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A comprehensive bibliographical retrieval of case reports on "airborne contact dermatitis" (ACD) was performed. The present review deals with the first cases published in 1986, 1991, 2001 by Huygens as well as by Dooms-Goossens, and continues with the other pertaining clinical presentations until to day. Solid particles, rather than gases or droplets, are the most frequently reported causes of ACD.
Allyl isothiocyanate is present in many plants. Allergic contact dermatitis from allyl isothiocyanate is well known but infrequently reported. The aim of this study was to investigate the prevalence of contact allergy to allyl isothiocyanate in patients with suspected contact dermatitis from vegetables and food. 259 such patients were tested at the Department of Dermatology, Gentofte Hospital, Denmark, from 1994 to 2003. Only 2 patients (0.8%) had a positive reaction (+) to allyl isothiocyanate and 43 patients (16.6%) had a ?+ reaction. One of the patients with a positive reaction provided samples of margarine, salad cream, oil and mayonnaise. These were analysed with high-performance liquid chromatography, and a moderate concentration of allyl isothiocyanate (2.5 ppm) was detected in the sample of margarine. This patient was a professional sandwich maker presenting with fingertip dermatitis mimicking 'tulip fingers' or allergic contact dermatitis from garlic and onions. In conclusion, allergic contact dermatitis from allyl isothiocyanate occurs in only a limited number of cases, despite frequent exposure. The large number of ?+ reactions raises the question as to whether the recommended patch test concentration is too low.
Contact dermatitis, an inflammatory response of the skin to an irritant or an allergen, can affect hospital staff. Most clinicians are routinely exposed to irritants such as latex, detergents, and chemicals. Treatment with topical corticosteroids and avoidance of suspect irritants usually resolves the dermatitis. A case study is presented of a licensed practical nurse who developed persistent contact dermatitis. The dermatitis did not resolve with 15 months of traditional treatments. Only after 3 months of treatment with two investigational topical products, which are now available to the public, was the dermatitis resolved and complete healing achieved. This case study discusses the new products and traditional treatment products used and presents results of irritant specificity testing and a series of photographs documenting resolution and healing.
We report an outbreak of irritant contact dermatitis in the aerospace industry from electrodischarge machining (EDM). 20 workers doing EDM developed irritant contact dermatitis from the dielectric fluid used in EDM, a form of precision metal machining that is widely used in mould making and precision engineering. Dielectric fluid contains hydrocarbons that are aromatic, paraffinic or naphthenic and are skin irritants. Irritant contact dermatitis from dielectric fluid has not been reported previously. EDM will become more widespread and occupational dermatitis from dielectric fluid is likely to become more prevalent in the future. Our experience was that irritant contact dermatitis from dielectric fluid can be prevented by simple preventive measures such as personal hygiene and health education.
We report a case of contact dermatitis due to sodium bisulfite in Tathion eye drops. A 72-year-old woman was treated daily with two solutions including Tathion eye drops for senile cataract for two years and three months. She developed edema, swelling, erythema, and vesicles on her eyelids. Because contact dermatitis due to a topical medication was suspected, patch testing was performed after disappearance of her eruption. A positive reaction to sodium bisulfite in Tathion eye drops was confirmed. Therefore, we diagnosed her eruption as contact dermatitis due to sodium bisulfite. The reaction to sodium sulfite in the next patch testing was negative. To the best of our knowledge, this is the first report from Japan about contact dermatitis caused by this medication.
Cutaneous irritant and allergic responses account for the vast majority of cases of occupational contact dermatitis (OCD). Although the pathophysiologic responses to these two different exposures are distinct, the clinical differentiation between chronic cumulative irritant contact dermatitis and allergic contact dermatitis can be difficult and frequently requires patch testing. This article reviews the recommended algorithms that clinicians should utilize to assess whether a worker suffers from OCD. The prevalence of OCD, its predisposing factors (both endogenous and exogenous), and prognosis are discussed in depth. Finally, issues surrounding the assessment of impairment and disability resulting from OCD are summarized.
