bluuebunny/crossref_metadata_2025 huggingface dataset:
Application of a 4‐h human patch test method for comparative and investigative assessment of skin irritation
Authors: Robinson Michael K. , Perkins Mary A. , Basketter David A.
Published: February 2007

A human 4‐h patch test has recently been developed for testing the irritation hazard potential of chemicals. The original method was developed for comparative irritation assessments relative to benchmark irritants using simple statistical tests. In this context, the method has been shown to be robust in intra laboratory testing over time. Recent inter laboratory testing has also established the consistency of the method in assessment of the relative irritation potential of selected chemicals. These data help to position the method as a suitable replacement for animal test methods in assessment of skin irritation hazard. In addition, the method has great utility for investigating different parameters of clinical skin irritation. Using kinetic response patterns and curve fitting analysis, we have compared the relative irritation potential of chemicals in greater detail, using as a basis the time required for test subjects to respond as well as the incidence of positive responses. Also, using the response to 20% sodium dodecyl sulfate (SDS) as a benchmark, we've been able to examine the intersubject variation in clinical skin irritation responses. In general, subjects most reactive to 20% SDS, in terms of the exposure time required to produce a positive response, were relatively more sensitive to a 2nd irritant chemical as well. However, this was not an absolute correlation in that some test subjects showed divergent patterns of response. The method was also used to compare directly the relative skin reactivity of different populations, based on race (Caucasian versus Asian) or on neurosensory skin sensitivity. Our results using this acute exposure test method indicate little difference in visually assessed skin irritation among these diverse human subpopulations.
Acute irritant reactivity to sodium lauryl sulfate in atopics and non‐atopics
Authors: Basketter D. A. , Miettinen J. , Lahti A.
Published: February 2007

Predictive testing of chemicals to assess their acute skin irritation potential is an important part of the assessment of their toxicological profile. It is possible, where safety and ethical considerations can be met, to do this work in groups of human volunteers. Previously, the relative responsiveness of atopics and non‐atopics has been evaluated. The results showed that atopics (defined broadly by high IgE reactivity) were a little more susceptible to skin irritation, but not significantly so. In the present work, the relative reactivity of a skin atopic group versus a non‐atopic group was examined in more detail. Sodium lauryl sulfate (SLS) was applied at a range of concentrations and exposure times, such that a fairly constant degree of skin irritation was produced. At various time points, the irritation response was measured by visual assessment, chromametry, laser Doppler flowmetry and transepidermal water loss. Using all of the methods of assessment, the reactions in atopics were similar to or a little less than those seen in non‐atopics. The conclusion is that atopics and non‐atopics will give similar results in a predictive human test for acute skin irritation. Furthermore, the pattern of response obtained from short duration exposure should be predictive of that following longer durations of (single) exposure.
Topical provocation in 31 cases of fixed drug eruption: change of causative drugs in 10 years
Authors: Lee Ai‐Young
Published: February 2007

The pathomechanism of fixed drug eruption remains to be clarified, but patch testing has been used to determine the causative drug. 31 patients with fixed drug eruption were investigated to evaluate the diagnostic value of patch testing and to compare the causative drugs over the 10 years between the late 1980s and the late 1990s. 22 of them were given an oral provocation test to confirm the results of patch testing. A reaction showing definite infiltration, which occurred in 13 of 22 patients, reliably indicated the causative drug. In contrast, a patch test reaction without definite infiltration was not always correlated with systemic provocation. All except 1 patient found out their causative drug. The most frequent causative drug was sulfamethoxazole‐trimethoprim in the late 1980s, but it had become chlormezanone 10 years later.
Can glutathione‐containing emollients inactivate methylchloroisothiazolinone/methylisothiazolinone?
Authors: Gruvberger Birgitta , Bruze Magnus
Published: February 2007

Many persons are exposed to preservatives/biocides based on methylchloroisothiazolinone/methylisothiazolinone (MCI/MI), since toiletries and cosmetics, as well as products/water‐based systems used occupationally, may all contain MCI/MI. In toiletries and cosmetics, the MCI/MI concentration is often below 15 ppm (0.0015%). In some industries, workers handle high concentrations of MCI/MI, which can cause chemical burns and induce sensitization if skin is exposed. Contact allergy to MCI/MI is common and reports on chemical burns have been published. Thus, there is a need for prevention of skin diseases caused by MCI/MI. The inactivation of MCI/MI by glutathione (GSH) in emollients, containing different amounts of lipids, was studied by HPLC. Various amounts of GSH were added to Fenuril®, Essex®, and Locobase®, giving 3 preparations of each emollient containing 0.10%, 0.50% and 2.0% GSH, respectively. The inactivation of 15 ppm MCI/MI and the total inactivating capacity of GSH in these preparations, kept at room temperature and refrigerated, was studied over a period of 6 months. The inactivating capacity of GSH in the emollients was almost equivalent, regardless of the lipid contents of the emollients, type of storage and age. On the other hand, the GSH concentration in the emollients had a crucial importance on the inactivation of MCI/MI. Emollients containing 2% GSH were capable of inactivating up to 2400 ppm MCI/MI.
Contribution to chromium and nickel enrichment during cooking of foods in stainless steel utensils
Authors: Accominotti M. , Bost M. , Haudrechy P. , Mantout B. , Cunat P. J. , Comet F. , Mouterde C. , Plantard F. , Chambon P. , Vallon J. J.
Published: February 2007

