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Biomedical subjects

K Wrangsjö

Publications and source records attributed to K Wrangsjö.

15 recordsLinked to original sources

Contact allergy to Compositae plants in patients with summer-exacerbated dermatitis.

16 patients with summer-exacerbated dermatitis were examined by patch testing and photopatch testing with a battery of Compositae and standard allergens. IgE and RAST, and the thresholds to UVA and UVB, were determined. 6 female and 2 male patients showed allergic contact reactions to one or more Compositae extracts from flowers common in Sweden, also used in skin care products. The study points to the importance of including testing with Compositae allergens in patients with summer-exacerbated dermatitis. This group comprises patients with multiple contact reactions, photosensitivity and flares of atopic dermatitis.

Adult

IgE-mediated allergy to natural rubber in 30 patients with contact urticaria.

30 patients who had experienced contact urticaria after exposure to gloves, contraceptives, balloons or dental cofferdams went through a detailed examination including interviews on: exposure to rubber; local and distant symptoms; provocation tests; skin prick tests with (among other substances) latex extracts from the rubber tree Hevea brasiliensis; patch testing, IgE and RAST analyses. 23 patients (77%) reported additional symptoms from distant organs. 13 belonged to medical occupations; 25 were classified as atopics based on history; 21 had raised IgE-values; 25 were RAST-positive to the extracts from Hevea brasiliensis. 13 had a pre-existing hand dermatitis, of whom 6 were patch test positive to standard allergens. Skin prick tests with extracts from Hevea brasiliensis were the most sensitive diagnostic tool, while the RAST analysis was positive in 25/30 cases. These tests and analyses including RAST were negative in 40 control subjects. Provocation tests are of great value, but difficult to standardize. Several patients reported severe reactions at medical and dental examination/treatment situations (surgical gloves, dental cofferdams), and the risk of life-threatening anaphylactic reactions is emphasized.

Adolescent

Anaphylaxis and angioedema due to rubber allergy in children.

Delayed hypersensitivity to rubber chemicals is well known but there are an increasing number of case reports on an immediate type of hypersensitivity inducing contact urticaria and anaphylaxis in adults. We now report on three atopic children who developed angioedema, which in two of them progressed to anaphylaxis after exposure to natural rubber products. All three patients showed positive skin prick tests and one had a positive RAST test to latex from the rubber tree (Hevea brasiliensis). It is clear that sensitized subjects are at risk of developing anaphylaxis when exposed to natural rubber products, e.g. during medical examination or surgery when rubber gloves are used.

Adolescent

A double-blind study of Grenz ray therapy in chronic eczema of the hands.

The effect of Grenz ray therapy as an adjunct to topical therapy in chronic symmetrical eczema of the hands was assessed in 24 patients by randomly allocating active treatment to one hand while the other, which received simulated therapy, served as a control. Three Gy of Grenz rays were applied on six occasions at intervals of 1 week. There was a significantly better response to active treatment 5 and 10 weeks after the start of treatment compared with the untreated control.

Chronic Disease

IgE-mediated anaphylactoid reactions to rubber.

Delayed hypersensitivity to rubber chemicals is well known, but there are only a limited number of case reports on an immediate type of hypersensitivity inducing contact urticaria. We have recently seen several patients with rubber glove-induced contact urticaria who have had both positive skin prick tests and positive RAST tests to natural latex from the rubber tree (Hevea brasiliensis). We now report on five patients who also developed systemic reactions. It is clear that sensitized subjects are at risk of developing anaphylaxis during medical examination or surgery when rubber gloves are used. The occurrence of IgE-mediated allergy to rubber is probably underestimated.

Adult

Discomfort from rubber gloves indicating contact urticaria.

Rubber glove intolerance is a common dermatological problem and hypersensitivity of both delayed and immediate types occur. In order to study immediate skin reactions induced by rubber gloves, 15 patients with discomfort and itch produced by rubber gloves were examined. The patients were provoked by wearing rubber gloves, scratch tested with gloves, rubber chemicals and powders. RAST-tests were performed using an extract from the rubber tree (Hevea brasiliensis). In 6/15 patients, contact urticaria was confirmed, in 3 of whom IgE antibodies to latex were demonstrated.

Adult

Skin irritancy from nonanoic acid.

100 hospitalized patients with skin disease were patch tested with graded dilutions of nonanoic acid (NON), sodium lauryl sulfate (SLS) and benzalkonium chloride (BENZ). Smooth dose-response curves were obtained. The concentration needed to produce a discernible irritant reaction in 50% of the population (ID50) was found to be lower in cases of irritant than of allergic contact dermatitis; this finding warrants further study. Björnberg's observation that it is not possible to predict the strength of the reaction to one irritant by knowing the strength of the reaction to another was confirmed. Benzalkonium chloride caused a high frequency of pustular and/or bullous reactions with scarring as a sequela. It is suggested that this irritant could be replaced by nonanoic acid in experimental studies of topical irritancy, since the test reactions from nonanoic acid were reproducible, easy to read and left no staining or scarring.

Adolescent