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A Schnuch

Publications and source records attributed to A Schnuch.

At least 19 recordsLinked to original sources
PubMed2003

[Epidemiologic surveillance of contact allergens. The "monitoring series" of IVDK (Information Network ofDermatologic Clinics for Detection and Scientific Evaluation of Contact Allergy].

The selection of the most important contact allergens is subject to a continuous change. Several factors may influence the sensitization rates and thus the decision, which substances to include in the standard series of the most frequent allergens. The Information Network of Departments of Dermatology adds substances of interest for a certain time period to the standard series in order to evaluate parameters such as sensitization rate, grade of reaction, and clinical relevance of positive reactions. In 6 testing periods starting in 1996, 13 test substances were evaluated. Due to the results, propolis, compositae mix, and bufexamac were included in the standard series in 1999, while lyral was added in 2002. Sorbitansesquioleat, dispers blue mix, and iodopropynyl butylcarbamate are under further discussion. Substances such as glutaraldehyde and p-aminoazobenzole should be tested in certain risk groups only, whereas the steroids budesonide and tixocortol should be tested when clinically suspected.

Allergens↗
PubMed2003

[Decrease in nickel sensitization in young patients--successful intervention through nickel exposure regulation? Results of IVDK, 1992-2001].

BACKGROUND: In the early 1990s, the prevalence of nickel contact allergy was high-almost 20% on a population level, and some 40% in contact dermatitis patients. Around that time, nickel exposure was starting to be regulated. PATIENTS/METHODS: Descriptive and bivariate analyses of patch test results of all patients tested with nickel sulfate (5% pet.) in the departments joining the Network of Departments of Dermatology (IVDK) 1992-2001 (n=82,991, women: 52,709; men: 30,282). The annual frequency of sensitization to nickel was analyzed in women and men in four age subgroups (<31/31 to <44/44 to 58= or >58). RESULTS: In young women less than 31 (n=13.909) the prevalence of contact allergy to nickel decreased significantly from 36.7% in 1992 to 25.8% in 2001. In young men in the same age group (n=7087), the prevalence dropped from 8.9% in 1992 to 5.2% in 2001. CONCLUSIONS: The observed decline indicates that measures to limit the release of nickel from costume jewelry helped reduce the prevalence of nickel allergy. In general term, allergen elimination or reduction is an effective primary prevention strategy which does not depend on individual behavior modifications.

Adolescent↗
PubMed2003

[Severe allergic contact dermatitis with generalized spread due to bufexamac presenting as the "baboon" syndrome].

HISTORY AND CLINICAL FINDINGS: A 48-year-old woman presented with acute, pruritic, sharply demarcated, erythematous, maculopapulous exanthem in the anogenital area with disseminated maculae over the back. Several days before, the patient had applied as topical treatment a bufexamac-containing ointment to the anal region. INVESTIGATIONS: The patch test showed an allergic test reaction to bufexamac. DIAGNOSIS: The case presents a serious allergic contact dermatitis with generalization, imitating a baboon syndrome, unequivocally linked to the previous topical treatment. CONCLUSION: During the last 10 years allergic reactions to bufexamac have increasingly been reported, sometimes with erythema multiforme-like reactions. Because of the high rate of sensitization, the serious clinical course of bufexamac allergy and the insidious symptoms of this side effect, sometimes mimicking the disease to be treated, the substance should be used neither for proctological nor for dermatological diseases, even more as these patients are considered to be at high risk of developing allergic contact dermatitis because of the abnormal skin barrier. Considering the data presented, the use of bufexamac should be critically reassessed.

Administration, Topical↗
PubMed2003

Risk factors for contact allergy to nickel - results of a multifactorial analysis.

To quantify the independent impact of potential risk factors for nickel contact allergy (NCA), a multifactorial Poisson regression analysis of standardized anamnestic and patch test data (with nickel sulfate, 5% in petrolatum) was performed, comprising 74 940 patients assessed in the 33 German and Austrian contact dermatitis units of the Information Network of Departments of Dermatology (IVDK) between 1992 and 2000. NCA was observed in 15.5% patients. Female sex was the strongest risk factor (prevalence ratio 3.74, 95% CI: 3.51-3.98). Risk increased monotonically and significantly with decreasing age. Atopic dermatitis was not a risk factor. The year of patch test had no influence on NCA risk. Significant variation of risk between occupations was observed. In conclusion, our multifactorial analysis was able to quantify the impact of established risk factors and additionally address other, e.g. occupational, factors yet unidentified.

Adult↗
PubMed2003

Frequency of sensitization to antimicrobials in patients with atopic eczema compared with nonatopic individuals: analysis of multicentre surveillance data, 1995-1999.