Nickel ingestion can cause exacerbation of dermatitis in patients who are already nickel‐sensitive; Chromium (Cr VI) is the 2nd allergen, after nickel. However, stainless steel is widely used in home cookware. In this study, we determined nickel and chromium levels by atomic absorption spectrometry in 11 habitual menus cooked in different grades of stainless steel utensils. We noted a great difference in nickel and chromium intake depending on the menu, and a significant difference between the glass and stainless steel saucepans, but this was very low compared with the levels of nickel and chromium contained in the menus; mean intakes of these elements were under the tolerable daily intake (TDI) recommended by the World Health Organization. Hence, there is no advantage for nickel‐sensitive patients in switching to materials other than stainless steel, provided that this is of good quality.
Baseline biophysical parameters in subjects with sensitive skin
Authors: Seidenari Stefania , Francomano Mariangela , Mantovani Lucia
Published: February 2007

Sensitive skin has been described as a skin type showing higher reactivity than normal skin and developing exaggerated reactions when exposed to external factors. The stinging test, performed by applying lactic acid to the nasolabial fold and evaluating the intensity of subjective symptoms, is widely accepted as a marker of sensitivity and employed for the selection of subjects experiencing invisible cutaneous irritation. However, this test is based on self‐perceived assessment and lacks objectivity. In order to contribute to the finding of objective descriptors, we assessed baseline biophysical parameters in subjects with sensitive skin by means of transepidermal water loss (TEWL), capacitance, pH, sebum and skin colour measurements, and compared the data with those obtained in normal subjects, also correlating the results with those of clinical assessments and functional tests. Subjects with sensitive skin showed a trend towards higher scores at all assessment times both for the stinging and the washing test. The skin of sensitive subjects was described as less supple, less hydrated and more erythematous and telangiectatic with respect to the skin of normal subjects. A trend towards an increase in TEWL, pH and colorimetric a* values, and a decrease in capacitance, sebum and colorimetric L* values on the face of subjects with sensitive skin was observable. However, significances were only present for capacitance and a* values. Thus, alterations of baseline capacitance values indicate the tendency to barrier impairment and support the view that skin hyperreactivity to water‐soluble irritants is induced by a greater amount of irritants absorbed, whereas the increase in the erythema parameter shows that cutaneous vascular hyperreactivity in subjects with sensitive skin also corresponds to baseline vasodilation.
Cutaneous reactivity of the hands in nickel‐sensitive patients with hand eczema
Authors: Banfield C. C. , Basketter D. A. , Powell S. M.
Published: February 2007

This study compares the cutaneous reactivity between the hand and the back for 7 female patients with active hand eczema, who were found to be nickel‐sensitive on routine patch testing with the European standard series. Patients were patch tested to a dilution series of nickel sulfate on the back in order to determine the threshold concentration for elicitation of allergic contact dermatitis, and based upon this result a lower concentration of nickel was then used for patch tests on the hand. We found that in the majority of patients (6/7) the cutaneous responsiveness of the hand was not increased compared with that of the back. However, the hand of 1 patient was more sensitive to nickel and patch testing was accompanied with a flare of her eczema, which suggests that cutaneous hyperreactivity may be important in individual patients with hand eczema.
Down‐regulation of protein kinase C isoforms in irritant contact dermatitis
Authors: Li Lin‐feng , Fiedler Virginia C. , Kumar Raj
Published: February 2007

Protein kinase C (PKC) isoforms are important in cell signal transduction associated with regulation of cell proliferation and differentiation. In this study, alterations of PKC isoform levels in irritant patch test reactions were detected by Western immunoblots. 4 chemically and structurally different irritants, 4% and 8% hydrochloric acid (HCl); 1% and 2% sodium hydroxide (NaOH); 20% and 40% nonanoic acid (NON) in 1‐propanol; and 5% and 10% sodium dodecyl sulfate (SDS) were applied on the backs of mice in Finn Chambers and fixed with surgical dressings. The patches were kept on the skin for 24 h and removed. 24 h after removal, mild erythema with thickening of skin without vesicles was observed in all irritated skin, except that 4% HCl and 1% NaOH treated skin showed unremarkable skin reaction. No visible skin reaction was detected in vehicle‐treated skin. PKC isoform α, β, γ, and δ levels in irritated skin revealed a 10% to 65% decrease compared to vehicle treated skin. These results indicate that in HCl, NaOH, NON and SDS‐induced irritation, activation of the PKC related cell signal transduction cascade may be involved, and that PKC mediated events may be a common phenomenon in irritant contact dermatitis.
Thimerosal positivities: the role of organomercury alkyl compounds
Authors: Santucci B. , Cannistraci C. , Cristaudo A. , Camera E. , Picardo M.
Published: February 2007

