Moisturizers in the prevention of contact dermatitis.
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Dermatitis, Contact↗
Biomedical subjects
M Hannuksela
Publications and source records attributed to M Hannuksela.
The effects of monounsaturated-fat enriched diet and polyunsaturated-fat enriched diet on lipid and glucose metabolism in subjects with impaired glucose tolerance.
OBJECTIVE AND SUBJECTS: The effects of a high-fat, monounsaturated-fat enriched (Mono) diet and a reduced-fat, polyunsaturated-fat enriched (Poly) diet on lipid and glucose metabolism were compared in 31 subjects with impaired glucose tolerance. DESIGN AND INTERVENTIONS: After 3 weeks on a Run-in diet (37; 18:11:5, indicating energy percentages from total fat; saturated:monounsaturated:polyunsaturated fatty acids in the actual diets) subjects were randomized into a Poly-diet (34; 11:10:10) or a Mono-diet (40; 11:19:8) for 8 weeks. RESULTS: In the Mono group fasting plasma glucose (mean +/- SD) was lower after the test diet than after the run-in period (6.4 +/- 1.3 vs 6.0 +/- 0.8 mmol/L, 0 vs 8 weeks, P = 0.008), but remained unchanged in the Poly group (6.2 +/- 0.6 vs 6.1 +/- 0.7 mmol/L). Glucose effectiveness (SG), insulin sensitivity index and the first phase insulin response in an intravenous glucose tolerance test did not change significantly during either of the diets, but at the end of the study SG was higher in the Mono group than in the Poly group (P = 0.013). Serum total cholesterol, LDL cholesterol, and apolipoprotein B decreased in the Mono group, while in the Poly group only serum total cholesterol decreased significantly. However, the mean changes in serum lipids and lipoproteins did not differ significantly between the groups. CONCLUSIONS: In free-living subjects with impaired glucose tolerance both the Mono-diet and the Poly-diet consumed after a saturated-fat enriched Run-in diet improved serum lipid profile and the Mono-diet seemed to improve glucose metabolism as well.
Body Mass Index↗
Honey allergy is rare in patients sensitive to pollens.
We challenged in a double-blind manner 46 pollen-allergic patients with 30 g of honey and another 32 patients with a placebo (30 g of syrup). Minor, mostly subjective, symptoms were seen in or reported by 26% of those challenged with honey and 41% of those challenged with placebo. In no case could the symptoms with certainty be related to the challenge. Eight commercially available honeys were examined for allergen activity by RAST inhibition and immunospot methods. Both pollen and insect allergen activity was found in all honeys, and they could cause allergic reactions. However, no serious or even obvious reaction occurred in pollen-allergic patients challenged with honey.
Adolescent↗
Immediate irritant reactions to benzoic acid are enhanced in washed skin areas.
Factors affecting immediate irritant skin reactions are poorly understood. Our purpose was to study the effect of washing on reactions to benzoic acid, a well-known immediate-type irritant. 12 test subjects washed their left upper arms with a diluted dishwashing liquid 2X daily for 6 days. Benzoic acid in a dilution series was tested on both upper arms on days 0, 3 and 6. The reactions were graded visually, and the blood flow, skin color, transepidermal water loss and electrical capacitance of the test sites were measured. On days 3 and 6, the benzoic acid reactions were stronger on the washed arm than on the control arm. This was clinically visible and was associated with changes in blood flow and skin color measurements. Washing itself did not usually cause visible erythema, but transepidermal water loss increased and electrical capacitance decreased. Low concentrations of irritant substances, such as benzoic acid, may cause clinically relevant reactions in repeatedly washed skin. This should be taken into consideration in assessing product safety in the cosmetic, medical and household chemical industries, and when tests for chemical skin irritancy are designed and the results of such tests interpreted.
Adult↗
Chloromethylisothiazolone/methylisothiazolone (CMI/MI) use test with a shampoo on patch-test-positive subjects. Results of a multicentre double-blind crossover trial.
