decals, posters, wallpaper, glass, clothing, printed circuit boards, skis, surfboards, and credit cards (4).
Intravenous challenge with heparins in patients with delayed‐type skin reactions after subcutaneous administration of the drug
Authors: Trautmann Axel , Brôcker Eva‐B. , Klein C. Eberhard
Published: February 2007

Delayed‐phase reactions after subcutaneous (s.c.) injection of high‐ or low‐molecular‐weight heparins are not rare. They present as indurated s.c. swelling with overlying erythema/eczema, causing burning or itching (1). Occasionally, an exanthematous reaction supervenes. If further anticoagulation is necessary, cross‐reactivity with other anticoagulants (heparinoids), such as dermatan sulfate (OrgaranTM) or sodium pentosan polysulfate (FibrezymTM), is common (2). Even after the introduction of the new anticoagulant lepirudin (RefludanTM), heparins remain the drugs of choice, particularly for intravenous (i.v.) anticoagulation. The most important differential diagnosis from delayed‐type reactions after s.c. heparin is the initial stage of heparin‐induced skin necrosis, which may be a sign of heparin‐induced thrombocytopenia (HIT). Cutaneous necrosis is characterized by a well‐defined eschar surrounded by an inflammatory halo, and can occur either at the injection site or at distant sites.
Nickel content of standard patch test materials
Authors: Nakada Tokio , Hostynek Jurij J. , Maibach Howard I.
Published: February 2007

The nickel sulfate content in standard patch test materials currently used in the US, Europe and Japan was determined by inductively‐coupled plasma atomic emission spectroscopy, a state‐of‐the‐art microanalytical method which allows nickel detection to levels of 7 ppb (μg/l). In 2 materials with a nominal concentration of 5% nickel sulfate hexahydrate in pet., the range (calculated averages of triplicate analyses of 3 different batches) was from 4.72 to 4.87% and 4.97 to 5.39%, respectively. In 1 material with a 2.5% nominal concentration in pet., the values ranged from 2.41 to 2.48%. The range seen in a 5% NiSO4 hexahydrate aq. material was 4.95 to 5.03%. The range for 2.5% NiSO4 anh. in pet. was 2.39 to 2.49%. This data suggest a significant improvement in quality control compared to our previously published data.
Contact sensitivities in palmar plantar pustulosis (acropustulosis)
Authors: Yiannias James A. , Winkelmann R. K. , Connolly Suzanne M.
Published: February 2007

Acropustulosis, or chronic palmar plantar pustulosis (PPP), is a phenomenon of recurrent sterile pustules, erythema, and scaling affecting the palms and soles. Its pathogenesis is unclear, and it is difficult to treat. The purpose of this study was to elucidate further the factors involved in causing PPP, thereby enhancing the ability to manage this disease. All cases of PPP seen at Mayo Clinic Scottsdale from 1987 to 1993 were reviewed. 21 patients with PPP were identified, 15 of whom had been patch tested. 9 of the 15 patients (60%) showed positive patch test results. Fragrance was the most common sensitivity, but nickel, formaldehyde, para‐phenylenediamine, thiuram, neomycin, mercury, balsam of Peru, and cinnamic aldehyde sensitivities were demonstrated. Less important factors included atopy, fungal and bacterial infections, and irritation. Although the mechanism of this sterile pustulosis response does not depend solely on delayed hyper sensitivity mechanisms, we believe that we have demonstrated such a large number of positive patch tests in this chronic pustular dermatosis that patch testing should be considered in the routine work‐up of these patients.
Contact allergy to the monomers of p‐tert‐butylphenol‐formaldehyde resin in the guinea pig
Authors: Zimerson Erik , Bruze Magnus
Published: February 2007

In patients hypersensitive to p‐tert‐butylphenol‐formaldehyde resin (PTBP‐F‐R), and butylphenol derivatives therein, it is for diagnostic, therapeutic and preventive reasons necessary to know the identity of the primary sensitizing substances, their sensitizing capacities as well as their cross‐reaction patterns. The monomers in PTBP‐F‐R, 2‐methylol p‐tert‐butylphenol (2‐MPTBP) and 2,6‐dimethylol p‐tert‐butylphenol (2,6‐MPTBP), have been shown to be contact sensitizers in man. The aim of this study was to investigate the sensitizing capacities of the monomers and establish cross‐reacting patterns in the guinea pig with the guinea pig maximization test. 2,6‐MPTBP was shown to be a strong sensitizer while it was indicated that 2‐MPTBP was a sensitizer. Animals sensitized to 2,6‐MPTBP showed cross‐reactions to 2‐MPTBP and p‐tert‐butylcatechol. No cross‐reactions were shown to p‐tert‐butylphenol, tert‐butyl 4‐hydroxyanisole (BHA) and 3,5‐di‐tert‐butyl 4‐hydroxytoluene (BHT).
Prevention of nickel‐induced allergic contact reactions with pentoxifylline
Authors: Saricaoglu H. , Tunali S. , Bulbul E. , White I. R. , Palali Z.
Published: February 2007