Contact allergy to thimerosal (TH) has not been considered a marker for mercury allergy, since there is a low degree of cross‐sensitivity to inorganic as well as to organic mercury salts. 40 subjects, who previously gave a positive patch test reaction only to thimerosal 0.1% pet. (Hermal), when simultaneously repatch‐tested to solutions containing TH, mersalyl acid, p‐amino‐phenylmercuric acid, mercuric acetate and thiosalicylic acid, respectively, gave positive reactions only to TH. 36 out of 40 subjects were divided into 2 groups of 18 subjects and simultaneously repatch‐tested to solutions containing TH, methylmercury chloride (MeHgCl), thiosalicylic acid, and, ethylmercury chloride (EtHgCl), respectively. EtHgCl was tested in the 1st group at 0.031% and in the 2nd group at 0.015%. The results showed that all subjects gave concomitant positive reactions to TH, EtHgCl and MeHgCl. EtHgCl 0.031% gave a higher number of +++ reactions than EtHgCl 0.015%, underlining the rôle of the solvent in these reactions. Patch test results in 300 consecutive patients to a standard series, to which MeHgCl was added, showed that MeHgCl and TH were never able to give isolated positive reactions, and that the concomitant positive reactions occurred in only 3.6% of subjects. In conclusion, our data seem to suggest that the positive reactions to TH found in our patients were due to EtHgCl, and that the structural similarities with MeHgCl were so close that the skin reacted against each as if they were identical.
Contact sensitivity to chromate: comparison at a London contact dermatitis clinic over a 10‐year period
Authors: Olsavszky R. , Rycroft R. J. G. , White I. R. , McFadden J. P.
Published: February 2007

It has been argued that for chromate sensitivity to be reduced, then ferrous sulfate should be added to cement. This has not yet been done in the UK. To explore this further, we have looked at the comparative sensitization rates of patients attending the St. John's Institute of Dermatology Contact Dermatitis Clinic between the years 1982–3 and 1992–3. Patch‐test‐positive rates for females were not significantly different between the 2 populations studied (1982–3, 1.59% and 1992–3, 1.99% p NS). Similarly, there was no significantly different rate between the males (1982–3, 3.99% and 1992–3, 4.25% p NS) in the same time period. There was no difference in the distribution of eczema in chromate‐positive subjects, nor of cobalt co‐sensitization, a crude indicator of sensitization via cement. This work demonstrates no appreciable difference in the frequency of chromate sensitivity between the early 1980s and 1990s in London. Adding ferrous sulfate to cement may help to lower the frequency in the future.
Formaldehyde‐related textile allergy: an update
Authors: Scheman Andrew J. , Carroll Patricia A. , Brown Kenneth H. , Osburn Anne H.
Published: February 2007

Part I of this study explores whether clothing today contains formaldehyde levels likely to cause contact allergy in formaldehyde‐allergic patients. Part II of this study examines whether current reactions to textiles may be due to allergy to textile resins and whether individuals with formaldehyde‐related textile allergy will react to the newer low formaldehyde resins used in the textile industry. Part I: free formaldehyde was measured in 16 fabric specimens produced in the US and overseas. Additionally, since the textile industry has moved to the use of newer methods for measuring fabric formaldehyde content, the newer methodology was compared with the older methods used in the medical literature. Part II: 10 subjects with known textile contact allergy were patch tested to available Chemotechnique textile resins and 6 new low‐formaldehyde resins used by the textile industry. Part I: 8 fabric specimens yielded no detectable formaldehyde and 7 specimens yielded <200 ppm free formaldehyde, using Schiff's reagent and Merck testing methods. 1 specimen showed approximately 2000 ppm formaldehyde, as measured by the Merck test, but only 24 ppm free formaldehyde when retested by the method described in Japanese Law #112. Part II: all subjects reacted strongly to formaldehyde and DMDHEU (the predominant resin currently used in textiles). 6 subjects reacted to EUMF. 2 subjects had mild reactions to the newer low‐formaldehyde resins and 1 to the non‐formaldehyde Fixapret NF. Our results suggest that most clothing today yields free formaldehyde levels unlikely to cause contact allergy in formaldehyde‐allergic individuals. Japanese method #112 is the recommended methodology to measure free formaldehyde in future studies. DMDHEU may now represent the main cause of textile allergy and may be a better screen than EUMF for this problem. Newer resins yielding fabrics with <75 ppm free formaldehyde may cause occasional reactions, but are more likely to be tolerated by individuals with textile contact allergy. Treatment of these individuals should be directed at identification of reliable sources of garments utilizing these newer resins.
Allergic contact dermatitis from δ‐aminolevulinic acid used for photodynamic therapy
Authors: Gniazdowska Beata , Ruëff Franziska , Hillemanns Peter , Przybilla Bernhard
Published: February 2007

Photodynamic laser therapy, using topical δxs‐aminolevul‐inic acid (d‐ALA), is a method of treating superficial cancers and precancers (1–5). In this form, the chemical is usually well tolerated (2), which has also been shown in animals (6).
Contact dermatitis and prolonged photosensititivity induced by ketoprofen and associated with sensitivity to benzophenone‐3
Authors: Horn H. M. , Humphreys F. , Aldridge R. D.
Published: February 2007

The increasing topical use of NSAIDs has resulted in a number of case reports, mainly of photocontact dermatitis, since 1983 (1).
Textile dermatitis from Disperse Blue 85 in a knee brace
Authors: Lazarov A. , Ingber A.
Published: February 2007

In some cases, the diagnosis of contact dermatitis caused by textiles may be difficult because of its considerable clinical polymorphism (1, 2).
Erythema‐multiforme‐like lesions from triamcinolone acetonide
Authors: Valsecchi R. , Reseghetti A. , Leghissa P. , Cologni L. , Cortinovis R.
Published: February 2007

Triamcinolone acetonide is a class B corticosteroid of Coopman et al. (1), characterized by a C16, C17‐cis ketal or diol structure. To the best of our knowledge, only 3 cases of contact allergy to it have been reported (2, 3).
Eyeglass allergic contact dermatitis
Authors: Nakada Tokio , Maibach Howard I.
Published: February 2007

