bluuebunny/crossref_metadata_2025 huggingface dataset:
Oral hygiene in the control of occlusal caries
Authors: Arrow Peter
Published: February 2007

Abstract –

Occlusal pit and fissure caries accounts for a high proportion of the total caries burden among children. Studies from Denmark suggested that oral hygiene measures may be effective in the control of occlusal caries in permanent teeth. This study reports on the findings after 24 months of a controlled field trial comparing the caries‐preventive effects of a professional tooth‐cleaning and dental health education programme (test) with a standard preventive programme (control), comprising selective fissure sealing and application of topical fluorides. School Dental Service clinics of the Health Department of Western Australia, in Perth, were assigned to four test or four control clinics. Schoolchildren, mean age 6 years, with sound newly erupted first permanent molars were included in the study (207 test, 197 control). After 24 months, 179 test and 156 control children were examined by a calibrated examiner who was ‘blind’ to the test or control status of the child. Thirty‐two test and 31 control children developed occlusal caries on the first permanent molars; the estimated risk ratio was 0.90 (95% CI 0.58–1.41). Children in both groups had an average DMFT score of 0.30. The 24‐month results suggest that the two preventive programmes did not differ with respect to the control of occlusal caries in newly erupted molars.
Oral hygiene as a risk indicator of enamel and dentin caries
Authors: Mascarenhas Ana Karina
Published: February 2007

Abstract –

Dental researchers have postulated that the risk factors for enamel and dentin caries may not be the same. A review of the literature ascertained that data to support this theory are lacking. Objectives: To evaluate the risk indicators of enamel and dentin caries of the permanent dentition in a study group who had limited access to fluorides and made limited use of dental services. Methods: The study was conducted in Goa, India. Data came from a cross‐sectional survey of 1189 seventh grade children, which consisted of a clinical dental examination and a self‐administered questionnaire to their parents. The cavitated and non‐cavitated criteria were used to score for caries, and the Silness‐Loe index for plaque. Results: The mean age of the children was 12.2 years. The percentage of children caries free in the permanent dentition was 22.2%, the mean±s for dmfs, enamel and dentin lesions were 4.20±5.10, 2.59±2.89 and 1.61±3.30 respectively, and the mean plaque score was 1.00±0.48. Results of regression analyses showed that the risk indicators of prevalence and severity of caries differed depending on lesion type. The only variable that was consistently a risk indicator of presence and severity of both dentin and enamel caries was poor oral hygiene. Mother's highest level of education and presence of fluorosis were also risk indicators of enamel and dentin caries. The presence of decayed primary teeth was a risk indicator of enamel caries; and fluorosis severity, use of fluoride toothpaste at the time of the survey, and toothbrushing frequency were risk indicators of dentin caries. The observed caries‐oral hygiene association seen is explored further.
The Dental Subscale of the Childrens Fear Survey Schedule: a factor analytic study in the Netherlands
Authors: ten Berge Maaike , Hoogstraten Johan , Veerkamp Jaap S. J. , Prins Pier J. M.
Published: February 2007

Abstract –

The Dental Subscale of the Childrens Fear Survey Schedule (CFSSDS) is a well‐known instrument for assessing dental fear in children. Previous studies have shown that the scale has acceptable reliability and validity. Factor analysis using scores of a group of Finnish schoolchildren resulted in three factors. No other data on the factor structure have been published. In order to report on the factor structure of the Dutch parental version of the CFSS‐DS, the present study was undertaken. Factor analysis using scores from a group of Dutch children (n=150) demonstrated a factor pattern fairly similar to the results found in the Finnish study. Three factors were found: 1) fear of highly invasive dental procedures, 2) fear of less invasive aspects of treatment and 3) fear of medical aspects. Considering that almost all items load substantially (≥0.20) on more than one factor, it seems that one primary underlying dimension exists: fear of invasive treatment aspects. The CFSS‐DS is proposed as a reliable, one‐dimensional measure of dental fear.
Reliability and validity of the short version of the Dental Anxiety Inventory
Authors: Aartman Irene H. A.
Published: February 2007

Abstract –

The present study focused on a newly developed questionnaire to assess dental anxiety. The short version of the Dental Anxiety Inventory (S‐DAI) contains nine items of the Dental Anxiety Inventory (DAI), which was designed to take into account three situations that may evoke dental anxiety, four time elements in which dental anxiety may be provoked, and three reactions. The aim was to assess the validity and reliability of the S‐DAI in a sample of highly anxious dental patients applying for treatment at a dental fear clinic in the Netherlands. Three hundred and twenty‐one patientslled out several questionnaires assessing dental anxiety (S‐DAI, DAS, and a 10‐point Likert‐scale) and psychological complaints. Total mean score on the S‐DAI for women (mean=40.5, s=5.7) was some‐what higher than for men (mean=38.8, s=6.9) (t(306)=2.35; P=0.019). Cronbach's α for the present sample was 0.88. Correlations with other measures of dental anxiety were 0.73 with the DAS (P < 0.001) and 0.69 (P < 0.001) with the 10‐point scale. The results indicated that the S‐DAI has good reliability and construct validity. It was concluded that the S‐DAI is easy to administer in general dental practices and dental fear clinics and has satisfactory psychometric qualities.
ART restorations and glass ionomer sealants in Zimbabwe: survival after 3 years
Authors: Frencken Jo E. , Makoni Fiona , Sithole Wilson D.
Published: February 2007