BACKGROUND: Adolescents between the ages of 10 and 19 are exposed to a series of substances capable of causing contact dermatitis. OBJECTIVES: (1) To study the frequency and characteristics of allergic contact dermatitis in adolescents, (2) to characterize the group being studied, and (3) to verify the main sensitizing substances among this age group. METHODS: From 1996 to 2001, 1,027 patients with a suspicion of contact dermatitis were analyzed, and patients between 10 and 19 years of age were selected. These patients were submitted to contact tests. RESULTS: Among the 102 adolescents, 93 (91%) were female and 9 (9%) were male. The face was the area most affected by dermatosis. The contact tests were positive in 64 patients (56%), whereas in 45 (44%) they were negative. The main location of the contact dermatitis was the face (36%). The substances with higher frequencies of sensitization were nickel sulfate in 33 (31%) patients and tosylamide-formaldehyde resin in 13 (12%) patients. CONCLUSION: Contact dermatitis in adolescents was more frequent in white girls and on the face. The substances with greater frequency of sensitization were nickel sulfate and tosylamide-formaldehyde resin. These two substances are related to adolescent habits and behavior.
Contact dermatitis around a tracheostoma is quite rare. So far, there have been only 2 reports about this in medical literature. We, in this study, report herewith contact dermatitis in a 61-year-old Japanese man around a tracheostoma due to salbutamol sulfate and Aldecin. The patient used inhaled Sultanol and Aldecin for the treatment for allergic asthma. On examination, it was found that there was lichenified, exudative erythema with pigmentation around the tracheostoma. Patch testing with 1% aq. Sultanol and Aldecin revealed a positive reaction. Furthermore, patch testing for salbutamol sulfate 1% pet. also showed positive reaction. Although the contact allergen of our patient has not been fully determined (beclomethasone or other ingredients), this must be the first reported case of double contact dermatitis around a tracheostoma from salbutamol and Aldecin.
Histamine is released from mast cells in the skin, causing urticaria and itching. However, little is known about the roles of histamine in development of eczematous lesions in contact dermatitis. Effects of histamine on development of eczematous lesions in contact dermatitis were assessed using histamine-deficient mice in which contact dermatitis was developed by repeated application of diphenylcyclopropenone. Development of eczematous lesions in contact dermatitis was suppressed in histamine-deficient mice compared to wild-type mice. H(1) agonist ((6-12-(4-imidazol)ethylamino)-N-(4-trifluoro- methylphenyl)hepatanecarboxamide) promoted development of eczematous lesions in histamine-deficient mice. H(1) receptor antagonist (loratadine) suppressed development of eczematous lesions in wild-type mice, whereas H(2) agonist (dimaprit) and receptor antagonist (cimetidine) were ineffective. These results suggest that histamine facilitates the development of eczematous lesions in a murine model of contact dermatitis via H(1) receptors.
Black patients readily acquire allergic contact dermatitis from such contactants as paraphenylenediamine, nickel, chromates, and mercaptobenzothiazole. Such dermatitis is often complicated by hyperpigmentation and lichenification unless treated early anf vigorously with systemic corticosteroids. Patch testing is reliable on black skin. In addition, acne veneate (pomade acne, Vaselinoderma), which is characterized by noninflammatory acneiform lesions, is very common in black persons. Finally, the old wives' tale that blacks do not get poison ivy may be laid to rest, along with the popular notion that Indians chewed poison ivy leaves in order to prevent poison ivy dermatitis. Several years ago, I interviewed an Indian Chief on a western reservation and inquired whether, to his knowledge, Indians did ever chew poison ivy leaves. The chief's immediate answer was, "You white men must be crazy to think that we would be that foolish!".
Systemic contact dermatitis from the cashew nut shell oil resorcinol allergens cardol and anacardic acid is recognized clinically as a dermatitis with flexural accentuation, typically distributed on the extremities, groin, and buttocks, and occurring generally 1 to 3 days after ingestion of raw cashew nuts contaminated with allergenic oil. We report a case of systemic contact dermatitis to raw cashew nuts, an atypical and unexpected ingredient flavoring an imported pesto sauce. Plants with allergens that potentially cross-react with poison ivy and other Toxicodendrons, and the concepts of systemic contact dermatitis and hyposensitization are reviewed.