A literature review is presented of allergic contact dermatitis from eyeglasses. Causes are grouped into metals, plastics, plasticizers, solvents, UV stabilizers, antioxidants, dyes, and waxes. Plasticizers and UV stabilizers are currently the most common allergens.
Delayed local allergic reaction to intralesional paramethasone acetate
Authors: Miranda‐Romero A. , Pozo C. Bajo‐del , Sânchez‐Sambucety P. , Martinez‐Fernandez M. , Garcia‐Munoz M.
Published: February 2007

Among the drugs most commonly injected intralesionally (1–3) are corticosteroids. Contact hypersensitivity to corticosteroids is now frequently recognized (4).
Contact allergy to antihistamines is not common
Authors: Goossens A. , Linsen G.
Published: February 2007

Topical antihistamines are available as creams, lotions, eyedrops, nasal preparations, aerosols, and suppositories. Antihistamines (or H1‐receptor antagonists) have antipruritic properties, a mild local anesthetic effect and may also diminish capillary permeability. They can be classified into 6 groups by their chemical structure (1): alkylamines, ethanolamines, ethylenediamines, phenothiazines, piperazines, and other H1‐receptor antagonists. Application to the skin is generally considered to carry an unacceptably high risk of sensitization (1, 2). Recently, several cases have been reported of allergic contact dermatitis from topically‐applied doxepin hydrochloride, a tricyclic antidepressant that has very potent antihistaminic activity (3–5).
Hypersensitivity reactions to latex in patients having topical treatment applied by health professionals wearing latex gloves
Authors: Salim Asad , Warin Andrew P.
Published: February 2007

Latex allergy is a Type 1 reaction, causing contact urticaria and even anaphylaxis (1), which is currently a particular problem among health care and dental professionals (2). Their patients may also experience such reactions, one source being the wearing of latex gloves by nurses applying medicaments.
Occupational allergic contact dermatitis from isophoronediamine (IPDA) in operative‐clothing manufacture
Authors: Tarvainen Kylliki , Jolanki Riitta , Eckerman Maj‐Len Henriks , Estlander Tuula
Published: February 2007

Isophoronediamine (IPDA), 3‐amino‐methyl‐3,5,5‐tri‐methylcyclohexylamine, is a cycloaliphatic epoxy resin hardener (CAS 2855‐13‐2). It is a well‐known human sensitizer (1–6), and has also been shown to be an extremely strong sensitizer by the guinea pig maximization test (7). In addition, IPDA is a cause of occupational asthma (5). Contact allergy to IPDA has been reported from epoxy floor‐laying (2, 8), painting (5), manufacture of tennis rackets (1) and epoxy floor coating (5).
Allergic contact dermatitis from the adhesive remover wipe of stoma bags
Authors: Lazarov Aneta , Trattner Akiva
Published: February 2007

Skin disorders at ostomy sites are common and include irritant contact dermatitis from the draining fluid and/or the ostomy devices, intertrigo, and bacterial and mycotic infection (1). Allergic contact dermatitis has also been described, from a karaya seal ring (2), stoma adhesive paste (3), and rubber (4). The allergens causing contact dermatitis from ostomy bags, have been defined as epoxy resin (5–7), diaminodiphenylmethane (8) and polyisobutylene (9).
New developments in jewellery and dental materials
Authors: Vilaplana J. , Romaguera C.
Published: February 2007

This communication reviews the latest alloys introduced in the fields of jewellery and dental prostheses. For this we have scanned current patents and others to which we have access, and it is evident that, although not always correctly used, the words “antiallergic”, “hypoallergic”, “non‐allergic”, “to avoid allergies”, etc., now appear frequently, indicating manufacturers' awareness of the problems that nickel can cause. On the other hand, the problems that may be associated with other sensitizing metals, such as cobalt and palladium, are not yet addressed.
The effect of patch duration on the elicitation of para‐phenylenediamine contact allergy
Authors: McFadden J. P. , Wakelin S. H. , Holloway D. B. , Basketter D. A.
Published: February 2007

To study the length of exposure time required to elicit para‐phenylenediamine (PPD) allergic reactions, patients known to be allergic to PPD were recruited and patch tested. A group of 7 patients were patch tested with 1% PPD in pet. for 15 min, 30 min and for 120 min. The remaining 9 patients were patch tested with 1%, 0.3%, 0.1% and 0.01% PPD for 15 min, 30 min and for 120 min each. With exposure for 120 min, 11 of 16 subjects reacted to 1% PPD and 2 of 9 reacted to 0.01%. With exposure of 15 min, 6 of 16 reacted to 1% PPD and 0 of 9 reacted to 0.01% PPD. This study showed marked inter‐individual variability in eliciting a reaction to the PPD molecule on patch testing, with regard to both the exposure time and the concentration required.
Experimental study of contact dermatitis due to alstroemeria in guinea pigs
Authors: Harada Koichi , Ohmori Shoko , Wei Chang‐Nian , Arimatsu Yoshiki , Ueda Atsushi
Published: February 2007

Contact allergy from handling alstroemeria (Alstroemeria) has been widely observed in horticulturalists and florists (1–5). α‐methylene‐γ‐butyrolactone (α‐MBL) has been shown to be the causative agent (6, 7). In the present study, delayed‐type contact dermatitis due to alstroemeria was evaluated using the guinea pig maximization test (GMT) (8), and the intensity of allergic reactions was investigated by quantifying the contents of α‐MBL in different parts of alstroemeria by high‐performance liquid chromatography (HPLC) (9).
The myth of lanolin allergy
Authors: Kligman Albert M.
Published: February 2007