Abstract –

Atraumatic restorative treatment (ART) consists of removing demineralised tooth tissues with hand instruments only, restoring the prepared cavity and sealing the adjacent pits and fissures with an adhesive filling material. This relatively painless, no‐handpiece, minimal intervention approach to controlling dental caries is described. ART was applied in an oral health care programme in Zimbabwe that was carried out amongst secondary school students from 1994 to 1997. A new glass ionomer (Fuji IX) was used as the restorative and sealant material. Sealants were placed in high caries risk students using the ‘press‐finger’ technique. A total of 297 one‐surface ART restorations and 95 glass ionomer sealants were placed in 142 and 66 students, respectively. After 3 years, the lost‐to‐follow‐up percentages for one‐surface ART restorations and glass ionomer sealants were 30.6% and 30.5%, respectively. Actuarial (life table) analysis resulted in 3‐year survival rates of one‐surface ART restorations of 88.3% (95% CI: 92.4%–84.2%), ranging from 94.3% to 65.4% per operator. A total of 28 ART restorations placed in 25 students failed. Reasons for failure related to the material and the operator (11 restorations or 5.3% each), and to caries adjacent to the restoration (one restoration or 0.5%). Reasons for failure were not recorded for five restorations (2.3%). Seal‐ants were placed on surfaces diagnosed as early enamel lesions. After 3 years, 71.4% (95% CI: 81.7%–61.1%) of the fully and partially retained sealants survived with a range of 100% to 55.6% per operator. Of the sealed surfaces 96.3% (95% CI: 100%–92.2%) survived 3 years without developing caries. Experienced operators placed better ART restorations than inexperienced operators. This study has demonstrated that ART with a glass ionomer restorative material and sealants provided high quality preventive and restorative dental care to this student population. ART has become one of the treatment modalities available to oral health workers in managing dental caries.
Compliance in dentistry: general adherence, specific adherence and perceived dental health
Authors: Verweij Thaloen A. , Oosterveld Paul , Hoogstraten Johan
Published: February 2007

Abstract –

In this study it was attempted to replicate findings on the relationship between general and specific adherence and perceived health in the context of dental treatment. Furthermore the psychometric characteristics of a modied adherence scale for use in dental populations were investigated. A sample of 167 freshmen completed a questionnaire containing a general adherence scale (GAS) developed by DiMatteo et al. (Oncology 1992;6:507), a perceived health scale, a perceived dental health scale, and two items about adherence to recommendations on dental behaviour. The GAS showed adequate internal consistency. Positive correlations were found for general adherence on the one hand and for specific adherence, perceived health, and perceived dental health on the other. The results concerning the GAS and specific adherence do not correspond with the findings of DiMatteo et al. It is suggested that this discrepancy is due to the situation‐specificity of adherence in combination with differences in the samples and the specific adherence measures used in both studies.
Measuring patient satisfaction with mandibular prostheses
Authors: Awad Manal A. , Feine Jocelyne S.
Published: February 2007

Abstract –

Objectives: Previous research has shown that patients' evaluations of their prostheses correlate poorly with the clinicians' assessments, as well as with intraoral anatomic factors. It has been recommended that researchers conduct more studies that use patient satisfaction as the primary outcome measure in treatment evaluation and that more attention be paid to understanding exactly what measures of patient satisfaction represent. In this study, the relationship between patients' ratings of general satisfaction and their perceptions of different aspects of mandibular prostheses is investigated. Methods: One hundred and twenty subjects applied to participate in a randomized controlled clinical trial comparing two types of mandibular prostheses: conventional dentures and implant prostheses. At baseline, they were asked to rate on 100 mm visual analog scales (VAS) factors that edentulous patients indicated were important to them. These included comfort, ability to chew, stability, esthetics, ability to speak and ease of cleaning of their conventional dentures. Subjects were also asked to rate their general satisfaction with their dentures. In addition, they selected the one quality of their denture that they considered to be most important. Results: Multiple regression methods revealed that gender, as well as patients' ratings of comfort, stability, esthetics, ability to chew and ability to speak with their prostheses contributed significantly to general satisfaction (F < 0.0001). Furthermore, 89% of the variation in ratings of general satisfaction was explained by these factors. In addition, patients who considered ability to chew as the most important factor associated with their dentures rated their general satisfaction significantly higher than the other subjects (P < 0.0003). Conclusion: Patient satisfaction with conventional dental prostheses is highly dependent on gender, and the appearance and functionality of the appliance. The combined effect of these factors explained most of the variation in the satisfaction ratings.
The influence of toothbrushing frequency and post‐brushing rinsing on caries experience in a caries clinical trial
Authors: Chestnutt Ivor G. , Schäfer Fred , Jacobson Alyson P. M. , Stephen Kenneth W.
Published: February 2007

