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Biomedical subjects

M Bruze

Publications and source records attributed to M Bruze.

At least 73 records · Page 4Linked to original sources

An epidemic of occupational contact dermatitis from an immersion oil for microscopy in laboratory personnel.

Since November 1997, 14 successive cases of occupational contact dermatitis were observed in 13 laboratory technicians and 1 physician, working in a genetics laboratory in Leuven (Belgium) in 3 laboratories of bacteriology in Strasbourg, Montbeliard and Angers, and in the laboratory of hematology in Bordeaux (France). The dermatitis, located on the hands, forearms and face, relapsed after each exposure to an immersion oil for microscopy. Patch tests performed in 10 patients were positive to epoxy resin (ER) in the European standard series (10/10 patients) and to newly formulated Leica immersion oil (7/7), 1 patient testing negatively with the former oil. A breakdown performed in 2 patients with the oil's ingredients confirmed sensitization to liquid modified ER components, contained at >80% concentration in the oil. The presence of DGEBA was demonstrated by HPLC analysis at a +/-30% rate. Although the safety data sheet indicated a revision of the formula, nobody was alerted to the risk of sensitization and the need for skin protection. ERs, as a source of occupational allergy, can provoke epidemics of contact dermatitis in industry. This report of epidemic contact dermatitis from ERs, used for their optical properties in an immersion oil for microscopy, emphasizes the need for perpetual vigilance in occupational medicine and the usefulness of multicentre contacts in dermato-allergology.

Adult↗

Identification of coumarin as the sensitizer in a patient sensitive to her own perfume but negative to the fragrance mix.

The aim of this study was to identify the chemicals responsible for the sensitivity of a 44-year-old woman to her own perfume, but showing negative patch test results to the fragrance mix. For this purpose, the perfume concentrate from the eau de toilette was chemically fractionated. Each fraction obtained was afterwards tested on the patient using a ROAT and/or a patch test. Only 1 fraction gave a positive ROAT result. This fraction was analyzed and found to contain coumarin and ethyl vanillin. Coumarin, one of the most widely used fragrance compounds that is not present in the fragrance mix, was confirmed as being the sensitizer.

Adult↗

The flare-up reactions after systemic provocation in contact allergy to nickel and gold.

In a controlled double-blind experimental study, patients with contact allergy to nickel or gold were exposed systemically to their contact allergen. Nickel sulfate was given orally, gold sodium thiomalate intramuscularly, and placebo by both routes. Clinical reactions including body temperature were followed and 7 plasma cytokines and acute phase reactants were assayed before and 24 h after provocation. Clinical flare-up, with reactivation of healing patch tests and/or toxicoderma-like reactions, was observed in patients receiving their specific allergen. A transient fever was noted in patients allergic to gold when exposed to gold, not in others. There was a significant increase in plasma tumour necrosis factor-alpha, soluble tumour necrosis factor receptor 1, interleukin-1 receptor antagonist, and neutrophil gelatinase associated lipocalin in patients allergic to gold when exposed to gold allergen. Furthermore, in patients allergic to nickel exposed to nickel allergen there was a highly significant increase in plasma soluble tumour necrosis factor receptor 1. Interferon-gamma, interleukin-4, and C-reactive protein did not increase in any of the patient groups. Clinical reactions during flare-up in contact allergy are accompanied by release in the blood of several cytokines. This release is not a consequence of a toxic effect or bound to a particular allergen. Instead, the cytokine release should be considered a general phenomenon characteristic of the flare-up in contact allergy.

Acute-Phase Proteins↗

Gold--a controversial sensitizer. European Environmental and Contact Dermatitis Research Group.