Lanolin has the reputation of being an important contact sensitizer. The market place abounds with products that are labeled “lanolin free”. In fact, lanolin is at most a weak contact allergen. The supposed hazards of sensitization to lanolin products are a resultant of faulty science and failure to appreciate the limitations of patch testing. Lanolin allergy is a myth created mainly by overzealous professional patch testers. No one has succeeded in sensitizing animals or humans to lanolin or wool wax alcohols. Most of the case reports are false positives, in association with the angry back syndrome.
Objective assessment of nickel sulfate patch test reactions with laser Doppler perfusion imaging
Authors: Bjarnason Bolli , Fischer Torkel
Published: February 2007

The laser Doppler perfusion scanning technique was used to assess the superficial blood flow of nickel sulfate hexahydrate patch test reactions. There was good agreement between laser Doppler and visual assessments when the highest assessment values of reactions were studied. Earlier detection of reactions was possible with the laser technique. There was great inter‐individual variance in perfusion between identically tested patients. 4 patients were visually negative when a TRUE TestTM patch test dose of 0.20 mg/cm2 was applied for 48 h and the test area read 4× up to 168 h. These 4 showed a dose‐related increase in perfusion and visually positive reactions using longer application times. The instrument allowed a dose reduction not possible for visual assessments. Reading transparent patches in contact with the skin through transparent semi‐occlusive plastic foil or through windows in the tape strip over the patches, allowed us to detect perfusion at 48 h, where a longer application would have been needed using tape and visual assessments.
Sesquiterpene lactone mix contact sensitivity and its relationship to chronic actinic dermatitis: a follow‐up study
Authors: Du H. , Menage P. , Hawk J. L. M. , White I. R.
Published: February 2007

In a retrospective case note analysis over a 4‐year period, 0.9% of all patients tested with a standard patch test series (65 of 7600) were demonstrated to have clinically relevant responses to a sesquiterpene lactone (SQL) mix. Of these patients, 11 (17%) also had a diagnosis of chronic actinic dermatitis. This group made up 25% of all patients diagnosed as suffering from CAD in this 4‐year period. These figures differ somewhat from those reported by our group in an initial 4‐year period immediately following the introduction of the mix into our standard patch test series, when 1.5% of all patients tested had a clinically relevant response to the SQL mix, including 36% of all patients with a diagnosis of CAD. It is not uncommon for the prevalence of sensitivity to an allergen to be overestimated immediately following its introduction into routine testing. Possible reasons for our findings are discussed.
Thimerosal positivities: the rôle of SH groups and divalent ions
Authors: Santucci B. , Cannistraci C. , Cristaudo A. , Camera E. , Picardo M.
Published: February 2007

For a better understanding of the mechanistic details of the interactions of organomercury compounds inside the skin, 32 subjects who previously had given positive patch‐test reactions to thimerosal (TH) and negative reactions to thiosalicylic acid, were divided into 2 groups. 16 subjects were repatch tested to ethylmercury chloride (EtHgCl) and to solutions containing EtHgCl mixed with L‐cysteine and glutathione, respectively. The remaining 16 were repatch tested to EtHgCl and to solutions containing EtHgCl mixed with chlorides of Zn, Mg, and Mn, respectively. The results showed that whilst L‐cysteine, glutathione and ZnCl2 were able to abolish or to reduce the positive reactions to EtHgCl, chlorides of Mg and Mn were unable to do so. Patch tests revealed that in causing positive reactions to TH, EtHg probably interacted with thiol groups and with Zn ions, as in biological systems when causing toxic effects. The limited number of TH reactions in the general population, the constant presence of concomitant positive reactions to EtHgCl and MeHgCl, and the lack of cross‐reactivity with other organic or inorganic mercury compounds, lead us to speculate that reactions to TH are due to organomercury alkyl compounds, and that positive subjects have a constitutively reduced capability to metabolize organomercury compounds, rather than to reveal previous exposure.
Deodorants: a clinical provocation study in fragrance‐sensitive individuals
Authors: Johansen J. D. , Rastogi S. C. , Bruze M. , Andersen K. E. , Frosch P. , Dreier B. , Lepoittevin J. P. , White I. , Menne T.
Published: February 2007

Deodorants are one of the most marketed types of cosmetics and are frequently reported as a cause of dermatitis, particularly among fragrance‐sensitive persons. The aim of this study was to investigate the ability of deodorants, which had previously caused axillary dermatitis in fragrance‐mix‐sensitive eczema patients, to provoke reactions on repeated open application tests on the upper arm and in the axillae, and to relate the findings to the content of fragrance‐mix constituents in those deodorants. 14 eczema patients performed a 7‐day use test with 1 or 2 deodorants that had caused a rash within the last 12 months. 2 applications per day were made in the axilla and simultaneously on a 25 cm2 area on the upper arm. A total of 20 deodorants were tested among the 14 patients. Afterwards, the deodorants were subjected to quantitative chemical analysis identifying constituents of the fragrance mix. 12/20 (60%) deodorants elicited eczema on use testing in the axilla. 8/12 deodorants were positive in the axilla on day (D) 7 and 4 both in the axilla and on the upper arm. 2 of the 4 developed a reaction in the axilla before it developed on the upper arm. Chemical analysis revealed that 18/19 deodorants contained between 1 and 6 of the fragrance‐mix constituents, on average 3 being found. The mean concentration of fragrance‐mix constituents was generally higher in the deodorants causing a positive use test, as compared with those giving a negative reaction, indicating that the differences between the deodorants in terms of elicitation potential were more related to quantitative aspects of allergen content than of a qualitative nature. It is recommended that deodorants are tested in the axilla in the case of a negative use test on the upper arm and a strong clinical suspicion.
Patch testing with nickel sulfate: comparison between 2 nickel sulfate preparations and 2 different test sites on the back
Authors: Slmonetti Vlto , Manzini Blanca Maria , Seidenari Stefania
Published: February 2007

