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Biomedical subjects

M Bruze

Publications and source records attributed to M Bruze.

At least 109 records · Page 6Linked to original sources
PubMed1996

Flare-up at contact allergy sites in a gold-treated rheumatic patient.

Contact allergy to gold sodium thiosulfate and gold sodium thiomalate was established by skin testing in a rheumatic patient intended for gold therapy. An intramuscular test dose of gold sodium thiomalate (Myocrisin) induced a flare-up of previously positive epicutaneous and intradermal test reactions, with a histological and immunohistochemical picture compatible with an allergic contact dermatitis. Since gold allergy is frequent, the cutaneous side-effects of gold therapy ("gold dermatitis") may be explained by such an immunopathological reaction.

Antirheumatic Agents↗
PubMed1996

Occupational dermatoses in nursery workers.

BACKGROUND: Several workers at a nursery complained of skin problems. An occupational allergic contact dermatitis from tulip was diagnosed in 2 of the workers. OBJECTIVE: The aim of this study was to survey the frequency of occupational dermatoses among nursery workers and to investigate whether the tulip sensitizer alpha-methylene-chi-butyrolactone traces all contact allergy to tulip. METHODS: A questionnaire was delivered to 41 employees, and everyone with a present or previous skin disease was offered a consultation including patch testing with the known tulip sensitizer as well as two types of tulip extracts and parts of the plant. RESULTS: Occupational dermatoses were diagnosed in 11 workers, allergic contact dermatitis in 9 workers (tulip and/or daffodil), and irritant contact dermatitis in 2 workers. CONCLUSION: Occupational dermatoses are common among nursery workers. All workers with contact allergy to tulip was traced by alpha-methylene-chi-butyrolactone.

Allergens↗
PubMed1996

Clinical reactions to systemic provocation with gold sodium thiomalate in patients with contact allergy to gold.

In a double blind experimental study, 20 patients with a contact allergy to gold sodium thiosulphate were challenged intramuscularly with the chemically similar gold sodium thiomalate and with placebo. The most spectacular clinical reaction in the 10 patients given the active agent, was an epidermal and dermal flare up of healed patch-test reactions to the gold salts, as well as a high, but transient, rise in body temperature. Previous intradermal tests were similarly reactivated. In addition, toxicoderma-like rashes were observed in several cases, but a flare up of a previous contact dermatitis site was seen in one patient only. The specificity of the positive provocations was demonstrated.

Adult↗
PubMed1995

Biomonitoring of 4,4'-methylene dianiline by measurement in hydrolysed urine and plasma after epicutaneous exposure in humans.

Five healthy volunteers were dermally exposed for 1 h to 0.75-2.25 mumol 4,4'-methylene dianiline (MDA) dissolved in isopropanol, by use of a patch-test technique. Determination of MDA remaining in the patch units after exposure showed that a median of 28% (range 25-29%) was absorbed. By analysis of hydrolysed plasma, an initial accumulation of MDA could be shown, and then a decline. MDA was also detected in hydrolysed urine. The maximum rate of MDA excretion in urine was found 6-11 h after the onset of exposure. Within two subjects studied at three doses, the urinary excretion was proportional to the exposure. The elimination half-lives (elim-t1/2) in plasma and urine had medians of 13 and 7 h, respectively. In eight out of nine exposures, the elim-t1/2 was longer in plasma than in urine. Slow acetylation seemed to be associated with short elim-t1/2 in urine. The median of total MDA amount excreted in urine during 48 h, was 33 nmol for the five subjects exposed to 0.75 mumol, which corresponded to roughly 16% (range 2%-26%) of the absorbed dose while only a limited number of individuals were studied, the data still indicated that MDA in hydrolysed plasma or urine can be used for biological monitoring of occupational dermal exposure. However, the individual variation must be taken into account. Sampling should preferably be made several hours post shift. Urine is preferred before plasma at low exposures, because of its higher concentrations of MDA.

Acetylation↗
PubMed1995

Contact allergy to allyl glycidyl ether present as an impurity in 3-glycidyloxypropyltrimethoxysilane, a fixing additive in silicone and polyurethane resins.

We present a 43-year-old man who worked in the plastics industry and who suffered from an occupational dermatitis on the hands and forearms. He was found to be allergic to an epoxy silane compound that was contaminated with allyl glycidyl ether, a reactive epoxy diluent. HPLC analysis and patch testing indicated that this impurity was probably the only sensitizer. Moreover, the gloves used provided absolutely no protection, as the inner side also generated strong positive reactions.