A randomized, multicentre, double-blind, 2-period crossover study with 2 shampoos was performed on subjects patch-test-positive to 100 ppm CMI/MI. One shampoo was preserved with 15 ppm a.i. CMI/MI, the other with 0.3% imidazolidinyl urea (IU). 27 subjects from 5 European dermatology clinics participated. 1 subject discontinued use after severe adverse reactions to the CMI/MI-preserved shampoo and did not evaluate the other shampoo. Another 2 subjects developed moderate symptoms with the CMI/MI-preserved shampoo and discontinued its use, but tolerated the IU-preserved shampoo for the full 2-week period. 2 subjects discontinued use after 1 or 2 washes after severe adverse reactions to the IU-preserved shampoo. 1 of these subjects tolerated the CMI/MI-preserved shampoo for 2 weeks without any untoward effects. However, the majority of subjects had negative findings on the scalp, face, neck, and hands for both shampoos. The physicians' global evaluation data indicated that shampoo with CMI/MI caused fewer skin problems than shampoo with IU (38% versus 27%, n.s.), with over 1/3 of the subjects (35%) having no skin problems with either preservative. The current study showed that most subjects previously sensitized to CMI/MI can successfully use shampoo preserved with CMI/MI. Since some subjects previously sensitized to CMI/MI, or possibly to IU, may develop clinical reactions, it would still be prudent for the clinician to advise alternative products to patients with sensitivity to a shampoo or cosmetic ingredient. Full ingredient labelling will ensure that this is possible. As the overall rate of adverse effects in sensitized individuals was low, studies of this nature should also be conducted for other allergens.(ABSTRACT TRUNCATED AT 250 WORDS)
Cross-Over Studies↗
The 12-year prognosis of hand dermatosis in 896 Finnish farmers.
In all, 896 Finnish farmers (305 men and 587 women), representing 77% of those reporting hand or forearm dermatosis in a questionnaire survey in 1979, were asked again about their dermatosis and current work in 1991. More than 50% of the study population had left farming since 1979. In 1991, 26% of men and 21% of women had a current dermatosis on the hands or forearms, and altogether, 44% of men and 39% of women reported a hand dermatosis within the past 12 months. Significant determinants of persistent hand dermatosis, in a logistic regression model, were continuation of farm work, history of skin atopy, symptoms of metal allergy, and age under 45 years. Handling cattle, e.g., milking, was considered an exacerbating factor of the dermatosis by 37% of those who had milked sometimes in their lives. In this group, 75% of hand dermatoses in those who had finished milking work had healed. The results indicate that giving up or changing work improves the prognosis of hand dermatosis in farming.
Aged↗
Hand eczema in Finnish farmers. A questionnaire-based clinical study.
In a population of 2005 Finnish farmers, 172 (8.6%) reported hand or forearm dermatoses in a self-administered questionnaire. 138 (80%) of them attended a clinical examination. Skin prick tests (SPTs) were done to 80% and patch tests (PTs) to 77% of the examined farmers. 93% of hand dermatoses were eczema and 70% were considered work-related. Cow allergy was found in 41 of 104 prick- and patch-tested farmers (39%). Immediate allergy to cow epithelium was encountered in a total of 28/41, in 20 with SPTs, and in 8 only with 20 min PTs. Delayed contact allergy to cow dander was found in 27/41. The result suggests that in addition to SPTs using commercial cow epithelium extract, PTs using fresh cow dander should also be done, and both immediate and delayed responses should be read.
Adolescent↗
Irritant effects of a detergent in wash and chamber tests.
Irritant properties of detergents can be tested by using patch and chamber tests and various kinds of use tests. The aim of the present study was to compare the results of use and 12 mm Finn Chamber tests. Study subjects (10 atopic and 11 non-atopic medical students) washed the outer aspect of 1 upper arm with liquid detergent for 1 minute 2 x daily for 1 week. 48-h chamber test with 5 concentrations of the same detergent in water were concurrently applied to upper back skin. Transepidermal water loss (TEWL), electrical capacitance and skin blood flow were measured to quantify reactions on days 0, 2, 5 and 7. Irritant contact dermatitis developed equally in atopics and non-atopics in the wash test, whereas in the chamber test with a 10% aq. solution of the detergent, increase in TEWL was significantly higher in atopics than in non-atopics. The chamber test results thus predicted poorly the result of the wash test. This might indicate that the wash test and the chamber test measure different aspects of skin barrier function.
Adult↗
Patch testing with fragrances: results of a multicenter study of the European Environmental and Contact Dermatitis Research Group with 48 frequently used constituents of perfumes.
