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Biomedical subjects

L Kanerva

Publications and source records attributed to L Kanerva.

At least 145 records · Page 8Linked to original sources
PubMed1996

Occupational allergic contact dermatitis caused by 2,4,6-tris-(dimethylaminomethyl)phenol, and review of sensitizing epoxy resin hardeners.

BACKGROUND: Epoxy resin compounds (ERC) include a large number of sensitizing chemicals such as epoxy resins (ER), hardeners (curing agents), and reactive diluents. Allergic contact dermatitis (ACD) caused by ERCS is often occupational. MATERIALS AND METHODS: We report a patient, sensitized to a hardener of a two-component epoxy paint. Three conventional patch test sessions were performed to diagnose the causative chemical. We also review the literature on sensitizing epoxy-resin hardeners. RESULTS: A 47-year-old nonatopic woman developed dermatitis from a two-component epoxy paint. Patch testing with epoxy resin was negative, but 2,4,6-tris(dimethylaminomethyl)phenol (tris-DMP), used in the paint hardener, induced an allergic patch test reaction. We also review briefly other epoxy hardeners that have caused allergic dermatitis, including: (1) aliphatic polyamines, e.g., ethylenediamine, diethylenetriamine, triethylenetetramine, 3-dimethylaminopropylamine, and trimethylhexamethylenediamine; (2) cycloaliphatic polyamines, e.g., isophoronediamine and 3,3'-dimethyl-4,4-diaminodicyclohexylmethane; (3) aromatic amines, such as 4,4'-diaminodiphenylmethane, m-phenylene diamine, and 1,3-xylylene diamine; (4) dicyanodiamide; (5) triglycidyl isocyanurate, an epoxy compound that may be used as an epoxy-resin hardener; and (6) additives in epoxy accelerators, such as hexavalent chromate. CONCLUSIONS: No one chemical can be used to screen for sensitization to the many different epoxy hardeners. Extensive patch testing may be required to reveal the hardener that has caused the allergy. The hardener, 2,4,6-tris-(dimethylaminomethyl)phenol (tris-DMP), is a new sensitizer. To verify ACD caused by tris-DMP, patch-testing at 1% in petrolatum is suggested.

Dermatitis, Allergic Contact↗
PubMed1996

Occupational conjunctivitis associated with type IV allergy to methacrylates.

On rare occasions, exposure to methacrylates (MAs) may induce mucosal symptoms. Three patients, two dental laboratory workers and one hearing aid laboratory worker, are presented. All three had allergic contact dermatitis from MAs which disappeared after avoidance of contact with uncured MA compounds. Two of the patients, the dental laboratory assistant and the hearing aid worker, had also developed symptoms of conjunctivitis. Both were exposed to chemically curable and light-curable MAs. The association between their conjunctivitis and type IV allergy to MAs was supported by the following observations: 1) sensitization to several MAs including methylMA, 2-hydroxyethylMA, ethyleneglycol diMA, triethyleneglycoldiMA, tetrahydrofurfuryldiMA, and 1,4-butanedioldiMA, as well as to pentaerythritol triacrylate; 2) simultaneous appearance of their eye symptoms and allergic contact dermatitis; 3) high exposure to MAs because of disturbances of ventilation; 4) disappearance of the eye symptoms during holidays; and 5) opthalmologist's findings of follicular conjunctivitis with some papillae, eosinophilia, and lymphocytosis in conjunctival scrapings corresponding to allergic contact conjunctivitis. In addition, the activation of eosinophils in the conjunctival scrapings was demonstrated with the monoclonal antibody technique, and an elevated level of eosinophilic cationic protein was found in the tear fluid. Our cases suggest that conjunctivitis may be caused by type IV allergy to MAs, although type I allergy (even though prick tests were negative), other hypersensitivity mechanisms, or irritation cannot be excluded. 4H-Gloves seem to give adequate hand protection even to allergic patients. More attention should be paid to ventilation systems if MA exposure occurs. In some cases, patients with eye symptoms need to be patch tested.

Conjunctivitis, Allergic↗
PubMed1996

Allergic patch test reactions caused by the rubber chemical cyclohexyl thiophthalimide.

