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Biomedical subjects

R Jolanki

Publications and source records attributed to R Jolanki.

At least 109 records · Page 6Linked to original sources

Occupational allergic contact dermatitis caused by photobonded sculptured nails and a review of (meth) acrylates in nail cosmetics.

BACKGROUND: Mono(meth)acrylates (monoacrylates and monomethacrylates) are moderate to strong sensitizers. They are used in the production of a great variety of polymers, including nail cosmetics. OBJECTIVE: A patient who became occupationally sensitized to photobonded sculptured nails is reported. Detailed patch testing and analyses of the patient's nail cosmetics containing mono(meth)acrylates clarified the cause of her hand and face dermatitis. The current knowledge on mono(meth)acrylates in nail cosmetics is also reviewed. METHODS: Patch testings with conventional methods, including patch testing with the patient's own substances, were performed. The patient's nail cosmetics suspected of containing mono(meth)acrylates were analyzed with gas chromatography/mass spectrometry analysis. RESULTS: In the (meth)acrylate series, 15 of the 31 (meth)acrylate compounds tested gave an allergic reaction: 2 acrylates, 5 methacrylates, 3 dimethacrylates, and 5 diacrylates. Epoxy diacrylates, cyanoacrylate, triacrylates, and methacrylic acid were negative. Three of seven of her own nail cosmetic preparations contained mono(meth)acrylates as revealed by the gas chromatography/mass spectrometry analysis, and these also gave allergic patch test reactions, namely, the nail liquid, nail hardener, and UV-cured nail gel. CONCLUSION: The patient probably had been sensitized to the following (meth)acrylate compounds from her nail cosmetics: tripropylene glycol diacrylate and methyl acrylate from her photobonded nail gel; ethyl methacrylate, triethylene glycol dimethacrylate, and methyl methacrylate from her nail liquid; and butyl methacrylate from her nail hardener. She was probably also sensitized to the rare sensitizer aliphatic urethane diacrylate, but the source was not verified. Because nail cosmetics containing mono(meth)acrylates are strong sensitizers, both the workers and the customers should be aware of their sensitizing capacity; they should use no-touch techniques regarding the skin before the mono(meth)acrylates are polymerized.

Acrylates↗

Occupational respiratory and skin sensitization caused by polyfunctional aziridine hardener.

Polyfunctional aziridine (PFA) is increasingly used as a water-based crosslinker in two-component paints, paint primers, lacquers, topcoats and other protective coatings. The crosslinker is made by reacting multifunctional acrylic monomer with a highly reactive aziridine compound. Respiratory allergy or hypersensitivity from PFA has not been reported previously. During 1978-1991 we came across nine cases with hypersensitivity from PFA: two had allergic contact dermatitis (ACD), four had occupational asthma and three had both of them. Five of the patients were parquet layers, two were fibreboard painters, one was a spray painter and one was a salesman of PFA products. ACD was diagnosed by positive allergic patch test reactions with PFA in a dilution series in petrolatum: 0.32%-0.5% gave a 2(+)-3+ allergic reaction in the five cases with ACD but 0.1% gave only a weak reaction in one case, whereas the methacrylate patch test series was negative. The diagnosis of seven cases of occupational asthma due to PFA hardener was based on symptoms related to exposure to PFA hardener at work, and on positive provocation tests with PFA hardener. One had an immediate type reaction, one a had a dual reaction, and the others had late reactions. The positive reactions with the PFA hardener and the negative reactions with the acrylate compounds indicate that PFA caused ACD which is different from the previous reports in which acrylates present as impurities in the PFA hardener caused the sensitization.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Occupational allergic contact dermatitis from 2-hydroxyethyl methacrylate and ethylene glycol dimethacrylate in a modified acrylic structural adhesive.

Acrylates have a broad area of application in various products including glues, sealants and adhesives. Whereas anaerobic acrylic sealants are well-known sensitizers, acrylate glues that cure in air have only seldom been reported as allergens. Here a patient sensitized to such a glue, and developing hand dermatitis that spread to the lower arms, chest, neck and face, is presented. Her glue was analyzed by gas chromatography/mass spectrometry (GC/MS) and contained 24.6% 2-hydroxyethyl methacrylate (2-HEMA) and 0.4% ethylene glycol dimethacrylate (EGDMA). These 2 acrylate compounds, as well as her glue, provoked an allergic patch test reaction. Also many other acrylate compounds, e.g., tetrahydrofurfuryl methacrylate, gave an allergic reaction indicating cross-allergy. The patient could not continue in her previous workplace because of severely relapsing skin symptoms.

