Search PubMed⌕ Search

Biomedical subjects

R Jolanki

Publications and source records attributed to R Jolanki.

At least 127 records · Page 7Linked to original sources
PubMed1993

Occupational allergic contact dermatitis from mercury.

Occupational allergic contact dermatitis from metallic mercury is rare. Here we present the only 2 patients with relevant occupational mercury allergy detected at our clinic since 1974. The first patient was a dental nurse who became sensitized to metallic mercury from amalgam when handling uncured amalgam without protective gloves. The second patient had previously been sensitized to mercury from topical medicaments and developed work-related dermatitis when a mercury thermometer was broken at her place of work. Both patients had a positive patch test reaction to metallic mercury.

Adult↗
PubMed1993

Occupational contact allergy to unsaturated polyester resin cements.

6 men contracted occupational allergic contact dermatitis from unsaturated polyester (UP) cements. 4 of the men were employed in car repair painting and the remaining 2 in mold manufacturing. The exposure time to UP cements ranged from 6 to 32 years before onset of skin symptoms. All patients had eczema on their hands; in addition, 4 had skin symptoms on airborne areas, i.e., wrists, neck and face. All 6 patients developed allergic reactions when patch tested with UP resin at 0.5-10% in petrolatum (pet.). None of the tested patients reacted to auxiliary or cross-linking chemicals of the cements. Diethylene glycol maleate (DGM) was purified and identified from the UP resin of a cement. 1 patient reacting to UP resin was also patch test positive to DGM and he produced an allergic reaction to DGM down to a concentration of 0.0032% pet. DGM was found in both uncured and cured UP resin. None of the patients could continue their work with UP cements after their sensitization.

Adult↗
PubMed1993

Occupational allergic contact dermatitis caused by exposure to acrylates during work with dental prostheses.

Between 1974 and 1992, we were consulted by 4 patients (an orthodontist, 2 dental technicians and a dental worker trained in-house) who had developed occupational allergic contact dermatitis from working with dental prostheses. All patients had positive allergic patch test reactions to methyl methacrylate (MMA), the acrylate which is the most widely used in work with prostheses. All but the orthodontist also reacted to dimethacrylates, which are used in cross-linked dental prostheses. The last patient, investigated in 1992, had been exposed mainly to light-cured acrylics, which are similar in composition to dental composite resins. These acrylics, only recently introduced into prosthetic work, contain more potent acrylic sensitizers than MMA. Accordingly, dental personnel working with prostheses may face a higher risk of sensitization than previously. To detect cases of occupational allergic contact dermatitis, we suggest that patients working with dental prostheses should be patch tested with MMA, 2-hydroxyethyl methacrylate, dimethacrylates, epoxy acrylates and urethane acrylates.

Acrylic Resins↗
PubMed1993

Long-lasting allergic patch test reaction caused by gold.

Allergic contact dermatitis caused by gold is rare, and only isolated cases have been reported. Patch testing with gold may cause a long-lasting reaction. The purpose of this study is to describe a well-studied case of gold allergy caused by dental gold crowns. A gold-sensitized patient and a non-sensitized control subject were examined using patch tests, immunohistochemistry, electron microscopy and blast transformation reactions. Sodium thiosulfate, auranofin and sodium thiomalate gave positive patch test reactions. Immunohistochemistry and electron microscopy were performed from biopsies taken from allergic patch test reactions caused by gold sodium thiosulfate 1 day and 17 days after applying the patches, from normal skin and from a 17-day-old allergic patch test reaction caused by ammonium persulfate. Down-regulation had taken place by 17 days in the allergic ammonium persulfate reaction, but not in the 17-day allergic gold test reaction. The patient reacted to all but one of the gold-induced blast transformation tests, sodium chloroaurate being non-inductive. The non-sensitized control subject did not exhibit any reactions. In conclusion, gold sodium thiosulfate, gold sodium thiomalate and auranofin can be used as patch test substances for gold allergy, though long-lasting allergic patch test reactions may develop. In vitro gold salt induced blast transformation is an alternative test for gold allergy. The slow down-regulation of the allergic patch test reactions needs to be studied further.

Crowns↗
PubMed1993

Exposure, skin protection and occupational skin diseases in the glass-fibre-reinforced plastics industry.