BACKGROUND: Atopic eczema, a multifactorial disease, is influenced by bacterial factors, particularly Staphylococcus aureus. Consequently, treatment includes therapy with antibiotics and nonantibiotic antimicrobials. OBJECTIVES: In our study the sensitizing potential of some topical antimicrobials was investigated by comparing proportions sensitized to various antibiotics and antiseptics between patients with current or past atopic eczema, and patients who had never had atopic eczema. METHODS: Data of all patients patch tested in the Departments of Dermatology participating in the Information Network of Departments of Dermatology (IVDK) between 1995 and 1999 were analysed. Patients with a current leg ulcer or stasis dermatitis that might cause a confounding effect were excluded. RESULTS: Controlling for the additional confounding effect of sex and particularly age, we did not find that patients with atopic eczema had a generally higher risk compared with nonatopic individuals. CONCLUSIONS: While the risk of sensitization should always be considered when applying topical therapy, our data-within the methodological limitations of this type of study-would not support a very restrictive use of these agents in the management of atopic eczema.

Adult↗
PubMed2002

The preservative iodopropynyl butylcarbamate: frequency of allergic reactions and diagnostic considerations.

The preservative iodopropynyl butylcarbamate (IPBC) (0.1% in petrolatum) was tested in 4883 consecutive patients for 18 months between January 1998 and June 1999. With regard to the MOAHLFA-Index, the study population comprised 37% males; 17% with occupational and 19% with atopic dermatitis; 31% with hand, 10% with leg and 17% with face dermatitis; 61% were age 40 and above. According to readings at D3, 0.3% were allergic to IPBC, with 14 + and 2 + + reactions. Doubtful or irritant reactions occurred twice as frequently. Patients exposed for 24 h (n = 1814) reacted less frequently (0.1%) than the remaining patients exposed for 48 h (0.5%). Considering the possibility that a certain proportion of + reactions could be false positive, the reaction pattern was evaluated. More than 80% of the positive reactions displayed a crescendo or plateau time pattern. Furthermore, 18 of 43 doubtful reactions (?) appeared as late as D3 (thus, these could be false negative), whereas the majority of doubtful reactions occurred earlier and displayed a decrescendo pattern (corresponding to a typical irritant pattern). In conclusion, the large proportion of '?' reactions may be due not only to the irritant potential of the substance, but also to test concentrations not being high enough to elicit an allergic reaction. We propose that higher concentrations of IPBC (0.3%) should be evaluated in a study also addressing suitable validation tests like ROAT or PUT.

Adult↗
PubMed2002

Epidemiology of contact allergy: an estimation of morbidity employing the clinical epidemiology and drug-utilization research (CE-DUR) approach.

Clinical epidemiology (CE) is considered unable to estimate morbidity concerning either contact sensitization (CS) or allergic contact dermatitis (ACD) at the population level. Drug-utilization research (DUR) methods estimate the morbidity of suitable diseases based on prescription data for disease-specific drugs. Our objective was to estimate population figures for incidence and prevalence of ACD and CS based on sales data for patch test material in Germany and on patient data from the Information Network of Departments of Dermatology (IVDK). Approximately 600000 standard series are sold per year in Germany, according to the 2 main manufacturers. This raw sales figure was corrected for certain effects (discarded preparations, proportion of formerly patch-tested patients, proportion of patients with ACD seeking medical advice) to obtain an estimate of the denominator of patients eligible for patch testing annually, and combined with patch test results from the Information Network of Departments of Dermatology (IVDK). In 17.8% (of 9266 IVDK patients) ACD was established. Extrapolated to the general population, an incidence of ACD of between 1.7 and 7 per 1000 per year was estimated, depending on whether conservative or more liberal assumptions concerning the above effects were made. Of 78067 IVDK patients tested between 1992 and 2000, 46.8% had at least 1 positive reaction (+ to + + +), and 22.7% had at least 1 stronger positive reaction (+ + or + + +). The 9-year prevalence of CS was estimated to lie between 4.0% and 16.6% for the first outcome, and between 2.0% and 8.1% for the second. Concerning single allergens, 1.9-4.5 million individuals are probably sensitized to nickel, and 1.4-3.4 million to fragrance mix among the German population of 82 million inhabitants. The morbidity data found in this study are in good accordance with data from population-based epidemiological studies. In comparison to these, the CE-DUR approach seems to be an economically feasible method to estimate continuously the population impact of ACD and CS.

Allergens↗
PubMed2002

When should a substance be designated as sensitizing for the skin ('Sh') or for the airways ('Sa')?

In the List of MAK and BAT Values compounds are designated with 'Sa' ('sensitizing for the airways') or 'Sh' ('sensitizing for the skin') if, according to scientific evidence, they are allergens. Mainly based on suggestions by a WHO working group and based on our own experience, extended criteria have been elaborated by the working group 'skin and allergy' of the Commission of the Deutsche Forschungsgemeinschaft for the Investigation of Health Hazards of Chemical Compounds in the Work Area, which are presented in this article. They serve as guidelines for deciding which substances have to be labelled 'Sa' and 'Sh', respectively, for the prevention of sensitization and subsequent allergic diseases in workers. Although in some special cases their strict application may not be deemed necessary or possible, the proposed new criteria should be used to make the procedure of classification of substances: 1) more rational, 2) more consistent, 3) more comprehensible, and 4) more transparent. This paper informs readers working scientifically or administratively in this field and invites a critical discussion of the issue.