Until recently, gold allergy was considered to be extremely rare. Gold has been used and worshipped for thousands of years without any obvious complaints of skin problems, either in those participating in mining and other ways of prospecting, or in those wearing jewellery. When studies on contact allergy to gold sodium thiosulfate were published at the beginning of the 1990s, the allergic nature of the reported positive patch test reactions to gold was questioned. The major argument for such questioning was the lack of demonstrable clinical relevance in most positive reactors. A major reason for the questioning may have been confusion in differentiating between contact allergy and allergic contact dermatitis. To arrive at a diagnosis of allergic contact dermatitis, 3 steps have, in principle, to be fulfilled: (i) establishment of contact allergy; (ii) demonstration of present exposure; (iii) assessment of clinical relevance, i.e., causing or aggravating a contact dermatitis. In this paper, these steps are discussed with regard to gold. With our present knowledge of contact allergy-allergic contact dermatitis, we do not recommend including gold sodium thiosulfate in the standard series. It should be applied for scientific purposes and when allergic contact dermatitis from gold is suspected.

Dermatitis, Allergic Contact↗

Laser Doppler perfusion imaging for the documentation of flare-up in contact allergy to gold.

A healed or healing allergic contact dermatitis is easily reactivated to a flare-up if the patient is provoked systemically with his particular allergen. 5 patients with contact allergy to gold were patch tested with a serial dilution of gold sodium thiosulfate. 1 to 2 months later, when positive test reactions were healed, the patients were given 1 intramuscular injection of gold sodium thiomalate. This resulted in a flare-up of patch tests as well as a transient fever and toxicoderma-like reactions. The flaring tests were registered by digital photographs and laser Doppler imaging (LDI). An increased cutaneous blood flow in the formerly positive patch tests was discernible within 1 h after provocation, increased to a vigorous maximum after 4-6 h, and subsided during the following few days. The earliest increase and the highest peak of blood flow were observed in the test areas of the strongest original test concentration. LDI provides a most suitable technique for studying the dynamics of this rapidly developing inflammation of a mainly dermal character.

Adult↗

Thoughts on sensitizers in a standard patch test series. The European Society of Contact Dermatitis.

Patch testing is the predominant method of establishing contact allergy. The present patch test technique is the result of a continuous process of development and improvement since its first application in the late 19th century. The perfect patch test should give no false-positive and no false-negative reactions. The ideal patch test should also cause as few adverse reactions as possible, particularly no patch test sensitization. Even though the history and examination of a patient with suspected allergic contact dermatitis will give clues to possible sensitizers, it is not sufficient to patch test only with initially suspected sensitizers; unsuspected sensitizers used for patch testing frequently turn out to be the real cause of the dermatitis. Fortunately, a small number of substances are considered to account for the majority of delayed hypersensitivity reactions. Therefore, generally 20-25 test preparations consisting of chemically defined compounds, mixes of allergens, and natural and synthetic compounds, are grouped into a standard test series. The requirements to be fulfilled by a sensitizer in a standard patch test series are discussed in this article. A procedure of investigations is proposed before a sensitizer is included in a standard series.

Allergens↗

In vivo testing of the protection of gloves against acrylates in dentin-bonding systems on patients with known contact allergy to acrylates.

Occupational contact allergies to dental acrylates are increasing. Commonly used gloves protect poorly against acrylates. The protective efficacy in vivo of other, newer glove materials is not fully known. In this study, an open chamber system was used for testing the protection in vivo of 6 different gloves (1 vinyl glove, 2 latex gloves, 2 nitrile gloves and the 4H glove) against a commonly used dental adhesive, Scotchbond 1, containing 2-hydroxyethyl methacrylate (2-HEMA) and triethylene glycol dimethacrylate (TREGDMA). 8 patients with known contact allergy to 2-HEMA participated. Provocation with 50 microl of the adhesive for 7.5, 15 and 30 min was performed for each glove. The test demonstrated clear differences in the protective efficacy between the gloves. The 4H glove gave by far the best protection, followed by one of the nitrile gloves. One of the latex gloves and the vinyl glove gave a very poor protection against the adhesive. A dose-response relationship was observed between different application times of the acrylate product. The test model promises to be a useful clinical complement to in vitro methods in individual preventive measures against contact sensitization to acrylates.

Adhesives↗

In vivo testing of the protective efficacy of gloves against allergen-containing products using an open chamber system.