Among patients routinely undergoing patch testing for suspected allergic contact dermatitis (ACD), nickel is the most frequently sensitizing hapten, with a clear predominance in the female population. However, some patients who report the appearance of dermatitis upon exposure to metal objects show negative patch test results to a nickel sulfate 5% pet. application. In some cases, a positive response to nickel can be observed simply by repeating the patch test. The objective of our study was to assess if, during routine patch testing, positive responses to nickel sulfate are missed owing to contingent problems, referring to application site, patch test execution or variations in skin reactivity. To this end, we applied 2 different patch test materials containing nickel sulfate 5% pet. to 3040 consecutive patients, undergoing patch testing for suspected allergic contact dermatitis, during the same session. The rôle of the test site was also investigated by applying the preparation on 2 different sites of the back in 30 patients. Of the whole, 612 patients (20%) showed positive patch test responses. The 2 nickel materials were almost equivalent: 78% of nickel‐sensitive patients had positive reactions to both, whereas 11% showed a positive response to 1 preparation alone. No variations in patch test responses in relation to application site were observed. Our data show that false‐negative patch test responses to nickel are frequent. The use of 2 different preparations during the same patch test session increases the response rate by 10%.
A metallurgical approach to metal contact dermatitis
Authors: Flint G. N.
Published: February 2007

It is well‐known that some metals/alloys are sensitizing on skin contact, but it is not so well appreciated that sensitization is dependent on the reaction of the metal/alloy with sweat. The first step in skin sensitization by metals/alloys is a corrosion process and the formation of soluble metal ions. The nature of this process has implications with respect to occurrence of metal contact dermatitis, to testing techniques and to classification of metals/alloys as skin sensitizers.
Glove powder affects skin roughness, one parameter of skin irritation
Authors: Brehler R. , Voss W , Muller S.
Published: February 2007

Most patients with immediate‐type‐hyper sensitivity to natural rubber latex (NRL) give a history of hand eczema. Susceptibility to allergens is increased by irritant hand eczema due to damage to the skin barrier. Therefore, especially for employees in medical or paramedical professions, reduction in skin irritation is of importance. The present study reports the effect of glove powder on skin roughness, one feature of skin irritancy. Skin replicas, performed before and after wearing different types of gloves, were evaluated by laser profilometry. Significant alteration of skin roughness was evident and determined by different factors. Use of unpowdered Biogel gloves on prepowdered hands results in an increase in skin roughness, in contrast to the use of Biogel gloves on hands without any pre‐application. On the other hand, powdered Manex neoderm gloves show no influence on the skin structure, whereas powdered Peha taft gloves also increase the roughness of the skin. Other potential candidates causing skin morphology alteration could be the glove pH, rubber chemicals with irritant potential and other characteristics of gloves, which are already under investigation.
The effects of prolonged use of surfactants on the skin of normal and photo‐exposed hairless mice*
Authors: Tavakkol Amir , Kligman Lorraine H. , Morrison Boyce M. , Polefka Thomas G.
Published: February 2007

Laboratory tests to assess the irritant potential of materials, such as skin cleansers, which are normally used over a long period by humans, fail to mimic actual use. Most washing tests last a few days or at most a few weeks. Skin sites and techniques are often not standardized. The more standardized patch test involves occlusion and results in exaggerated reactions, since even water and blank patches produce visible and pathophysiologic changes. All of these tests rely on visual assessment despite strong evidence that similarly appearing skin can be very different histologically. The primary objective of this study was to use a well‐defined animal model to evaluate the cumulative effects of repeated skin exposure to low levels of surfactants of varying skin irritation potential. A secondary aim was to examine whether or not surfactant‐induced skin changes were exacerbated by suberythemal UV radiation. Test materials were applied topically, 2× daily to the dorsal areas of normal and low‐dose solar simulator exposed mice for 15 weeks. Our results show that, with conditions mimicking typical normal use, these surfactants and skin cleansers produce little or very mild histological changes in the skin. UV irradiation alone produced the greatest change in all histological parameters examined, with no synergistic or additive effects with the topical treatments.
Clinical morphology of sodium lauryl sulfate (SLS) and nonanoic acid (NAA) irritant patch test reactions at 48 h and 96 h in 152 subjects
Authors: Reiche Louise , Willis Carolyn , Wilkinson John , Shaw Stephanie , De Lacharriere O.
Published: February 2007