Adult↗
PubMed1995

A study on expert reading of patch test reactions: inter-individual accordance.

To diagnose allergic or irritant contact dermatitis, a clinically relevant contact allergy has to be demonstrated or ruled out, respectively. Although patch testing has been used for 100 years, it remains the method of choice for diagnosing contact allergy. A disadvantage of patch testing is that reading is subjective, based on inspection and palpation of the test area, implying that the assessment is subject to the reader's knowledge and experience. This study was carried out to investigate the accordance in reading patch test reactions between 5 dermatologists. 4 groups, each with 10 patients, participated. Within each group, all 10 were allergic to one and the same sensitizer; nickel, epoxy resin, ethylenediamine, or Kathon CG. The sensitizers were tested in serial dilutions and applied randomly to the back. The tests were read independently by the dermatologists in a blinded fashion. A protocol was used where the dermatologists had to note the presence of the morphological features erythema, infiltration, papules, vesicles, and bullae. In this way, it was possible to allocate the various readings into 4 classification systems, 3 European and one American, although the definition of the various classifications might differ slightly. Based on the readings and classifications, it was possible to calculate the degree of accordance within the 4 systems used. It was also possible to analyze the degree of accordance for the various morphological features. Total accordance for the 5 reading dermatologists for positive and negative test reactions was noted in 36% and 46%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

Occupational allergic contact dermatitis from ethyl cyanoacrylate.

Glues based on cyanoacrylates are widely used as contact adhesives for metal, glass, rubber, plastics and textiles, as well for biological materials, including binding tissues and sealing wounds in surgery. In this paper, an apprentice cobbler with an occupational allergic contact dermatitis from an ethyl cyanoacrylate glue, in which the major monomer was shown to be the sensitizer, is reported. Initial patch testing with the cyanoacrylate glue dissolved in acetone with the Finn Chamber (aluminium) technique yielded false-negative reactions. Positive test reactions were obtained with the same preparations using Van der Bend chambers. With petrolatum as vehicle for the glue, there was no difference between Finn Chamber technique and Van der Bend chamber technique. The role of aluminium in the false-negative reactions is discussed.

Abdomen↗
PubMed1995

The influence of patch tests with clobetasol propionate on adjacent patch test reactions.

Contact allergy to corticosteroids now seems frequent among patients being patch tested. As corticosteroids are intrinsically anti-inflammatory, we investigated whether patch tests with a potent corticosteroid might suppress simultaneous adjacent patch test reactions to another allergen. Nickel-sensitive subjects were patch tested with an aqueous dilution series of nickel in duplicate, adjacent to patch tests with clobetasol propionate 1% in ethanol and with ethanol, respectively. Statistical evaluation of the results obtained in 2 different centers, using their own patch test techniques, did not reveal any suppression of the positive nickel patch test reactions.

Clobetasol↗
PubMed1995

Skin testing with gold sodium thiomalate and gold sodium thiosulfate.

Recently gold sodium thiosulfate was found to be the most common sensitizer after nickel sulfate in our routinely patch tested dermatitis patients. When patients hypertensive to gold sodium thiosulfate were tested with another monovalent gold salt, gold sodium thiomalate, at equimolar concentrations, in principle, no positive reactions were obtained. Gold sodium thiomalate is used for treatment of rheumatoid arthritis, a treatment with a high frequency of adverse skin reactions. To investigate whether the reactivity difference between the 2 gold salts was due to differences in bioavailability, some experiments were carried out. Intracutaneous tests with the 2 gold salts at equimolar concentrations yielded equivalent reactions. When the concentration of gold sodium thiomalate for epicutaneous testing was increased, all 12 gold-allergic patients reacted positively. Therefore, in our department, contact allergy to gold sodium thiomalate is probably as common as contact allergy to gold sodium thiosulfate.

Administration, Cutaneous↗
PubMed1995

Occupational allergic contact dermatitis from alkanolamineborates in metalworking fluids.

Alkanolamineborates are extensively used in coolants as corrosion inhibitors. In this paper, 3 machinists with contact allergy to alkanolamineborates are reported. To avoid false-positive test reactions due to the alkalinity of the alkanolamineborates, they should be tested when dissolved in an acidic buffer. When various alkanolamineborates were tested in dilution series in the 3 patients, 2 types of reactivity patterns emerged, indicating the existence of at least 2 separate sensitizers in alkanolamineborates. The raw materials, ethanolamines and boric acid, did not yield any positive patch test reactions. Thin-layer chromatography investigations demonstrated that each alkanolamineborate consists of many substances, which differed in part between different alkanolamineborates. The present study shows that it is not possible to use 1 particular alkanolamineborate for tracing contact allergy to alkanolamineborates in general.

