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J Geier

Publications and source records attributed to J Geier.

At least 37 records · Page 2Linked to original sources
PubMed1998

Contact allergies in healthcare workers. Results from the IVDK.

Healthcare workers often suffer from occupational skin disease frequently caused by allergic sensitization. Therefore the patch-test results and important patient history items of 31,849 patients recorded between 1992 and 1995 in the 24 allergy departments participating in the Information Network of Departments of Dermatology (IVDK) were evaluated. Significantly increased sensitization rates common to the healthcare sector as a whole were found for the vaccine preservative thiomersal (12.6% vs. 4.9%), the surface and instrument disinfectants glutardialdehyde (9.9% vs. 2.6%), formaldehyde (3.6% vs. 2.1%) and glyoxal (4.2% vs. 1.4%), and for the compounds of the thiuram mix (6.7% vs. 2.6%) present in protective gloves. Formaldehyde seems to lose its importance, but glyoxal must be added to the list of occupational allergens in the healthcare sector. In addition, occupation-specific sensitization was observed, with fragrances in massage therapists (16.1% vs. 10.6%) and nurses (13.8% vs. 11.4%), as well as with methacrylates in dental technicians. The often assumed importance of drugs as type-IV allergens was not confirmed, at least in terms of quantity. The identification of subgroups of increased risk and of occupation-specific allergens could be the basis of targeted preventive action in the healthcare sector.

Adult↗
PubMed1998

Genotype and phenotype of N-acetyltransferase 2 (NAT2) polymorphism in patients with contact allergy.

We investigated whether patients with contact allergy differed from non-contact-allergic, non-atopic controls with regard to genotype and phenotype of the polymorphic enzyme N-acetyltransferase 2 (NAT2). 55 contact-allergic patients recruited from the Information Network of Departments of Dermatology (IVDK) were compared to 85 controls from among local health care personnel. NAT2 activity was calculated from HPLC analysis of the ratio of the caffeine metabolites 5-acetylamino-6-formylamino-3-methyluracil (AFMU) and 1-methylxanthine (1MX) in the urine. NAT2 genotype was determined by polymerase chain reaction (PCR). A statistically significantly increased proportion of rapid acetylators was found in contact-allergic patients. This may have 2 possible implications: acetylation may enhance contact sensitization; or NAT2 status may be a genetic marker for contact sensitizability.

Acetylation↗
PubMed1997

National rates and regional differences in sensitization to allergens of the standard series. Population-adjusted frequencies of sensitization (PAFS) in 40,000 patients from a multicenter study (IVDK).

Sensitization rates to contact allergens vary between centers and are influenced by sex and age. Eliminating the latter 2 factors by standardization of data by age and sex, the present analysis addresses possible differences between centers remaining after elimination of these confounders, and analyzes other factors which might influence rates, e.g., the MOAHL index. Overall standardized rates were well within the range reported in previous studies and may be regarded as representing the rates of the "patch test population" in Central Europe (e.g., nickel sulfate 12.9%, fragrance mix 10.5%, balsam of Peru 7.3%, thimerosal 5.6%). For this analysis, data of those departments which contributed more than 2000 patients, or of those with extreme proportions concerning sex, age and occupational cases were selected. Patients from these 10 departments differed considerably with regard to the items of the MOAHL index and with regard to standardized rates. The items of the MOAHL index proved to be suitable for describing different patch test populations and for explaining some differences between centers. Only 'atopic dermatitis' seems to have little influence on (standardized) rates. Face dermatitis is not yet represented in the MOAHL index, but should be included, together with age > 40 years, in an extended index (acronym: MOAHLFA). Regional allergen exposure (with striking differences between East Germany, West Germany and, to a lesser extent, Austria) seems to have a great influence on the sensitization pattern observed in a department. In addition, sociological factors may influence sensitization rates, which is exemplified by high rates of nickel allergy in a socially defined subgroup. Future studies should focus on these factors, as well as on factors concerning patch test practices and quality control.

Adult↗
PubMed1997

Patch test results in schoolchildren. Results from the Information Network of Departments of Dermatology (IVDK) and the German Contact Dermatitis Research Group (DKG)

Our aim was to explore the current spectrum of contact allergens in schoolchildren, as a basis for diagnosis and prevention of allergic contact dermatitis. Results of patch tests in children 6-15 years old, performed in the years 1990-1995 by 22 centres of the German Contact Dermatitis Research Group and filed by the Information Network of Departments of Dermatology, were analysed and evaluated retrospectively, including epidemiologic data. Children with positive tests (62 out of 156 boys and 108 out of 260 girls tested) had a higher frequency of allergic contact dermatitis and a lower frequency of atopic dermatitis than patch test negative ones. 16 distinct allergens elicited positive reactions in > or = 1% of the children tested. Reactions to nickel sulfate occurred in 15.9% of all children tested, but in 25.0% of girls 14/15 years old, and in only 4.5% of boys 6-13 years old. Double-sensitizations with cobalt salts, potassium dichromate and palladium were seen. Mercury compounds were found in 2nd place (thimerosal: all children: 11.3%; 6-13 years old: 14.3%; 14/15 years old: 8.0%), followed by fragrance allergens. We conclude that contact allergy in children is related to their sex and age. Prophylaxis against nickel, mercury, and fragrance allergy needs to be improved. A shortened standard series may be sufficient for testing children.