Abstract –

Objectives: To examine the effect of reported toothbrushing frequency and method of rinsing after brushing on caries experience and increment. Methods: Data are presented from 2621 adolescents (mean age 12.5 years at outset) participating in a 3‐year double‐blind caries clinical trial. At baseline, examiners questioned each participant about their toothbrushing habits, and at subsequent examinations, this information was obtained using a self‐administered computer‐based questionnaire. Participants used a fluoride‐containing dentifrice through‐out and clinical examinations were conducted using a mirror, CPITN probe and fibre‐optic transillumination. Results: The reported brushing frequency increased throughout the trial. Caries experience at baseline was inversely related to tooth‐brushing frequency with mean DMFS=9.66, 8.12 and 7.63 respectively for < 1/day, 1/day and > 1/day brushers (P < 0.001). Mean 3‐year DMFS increments of 8.90, 6.63 and 5.48 (P < 0.01) were observed in those reporting to brush < 1/day, 1/day or > 1/day, on not less than two of the three clinical examinations during the trial. Caries increment was also significantly related to the claimed method used to rinse post‐brushing. Overall frequency of brushing and rinsing method accounted for over 50% of the explained variance in the ANOVA model used to analyse the DMFS increments. Conclusions: Stated toothbrushing frequency and rinsing method after brushing were found to be strongly correlated with caries experience and caries increment. These factors should be reflected in the design of oral health education material and taken into account in the design and analysis of caries clinical trials.
Association of salivary mutans streptococci with discoloured pits and fissures
Authors: Steiner Marcel , Helfenstein Ulrich , Menghini Giorgio
Published: February 2007

Abstract –

Experimental studies have demonstrated that mutans streptococci play a major role in caries etiology. Several previous epidemiologic studies found a positive association of salivary mutans streptococci with caries prevalence. The present epidemiologic study aimed at detecting a possible association of salivary mutans streptococci with brown discoloured pits and fissures, supposing that discolouration indicates caries. In the Canton of Zurich 1035 schoolchildren, aged 6.5–12.5, were examined with regard to caries prevalence and presence of discolourations in pits and fissures. A commercially available, semi‐quantitative test was used to estimate the salivary level of mutans streptococci in each child. The salivary level (low/high) of mutans streptococci was significantly associated with the presence of slightly brown discoloured (C1), clearly brown discoloured (C2) and cavitated (C3) pits and fissures. The odds ratios were 1.5 (P < 0.01) for C1, 2.5 (P < 0.001) for C2 and 5.0 (P < 0.001) for C3 pits and fissures. Then fidings are consistent with the hypothesis that brown discolouration indicates caries. Further‐more, then fidings suggest that this type of discolouration at elementary school age indicates increased caries activity.
Orthodontic treatment need prior to treatment and 5 years postretention
Authors: Al Yami Essam A. , Kuijpers‐Jagtman Anne M. , Hof Martin A. van't
Published: February 2007

Abstract –

Objectives: To assess orthodontic treatment need prior to treatment and 5 years postretention in a large university sample. Methods: A random sample of 920 patients (400 male and 520 females) from the Department of Orthodontics and Oral Biology, University of Nijmegen, the Netherlands, were included in this study. Dental casts were evaluated using the Index of Orthodontic Treatment Need (IOTN) at the pretreatment (TP) and 5‐year postretention stages (T5). The mean age at TP was 12.2±3.0 years and at T5 21.6±3.1 years. At TP and T5 the aesthetic component (AC) and the dental health component (DHC) were assessed The difference between TP and T5 was compared for males and females and tested by the t‐test. The changes in AC, DHC and treatment need categories were described at TP and at T5. Results: On the basis of combined AC and DHC treatment need categories, 83% of the patients fell into the Definite e need d category prior to treatment and 10% of the treated patients were categorised as having “Definite need” 5 years postretention. No significant differences were found between males and females for the change in AC and DHC between TP and T5. Conclusions: The results indicate that the policy used in the department for patient selection gives priority to patients with a high treatment need. The results also provide a general impression of treatment outcome utilising the IOTN to analyse the change in the treatment need categories.
Caries conditions among 2–5‐year‐ old immigrant Latino children related to parents' oral health knowledge, opinions and practices
Authors: Watson Maria‐Rosa , Horowitz Alice M. , Garcia Isabel , Canto Maria T.
Published: February 2007

Abstract –

Objectives: To collect baseline data prior to initiating a community‐based, oral health promotion program in an inner city Latino community in Washington DC, populated by Central American immigrants. Methods: In 1995, an oral survey of a convenience sample of children 2–5 years of age (n= 142) and a survey of the knowledge, opinions and practices (KOP) of their parents (n= 121) were completed. Clinical data of children were matched with parent respondents of the KOP survey. Data were analyzed for statistical associations using univariate odds ratios, Fisher's exact tests, and multiple logistic regression. Results: Only 53% of the children were caries free. Eighteen percent of all children were in need of immediate dental care and 26% were in need of early or non‐urgent dental care. Only 7% of the parents knew the purpose of sealants and 52% knew the purpose of fluorides. Further, only 9% thought that brushing with toothpaste can prevent tooth decay. The strongest predictors of dental caries in this population, after adjusting for child's age and mother's education, were recency of mother's residence in the United States and report of an uncooperative child when attempting toothbrushing. Conclusions: Regimens of caries prevention have been successful in reducing dental decay for a large segment of the US population, yet this disease remains prevalent especially among low socioeconomic groups. The oral health status of the children and the oral health KOP of the parents in this community are disturbingly deficient.
Cigarette smoking and periodontitis: methodology to assess the strength of evidence in support of a causal association
Authors: Gelskey Shirley C.
Published: February 2007