In this study of 152 women, comparison of patch test responses between 2 irritants over 96 h at 2 symmetrical anatomical sites is studied. 2 irritants, each at 4 different concentrations (nonanoic acid (NAA) 80%, 40%, 20%, 10%; sodium lauryl sulfate (SLS) 3%, 2%, 1% and 0.5%) and using propan‐lol and‘water for injection’as the respective controls, were placed as 15 μl aliquots, soaked onto filter paper discs in Finn Chambers, on the volunteer's left and right lower back. The patches were removed at 47, and read at 48 and 96 h. Irritant reactions were evaluated for erythema and surface changes by degree and area affected. Statistical analysis of the results showed that erythema decreased with time for all concentrations of NAA, and at higher concentrations for SLS. Surface changes increased with time for SLS and at higher concentrations of NAA. There was no statistically significant difference comparing left and right sides. Traditionally in patch testing, reactions which fade after 48 h have been regarded as irritant rather than allergic. This study refutes that assumption. Data from our left to right comparisons, made in the same individuals at the same time, show that irritant reactions may be more reproducible than previously appreciated.
Cutaneous sensitization to some polyisocyanate prepolymers in guinea pigs
Authors: Zissu Danièle , Binet Stéphane , Limasset Jean‐Claude
Published: February 2007

Isocyanates are used extensively in the polyurethane industry. Pulmonary and dermal sensitization resulting from exposure to diisocyanates has frequently been reported, but the potential effects of polyisocyanates on health are less well known. Thus, since 1978, occupational exposure limits have been established for diisocyanates only. Nevertheless, respiratory diseases and dermatitis have been reported in the polyurethane industry after accidental isocyanate contact during spills or splashes. The aim of this experimental work was to assess the dermal hypersensitivity of guinea pigs to some polyisocyanate prepolymers by means of a well‐conducted standard predictive Buehler test. Our results showed that dicyclohexylmethane 4,4′‐diisocyanate (HMDI), toluylene 2,4‐diisocyanate (TDI), TDI adduct triol, TDI isocyanurate, 1,6‐hexamethylene diisocyanate (HDI), HDI isocyanurate, HDI biuret and isophorone diisocyanate (IPDI) induced dermal sensitization while IPDI isocyanurate did not. In conclusion, the dermal hypersensitivity of guinea pigs to some polyisocyanates was similar to those of their corresponding monomers except for IPDI isocyanurate, suggesting that the results from diisocyanate monomers could not be a valuable approach for the detection of the sensitization potency of the corresponding prepolymers.
Patch tests versus use tests in skin irritation risk assessment
Authors: Basketter David , Gilpin Geoff , Kuhn Michael , Lawrence Dick , Reynolds Fiona , Whittle Ed
Published: February 2007

In the risk assessment of the ability of a substance or preparation to cause skin irritation, a patch test involving human volunteers is often seen as providing definitive information. However, the skin exposure conditions found in an occluded patch may be far removed from those in a particular use situation, not least for such reasons as the high dose per unit area, the duration of exposure and the maceration of the skin. Whilst these factors may enhance sensitivity in the identification of intrinsic hazard, they may do little to ensure accurate safety evaluation for real use. In this paper, we report data from a series of studies with an unmarketed facial skin cosmetic product. Whilst the product was unexpectedly highly irritating in a standard patch test in 30 volunteers, subsequent use tests, including a 6× daily open application to the elbow for 3 weeks and 2× daily application in a half‐face test lasting 3 to 4 weeks and involving 52 volunteers failed to show any evidence of skin irritation. It is concluded that the most meaningful results for skin irritation risk assessment are likely to come from studies which involve relevant patterns of exposure.
Contact dermatitis in children: 6 years experience (1992–1997)
Authors: Romaguera C. , Vilaplana J.
Published: February 2007

We report the results of patch tests carried out over the last 6 years (1992‐1997) on 141 children. This corresponds to 2.8% of the total patients who were patch tested in our Allergy Department (5,014). These 141 children were patch tested using the TRUE TestTM standard series and an additional allergen, metallic mercury. Allergens from the Chemotechnique medicaments, cosmetics, plants and shoe series were added in some. The most frequent localization of eczema was to the feet, face and hands and the most frequent suspected causes were costume jewellery, footwear, topical medicaments and cosmetics. The most frequent allergens, assessed by degree of relevance, were first, nickel, followed by cobalt, mercurials (thimerosal and metallic mercury), fragrance and rubber chemicals (naphthyl mix, mercapto mix, carba mix and PPD mix). 13 children, 18% of the total, between the ages of 12 and 14 years, showed positivities relevant to some occupation, i.e., metalworking, building, hairdressing, catering, etc. Once patch tests had been carried out and relevant positive patch tests assessed, the most frequent diagnoses were contact dermatitis 45%, atopic dermatitis 25%, juvenile plantar dermatitis 15%, and other diagnoses in the remaining 15%.
Metal release from gold‐containing jewellery materials: no gold release detected
Authors: Liden Carola , Nordenadler Marianne , Share Lizbet
Published: February 2007

Metal release from 13 different gold‐containing jewellery alloys stored for 1 and 3 weeks in artificial sweat was analysed. For chemical analysis, inductively‐coupled plasma detection (ICP) and atomic absorption spectrophotometry (AA), with flame and with furnace, were used. No release of gold was detected. It is unlikely that skin contact with gold‐containing metallic items such as jewellery is responsible for inducing contact allergy to gold or allergic contact dermatitis due to the gold. The patch‐test reactivity to gold sodium thiosulfate needs to be explained by some other mechanism(s).
Oral and epicutaneous desensitization in urushiol contact dermatitis in guinea pigs sensitized by 2 methods of different sensitizing potency
Authors: Ikeda Yoshihiro , Yasuno Hirokazu , Sato Atsuchi , Kawai Keiichi
Published: February 2007