Adhesives↗

Occupational allergic contact dermatitis caused by epoxy diacrylate in ultraviolet-light-cured paint, and bisphenol A in dental composite resin.

Allergic contact dermatitis (ACD) caused by epoxy di(meth)acrylates or bisphenol A is rare. Here 2 such cases are reported. A dental assistant had allergic contact dermatitis (ACD) caused by bisphenol A contained in dental composite resin (DCR) products based on epoxy dimethacrylate. The contact allergy was verified by allergic patch test reactions to bisphenol A and 2 DCRs. The DCRs giving allergic reactions were analyzed, and 0.014-0.015% of bisphenol A was detected. Occupational ACD caused by bisphenol A in dental composite resins has not been described before. The other patient was a male process worker in a paint factory. He was sensitized by an epoxy diacrylate, 2,2-bis[4-(2-hydroxy-3-acryloxypropoxy)phenyl]-propane (BIS-GA), and other acrylate compounds contained in raw materials of ultraviolet-light-curable paint. The epoxy diacrylate gave an allergic patch test reaction down to 0.016% in pet. He also had an allergic patch test reaction to several other acrylate compounds, 2-hydroxyethyl acrylate, 2-hydroxypropyl acrylate, 1,4-butanediol diacrylate, 1,6-hexanediol diacrylate, diethyleneglycol diacrylate, triethylene glycol diacrylate, and tripropylene glycol diacrylate, indicating cross and/or concomitant sensitization.

Acrylates↗

Immunologic contact urticaria due to airborne methylhexahydrophthalic and methyltetrahydrophthalic anhydrides.

Acid anhydrides are low-molecular-weight chemicals known to cause respiratory irritancy and allergy. Skin allergy has on rare occasions been reported. 2 workers contracted hives and itching on uncovered skin after 2 months exposure to methyltetrahydrophthalic anhydride (MTHPA) and methylhexahydrophthalic anhydride (MHHPA), to which they had airborne exposure. Later, the patients also developed conjunctivitis, rhinitis, sore throat, cough or asthma. In addition to MTHPA, 1 worker was also exposed to unsaturated polyester resin (UP). Both patients' immediate allergy to MTHPA and MHHPA was verified by positive prick tests to MTHPA and MHHPA, conjugated with human serum albumin (HSA), and positive radioallergosorbent tests (RASTs) to these anhydrides. On prick testing, both patients also reacted to a phthalic anhydride (PA)-HSA-conjugate and 1 of the patients to UP-HSA-conjugate. Specific immediate allergy to UP was shown by RAST. RAST inhibition with MTHPA, MHHPA and UP-resin conjugates confirmed IgE-mediated allergy and cross-reactivity between anhydrides. Our patients had developed airborne contact urticaria caused by phthalic anhydrides, in addition to respiratory allergy. Phthalic anhydride contained in the UP resin was possibly responsible for the immediate reaction of the skin.

Adult↗

Occupational allergic contact dermatitis and contact urticaria caused by polyfunctional aziridine hardener.

Polyfunctional aziridine (PFA) is increasingly used as a water-based cross-linker in 2-component paints, paint primers, lacquers, topcoats and other protective coatings. The cross-linker (PFA hardener) is made by reacting multifunctional acrylic monomer with a highly reactive aziridine compound. During 1992-1993, we came across 2 patients with allergic patch test reactions provoked by PFA hardener. One of the patients was a parquet layer, and the other a printer. Allergic contact dermatitis (ACD) was diagnosed by positive allergic patch test reactions to PFA hardener in a dilution series in pet.:0.3%-1% gave ++ to allergic reactions in both patients, whereas 0.1% gave a weak (+) or questionable reaction (?+), respectively. The methacrylate patch test series was negative in both patients, although gas chromatography/mass spectrometry analysis showed that PFA hardener contained 0.3% of trimethylolpropane triacrylate (TMPTA), a multifunctional acrylic monomer. One of the patients also had symptoms of contact urticaria, and a prick test with PFA hardener (1% aq.) induced a histamine-sized prick test reaction. The positive reactions with the PFA hardener and the negative reactions with the starting chemicals and additives in PFA, namely acrylates, propyleneimine and dimethylethanolamine, indicate that PFA caused ACD. This is in accordance with our previous observations, but differs from the reports of others, whose patients had been sensitized to acrylates present as remnants in the PFA hardener. As test substance, 0.5% PFA hardener in pet. is recommended for patch testing. Testing should be performed in patients with contact dermatitis if exposure to PFA has occurred. Skin prick tests may be of help to detect contact urticaria.