A total of 100 workers, 86 from the glass-fibre-reinforced plastics (GRP) industry, 11 from polystyrene production and 3 from polyester resin coating manufacture, were examined for occupational skin hazards and for evaluation of skin protection. The workers had been exposed to many chemicals. Those working in the GRP industry had also been exposed to glass fibre and to dust produced by finishing work. 94% used protective gloves. 22 workers, all employed in the GRP industry, had contracted occupational skin disorders. 6 had allergic and 12 irritant contact dermatitis. 4 workers had an accidental injury caused by a peroxide catalyst, fire, hot air and constant mechanical friction. Allergic dermatoses were due to natural rubber (latex) (4 cases) in protective gloves, phenol-formaldehyde resin (1 case) and cobalt naphthenate (1 case). Irritant hand dermatoses (5 cases) were caused by the combined hazardous effect of unsaturated polyester or vinyl ester resins, organic solvents, glass fibre and dust from finishing work on the skin. Other cases of irritant dermatoses (7 cases) were due to the dust, promoted by mechanical friction of clothes. Skin disorders in the GRP industry were common (26%) but the symptoms were mild and only 3 patients had been on sick leave because of occupational skin disease.

Adult↗
PubMed1993

Occupational allergic contact dermatitis caused by diethylenetriamine in carbonless copy paper.

Carbonless copy paper, or 'no carbon required' (NCR) paper, has often been implicated as the cause of skin, respiratory, or general symptoms, but allergy has been verified in only a few cases. A 43-year-old machinist whose work involved the manufacture of NCR paper developed occupational dermatitis on the hands. On patch testing, both the NCR paper and 1 of the chemicals used to produce the microcapsules of the NCR paper, namely diethylenetriamine (DETA), provoked an allergic reaction. Analysis of the paper showed that it contained enough DETA to induce allergic contact dermatitis. People who handle NCR paper and develop symptoms of contact dermatitis should be patch tested with DETA.

Adult↗
PubMed1993

Occupational allergic contact dermatitis due to coconut diethanolamide (cocamide DEA).

Coconut diethanolamide (CDEA), manufactured from coconut oil, is widely used as a surface-active agent in hand gels, hand-washing liquids, shampoos and dish-washing liquids. CDEA has rarely caused allergic contact dermatitis. During 1985-1992, we investigated 6 patients with occupational allergic contact dermatitis caused by CDEA. 2 became sensitized from a barrier cream, 3 from a hand-washing liquid, and 1 had been exposed both to a hand-washing liquid and to a metalworking fluid containing CDEA. Leave-on products (hand-protection foams) caused sensitization much more rapidly (2-3 months) than rinse-off products (hand-washing liquids; 5-7 years). Due to the extensive use of CDEA and the lack of proper declaration of products, it is difficult to avoid CDEA exposure. No contact allergy to another coconut-oil-derived sensitizer (cocamidopropyl betaine) was found in the patients.

Adult↗
PubMed1993

Dentist's occupational allergic contact dermatitis caused by coconut diethanolamide, N-ethyl-4-toluene sulfonamide and 4-tolyldiethanolamine.

Dental personnel are exposed to many sensitizing compounds at work and often develop multiple delayed allergies. Here we report on a dentist who got sensitized to several products that have not, or only seldom, caused sensitization earlier. These products were: coconut diethanolamide from her handwashing liquids, N-ethyl-4-toluene sulfonamide, a resin carrier in dental materials for isolating cavities underneath restorations, and 4-tolyldiethanolamine, an accelerator for inducing polymerization of dental acrylic resins at room temperature. The patient also had allergic patch test reactions to formaldehyde, phenol-formaldehyde resin, fragrance mix, and lauryl monoethanolamide, possibly from occupational exposure.

Allergens↗
PubMed1992

Occupational pharyngitis associated with allergic patch test reactions from acrylics.

A female dentist specialized in orthodontics repeatedly developed symptoms of pharyngitis at work. A chamber provocation test indicated that her symptoms were caused by acrylics. Prick tests with acrylics were negative, while patch tests were strongly positive although the patient had no skin symptoms. The relationship between the symptoms and the patch test results is discussed. It is suggested that type IV allergic reactions may be involved in symptoms of the upper respiratory tract.

Bronchial Provocation Tests↗
PubMed1992

Contact dermatitis from telefax paper.

A nonatopic female secretary developed hand dermatitis after 1 year of full-time work with telefax paper. Her dermatitis improved on sick leave and vacation and relapsed at work. Patch testing showed allergic reactions to several fragrances, balsam of Peru, colophony and neomycin. In 3 patch test sessions, her own telefax papers gave a doubtful reaction which persisted for 4 days, but it could not be determined whether the reactions were allergic or irritant. The colophony content of the telefax paper was about 1%, and it was possible that colophony in the telefax paper was responsible for the weak path test reactions. Accordingly, the contact dermatitis would have been allergic. The patient has now been relocated, does not handle telefax paper, and is symptomless. We concluded that our patient had an occupational hand contact dermatitis induced by telefax paper and possibly caused by colophony allergy.