Rubber chemicals are among the most common occupational contact sensitizers. The most common rubber sensitizers are thiurams, thiazoles, carbamates and paraphenylenediamine derivatives. Here we present data on a less-well-known rubber chemical, N-(cyclohexylthio)phthalimide (CTP; CAS 17796-82-6). This chemical is currently the most widely used vulcanization retarder, but data on allergic contact dermatitis caused by CTP are lacking. We conducted a survey of 310 patients who had been patch tested with 30 rubber chemicals including CTP. 11 (3.5%) showed an allergic patch test reaction provoked by CTP, and 9.0% by thiurams. 4 of the patients reacted only to CTP and not to other rubber chemicals, whereas the other 7 concomitantly reacted to other rubber chemicals. After analyzing the patch test data of these 11 patients, it was concluded that CTP probably did not cross-react with the other rubber chemicals. Therefore the patch test results may indicate independent sensitization to CTP and other rubber chemicals. Because very little data on the components of rubber chemicals in rubber products are available, the source of the putative sensitization to the rubber vulcanization retarder CTP is unknown.

Cross Reactions↗
PubMed1996

Allergic patch test reactions to palladium chloride in schoolchildren.

A study of the prevalence of allergic patch test reactions to palladium chloride compared to nickel sulfate was performed in a group of Finnish schoolchildren. All adolescents 14-18 years of age in a Finnish town with 40,000 inhabitants, who had received orthodontic treatment with metallic appliances at a municipal dental clinic, were included in the study. The selection of patients was based on patient records. A non-treatment control group was randomly selected from the same age groups of the town population. A total of 700 subjects (77% of those invited), 417 (60%) girls and 283 (40%) boys, participated. The majority (91%) of the girls had pierced ears. Orthodontic treatment was equally common (67-70%) in the boys and the girls. The girls had a much higher frequency of allergic patch test reactions to both nickel sulfate and palladium chloride. Of the 700 adolescents tested, 48 (7%) had an allergic patch test reaction to palladium chloride. Of the 417 girls, 44 (11%) were palladium-chloride-positive, whereas only 4 of the 283 boys tested (1%) had an allergic patch test reaction to palladium chloride. 3 patients reacted to palladium chloride only, whereas all other patients with allergic patch test reactions to palladium chloride also had an allergic patch test reaction to nickel sulfate. The results support the concept of cross-reactivity between nickel sulfate and palladium chloride. The clinical significance of the allergic patch test reactions caused by palladium chloride remains unclear.

Adolescent↗
PubMed1996

Oral mucosal diseases investigated by patch testing with a dental screening series.

The rôle of contact allergies in oral mucosal diseases was studied. The subjects were 24 patients out of 479 tested, who had oral mucosal symptoms and positive patch test reactions in a dental series during 1987-1994 at the Department of Dermatology, Helsinki University Hospital. The clinical diagnoses were oral lichen planus (LPO, 13 patients), leukoplakia (2), glossodynia, i.e., 'burning mouth syndrome' (4), stomatitis (3) and recurrent angioedema (2). Only 1 patient had symptoms in relation to dental care. All but 2 patients had allergic reactions to mercury (Hg) (12 patients), gold sodium thiosulfate (Au) (13 patients) or both. A clinical connection between oral symptoms and contact allergy was seen in 10 patients. 9 patients (7 LPO, 2 leukoplakia) had Hg allergy. In these cases, the oral lesions disappeared after the amalgam fillings had been removed. 1 patient had recurrent stomatitis and perioral eczema after dental care and 2,2-bis(4-(2-hydroxy-3-methacryloxypropoxy)phenyl)propane (BIS-GMA) allergy. Her symptoms were caused by drilling of acrylic fillings. In addition, a connection between localized stomatitis and contact allergy was considered probable in 2 cases. 1 patient had stomatitis from contact with an orthodontic device and nickel allergy. The other had stomatitis from contact with a dental gold crown and gold allergy. No clinical connection was found between gold allergy and the oral symptoms of other patients.

Adult↗
PubMed1996

Occupational allergic contact dermatitis caused by decorative plants.