This investigation was conducted to study the relationship between the different intensities of sensitization to urushiol induced by the maximization test method (MT) or by the ear‐flank method (EF) in guinea pigs, and hyposensitization induced by repeated oral and/or epicutaneous administration of the allergen, and to compare the immune tolerance achieved between these routes of dosing. During the observation period of 10 weeks, both oral and epicutaneous administration produced hyposensitization to urushiol after weak sensitization by EF; however, only combined administrations via the oral and epicutaneous routes achieved hyposensitization after potent sensitization, while inadequate tolerance was induced by oral dosing and none by epicutaneous dosing. Thus, it is indicated that difficulty in establishing immune tolerance may increase with increasing intensity of primary sensitization, and that hyposensitizing potency tends to increase in the order epicutaneous, oral and combined (e.p.+p.o.) administrations of urushiol.
Is benzoquinone the prohapten in cross‐sensitivity among aminobenzene compounds?
Authors: Lisi Paolo , Hansel Katharina
Published: February 2007

Cross‐sensitivity in allergic contact dermatitis is a simultaneous allergy to 2 or more contact substances which have in common an antigenic determinant or a metabolic derivative. One of the most notable examples is the cross‐sensitivity among aromatic compounds which may be oxidized in vivo to benzoquinone (BQ). However, it has also been hypothesized that the allergenicity and cross‐sensitization are modulated by the chemical reactivity of the substituents in the para position. A serial dilution of BQ (from 1% to 0.1% in pet.) and three 1,4‐substituted benzene derivatives (p‐aminophenol, hydroquinone, metol), theoretically capable of conversion to BQ by oxidation, were patch tested in 22 p‐phenylenediamine (PPD) positive patients and in 20 controls. The patients and a further 116 subjects with a positive history of sensitivity to 1 or more aminoaromatic compounds were also tested with some haptens of the para group (PPD, p‐aminobenzoic acid, p‐aminodiphenylamine, benzocaine, procaine chloride, p‐toluenediamine sulfate). The results show that (i) the optimal patch test concentration for BQ was 0.2%, (ii) only 4 of the 22 patients allergic to PPD gave a clearly positive allergic reaction to BQ, and (iii) the number of positive reactions to the aromatic compounds was correlated with the presence of activating (‐NH2, ‐OH, ‐CH3) and deactivating (‐COOH) groups in the para position or, perhaps, with their effect on percutaneous penetration. The data suggest that BQ is not the only intermediate in the cross‐sensitization of para group haptens. This is probably conditioned by other oxidation products and/or the chemical structure of the substituents in position 4 of the benzene ring.
Development of occupational skin diseases during vocational training in baker and confectioner apprentices: a follow‐up study
Authors: Bauer A. , Bartsch R. , Stadeler M. , Schneider W. , Grieshaber R. , Wollina U. , Gebhardt M.
Published: February 2007

Baker and confectioner apprentices have been included in a prospective follow‐up study in the region of East Thuringia, to evaluate risk factors for the development of hand dermatitis. Starting in August 1996, the apprentices have been interviewed and examined in a standardized way right at the beginning (n=91) of their vocational training, 6 (n=79) and 12 months (n=63) later. To gain objective data, TEWL score was also assessed at 3 standardized sites on the hands. In their case histories, 3.3% (n=3) of the apprentices reported hand dermatitis. The 1st assessment after 2 to 4 weeks vocational training revealed hand eczema in 17.5% (n=16) of the individuals. At the follow‐up after 6 months of training 29.1% (n=23), and after 12 month of training 27.0% (n=17), of the apprentices had hand dermatitis of mild to moderate severity. Within 6 months, the TEWL score rose significantly (p<0.001) from 11.9 g m−2 h−1 (± 5.4) to 16.8 g m−2 h−1 (± 9.5). After 12 months, the TEWL score was 14.9 g m−2 h−1 (± 4.6). For the atopic skin diathesis (> 10 points of Diepgen's atopy score), there was a significant tendency to be a predictive factor for the development of occupational hand dermatitis. TEWL score failed to correlate with the development of skin damage in our study. The same was true for respiratory atopy and metal sensitization.
Dermatoses in cement workers in southern Taiwan
Authors: Guo Yueliang L. , Wang Bour‐Jr , Yeh Kung‐Chieh , Wang Jen‐Chang , Kao Huy‐Hwa , Wang Ming‐Tsan , Shih Hung‐Chih , Chen Chiou‐Jong
Published: February 2007

Construction workers are known to have occupational dermatoses. The prevalence of such dermatoses was unknown in Taiwanese construction workers. The objective of this study was to determine the work exposure, prevalence of skin manifestations, and sensitivity to common contact allergens in cement workers of southern Taiwan. A total of 1147 current regular cement workers were telephone‐interviewed about skin problems during the past 12 months, work exposure, and personal protection. Among those interviewed, 166 were examined and patch tested with common contact allergens. A high % of cement workers reported skin problems in the past 12 months. More men (13.9%) reported skin problems possibly related to work than women (5.4%). Prevalence was associated with lower use of gloves, duration of work as cement worker, and more time in jobs involving direct manual handling of cement, especially tiling. A high % of dermatitis was noted in the 166 workers examined, which correlated with reported skin problems. On patch testing, construction workers had a high frequency of sensitivity to chromate. Sensitivity to chromate or cobalt was associated with reported skin problems, or dorsal hand dermatitis on examination. These workers’dermatitis was under‐diagnosed and inadequately managed. It is concluded that cement workers in southern Taiwan had a high prevalence of skin problems related to cement use. Protective measures, work practice, and physician education should be improved to prevent or manage such problems.