Abstract –

Identication of the cause of the development and progression of periodontitis has received extensive attention, with notable advances over the past decade in clinical, microbiological, immunological, biochemical, and behavioral knowledge. However, it is still largely unknown which factors lead to the conversion of non‐destructive forms of periodontal disease into destructive forms and disease progression. Chronic adult periodontitis is believed to be inuenced by an interaction of host defense and environmental factors. Although these variables have been studied extensively, no study has employed randomized controlled prospective human or randomized controlled community intervention designs, methodologies necessary to prove a variable to be a cause of periodontitis. Owing to the absence of literature employing rigorous experimental design, this article assesses systematically observational, cross‐sectional and longitudinal studies to examine the potential causal association between cigarette smoking and periodontitis. The methodology of Sir Bradford Hills's criteria for causation was used as the framework. Results suggest that cigarette smoking is causally associated with periodontitis. That is, cigarette smoking is consistently associated with an increased prevalence/severity of periodontitis and is suspected on theoretical grounds of playing a causal role. Hills criteria provide a useful methodology to better understand the pathogenesis of periodontal diseases and may be applied to study the pathogenesis of other dental diseases as well.
Fluoride supplements and fluorosis: a meta‐analysis
Authors: Ismail Amid I. , Bandekar Rajesh R.
Published: February 2007

Abstract –

This paper presents a systematic review of the dental literature that was carried out to investigate whether the regular use of fluoride supplements in non‐fluoridated communities during the period of tooth development increases the risk of dental fluorosis. A MEDLINE search was organized for all documents published, in English, between January 1966 and September 1997 using the following key words: fluorosis, dental, fluoride, fluoride supplement or supplements, drop or drops, and tablet or tablets. Twenty‐four studies that assessed the development of dental fluorosis in children who had used fluoride supplements earlier in their life were included in this review. Of the 24 studies, 10 were crosssectional/case control studies and four were follow‐up studies. These studies had data that allowed a quantitative estimation of the risk of developing dental fluorosis in users of fluoride supplements. The other 10 studies were excluded because they either did not present enough data or had other methodological problems. A qualitative review of the studies found a consistent and strong association between the use of fluoride supplements and dental fluorosis. The meta‐analyses of the cross‐sectional/case‐control studies estimated that the odds ratio of dental fluorosis in users of fluoride supplements compared with non‐users ranged between 2.4 and 2.6. The meta‐analyses of the follow‐up studies estimated that the relative risk in long‐term users was between 5.5 and 12.2. This review confirmed that in non‐fluoridated communities the use of fluoride supplements during the first 6 years of life is associated with a significant increase in the risk of developing dental fluorosis.
Fluoride supplements for young children: an analysis of the literature focusing on benefits and risks
Authors: Riordan Paul J.
Published: February 2007

Abstract –

The use of fluoride supplements to prevent caries has been advised for more than 100 years, but serious promotion of this strategy occurred only after the effectiveness of water fluoridation was established, in the late 1950s and 1960s. Although the effectiveness of fluoride supplements was apparently endorsed by many small clinical studies, closer examination of the experimental conditions of these, their methods and the analysis of their results undermined confidence in their findings. It is likely that confounding resulted in spurious conclusions in many of them. More modern, well‐conducted clinical trials of supplements suggest that today, in children also exposed to fluoride from other sources such as toothpaste, the marginal effect of fluoride supplements is very small. There is evidence that fluoride lozenges, designed to maximise any local effect, may have a small caries preventive effect, particularly in deciduous teeth. Overall, poor compliance makes fluoride supplements a poor public health measure. Supplement use by young children is associated with a substantial risk of dental fluorosis. Fluorosis is an issue about which the public is becoming concerned in several countries and this concern, if translated into opposition to all fluoride use, could jeopardise the most successful caries preventive aid we have. The potential for dental fluorosis, concern about the public's reaction to this, the poor effectiveness of supplements and the public's poor compliance with their use are persuasive arguments for a radical reduction in the use of supplements by young children. Recent changes in fluoride dosage schedules and deferment of the age of commencing the use of supplements, implemented in many countries, have followed from these concerns. Supplements formulated as lozenges maximise topical exposure of enamel to fluoride and such products may offer older children and some adults a way of maintaining an elevated fluoride level in saliva at times when toothbrushing is not practical.
Serum and urine nickel in nickel‐sensitized women: effects of oral challenge with the metal
Authors: Andreassi M. , Gioacchino M. Di , Sabbioni E. , Pietra R. , Masci S. , Amerio P. , Bavazzano P. , Boscolo P.
Published: February 2007

15 women with a positive patch test only to nickel (Ni) and without atopy and 10 control women were selected for the study. Blood and urine specimens were collected with a standard procedure either before (at 8 a.m.) or 4 and 24 h after the ingestion of 10 mg of Ni (as Ni sulfate). 7 of the Ni‐sensitized patients showed a flare‐up of eczema and/or urticaria during the test, while the other women were non‐symptomatic. Serum and urine Ni of controls and Ni‐sensitized women did not significantly differ. Serum and urine Ni levels determined before the oral Ni challenge were in the range of reference values recently reported by other authors (0.2–2.0 μg/l of serum or urine). Ni was greatly augmented in urine and serum 4 h after the challenge (25th–75th percentiles: 43–264 μg/l urine Ni and 15–52 μg/l serum Ni). 24 h after Ni ingestion, urine Ni was 41–153 μg/l and serum Ni 4–17 μg/l. Our study confirms a previous investigation showing similar levels of serum and urine Ni following ingestion of the metal in control and Ni‐sensitized women without atopy.
Occupational dermatitis in Danish gardeners and greenhouse workers
Authors: Paulsen E.
Published: February 2007