In vitro degradation and permeation testing of glove materials is important in the assessment of the protective efficacy against chemicals. In vivo factors, such as skin-glove contact, skin temperature and humidity may, however, influence the protective effect of the glove. These factors must thus be considered in the overall assessment of a protective glove. An in vivo glove test should as far as possible imitate the practical use of the glove, as well as the exposure to the product/chemical against which the glove should protect. An open chamber system for human in vivo glove testing is presented. This system enables simultaneous testing of 6-8 gloves with 3 provocation times for each glove. Positive controls (no glove) can be included. As a control of the subject's present reactivity to the chemical of interest, conventional patch testing with a dilution series can be performed in parallel. The method is easy to use and convenient for the patient. It promises to be a useful clinical tool in individual preventive measures against contact allergy. The method can be used in glove testing against many hazardous chemicals, both contact allergens and toxic/irritant compounds in workplaces such as the plastics industry and the chemical industry.

Allergens↗

Isoeugenol is an important contact allergen: can it be safely replaced with isoeugenyl acetate?

The prevalence of contact allergy to the fragrance mix in individuals with eczema is up to 10%. Within the mix, isoeugenol (CAS 97-54-1) is an important individual allergen. Until May 1998, the IFRA (International Fragrance Association) guidelines suggested that isoeugenol could safely be used at a level of 0.2% in consumer products. In May 1998, IFRA recommended that isoeugenol should not be used at a level that exceeds 0.02% in consumer products, but did not provide guidance on allergen substitution. An alternative to isoeugenol, based on aroma and absence of guidelines on use, is isoeugenyl acetate (CAS 93-29-8). 155 consecutive subjects were patch tested to isoeugenyl acetate (1.2%, 0.4%, 0.13% eth.) and isoeugenol 1% pet. 6 (3.9%) had an allergic reaction to 1.2% isoeugenyl acetate at D4. The reactions to the other 2 dilutions tended to be graded. 8 individuals had at least a palpable erythema by D4 to isoeugenol 1% pet. The majority of individuals allergic to isoeugenol were also intolerant of isoeugenyl acetate. Effective labelling of fragrance substances on consumer products will facilitate monitoring of exposure.

Allergens↗

Contents of fragrance allergens in children's cosmetics and cosmetic-toys.

Fragrances are one of the major causes of allergic contact dermatitis from use of cosmetics. The aim of the current study was to assess the possible exposure of infants and children to fragrance allergens from cosmetic products and "toy-cosmetics". 25 children's cosmetics or toy-cosmetic products were analysed by gas chromatography - mass spectrometry. Target substances were the fragrance allergens from the fragrance mix and 14 other fragrance substances, most of which have been described as contact allergens. The fragrance mix ingredients were either not present in children's shampoos/shower gels and cream/lotions, or they were present in fairly low concentrations. In hydro-alcoholic products, such as eau de parfum, eau de toilette, several ingredients of the fragrance mix were found: geraniol was present in 7/7 products, hydroxycitronellal in 6/7 and isoeugenol in 2/7 products. Isoeugenol was present in a maximum concentration of 0.07%. In one cosmetic-toy, cinnamic alcohol was present at 3.7% which exceeds the current industry guideline for safe products by a factor of 5. In all types of products other fragrance allergens were frequently found. In conclusion, children are already exposed at an early age to well-known allergens, sometimes at concentrations which are considered to be unsafe. As contact allergy usually persists for life, manufacturers of children's cosmetics should be aware of their special responsibility and apply the highest possible safety standards.

Allergens↗

The significance of previous contact dermatitis for elicitation of contact allergy to nickel.

In 2 earlier studies, we found increased nickel re-test reactivity at earlier experimentally induced nickel eczema sites. The aim of this study was to investigate if earlier contact dermatitis caused by another allergen or earlier irritant contact dermatitis also influenced the reactivity when nickel was applied topically on earlier but healed dermatitis sites. Twenty-three females with contact allergy to both nickel and cobalt were involved in the study. Experimental contact dermatitis from nickel, cobalt and SLS was induced on the lower back. One month later, challenge patch testing with a serial dilution of nickel on the previous but healed dermatitis sites, and on a control area, was done. The tests were read blindly. Significantly higher test reactivity was found at the site with previous allergic contact dermatitis from nickel, and significantly lower test reactivity was observed at the previous SLS dermatitis site.