The objective of this study was to determine the frequency of reactivity to a series of commonly used fragrances in dermatological patients. A total of 48 fragrances (FF) were chosen, based on the publication of Fenn in 1989 in which the top 25 constituents of 3 types (1. perfumes, 2. household products, 3. soaps) of 400 commercial products on the US market had been determined. In a pilot study on a total of 1069 patients in 11 centres, the appropriate test concentration and vehicle were examined. For most fragrances, 1% and 5% were chosen, and petrolatum proved to be the best vehicle in comparison to isopropyl myristate and diethyl phthalate. In the main study, a set of 5 to 10 fragrances at 2 concentrations was patch tested in each centre on a minimum of 100 consecutive patients seen in the patch test clinic. These patients were also patch tested to a standard series with the 8% fragrance mix (FM) and its 8 constituents. In patients with a positive reaction to any of the 48 FF, a careful history with regard to past or present reactions to perfumed products was taken. A total of 1323 patients were tested in 11 centres. The 8% FM was positive in 89 patients (8.3% of 1072 patients). Allergic reactions to the constituents were most frequent to oak moss (24), isoeugenol (20), eugenol (13), cinnamic aldehyde (10) and geraniol (8). Reactions read as allergic on day 3/4 were observed only 10X to 7 materials of the new series (Iso E Super (2), Lyral (3), Cyclacet (1), DMBCA (1), Vertofix (1), citronellol (1) and amyl salicylate (1)). The remaining 41 fragrances were negative. 28 irritant or doubtful reactions on day 3/4 were observed to a total of 19 FF materials (more than 1 reaction: 5% citronellol (2), 1% amyl salicylate (2), 1% isononyl acetate (3), 0.1% musk xylol (2), 1% citral (2), and 1% ionone beta (2)). Clinical relevance of positive reactions to any of the FF series was not proved in a single case. This included the 4 reactions in patients who were negative to the 8% FM. In conclusion, the top 25 fragrances commonly found in various products caused few reactions in dermatological patients and these few appeared to be clinically irrelevant, with the possible exception of Lyral. However, this data should be interpreted in the light of the relatively small number of patients tested (only 100 in most centres).
Acrolein↗
Skin prick tests and in vitro immunoassays with native spices and spice extracts.
BACKGROUND: Skin prick tests of native spices (commercial powdered spices) are common in patients with allergy to birch or mugwort pollen. Clinical symptoms from spices are infrequent but occasionally severe. OBJECTIVE: To compare the skin prick test results with native spices and spice extracts and to determine the clinical relevance of test material. METHODS: Skin prick tests with the native spices coriander, caraway, paprika, cayenne, mustard, and white pepper were made twice at 2-month to 2.9-year intervals in 49 patients. During the latter time, tests were also made with spice extracts and spice-specific serum IgE was measured. RESULTS: The reproducibility of skin test results with native spices was 67% to 100%. Spice extracts, except white pepper, elicited positive skin test reactions in half those with positive reactions to native spices. Higher specific IgE concentrations (> or = 3.5 PRU/mL) were seen in cases where the skin tests were positive to the corresponding spices with 5% extracts of > 8 kD Mw. Three-fourths of the patients with positive skin tests to native spices were positive to birch pollen and one-half to a vegetable. Mild clinical symptoms from spices were reported by one-third. CONCLUSIONS: Spice allergens partly crossreact with those of pollens and vegetables. A minority of spice allergens may give clinical symptoms. The > 8-kD 5% extracts may be relevant skin prick test materials for identifying patients at risk of developing severe symptoms from ingested spices.
Adolescent↗
[Should amalgam fillings be replaced?].
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Dental Amalgam↗
[Treatment of seborrhoeic dermatitis].
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Administration, Topical↗
Assessment of skin erythema by eye, laser Doppler flowmeter, spectroradiometer, two-channel erythema meter and Minolta chroma meter.
Visual grading, a laser Doppler flowmeter, a spectroradiometer, a two-channel erythema meter and a Minolta chroma meter were compared in the measurement of erythemas arising from immediate contact reactions produced either by 250 mM benzoic acid or 10 mM methyl nicotinate in petrolatum in an open application test or by ultraviolet irradiation. A good correlation between visual grading and objectively measured values was found for all the instruments, but the laser Doppler flowmeter gave proportionally lower values for the ultraviolet erythemas than the skin reflectance meters, suggesting that these differ from erythemas induced by benzoic acid or methyl nicotinate. The laser Doppler flowmeter gave less repeatable results than other meters when measuring moderate and pronounced erythemas produced by ultraviolet irradiation. Measuring both the blood flow and the actual erythema may give more information about the reaction than either measurement system alone.
Adult↗
Size of the test area does not affect the result of the repeated open application test.
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Adolescent↗
Alcohol vehicles in tests for non-immunological immediate contact reactions.
In a search for vehicles that might enhance the sensitivity of human skin tests for nonimmunological immediate contact reactions, benzoic acid was tested in 17 liquid vehicles on 16 medical students using the open application test method on the upper back. The results were read visually and the change in blood flow was measured using a laser-Doppler flowmeter 20, 40 and 60 min after application of the test substances. 2-propyl alcohol (isopropanol), ethyl alcohol (ethanol), 1,2-propylene glycol and water were mixed to form alcohol, alcohol/water, alcohol/alcohol, alcohol/propylene glycol and propylene glycol/water vehicles. The reactions were stronger in the alcohol/water vehicles than in the alcohols as such. The addition of 25% propylene glycol to isopropanol and ethanol had the greatest enhancing effect on the reactions. Ethanol has been the most popular liquid vehicle in tests for non-immunological immediate contact reactions, but at least with benzoic acid, stronger reactions can be elicited if alcohol/propylene glycol or alcohol/water mixture are used.