The aim of the study was to assess the distribution of different types of occupational eczema among employees in floristry and detect the allergens most commonly involved. Based on a postal questionnaire, 253 gardeners and greenhouse workers with occupational skin symptoms and 52 randomly‐selected without symptoms were examined and patch tested. Routine tests comprised the standard series, the Compositae mix, feverfew and 3 fungicides, with additional testing based on case records. 184 persons from the symptom group and 1 from the random group had occupational eczema. Irritant occupational contact eczema was suspected in 150 persons (59%). Nevertheless, 48% of the 250 persons patch tested had at least 1 positive reaction, most frequently to nickel, followed by Compositae which were positive in 25 cases (10%), of whom 24 were possibly occupationally sensitized. 13 persons from symptom group had positive reactions to fungicides. Occupational allergic eczema was suspected in 43 persons (17%), most often caused by plants belonging to the Compositae, Geraniaceae and Liliaceae families. New plant sensitizers were Exacum affine and Begonia lorraine. Exposure to specific plant species seemed to be the most important eliciting factors in both allergic and irritant occupational dermatitis in floristry, and preventive measures should include reduction of contact with plants.
A method for quantification of formaldehyde in the presence of formaldehyde donors in skin‐care products
Authors: Karlberg Ann‐Therese , Skare Lizbet , Lindberg Ingrid , Nyhammar Eva
Published: February 2007

Reliable and uncomplicated methods for detection of free formaldehyde in products preserved with formaldehyde donors are desirable to decrease the risk of allergic contact dermatitis. The aim of this study was to develop a method that could be used in clinics and workplaces for quantification of free formaldehyde in products preserved with formaldehyde donors. The method developed is named the closed container diffusion (CCD) method. Formaldehyde in a sample is allowed to evaporate in a closed container and react with 2,4‐dinitrophenylhydrazine coated on a glass fibre filter. The hydrazone formed is analyzed with HPLC. The method was tested on 3 different formaldehyde donors, imidazolidinyl urea, diazolidinyl urea and 2‐bromo‐2‐nitropropane‐1,3‐diol, using 4 different cream bases. The results obtained with this method accord with those obtained with the official method within the European Union (EU). The method is sensitive enough for analysis of patients' products and for control of labelled amounts of formaldehyde in technical products without solvent extraction. As a result of our studies, we observed a risk of exceeding the labelling limit for free formaldehyde in cosmetic products when using the highest amount of diazolidinyl urea allowed within the EU.
Deodorants on the European market: quantitative chemical analysis of 21 fragrances
Authors: Rastogi S. C. , Johansen J. D. , Frosch P. , Menne T. , Bruze M. , Lepoittevin J. P. , Dreier B. , Andersen K. E. , White I. R.
Published: February 2007

Deodorants are one of the most frequently used types of cosmetics and side‐effects from them are common. Recent studies relate perfume allergy to this type of product. 73 deodorants were analyzed by gas chromatography ‐ mass spectrometry for the determination of the contents of 7 well‐known fragrance allergens from the fragrance mix and 14 other commonly used fragrance materials. The deodorants were purchased at retail outlets in 5 European countries. It was found that in general, fragrance mix ingredients were more frequently present in vapo‐ and aerosol sprays than in roll‐on products. The levels of the fragrance mix substances ranged from 0.0001–0.2355%. The products investigated contained cinnamic aldehyde and isoeugenol less frequently (17% and 29% respectively), and eugenol and geraniol most frequently (57% and 76% respectively). The 14 other fragrance materials were found in 40–97% of the deodorants, with hedione and benzyl acetate the most frequently found substances. The concentration of these 14 substances ranged from 0.0001–2.7%. It is concluded that the levels of cinnamic aldehyde and isoeugenol found in the deodorants could prove to be relevant for elicitation of contact dermatitis. No conclusions could be drawn about the other fragrance mix constituents, as threshold levels in sensitized individuals have not been investigated. Furthermore, all of the fragrance materials investigated were frequently found in deodorants and, apart from the fragrance mix ingredients, the extent of problems with sensitization to these fragrance materials is largely unknown.
Interleukin‐4 and the interleukin‐4 receptor in allergic contact dermatitis
Authors: Rowe A. , Bunker C. B.
Published: February 2007