Adult↗

Preservatives in moisturizers on the Swedish market.

The presence of 9 common preservatives was investigated in 100 moisturizers by high-performance liquid chromatography. According to the manufacturers/suppliers 88 of the 100 moisturizers contained at least one of the 9 preservatives. This information was erroneous in 9 cases (10.2%). When the moisturizers were investigated for the presence of the 9 preservatives which should not be present in the moisturizers according to the manufacturers/suppliers, at least one of the preservatives was detected in 17 moisturizers (17.0%). Parabens were the most common preservatives. The concentrations of the 9 preservatives did not exceed the maximum concentrations allowed in cosmetics. When a patient with suspected allergic contact dermatitis tests positively to a preservative, the assessment of present clinical relevance requires demonstration of exposure to the sensitizer. This demonstration cannot rely solely on information on the packages or from the manufacturers/suppliers but has often to be supplemented by chemical analysis.

Chromatography, High Pressure Liquid↗

Deodorants on the European market: quantitative chemical analysis of 21 fragrances.

Deodorants are one of the most frequently used types of cosmetics and side-effects from them are common. Recent studies relate perfume allergy to this type of product. 73 deodorants were analyzed by gas chromatography--mass spectrometry for the determination of the contents of 7 wellknown fragrance allergens from the fragrance mix and 14 other commonly used fragrance materials. The deodorants were purchased at retail outlets in 5 European countries. It was found that in general, fragrance mix ingredients were more frequently present in vapo- and aerosol sprays than in roll-on products. The levels of the fragrance mix substances ranged from 0.0001-0.2355%. The products investigated contained cinnamic aldehyde and isoeugenol less frequently (17% and 29% respectively), and eugenol and geraniol most frequently (57% and 76% respectively). The 14 other fragrance materials were found in 40-97% of the deodorants, with hedione and benzyl acetate the most frequently found substances. The concentration of these 14 substances ranged from 0.0001-2.7%. It is concluded that the levels of cinnamic aldehyde and isoeugenol found in the deodorants could prove to be relevant for elicitation of contact dermatitis. No conclusions could be drawn about the other fragrance mix constituents, as threshold levels in sensitized individuals have not been investigated. Furthermore, all of the fragrance materials investigated were frequently found in deodorants and, apart from the fragrance mix ingredients, the extent of problems with sensitization to these fragrance materials is largely unknown.

Acrolein↗

Occupational dermatoses in a plant producing binders for paints and glues.

A survey of occupational dermatoses, based on a questionnaire, clinical examination and patch testing, was carried out among present and former employees in a plant producing binders for glues and paints. The binders are chemically based on vinyl acetate and/or acrylates. Preservatives are needed and those based on methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) are the most commonly used. The questionnaire was answered by 83 out of 85 present employees (97.6%) and 12 out of 15 former employees (80.0%). 76 of the present (89.4%) and 11 of the former employees (73.3%), respectively, participated in the clinical examination and patch testing, which was conducted with a standard test series and chemicals from the work environment. Occupational dermatosis was diagnosed in 22 present workers (28.9%). Irritant and allergic contact dermatitis was demonstrated in 9 (11.8%) and 13 (17.1%) employees, respectively. Occupational contact allergy to acrylates and formaldehyde was detected in 3 workers and 1 worker, respectively. 12 individuals (9 present and 3 former production workers) had an occupational contact allergy to MCI/MI. 4 of the present workers had spilled Kathon LX on their skin resulting in chemical burns and allergic contact dermatitis. In total, the figure for occupational skin diseases among all present production workers was 40.4%.

Acrylates↗

Bowlers' grip.

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Dermatitis, Allergic Contact↗