Acrylates↗

Frequencies of occupational allergic diseases and gender differences in Finland.

In Finland occupational diseases are registered by diagnosis, causative agent, age, occupation, field of work, and gender. This report analyzes in detail the 1991 statistics on gender differences in occupational allergic diseases. A total of 1314 cases of occupational allergic diseases were reported, comprising 14.2% of all registered occupational diseases. The following allergic occupational diseases were encountered: allergic contact dermatitis (412 cases), bronchial asthma (352), allergic rhinitis (319), contact urticaria/protein contact dermatitis (146), and allergic alveolitis (85). The number of cases of allergic alveolitis (men, 42 cases; women, 43 cases) and bronchial asthma (176 men/176 women) was about equal in both genders. Women were overrepresented in allergic rhinitis (195 women/124 men), allergic contact dermatitis (247 women/165 men), and contact urticaria/protein contact dermatitis (109 women/37 men). According to current knowledge, there are no great gender differences in the development of asthma or allergic rhinitis. The greater number of women with occupational respiratory allergy and immediate skin allergy may indicate that women in Finland are more exposed to type I allergens than men. The greater number of cases of allergic contact dermatitis in women may reveal women's predisposition to delayed-type allergy, or women's greater occupational exposure to contact allergens.

Allergens↗

Concomitant sensitization to triglycidyl isocyanurate, diaminodiphenylmethane and 2-hydroxyethyl methacrylate from silk-screen printing coatings in the manufacture of circuit boards.

A 48-year-old female silk-screen printer had worked in the manufacture of circuit boards for 12 years before she got the first symptoms of dermatitis on her wrists and lower arms. On the 1st patch test session, epoxy resin and the remainder of the standard series were negative, while a plastics and glues series gave an allergic reaction to 4,4'-diaminodiphenylmethane (DDM). The 2nd test session revealed allergic reactions to several acrylics, several epoxy compounds and 3 ink components. According to the material safety data sheets, 1 ink hardener contained DDM, but the causative agent in 1 ink and 1 ink hardener remained uncertain. The manufacturers of the 2 inks kindly provided us with their components for further patch tests. 2 of these components gave allergic reactions: triglycidyl isocyanurate (TGIC) and 2-hydroxyethyl methacrylate (2-HEMA). Our case report shows that the manufacture of circuit boards involves exposure to highly sensitizing chemicals. DDM, TGIC and 2-HEMA should be remembered as silk-screen printers' potential contact sensitizers in the manufacture of circuit boards.

Aniline Compounds↗

A single accidental exposure may result in a chemical burn, primary sensitization and allergic contact dermatitis.

It is known from experimental studies that antigenic potency and the concentration of antigen determine whether exposure to an antigen will result in sensitization. A single accidental exposure to concentrated antigen may therefore induce primary sensitization. The purpose of this report was to collect clinical cases in which a single exposure had resulted in contact dermatitis suspected to be allergic. Only patients without previous relevant skin symptoms were included. Patch testing was used to demonstrate sensitization. 6 patients developed occupational allergic contact dermatitis from accidental exposure. Patch testing revealed allergy to diglycidylether of bisphenol A epoxy resin, polyfunctional aziridine hardener, methyl acrylate, phenol-formaldehyde resin, and methylchloroisothiazolinone/methylisothiazolinone (Kathon LX), respectively. Furthermore, 2 patients developed allergic contact dermatitis from their first exposure to tear gas chemicals, namely omega-chloroacetophenone and ortho-chlorobenzylidene malonitrile. A single exposure can therefore induce both sensitization and subsequent allergic contact dermatitis without further exposure. The allergens described must be considered strong allergens. The skin should immediately be cleaned if an accidental splash with such an allergen has taken place.