Cutaneous immune responses involving T helper (TH) type 1 (TH1) and type 2 (TH2) T cells, characterised by secretion of interferon‐γ (Ifn‐γ) and interleukin‐4 (IL‐4), respectively, have both been reported in allergic contact dermatitis (ACD). We used immunohistochemistry to localize expression of IL‐4 in ACD lesions and unaffected skin. Atopic dermatitis (AD) and psoriasis biopsies provided positive and negative IL‐4 immunoreactivity controls. To investigate the rôle of IL‐4 in ACD, we investigated expression of IL‐4 receptors in ACD, AD and psoriatic skin. IL‐4 immunoreactivity was found in cells in the dermal infiltrate in 3 out of 7 ACD lesions, but not in unaffected skin from these patients. IL‐4 immunoreactivity was found in the dermal infiltrate of all lesional and unaffected AD biopsies, but in none of the psoriatic biopsies. IL‐4 receptor α chain immunoreactivity, associated with dermal mast cells, was found in all patients. Local expression of IL‐4 in ACD indicates either TH2 or TH0 immunoregulation in some allergic contact dermatitis lesions. Our findings do not support exclusive TH1 or TH2 cutaneous immune responses in ACD. Expression of IL‐4 receptors by cutaneous mast cells provides a route through which local effects of IL‐4 might be mediated.
Immediate contact hypersensitivity to pomegranate
Authors: Valsecchi R. , Reseghetti A. , Leghissa P. , Cologni L. , Cortinovis R.
Published: February 2007

Pomegranate is the fruit of the pomegranate tree (Punica granatum), native to Africa, introduced into the Mediterranean area, and now widely cultivated. The tree be‐longs to the Myrtaceae family and is currently used therapeutically for gingivitis and gastric‐duodenal trait. The fruit pulp is made up of a cluster of red‐violet seeds.
Detection of formaldehyde in moistened baby toilet tissues
Authors: Piletta‐Zanin P.‐A. , Pasche‐Koo F. , Auderset P. C. , Huggengerger D. , Saurat J. H. , Hauser C.
Published: February 2007

Formaldehyde is a ubiquitous and potent sensitizer. Formaldehyde‐sensitive patients may have long‐lasting hand eczema (1). Contact dermatitis from formaldehyde is often chronic, probably because it is so difficult to avoid exposure to formaldehyde‐containing products. An investigation in Denmark showed that 1/3 of all cosmetic products contained formaldehyde or formaldehyde‐releasing preservatives (2). Formaldehyde can also be found in many houshold products. In recent years, the use of moistened baby toilet tissues has greatly increased.
Frictional sweat dermatitis
Authors: Ramam M. , Khaitan Bindo K. , Singh Manoj K. , Gupta Siddhartha Datta
Published: February 2007

In the past few years, we have observed a striking pattern of dermatitis occurring in summer, localized to the skin directly beneath the undergarments.
7 years experience of photopatch testing with sunscreen allergens in Sweden
Authors: And Berit Berne , Ros Anne‐Marie
Published: February 2007

Since 1990 7 sunscreen allergens have been included in the standard photopatch protocol at 2 Swedish dermatology clinics. 355 consecutive patients with suspected photosensitivity were tested, and in 28 of these (7.9%), a total of 42 allergic reactions were found. 80% of the reactions were of photocontact origin. The most common allergen was benzophenone‐3 (Eusolex 4360), with 15 photocontact and 1 contact allergic reactions, followed by isopropyl dibenzoylmethane (Eusolex 8020) (8 photocontact, 4 contact) and butyl methoxydibenzoylmethane (Parsol 1789), with 6 photocontact reactions. There were 2 cases of photocontact allergy to phenylbenzimidazole sul‐fonic acid (Eusolex 232), which has not been reported previously. 1 case of contact urticaria from benzophenone‐3 was accidentally found. In addition, 21 p reactions of doubtful relevance were noted in 14 patients: 16 on irradiated and 5 on non‐irradiated test sites. Among these, irritant and phototoxic reactions may be included. These results indicate that the inclusion of UV filters in the standard photopatch protocol is important. Immediate‐type testing for urticaria could also be of value.
Fixed drug eruption due to amlexanox
Authors: Sugiura Mariko , Hayakawa Ritsuko , Osada Takashi
Published: February 2007

A 23‐year‐old woman developed allergic rhinitis in 1993. Her doctor prescribed for her Solfa (amlexanox 25 mg) and Lysozymen 90 (lysozyme chloride 90 mg) tablets. She took the tablets occasionally, whenever she developed allergic rhinitis. She noticed a macular erythema of about 3.5 cm wide on her buttocks in 1994, about 1 year after the initial prescription. We conducted a series of tests with the tablets. On patch testing, the patient had a positive reaction to Solfa 50% pet. on the eruptive area, but no such reaction on the non‐eruptive area. Furthermore, on patch testing, she had no reaction to Lysozymen 90 50% pet. on either the eruptive or the non‐eruptive area. We also used open application test with Solfa 50% pet. to confirm the cause of her erythema.
Flutamide photosensitivity ‐ residual vitiliginous lesions
Authors: Vilaplana J. , Romaguera C. , Azon A. , Lecha M.
Published: February 2007

A case of flutamide photosensitivity is reported in a patient receiving treatment for prostate cancer. Photopatch testing with flutamide at 10 and 20% in acetone was positive and controls negative. Other reports in the literature indicate that flutamide photosensitivity can be produced either by UV‐A or UV‐B, but the small number of reports and the differences in the tests performed do not allow the specific characteristics of flutamide photosensitivity to be established. Presently it would be advisable, due to the frequent use of this drug, to include flutamide in the investigation of photosensitive patients.
Delayed‐type hypersensitivity to contact allergens in psoriasis
Authors: Heule F. , Tahapary G. J. M. , Bello C. R. , van Joost Th.
Published: February 2007