Dermatitis, Allergic Contact↗
PubMed1992

Occupational dermatitis from exposure to polyurethane chemicals.

In addition to asthma, contact dermatitis may also develop from occupational contact with polyurethane (PU) chemicals. 6 cases of allergic contact dermatitis from exposure to PU chemicals were diagnosed in 1974-1990. The present paper summarizes the results and gives detailed descriptions of 3 such patients. 3 patients were allergic to 5 different diisocyanates (DICs), including 4,4'-diphenylmethane DIC (MDI), toluene DIC (TDI), 1,6-hexamethylene DIC (HID), and furthermore to diaminodiphenylmethane (MDA). 3 patients were sensitized by exposure to MDI. 2 of these reacted to MDI and MDA, and 1 to TDI in addition. 1 of the 3 patients reacted only to MDA, possibly formed by hydrolysis of MDI. Primary sensitization to MDA and cross-allergy to MDI could explain the reactions of the patients exposed to MDI, but separate sensitization may also be possible. Patch tests with fresh petrolatum (pet.) mixtures were first made and a 2% concentration was recommended for MDI and TDI. In order to determine the stability of DIC test substances, the last 2 patients were tested with old test substances. Tests with MDI 1.5% pet. and TDI 1.5% pet., 5.5 months and 15.5 months old, were positive. The results suggest that, when allergy to PU chemicals is suspected, patch tests should include, in addition to MDA, at least MDI and TDI 1.5-2% pet. They also suggest that test substances can be used for over a year, and that allergy to MDA may point to MDI exposure contained in PU chemicals.

Adult↗
PubMed1991

Occupational urticaria from welding polyurethane.

An urticarial reaction associated with high fever developed in a welder on four occasions while he was welding steel profiles filled with polyurethane. The fumes emitted during pyrolysis of polyurethane and inhaled by the patient probably caused the urticarial reaction. Provocation tests with two pyrolysis products, 4,4-diphenylmethane diisocyanate and 4,4-diaminophenylmethane, were negative. This case demonstrates the difficulty in detecting the cause of urticaria induced by airborne chemicals.

Adult↗
PubMed1991

Allergy from cellulase and xylanase enzymes.

Modern biotechnical methods have enabled production of many new types of potentially allergenic proteins. Enzymes have long been known to be respiratory allergens, but relatively few cases of skin allergy have been reported. Here we describe four patients who developed occupational allergic respiratory symptoms, three with bronchial asthma and one with allergic rhinitis, caused by cellulase and/or xylanase enzymes. Each patient also had urticarial symptoms after skin contact with these enzymes. In addition, one of the patients had allergic contact dermatitis from cellulase, and one from xylanase. Allergic contact dermatitis was verified by positive patch tests with the enzymes, and the immediate allergy was revealed by skin prick tests, specific IgE determinations (RAST) and RAST-inhibition tests. All patients had positive RASTs to both cellulase and xylanase. In the RAST inhibition test 20 microliters of cellulase brought about a 94% inhibition, indicating the specificity of the RAST. Xylanase (20 microliters, 5% w/v) gave an 92% inhibition of cellulase RAST, indicating cross-reactivity between cellulase and xylanase. Three patients have been able to continue at their previous places of work, but at different worksites. One of the patients requires continuous medication for asthma and had to change her job because of persistent symptoms.

Adult↗
PubMed1991

Allergic contact dermatitis from non-diglycidyl-ether-of-bisphenol-A epoxy resins.

In addition to previously presented patients with allergic contact dermatitis from cycloaliphatic epoxy resins (ERs), during 1974-1990, we have seen 4 patients with allergic contact dermatitis (ACD) caused by products containing uncured non-diglycidyl-ether-of-bisphenol-A ER. The patients were negative on patch testing with the standard ER based on diglycidyl ether of bisphenol A (DGEBA-ER). The following non-DGEBA-ERs were included in the causative agents: heterocyclic dimethylhydantoin ER, phenol novolak ER, and brominated ER. We were unable to specify the type of ER in an epoxy primer used by the 4th patient. Apart from the ACD caused by the brominated ER, 1 of the patients also had IgE-mediated occupational rhinitis caused by methyl hexahydrophthalic anhydride (MHHPA), an epoxy hardener. The diagnosis was verified by positive prick tests and specific IgE determinations with MHHPA. Intense rhinitis evoked by a bronchial challenge with MHHPA confirmed the diagnosis. We stress the importance of performing patch testing with the relevant epoxy resins to which the patient has been exposed, in addition to patch testing with the standard ER.