Adolescent↗
PubMed1996

[Dental materials--problem substances in allergologic diagnosis? I: Analysis of test results in patients with mouth mucosa/dental material problems].

Patch testing as a part of the diagnostic evaluation of patients suffering from oral mucosal complaints or with symptoms where dental materials are suspected to be the cause is hampered by numerous difficulties. The ingredients of denture materials as well as their liberation in the oral cavity are often unknown. Contact with many of the potential ingredients of denture materials can occur on other occasions, as well, thus making it difficult to find out where the patient has acquired his or her sensitization. The special morphological and immunological situation in the oral mucosa may produce tolerance of substances which evoke a positive patch test reaction on the skin of the back. This paper introduces the possible spectrum of allergens in these patients and discusses the difficulties in the assessment of the relevance of positive patch test reactions. From August 1992 to July 1994, 756 patients with complaints of the oral mucosa and/or suspected contact allergy to denture materials were patch tested in the departments of dermatology joining the Information Network of Departments of Dermatology in Germany (IVDK). Among these patients, women were overrepresented, while individuals with atopic dermatitis were underrepresented. The allergen spectrum included amalgam, mercury compounds, gold salts, palladium chloride and methyl methacrylate. However, the epidemiological value of these data is limited. A second part of this paper will review the various groups of allergens.

Adult↗
PubMed1996

Evaluation of patch test results with denture material series.

791 patients, among them 59 dental technicians and 732 other patients, were tested with the denture material series (DMS) recommended by the German Contact Dermatitis Research Group (DKG) in the hospitals of the Information Network of Departments of Dermatology (IVDK) between January 1990 and July 1993. Most frequently, positive reactions occurred to cadmium chloride in both groups. However, there was no evidence at all for relevance of these reactions. Benzoyl peroxide (BPO) ranked 2nd in patch test positivity. Although not statistically significant, reactions were more frequent in dental technicians, who might be exposed to BPO the in working environment. Methyl methacrylate (MMA) and triethylene glycol dimethacrylate (TEGDMA) were common sensitizers in dental technicians but not in other patients. This finding, too, has its explanation in the working process of manufacturing dental prostheses.

Adult↗
PubMed1996

Dynamic patterns of allergic patch test reactions to 10 European standard allergens. An analysis of data recorded by the Information Network of Departments of Dermatology (IVDK).

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

Adult↗
PubMed1996

Olaquindox-induced airborne photoallergic contact dermatitis followed by transient or persistent light reactions in 15 pig breeders.

There have been no previous reports of photosensitivity following photoallergy to airborne olaquindox in a large group. 15 pig breeders, with photo-distributed dermatitis related to olaquindox dust, were investigated to study the nature, promoting factors, and course of this disease. Minimal erythema doses for UVA and UVB were established before photopatch testing and at intervals thereafter. All patients presented with olaquindox-induced photoallergy. In 14 cases, this was followed by prolonged increased sensitivity to UVA. 7 patients also displayed an increased sensitivity to UVB. 13 farmers came into contact with olaquindox in mineral feed (1000 mg/kg) and only 2 in final feed (50 mg/kg). 8 patients avoided further contact with olaquindox because of warnings in the media. Allergies and photoallergies to other occupational substances preceded or followed olaquindox (photo)allergy. Because of their increased sensitivity to light, most of these farmers used sunscreens, and 2 of them developed (photo)allergy to UV-absorbers. As a result of our studies, we recommend photopatch testing for olaquindox in pig breeders with photo-distributed dermatitis. This would enable the early recognition of photoallergy to olaquindox and the prevention of persistent light reaction.

Adult↗
PubMed1996

Good clinical practice in patch testing: readings beyond day 2 are necessary: a confirmatory analysis. Members of the Information Network of Departments of Dermatology.