The possibility for patch testing procedures to detect contact allergy was examined in 85 hospitalized patients with forms of psoriasis. Exclusion criteria were active lesions on the back, the use of strong topical corticosteroids, methotrexate, cyclosporin and UV therapy. After screening, a group of 47 patients with different forms of psoriasis were selected for patch testing. Personal history, including topical treatment, occupation and domestic circumstances, were reasons to extend the standard series of allergens. Tars, nickel sulfate, perfume and balsam of Peru scored high. The overall positive rate was 68%. This is higher than that observed in earlier studies. The unexpected results are discussed in the light of the possible mechanism of action.
Active sensitization and occupational allergic contact dermatitis caused by para‐tertiary‐butylcatechol
Authors: Estlander Tuula , Kostiainen Mlnna , Jolanki Rlitta , Kanerva Lasse
Published: February 2007

Para‐tertiary‐butylcatechol (PTBC) is a rare allergen which is used in the rubber, paint and petroleum industries. We present 9 patients who were sensitized to PTBC and examined at the Finnish Institute of Occupational Health (FIOH) between 1974 and 1995. 3 of the patients had been exposed to PTBC in their work. 2 of them also had allergic reactions to para‐tertiary‐butylphenol (PTBP)‐formaldehyde resin and to PTBP 5 of the patients became sensitized to PTBC from patch testing. PTBC was found to be one of the most common causes of active sensitization in our clinic. Accordingly, at the FIOH, the patch test concentration of PTBC was lowered to 0.25% and this lower concentration is recommended for general use.
Detergents and bleaches are sources of chromium contact dermatitis in Israel
Authors: Ingber Arieh , Gammelgaard Bente , David Michael
Published: February 2007

Total chromium levels were determined in 38 detergents and 12 bleaches on the market in Israel (45 locally produced, 5 imported). The samples were analyzed by Zeeman‐corrected graphite furnace atomic absorption spectrophotometry. Chromium levels were higher than 5 ppm in 28 (56%) of the 50 products, from 1 to 5 ppm in 16 (32%), and lower than 1 ppm in only 6 (12%). Among the 5 imported products, only 1 had a chromium level below 1 ppm and the other 4 (1 from Germany, 3 from the USA) had high levels. Since almost 90% of the detergents and bleaches examined contained chromium levels higher than 1 ppm, it is concluded that these consumer products may be the cause of the high incidence of chromium sensitivity in Israel.
Pretreatment of skin with a Ginkgo biloba extract/sodium carboxymethyl‐β‐1,3‐glucan formulation appears to inhibit the elicitation of allergic contact dermatitis in man
Authors: Castelli D. , Colin L. , Camel E. , Ries G.
Published: February 2007

The clinical efficiency of mitigating contact dermatitis with a Ginkgo biloba extract and carboxyme‐thyl‐β‐1,3‐glucan formulation was investigated in a double‐blind versus placebo study using 22 subjects (Caucasian women aged 22–55 years) with allergic contact dermatitis from various substances in the European standard series. The formulation was applied to intact skin 2× a day for 2 weeks (“in use” application) prior to a single application of a selected contact allergen under a Finn Chamber for 24 h. Readings were carried out in a blind study by a dermatologist 2 and 3 days after patch removal. Representative photographs were taken of treated, placebo and untreated test areas. 68.2% of the panelists showed significantly reduced skin reactivity (p= 0.037*) on the treated site 2 days after patch removal, versus untreated and/or placebo sites. This finding indicates that the Ginkgo biloba/carboxymethyl‐β‐1,3‐glucan formulation can mitigate against allergic contact dermatitis.
Occupational dermatitis in Danish gardeners and greenhouse workers (III)
Authors: Paulsen E. , Sogaard J. , Andersen K. E.
Published: February 2007

The clinical part of the study aimed at describing epidemiological and diagnostic aspects of occupational Compositae dermatitis. Patch testing with the sesquiterpene lactone (SL) and Compositae mixes, feverfew extract and supplementary allergens in 250 selected gardeners showed Compositae allergy in 25, 17 females and 8 males. 24 were possibly occupationally sensitized. The mean age was lower and the preponderance of women higher compared to classical Compositae dermatitis, and the distribution and course of the dermatitis most often did not differ from other occupational plant dermatoses. The Compositae mix detected 2× as many as the SL mix, and the overall detection rate with both was 76%, making aimed patch testing necessary. Chrysanthemum (Dendranthema), marguerite daisy (Argyranthemum frutescens) and lettuce (Lactuca sativa) were frequent sensitizers. Occupational type I allergy to Compositae comprised sensitization to Gerbera, chrysanthemum, lettuce, Senecio cruentus and Aster. Among 1657 respondents in the questionnaire part of the study, 824 had worked with Compositae, and 160 (19%) reported occupational Compositae‐related symptoms of skin and mucous membranes. Possible risk factors for the development of these were assessed in a stepwise logistic regression model and a history of childhood eczema, hay fever and duration of exposure were significantly associated with Compositae‐related irritant and allergic symptoms in both sexes.
Acute irritation thresholds in subjects with Type I – Type VI skin
Authors: McFadden J. P. , Wakelin S. H. , Basketter D. A.
Published: February 2007