Accidents, Occupational↗

Occupational allergic contact dermatitis caused by thiourea compounds.

Thiourea compounds are mainly used as accelerators in the rubber industry, but also in other industries, e.g., as antioxidants in the graphics industry. Thiourea compounds may provoke allergic contact dermatitis, although the number of reported cases is relatively low. During 1985-1991, we had 5 patients with allergic patch test reactions caused by thiourea compounds. 1 of our patients had to use a knee brace after an occupational accident. He developed allergic contact dermatitis caused by the knee brace, probably because he had become sensitized to diethylthiourea. 2 patients were probably sensitized by diphenylthiourea in neoprene gloves. A florist had an allergic patch test reaction to diphenylthiourea and might have been sensitized by fungicides or pesticides, which break down into thioureas. It is often difficult, however, to detect the source of thiourea compound sensitization. If the patient has contact dermatitis and has been exposed to products that may contain thiourea compounds (or compounds that break down into thiourea compounds), such as rubber, PVC plastic or adhesive, diazo paper, paints or glue remover, anticorrosive agents, fungicides or pesticides, patch testing with a series of thiourea compounds needs to be performed. If patch testing with thiourea compounds is not performed, allergic contact dermatitis caused by thiourea compounds is not likely to be diagnosed.

Adult↗

Nickel release from metals, and a case of allergic contact dermatitis from stainless steel.

The prevalence of allergic contact dermatitis (ACD) caused by nickel is increasing. The probable cause is the increased use of nickel-containing metals in intimate contact with the skin. The critical factor is the amount of nickel released from these metals (bioavailable nickel) onto the skin. In the present study, we determined, with flame atomic absorbtion spectrometry, the amount of nickel released into synthetic sweat from metal samples. The results of this method were compared with the results of the dimethylglyoxime (DMG) test, which is considered to be a reliable means of identifying whether nickel-containing metals may cause allergy symptoms in sensitive individuals. Out of 10 samples studied, only small amounts (< 0.5 microgram/cm2/week) were released from 2 samples, and the DMG test was negative. From 5 samples, more than 0.5 microgram/cm2/week was released, and the DMG test was positive. For 3 samples, however, the DMG test was negative, though the flame atomic absorption spectrometry test showed considerable release of nickel. Therefore, although the DMG test can be used as a first line test for determining nickel release, some DMG-negative metal materials probably induce nickel sensitization, and should by no means be advertised as safe in this respect. We also report a nickel-allergic patient who developed ACD from stainless steel, indicating that some types of stainless steel release enough nickel to elicit allergic symptoms.

Dermatitis, Allergic Contact↗

Occupational skin allergy in the dental profession.

Dental personnel are exposed to a high number of sensitizing chemicals such as acrylics, metals, anesthetics, fragrances, and antimicrobials. Although these chemicals usually cause allergic contact dermatitis, they also may cause immediate contact reactions. Usually the diagnostics involve patch testing, but prick testing needs to be performed to confirm immediate allergy. This article reviews the important causes and diagnostics of skin allergy in dental personnel. Special attention is given to the acrylates and methacrylates.

Acrylic Resins↗

Immediate and delayed allergy to nickel with contact urticaria, rhinitis, asthma and contact dermatitis.

A 27-year-old woman had for 2 years performed manual grinding of metal castings that contained nickel. She had previously had allergic contact dermatitis from nickel but started to get contact urticaria, rhinitis and asthmatic attacks at work. The symptoms disappeared at weekends and on holiday. Scratch chamber tests, open tests, specific IgE determinations (RAST), and RAST-inhibition test indicated that she had developed an IgE-mediated allergy to nickel; the bronchial provocation reaction with NiSO4 was, however, a late one. Patch tests confirmed her allergic contact dermatitis to be caused by nickel. This is the first patient, to the best of our knowledge, reported to have developed allergic contact dermatitis, allergic contact urticaria, rhinitis and asthma from nickel.

Adult↗