Adult↗
PubMed1995

The development and course of test reactions to gold sodium thiosulfate.

In our department, gold sodium thiosulfate has become the 2nd most common allergen in routinely patch tested dermatitis patients, with a rate around 10%. Test reactions to this compound often appear late, sometimes so late that active sensitization may be suspected. This study was performed to study the time course of the allergic reaction to gold sodium thiosulfate and to elucidate whether late test reactions mean active sensitization. 10 patients with contact allergy to gold sodium thiosulfate (0.5% pet.) were retested epicutaneously (e.c.) and intracutaneously (i.c.) with dilution series. The clinical course was followed for 2 months with initially short intervals, later more extended. During the entire study, 26 positive e.c. reactions were diagnosed. Within the 1st week, 17 (65%) were recorded. 12 reactions (46% of 26) were noted at the ordinary reading, 3 days after test application. After 10 days, another 9 reactions (35%) appeared. The patients with the latter reactions also had positive test reactions within the 1st week. After 2 months, 9 reactions remained. Out of 30 i.c. tests applied, 25 became positive within 1 week. 19 (76%) of these reactions changed in morphology from thin infiltrates to deep nodules. Another 4 nodules appeared in patients with previous negative i.c. tests. All 23 nodules remained after 2 months. E.c. and i.c. test reactions to gold sodium thiosulfate are long-lasting. Positive patch test reactions emerging after 10 days do not automatically imply active sensitization. To diagnose contact allergy to gold sodium thiosulfate, the ordinary reading at day 3 is insufficient; even reading at 1 week is insufficient and must be supplemented by a reading at 3 weeks. All the i.c. test reactions, however, appeared within 1 week and, in several, a dermal nodule was formed.

Allergens↗
PubMed1995

[Improved management of allergic contact eczema].

Allergic contact dermatitis (ACD) is common. Its diagnosis requires patch testing to establish ACD, followed by repeat open application testing (ROAT) to confirm that the putative allergen is in fact responsible for the ACD. The aim of primary management is to eliminate or minimise exposure to the allergen and its cross reactants. To promote healing and ease discomfort, local treatment is given, which in principle always consists of a short course of corticosteroids and an emollient. Sometimes antibiotics may be necessary, as well as systemic corticosteroid treatment for a brief period. In cases of persistent ACD, and sometimes in cases with a multifactorial background, further treatment may be required, first and foremost phototherapy. In isolated cases, treatment with low-energy roentgen (grenz rays), retinoids or cyclosporine may be called for. Desensitisation is not possible, and at present treatment with chelating agents and diet has no place in the management of ACD.

Administration, Topical↗
PubMed1994

Clinical relevance of contact allergy to gold sodium thiosulfate.

BACKGROUND: In our routinely patch tested patients with dermatitis gold was shown to be the second most common sensitizer. In most patients it was difficult to explain the source of sensitization to gold and to see any clinical relevance. OBJECTIVE: Our purpose was to elucidate the clinical relevance of contact allergy to gold sodium thiosulfate. METHODS: A questionnaire on gold exposure and gold sensitivity was answered by 156 consecutive patients with dermatitis. In another group of 1056 routinely tested patients data were collected and analyzed regarding factors such as profession, atopy, localization of the dermatitis, and presence of contact allergies. RESULTS: Gold allergy was overrepresented in those having dental gold. In persons with contact allergy to gold a dermatitis on the ears, fingers, or eye area was most frequent. CONCLUSION: Exposure to gold jewelry and to dental gold may be important in the sensitization and elicitation of dermatitis.

Allergens↗
PubMed1994

High frequency of contact allergy to gold sodium thiosulfate. An indication of gold allergy?

When gold sodium thiosulfate was added to the patch test standard series, positive reactions were obtained in 8.6% of 823 consecutive patients with suspect contact allergy. The test reactions were clinically of an allergic type and, in several cases, long-lasting. There was no correlation with other allergens in the standard series. In a special study on 38 patients with contact allergy to gold sodium thiosulfate, the following principal findings were obtained: positive patch tests to the compound itself in dilute concentration; positive patch tests to potassium dicyanoaurate; negative patch tests to gold sodium thiomalate, sodium thiosulfate, and metallic gold; positive intradermal tests to gold sodium thiosulfate. Our findings make gold sodium thiosulfate the 2nd most common contact allergen after nickel sulfate. It is suggested that a positive skin test to gold sodium thiosulfate represents gold allergy.

Adult↗