Adult↗
Dose ranging study: cetirizine in the treatment of atopic dermatitis in adults.
One hundred seventy-eight adults with atopic dermatitis were included in this double-blind, parallel, randomized study where the effects of placebo, and cetirizine, 10, 20, and 40 mg administered daily during 4 weeks were measured. Local rescue therapy, which consisted of emollients and 1% hydrocortisone, was permitted and patients in all four groups used it in the same regular way. Severity of atopic dermatitis was measured via the following parameters: pruritus (visual analog scales used by both the investigator and patients), four point scale (absent, slight, moderate and serious) symptom scores for erythema, vesicles, excoriation, and lichenification in 14 body areas and a final visit assessment of the patient's general condition. The patient's quality of sleep was also measured along with standard blood chemistry tests. Adverse events during the study were recorded as well. In total 127 patients were assessed for efficacy. A statistically significant (P < or = .05) improvement was observed in all therapeutic groups for the following parameters: erythema, excoriation, lichenification, total symptom score, area involved, and pruritus. Cetirizine showed a dose-related improvement in the following parameters measured: erythema, lichenification, total symptom score, area involved, final assessment, and pruritus (measured by the patient at each visit). At 40 mg, cetirizine was significantly (P < or = .05) more effective than placebo for these parameters. At 20 mg, this was true only for pruritus (measured by the patient at each visit).(ABSTRACT TRUNCATED AT 250 WORDS)
Administration, Topical↗
Evaluation of plasma cholesteryl ester transfer protein (CETP) activity as a marker of alcoholism.
Plasma cholesteryl ester transfer protein (CETP) activity was measured in 52 alcoholics and 38 controls and compared with conventional laboratory markers of alcoholism. Mean daily alcohol intake was 180 g/day among the alcoholics and 10 g/day among the controls. Plasma CETP activity was 26% lower in the alcoholics (P < 0.001) and was inversely correlated with daily alcohol intake (r = -0.288, P < 0.05). CETP activity detected 63% of the alcoholics, and its specificity was 82% if the cut-off point was set at the mean CETP activity of the controls -1 SD. The mean -2 SD gave a very low sensitivity for CETP (8%) and cannot be used as its cut-off point. The sensitivities and specificities of gamma glutamyltransferase, aspartate aminotransferase, alanine aminotransferase, mean corpuscular volume and high-density lipoprotein cholesterol were similar to those of CETP activity when the cut-off point for CETP was mean -1 SD. The results thus indicate that plasma CETP activity is not sufficient as a single marker of alcoholism but could be used as an additional method to detect alcohol misuse, although its wide variation in normal population and the elaborate analysis limit its usefulness.
Adult↗
Reduction in the concentration and activity of plasma cholesteryl ester transfer protein by alcohol.
Plasma cholesteryl esters, synthesized within high density lipoproteins (HDL), may be transferred from HDL particles to other lipoproteins by plasma cholesteryl ester transfer protein (CETP). Alcohol consumption is associated with increased HDL cholesterol concentration and reduced plasma CETP activity. The alcohol-induced decrease in CETP activity may be due to a low concentration of CETP in plasma or the inhibition of CETP by specific inhibitor proteins or alterations in the composition of plasma lipoproteins. The first two possibilities are studied further in this paper using data on 47 alcohol abusers and 31 control subjects. The activity of CETP was measured as the rate of cholesteryl ester transfer between radio-labeled low density lipoproteins and unlabeled HDL using an in vitro method independent of endogenous plasma lipoproteins. Plasma CETP concentration was determined by a Triton-based radioimmunoassay. The alcohol abusers consuming alcohol (on average 154 g/day) had 28% higher HDL cholesterol (P less than 0.01), 27% lower plasma CETP concentration (P less than 0.001), and 22% lower plasma CETP activity (P less than 0.001) than the controls. Plasma CETP concentration showed a negative correlation with HDL cholesterol among all the subjects (r = -0.317, P less than 0.01) but not among the alcohol abusers alone (r = -0.102, N. S.). During 2 weeks of alcohol withdrawal, plasma CETP concentration and activity of 8 subjects increased, whereas HDL cholesterol decreased by 42% (P less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