It has long been recognized that human skin can be subdivided into simple categories based on their sensitivity to sunlight ‐ from Type I, never tans, always burns, to Type VI, marked constitutive pigmentation. There is also evidence that the more readily sunburnt type of skin is also more susceptible to the effect of irritants. In the present work, the irritancy threshold for sodium lauryl sulfate (SLS) has been assessed using a recently described 4‐h acute skin irritation patch test. A total of 110 subjects covering all 6 skin types were examined and their threshold for acute irritancy defined as the lowest concentration of SLS, applied under 4‐h occlusion, which would induce a clinically detectable irritant response. The SLS dose response generated using a range of concentrations (0.1%‐20%) demonstrated that there was no significant difference between the groups under these test conditions. Even for Type VI skin (n=25), the dose‐response curve fell within the general pattern. These results reinforce the general applicability of predictions of acute irritant potential made in groups of human volunteers.
Evaluating skin‐protective materials against contact irritants and allergens
Authors: Zhai Hongbo , Willard Paul , Maibach Howard I.
Published: February 2007

2 acute irritants and 1 allergen were selected: sodium lauryl sulfate (SLS) representative of irritant household and occupational contact dermatitis, the combination of ammonium hydroxide (NH4OH) and urea to simulate diaper dermatitis, and Rhus to evaluate the effect of model protective materials. The putative protective materials and vehicle were applied to both ventral forearms of 10 subjects in each group, according to a randomized code. Test materials were spread over a marked 2.0 cm2 area, massaged in, allowed to dry for 30 min, and reapplied with another 30 min drying period. The model irritants and allergen were then applied (0.025 ml) to an Al‐test® occlusive patch, which in turn was placed for 24 h over each of the 8 designated sites. Inflammation was scored according to a clinical scale 72 h post‐application. Paraffin wax plus Acetulan® in cetyl alcohol, and beeswax plus Acetulan® in cetyl alcohol, markedly (p < 0.001) suppressed SLS irritation. Paraffin wax plus beeswax in cetyl alcohol, and Acetulan® in cetyl alcohol reduced NH4OH and urea irritation (p < 0.05), paraffin wax in cetyl alcohol significantly (p < 0.01) decreasing Rhus allergic contact dermatitis. This model, provides an easy approach to screening protectants. Its clinical significance requires comparison with an open rather than an occluded challenge.
Prevalence of natural rubber latex allergy (Type I and Type IV) in laboratory workers in The Netherlands
Authors: de Groot Hans , de Jong Nicolette W , Duijster Ellen , van Wijk Roy Gerth , Vermeulen Ab , van Toorenenbergen Albert W , Geursen Lidy , van Joost Theo
Published: February 2007

The objective of the study was to study the prevalence of Type IV and Type I allergy to natural rubber latex (NRL) in a population at risk in the Netherlands. Laboratory workers regularly using gloves were invited to complete a questionnaire and to be tested. We performed patch tests with standard contact allergens, rubber additives, glove powder and pieces of 4 gloves; prick tests with inhalant allergens, glove extracts, glove powder and fruit extracts; and RASTs. Glove‐related hand dermatitis was reported in 36.9% of the individuals interviewed. A positive patch test result for rubber additives was seen in only 6.6%. Glove‐related urticaria, rhinoconjunctivitis and/or asthma were reported in 24.6% of all cases. Confirmation of an IgE‐mediated reaction was achieved in 8.3% by prick test with glove extracts and 5.0% by RAST No reaction to glove powder was noticed in patch testing or in prick testing. A high prevalence rate of glove‐related symptoms and NRL Type I allergy was found in laboratory workers exposed to rubber gloves. Surprisingly, there was no co‐existence of Type I and Type IV allergy in this population.
Mechanism of allergic contact dermatitis from propacetamol: sensitization to activated N,N‐diethylglycine
Authors: Berl Valerie , Barbaud Annick , Lepoittevin Jean‐Pierre
Published: February 2007

In order to confirm the mechanism of skin sensitization to propacetamol, a pro‐drug of acetaminophen, 3 patients with allergic contact dermatitis from propacetamol were patch tested with N,N‐diethylglycine phenyl ester, an activated form of N,N‐diethylglycine. Positive patch tests were observed in all the patients at 10% in pet., while 20 control patients remained negative. This strongly suggests that propacetamol is acting as an activated form of N,N‐diethylglycine, transferring this part of the molecule to nucleophilic residues of proteins. This also explains why reactions to acetaminophen have never been observed in patients sensitized to propacetamol.
Contact depigmentation caused by an azo dye in alta
Authors: Bajaj A. K. , Pandey R. K. , Misra K. , Chatterji A. K. , Tiwari A. , Basu S.
Published: February 2007

Alta, a scarlet‐red solution used by some Indian women as a cosmetic to colour their feet, was found to be associated with depigmentation at the site of application. Chromatographic and spectroscopic analysis of 3 brands of alta confirmed the presence of 2 dyes: Crocein Scarlet MOO (CSM) (brilliant crocein) and rhodamine B (tetraethyl rhodamine). Patch testing produced depigmentation at the site of application of alta, CSM and para‐phenylenediamine (PPD). Although PPD has been reported to produce leukoderma, azo dyes have not previously been reported as depigmenting agents.