Allergens↗
PubMed2001

Another look at seasonal variation in patch test results. A multifactorial analysis of surveillance data of the IVDK. Information Network of Departments of Dermatology.

There is conflicting evidence concerning seasonal variability of patch test results and no evidence concerning the influence of season on weak-positive, possibly false-positive, irritant reactions, which was analysed in the present study. Data collected in the German Information Network of Departments of Dermatology (IVDK) 1992 to 1997 were combined with external environmental data on temperature and absolute humidity in Germany, and bivariate as well as logistic regression analyses performed concerning the association between reactivity to selected allergens and air temperature and absolute humidity on the respective days of patch testing. Between 39,239 and 41,629 patients had been tested with the 4 allergens considered here. Only formaldehyde exhibited a distinct increase in questionable or irritant as well as weak-positive reactions associated with dry, cold weather. Methylchloroisothiazolinone/methylisothiazolinone and lanolin alcohol showed only a weak, and epoxy resin no, association with climatic conditions. The results indicate that weak-positive reactions, at least to formaldehyde as a prototype of an allergen which is at the same time a marginal irritant, may sometimes be irritant rather than allergic. Patients showing these should be re-tested to improve the poor reproducibilty observed with this allergen.

Climate↗
PubMed2001

Associated positive patch test reactions to standard contact allergens.

BACKGROUND: Patch testing with a standard allergen series often yields positive reactions to more than 1 allergen in a patient. OBJECTIVE: To identify all significantly associated pairs of positive reactions and to assess their relation to the strength of the reactions and to the irritative potential of the allergens. METHODS: Based on the filed data of 57,822 patients, associations between positive reactions to 2 different allergens were quantified with odds ratios. Statistical methods included Fisher's exact test, the Bonferroni adjustment to account for the effect of multiple testing, and the Spearman rank correlation. RESULTS: Out of the 32,779 patients with complete readings of 24 standard allergens, 7,501 had shown more than 1 positive reaction. Statistically significant associations were detected for 166 out of the 276 possible different combinations of 2 distinct positive reactions, including combinations that had not been identified before. Patients with a strong reaction or a positive reaction to an allergen with a high irritative potential tended to have additional positive reactions to further allergens more often than others, but the number of significant associations was not dependent on these parameters. CONCLUSION: There are more significant associations that have to be taken into account for patch testing than has been known so far. Although irritation can favor a higher number of positive reactions, significant associations of positive reactions to distinct allergens are probably caused by other mechanisms that require further analyses.

Adult↗
PubMed2001

Glyoxal is an important allergen for (medical care) cleaning staff.

While disinfection is essential in medical practice, it carries the risk of serious adverse effects, including allergic contact dermatitis. To assess the current importance of glyoxal [CAS 107-22-2] as occupational allergen, a retrospective descriptive analysis of records of an occupational dermatitis clinic in Osnabrück and of national surveillance data of the Information Network of Departments of Dermatology (IVDK) in Germany and Austria was performed. Of 189 highly selected patients with occupational dermatitis tested with glyoxal (1% in water or, as trimer, 1% in petrolatum) in Osnabrück, 11 had positive reactions to glyoxal, which were occupationally relevant in 9 cases. Causative occupations included mainly nursing and room cleaning. In a less selected population of 2626 additional patients tested in other centres of the IVDK, 40 further positive reactions to glyoxal were observed. Concomitant sensitisation to glutardialdehyde and formaldehyde, respectively, was frequently observed. In conclusion, glyoxal should be tested in all patients with contact dermatitis working in occupations with possible exposure to respective disinfecting/cleaning agents.

Adult↗
PubMed2001

Association between occupation and contact allergy to the fragrance mix: a multifactorial analysis of national surveillance data.

OBJECTIVES: To assess the role of potential (occupational) risk factors for fragrance contact allergy (FCA). Most studies assessing the range of contact sensitisation in various clinical populations found the fragrance mix, a good screening tool for the detection of FCA in general, to be one of the leading allergens. The role of occupational exposure to fragrances is, however, yet unclear. METHODS: Firstly, crude analyses of the prevalence of FCA in various occupational fields including all 57,779 patients patch tested in the participating centres of the Information Network of Departments of Dermatology (IVDK) between January 1992 and December 1998. Secondly, a multifactorial Poisson regression analysis of these patients, including several potential risk factors. RESULTS: (a) The proportion of patients with FCA varied greatly between different occupational groups from 2.5% to 17.4%, (b) the highest occupational risk of FCA was associated with work as a masseur or physiotherapist, metal furnace operator, potter or glass maker etc, or geriatric nurse, (c) non-occupational factors that influenced risk of FCA included atopy, female sex, several sites, in particular the axillae, and increasing age. CONCLUSIONS: Occupations with a high risk of FCA were identified as targets of preventive action--that is, the substitution of scented products with fragrance free materials with which to work (skin disinfectants, cleaning solutions, personal care products) wherever possible.

Adult↗