BACKGROUND: Despite general recommendations, patch test readings are still sometimes terminated at day 2. OBJECTIVE: The consequences of failure to read patch tests after day 2 and the influence of exposure time to the patches is quantified. METHODS: Patch test data from 9,946 patients with at least one positive reaction at day 2 or later and readings at both days 2 and 3 (from 21,062 patients tested between January 1, 1990, and December 31, 1993) collected by the Information Network of Departments of Dermatology in Germany were analyzed. RESULTS: Comparing results at days 2 and 3, 34.5% of all positive reactions appeared at day 3 only, whereas 8.3% initially judged (weakly) positive were not considered allergic at day 3. Some standard allergens showed specific patterns. Additional positive reactions and an increasing percentage of diminishing reactions can be observed at day 4 (compared with day 3). CONCLUSION: The importance of late reading(s) is emphasized by the proportion of potentially false judgments based on readings at day 2 only.

Allergens↗
PubMed1995

Evaluation of patch test results by use of the reaction index. An analysis of data recorded by the Information Network of Departments of Dermatology (IVDK).

Results of patch tests performed in 15,553 patients by 18 dermatological departments (members of the German Contact Dermatitis Research Group) and recorded by the Information Network of Departments of Dermatology (IVDK) were analysed by comparing recently defined reaction indices (RIs). The RIs studied were calculated from the numbers of allergic (a), questionable (q), and irritant (i) reactions (RI = (a-q-i/(a + q + i)), which were obtained using 13 European standard allergens. RIs were calculated for all patients and for separate subgroups defined by age, sex, history of atopic dermatitis, time of allergen exposure (1 versus 2 days), and time of patch test reading (2 or 3 days after allergen application). Higher RIs were consistently obtained when patch tests were applied for 1 day, as compared to 2 days. Readings at 3 days after allergen application resulted in higher RIs than readings after 2 days. In contrast, sex, age, and history of atopic dermatitis of patients were not found to have a consistent influence on the RIs. We suggest that reading after 3 days should be obligatory, and that allergen exposure for 1 day instead of 2 days might make patch test evaluation easier. These suggestions need to be substantiated by data on clinical relevance.

Adult↗
PubMed1990

[Effect of phototoxic substances on simple biological systems. I. Standardizing the method with furocoumarins].

As a basis for the investigation of new substances in respect of their photosensitization effects, we established and standardized 3 microbiological test systems, which enabled us to do without animal experiments. Using several furocumarines and various sources of light, we performed a comparative study on the eukaryotes, Chlamydomonas reinhardii (CR) and Candida albicans, and the prokaryote, Bacillus subtilis. We found that, if different light qualities were employed, our test systems also allowed a comparison of different substances by means of half-quantitative evaluation of the inhibiting areolas, which appear after exposure. With regard to the furocumarines, 8- and 5-methoxypsoralene (MOP) had the strongest photosensitizing effect under all test conditions. The remaining furocumarines showed decreasing effectiveness from psoralene to trimethylpsoralene (TMP) and imperatorine; psoralene, however, was slightly more effective in CR than 5-MOP. With the exception of CR, TMP had a stronger effect on the micro-organisms than imperatorine.

Animals↗
PubMed1990

[Contact urticaria caused by rubber gloves].

We present 9 patients with contact urticaria due to rubber gloves. Others have reported an increasing incidence of the disease among females, patients with atopic dermatitis, and hospital personnel. Our data confirm these results. Scarification with water, in which the suspected glove was incubated, is a simple diagnostic method, both reliable and cheap, in order to test the solubility of the allergen(s) in water. In one of our patients, we proved a type-I allergy caused by tetramethyl thiuram disulfide.

Adult↗
PubMed1989

[Contact allergies caused by bufexamac].

Between 1983 and 1987, there were 24 cases of contact allergy due to bufexamac seen at the Dermatological Hospital of the University of Göttingen. Of these patients, 20 were female und four male. It was noticeable, that the course of disease was particularly protracted and refractory: 16 of 22 patients were hospitalized with an average duration of inpatient treatment of 2.9 weeks. Seven patients had a generalized allergic contact dermatitis. Five patients had used topical preparations containing bufexamac for only one week or less. In 15 of 24 patients, further epidermal sensitization could be found. In all forms of eczematous diseases, especially in patients with chronic eczema, contact allergy to bufexamac should be considered, even if bufexamac preparations were used for only a short time.

Administration, Topical↗
PubMedDate not supplied

[Tattooing. A review with special reference to adverse side effects].

Intentional and non-intentional (ornamental and accidental) tattoos are reviewed. First, a survey of the history of tattooing is given and the different motives for being tattooed are discussed. The technique of tattooing and the histological pattern of ornamental tattoos are described. Typical risks are presented in detail. Various methods for the treatment of tattoos are discussed. In the second part, non-intentional (accidental) tattoos are reviewed in respect to etiology, complications and special therapeutic methods.

Dermabrasion↗