Adult↗
PubMed1991

Occupational allergic contact dermatitis caused by nitroglycerin.

Irritant contact dermatitis caused by occupational contact with nitroglycerin has been known since the end of the last century. Nitroglycerin is an allergen, and the transdermal drug delivery systems for nitroglycerin recently used to treat angina pectoris have sensitized. 4 patients with allergic contact dermatitis caused by nitroglycerin from explosives are described, and 1 patient who was sensitized by transdermal nitroplaster. On patch testing, dynamite and/or the explosive components nitroglycerin, ethylene glycol dinitrate and dinitrotoluene gave allergic reactions. The following concentrations and vehicles are suggested for patch testing: nitroglycerin 0.5-2% pet., dinitrotoluene and ethylene glycol dinitrate 0.1-0.5% pet. Persons exposed to nitroglycerin at work should try to avoid skin contact by using protective gloves. It is advisable that those who have become allergic to nitroglycerin should wear disposable protective gloves when handling explosives.

Adult↗
PubMed1991

Occupational skin diseases from epoxy compounds. Epoxy resin compounds, epoxy acrylates and 2,3-epoxypropyl trimethyl ammonium chloride.

Of a total of 3731 patients investigated between 1974 and 1990, 1844 (49.4%) had an occupational skin disease. Of them 142 (7.7%) had an occupational skin disease caused by epoxy compounds--135 patients (95%) had allergic contact dermatitis, five had irritant contact dermatitis, and two had contact urticaria. Apart from dermatoses, two patients had IgE-mediated asthma from exposure to DGEBA epoxy resins. Thus epoxy compounds are one of the main causes of occupational allergic contact dermatoses and can be considered potential causes of occupational asthma. The most frequent causes were epoxy resin compounds, which together induced 93% (132 cases) of all epoxy compound dermatoses. The three most common causative products were epoxy paints and their raw materials (31%, 41 cases), epoxy resin compounds used in electrical insulation (29%, 38 cases) and epoxy glues (18%, 24 cases). Fewer cases were caused by products containing epoxy acrylate and EPTMAC. The present study found that, in addition to contact allergy to DGEBA epoxy resins, contact allergy to epoxy hardeners, non-DGEBA resins and reactive diluents is common. Polyamine hardeners, most frequently MDA, DETA and TETA, rarely IPDA, tris-DMP, EDA, TMD and XDA, were the second commonest causes of contact allergy induced by epoxy resin compounds, after DGEBA epoxy resins. Cycloaliphatic epoxy resins and other non-DGEBA epoxy resins, including heterocyclic dimethyl hydantoin, phenol novolak and brominated epoxy resins, were the third commonest causes, and reactive diluents the fourth commonest cause of allergic dermatitis due to epoxy resin compounds. Most patients sensitized to reactive diluents were allergic to PGE, ortho-CGE, HDDGE and BDDGE, whereas fewer patients were sensitized to AGE, NPGDGE and BGE. Cross-sensitization between reactive diluents was common. Cardura E 10 and Epoxide 8 provoked no reactions. The present study also indicated that DGEBA epoxy resins with a high average MW ought to be regarded as potential sensitizers, and organic solvents probably promote sensitization to DGEBA, even if the amount of DGEBA is low in the causative products. When contact dermatitis induced by epoxy compounds is suspected, an accurate diagnosis is made with the use of detailed data on the patient's exposure and extensive patch testing, including tests with the patient's own products. No chemical can be used alone to screen for sensitization to all different contact allergens of epoxy compounds.(ABSTRACT TRUNCATED AT 400 WORDS)

Benzhydryl Compounds↗
PubMed1991

Immediate and delayed allergy from epoxy resins based on diglycidyl ether of bisphenol A.

This case report presents two patients with immediate and delayed allergy to epoxy resins based on diglycidyl ether of bisphenol A (DGEBA). In patch testing, the epoxy resin (DGEBA-based) of the standard series gave allergic reactions. Both patients had a prick test reaction of histamine size or larger to the human serum albumin (HSA) conjugate of DGEBA-based epoxy resins. One had been occupationally exposed to methyl tetrahydrophthalic anhydride (MTHPA) and had a histamine-size prick test reaction to the HSA conjugate of MTHPA; the other did not react to the conjugate. Determinations of specific immunoglobulin E were carried out with HSA-DGEBA conjugates, two DGEBA-based epoxy resins, and phthalic anhydrides. The first patient had positive tests to DGEBA, the DGEBA-based epoxy resins, and two phthalic anhydrides, and the second to DGEBA and the DGEBA-based epoxy resins, but not to the phthalic anhydrides.

Adult↗