In this study, we investigated the effect of pentoxifylline, an inhibitor of TNF‐α, on the contact sensitivity response induced by nickel. For induction, open epicutaneous sensitization by NiSO4. 6H2O (25% aq.) solution was applied on the backs of 38 albino guinea pigs 5 days a week for 4 weeks. NaCl (0.9%) solution was applied epicutaneously to 10 albino guinea pigs as a control group. 19 were sensitized by nickel and developed positive patch test reactions. Patch tests were repeated after 10 of the sensitized pigs were given pentoxifylline 20 mg/kg/day orally. At the end of this study, only 2 positive patch test reactions were observed in the pentoxifylline‐treated group, while 7/9 of the untreated guinea pigs developed positive reactions. These results suggest that pentoxifylline inhibits the contact sensitivity response induced by nickel only during drug administration.
Thimerosal positivities: patch testing to methylmercury chloride in subjects sensitive to ethylmercury chloride
Authors: Santucci B. , Cannistraci C. , Cristaudo A. , Camera E. , Picardo M.
Published: February 2007

The aim of this paper was to evaluate whether methylmercury chloride (MeHgCl) aq., when patch tested in a group of thimerosal‐positive subjects reacting to ethylmercury chloride (EtHgCl), might be a reliable model for the better understanding of interactions between alkylmercury compounds and the skin. 19 out of 21 consecutive patients who previously had given positive patch‐test reactions to both ethylmercury chloride 0.0165% eth.(EtHgCl, 0.615 mM) and MeHgCl 0.031% aq.(1.23 mM), and negative reactions to thiosalicylic acid 0.05% (3.24 mM) aq./eth. 50/50, were repatch tested to 8 μl of MeHgCl 0.031% aq. and to 8 μl of aq. solutions containing MeHgCl mixed with cysteine, glutathione, ZnSO4, Mg SO4, Mn SO4, ZnCl2, MgCl2 and Mn Cl2, respectively. The results showed that cysteine, glutathione and Zn(II) salts were able to abolish the positive reactions, demonstrating the rôle played by both thiol groups and Zn(II) itself. Patch tests concomitantly carried out in 16 out of 19 patients to 8 μl of aqueous MeHgCl and to 8 μl of aqueous solutions containing MeHgCl and MeHgCl mixed to fragment 56‐61 of metallothionein I (MT I), MT I and MT II‐Zn, respectively, revealed that all the MTs tested were able to reduce or to inhibit the reactions, demonstrating the effect of the thiol groups. Due to the close chemical similarities to EtHgCl and to its water solubility, MeHgCl seems to be a suitable model for evaluating the reactivity of alkylmercury compounds in the skin. We speculate that both EtHg‐ and MeHg‐derivatives are xenobiotics with similar reactivity. However, the lack of clinical relevance of the reactions to both alkyl compounds lead us to conclude that, since environmental exposure does not seem to play a pivotal rôle, they probably have mostly to do with compounds included in in the standard series, and are elicited by reduced function of physiological SH chelators.
Patch testing with budesonide in serial dilutions: the significance of dose, occlusion time and reading time*
Authors: Isaksson M. , Bruze M. , Goossens A. , Lepoittevin J. P.
Published: February 2007

Budesonide is advocated as a marker molecule for corticosteroid contact allergy. When patch testing corticosteroids, one must consider their sensitizing potential but also their anti‐inflammatory properties, as well as the possibility of different time courses for such properties. The dose‐response relationship for budesonide was therefore investigated with regard to dose, occlusion time, and reading time. 10 patients were patch tested with budesonide in ethanol in serial dilutions from 2.0% down to 0.0002% with occlusion times of 48, 24, and 5 h. Readings were on D2, D4, and D7. The 48‐h occlusion picked up most positive reactors, 8/10. The D4 reading (48‐h occlusion) detected most positive reactors, 8/10, and here 0.002% picked up most contact allergies. Late readings favoured high concentrations. The “edge effect” was noted for several concentrations at early readings. Due to the individual corticosteroid reactivity, the dose‐response relationship and the time courses of the elicitation and the anti‐inflammatory capacity, several features may be explained, i.e., that lower concentrations may detect budesonide allergy better at early readings, that patients with an “edge reaction” can have positive reactions to lower concentrations.
Irritancy of industrial hand cleansers tested by repeated open application on human skin
Authors: English J. S. C. , Ratcliffe J. , Williams H. C.
Published: February 2007

The aim of this study was to compare the irritancy potential of 2 industrial hand cleansers with a brand leader of “mild” children's hand cleanser and with an emollient. The products were tested using repeated open application tests (ROATs) on the forearms of 40 subjects. Scoring of signs and symptoms (itching or burning), transepidermal water loss (TEWL) and stratum corneum hydration (Corneometer) evaluated responses. On all assessments, the children's hand cleanser was more irritant than the 2 industrial hand cleansers. The children's hand cleanser and industrial hand cleansers were more irritant than the emollient. The finding that a hand cleanser for children was more irritant than 2 industrial hand cleansers was surprising, and one which might hold serious implications for inducing or exacerbating atopic eczema in children. The combination of visual scoring, TEWL and Corneometer readings on ROATs is a potentially useful way of assessing irritancy strength of soap products on human skin.