12 cases of occupational allergic contact dermatitis caused by decorative plants were diagnosed in a 14-year period. The patients were middle-aged, and their average exposure time was 13 years. The plant families and plants causing occupational contact dermatitis were Compositae (5 patients; chrysanthemum, elecampane, gerbera, feverfew), Alstroemeriaceae (5 patients, Alstroemeria), Liliaceae (4 patients; tulip, hyacinth), Amaryllidaceae (2 patients; narcissus) and Caryophyllaceae (2 patients; carnation, cauzeflower). The known chemical allergens causing dermatitis were tuliposide-A and sesquiterpene lactones, such as alantolactones and parthenolide, in the Liliaceae and Compositae families. 7 of the 12 patients were able to continue their work; 5 were not because of severe relapses of skin symptoms. The plant allergen and extract series currently available are of great help in the diagnosis.

Adult↗
PubMed1996

Occupational dermatoses from exposure to epoxy resin compounds in a ski factory.

Of 22 workers in a ski factory, occupational allergic contact dermatitis was found in 8. 6 were sensitive to epoxy resin compounds, i.e., epoxy resins, hardeners or diluents, 1 to cobalt in glass-fiber reinforcements, and 1 to formaldehyde in a urea-formaldehyde glue and a lacquer. 4 workers had irritant contact dermatitis from epoxy resin compounds, lacquers, sanding dust, or glass-fiber dust. 3 had contact allergy from a new sensitizer, diethyleneglycol diglycidyl ether, in a reactive diluent. Immediate transfer of workers sensitized to epoxy resin from epoxy exposure prevents aggravation of their dermatitis and broadening of the sensitization to epoxy hardeners, diluents and other compounds.

Adhesives↗
PubMed1996

Occupational allergic contact dermatitis from spices.

About 1000 patients were investigated at our clinic during 1991-1995 for occupational skin disease, and 5 had occupational allergic contact dermatitis from spices. The patients were chefs, or kitchen, coffee room, and restaurant workers. All patients had hand (or finger) dermatitis. The causative spices were: garlic, cinnamon, ginger, allspice and clove. The same patients also had allergic patch test reactions to foods: tomato, lettuce and carrot. Paprika elicited a weak allergic patch test reaction in 2 patients. Occupational allergic contact dermatitis from spices is relatively rare, but needs to be taken into consideration in patients who have hand dermatitis, and work with spices and foods. Patch testing with spices as is is useful, but testing with dilutions in pet, may be needed to confirm that the patch test reactions are allergic. Patients also need to be prick tested with spices and foods.

Adult↗
PubMed1996

Statistical data on occupational contact urticaria.

Data on occupational contact urticaria (protein contact dermatitis included) in Finland during 1990-1994 were analyzed. Altogether 815 cases were reported to the Finnish Register of Occupational Diseases during this period, compared with 1944 cases of occupational allergic contact dermatitis. Accordingly, the total number of occupational allergic contact dermatoses was 2759, 29.5% being contact urticaria and 70.5% being allergic contact dermatitis. Occupational contact urticaria was much more common in women (70%) than in men (30%). The 6 most common causes of contact urticaria were (1) cow dander (362 cases = 44.4%), (2) natural rubber latex (193 cases = 23.7%), (3) flour, grains and feed (92 cases = 11.3%), (4) handling of foodstuffs (25 cases = 3.1%), (5) industrial enzymes (14 cases = 1.7%) and (6) decorative plants (13 cases = 1.6%). The occupations with the highest numbers of occupational contact urticaria were farmers (341 cases), domestic animal attendants (61), bakers (53), nurses (42), chefs (40) and dental assistants (28). The ranking list of the most common occupations with occupational contact urticaria per 100,000 employed workers was as follows: (1) bakers (140.5 cases per 100,000 employed persons), (2) preparers of processed food, (3) dental assistants, (4) veterinary surgeons, (5) domestic animal attendants, (6) farmers and silviculturalists, (7) chefs, cooks and cold buffet managers, (8) dairy workers, (9) horticultural supervisors, (10) laboratory technicians and radiographers, (11) physicians, (12) butchers and sausage makers, (13) laboratory assistants, (14) dentists and (15) nurses (21.2 cases per 100,000 employed person). Low-molecular-weight chemicals caused very few cases of occupational contact urticaria, the most common being 2-ethylhexyl acrylate (5 cases). To summarize, occupational contact urticaria forms a large group of occupational contact dermatoses, and dermatologists need to be able to diagnose IgE-mediated immediate skin allergic diseases.

Agriculture↗