Organic pigment as a cause of plastic glove dermatitis.
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Biomedical subjects
Publications and source records attributed to T Estlander.
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A 35-year-old machinist developed hand eczema from contact allergy to dibutylthiourea, a compound found in a paint and glue remover. Light and electron microscopy of his positive patch test was consistent with allergic contact dermatitis, showing Langerhans cell-mononuclear cell contacts in the epidermis.
The incidence of hand dermatitis and contact allergies was analyzed among dental technicians. A survey was carried out by postal questionnaire. It was returned by 106 technicians (88%); 30 had had skin problems, and 20 (19%) had present eruptions. All 20 were invited to a detailed dermatological investigation, but only seven participated. Epicutaneous tests to prosthetic materials were negative in these patients. The hand eruptions in 4 patients appeared to be irritant. 4 other patients (4%), who had had previous hand dermatitis, had a history of positive patch test reactions to methyl methacrylate, but they had become symptomless and refused to participate in further studies.
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A male laboratory assistant working in a metallurgical laboratory with airborne exposure to nickel dust developed highly pruritic, rosacea-like symptoms. The symptoms cleared within eight days without treatment when the patient was off work. Patch testing confirmed nickel allergy. Based on the patient's work and clinical history it was evident that occupational exposure to airborne nickel induced the highly abnormal rosacea-like symptoms, not previously reported from nickel.
Artificial acrylic nails may induce side effects such as fingertip dermatitis, periungual dermatitis, onycholysis, paresthesiae, Raynaud's phenomenon, ectopic facial involvement, and allergic contact dermatitis. We present a patient who developed allergic onycholysis from a cyanoacrylate used in a nail adhesive. She was able to use photobonded sculptured nails because they contain methacrylates that do not cross-react with cyanoacrylates.
Quaternary ammonium compounds are water-soluble antimicrobials which are widely used in disinfectants, sterilizers, skin cleansers and antiseptic creams. One quaternary ammonium compound, alkylammonium amidobenzoate (Osmaron B) has for decades been used in udder ointments. Here we present a ship technician with occupationally induced sensitization to alkylammonium amidobenzoate. The diagnosis was reached only when it emerged, after careful questioning, that the patient was exposed to a substance peculiar to his workplace but not to his occupation and was then patch tested for it. It turned out that an udder ointment had been used at the patient's workplace as a hand ointment. Patch testing was positive to the patient's hand ointment, and Osmaron B at 0.1-0.01% in petrolatum. Other sensitizing quaternary ammonium compounds, namely benzalkonium chloride, benzethonium chloride, benzoxonium chloride, N-benzyl-N,N-dihydroxyethyl-N-cocosalkyl-ammonium chloride, cetalkonium chloride, cetylpyridinium chloride, cetrimonium bromide, chloroallylhexaminium chloride, dequalinium chloride, domiphen bromide, methylbenzethonium chloride and 2,3-epoxypropyl trimethyl ammonium chloride are reviewed briefly. The importance of patch testing to all materials in use by the patient is emphasized. It is also important to select non-allergenic hand creams for use at work places.
An immuno-histochemical study of immuno-competent cells in the skin during fully developed 3-7 d patch tests was performed. Most inflammatory cells were OKT 11 positive T-lymphocytes. The majority of these cells were of the helper/inducer phenotype (OKT 4+), but in the later stages a relative increase of OKT 8+ cells was seen in 5 specimens out of 20. A focal decrease of OKT 6+ Langerhans cells was observed in the epidermis, while their number increased considerably in the dermis. Also observed was an inflammatory reaction of hair follicles with moderate numbers of OKT 6+ cells in the peribulbar infiltrate. This indicates that hair follicles may possibly act as shunt pathways for allergens.
Dermatitis caused by exposure to epoxy resin compounds was observed in the 1950s, shortly after epoxy resins were introduced. Following a description of the chemistry and the use of epoxy compounds, the authors discuss delayed and immediate allergic epoxy dermatitis and irritant epoxy dermatitis as well as factors such as exposure and skin testing.
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