A hospital maintenance employee developed an airborne contact dermatitis when cleaning respiratory therapy equipment. Patch-testing determined that she is allergic to glutaraldehyde, an ingredient in a popular commercial germicidal product. The increasing concern over acquired immunodeficiency syndrome (AIDS) and other infectious diseases has resulted in more intensive cleaning, sterilizing, and disposal procedures in health care facilities. This, in turn, may lead to an increased risk of contact dermatitis among health care workers. Glutaraldehyde is commonly used as a sterilizing agent in medical facilities. It is effective against most micro-organisms, including viruses, and is generally harmless to medical equipment. This report concerns a case of airborne allergic contact dermatitis caused by glutaraldehyde.
8 cases of allergic contact dermatitis from hydrangea seen in Angers, France, during the last 15 years are reported and compared to other cases found in the literature. In this review, allergic contact dermatitis from hydrangeas appears to be an occupational dermatosis among nursery workers, presenting as an eczema involving the hands and especially the first 3 fingers, with chronic features of fissuring and scaling and with a chronic course. Differential diagnosis from irritant contact dermatitis may be difficult. Patch tests with the stem as well as the leaf of hydrangeas gave strong positive reactions in all patients, and hydrangenol, the allergen of hydrangea, when tested, always also gave a positive reaction. Sensitization seems to occur after close and prolonged contact with the plant, which could explain the relative frequency in Angers because it provides almost 90% of hydrangea seedling production in France.
The Bordeles School of Le Coulant described in 1966, a contact dermatitis produced by "hepatics" of the Frullania genus. The hepatics together with the mosses and sphagnus form the group of Bryophytes. Only the hepatics with leaves or Jungermaniales have a capacity to cause sensitivity. They grow in dark colour plates on the bark of different trees such as the chestnut-tree, acacias, poplar-trees, beech-trees,and in particular, the oak-trees and evergreen oak-trees. The conifers are rarely affected by these epiphytes. The Frullania lives in the most adverse climates, growing not only on trees, but also on surfaces such as rocks, prefering humid sites. Cases of allergy to Frullania dilatata have been registered in France by Foussereau and Maleville and by De Graciansky. In British Columbia, Mitchel has described cases of contact dermatitis by another species of Frullania, the F. tamarisci subsp. nisquallensis. There are described six cases of contact dermatitis induced by Frullania dilatata that have been studied in the last five years. The indicated growth, because it is epiphyte on forest species, sensitizes those people who through their profession or way of life, come into contact with trees or wood. All our cases were men who had some sort of contact with oak-trees. The lesions fundamentely affected the face, hands and genitales; the diagnostic was established through a patch test with the plant itself. The lesions were of acute eczema so much macroscopic as well as mircoscopic. It has been proved that the responsible substance of the sensitization belongs to the group of sesquiterpenics lactons and that it is also responsible for the contact dermatitis produced by the chrysanthemum, ragweed, pyrstrum, etc. In one of the cases reported, a positive contact test was obtained using extract of chrysanthemum, and in the other case a hyposensitization was tried but it gave negative results.
INTRODUCTION: This is an epidemiologic study to compare allergic contact dermatitis patients in the private and subsidized clinics. PATIENTS AND METHODS: All patients diagnosed to have allergic contact dermatitis in the National Skin Centre from January 1999 to June 1999 were studied retrospectively. RESULTS: More private patients were evaluated for allergic contact dermatitis than subsidized patients in the study period (138 vs. 99). The female-to-male ratio in the paying clinics was greater than in the subsidized clinics (3:1 vs. 1:1). The mean age was the same for both groups i.e., 40 years. There was a greater proportion of unskilled workers attending the subsidized clinic (24.2% vs. 5.4%). The mean duration of rash before evaluation was longer for paying patients than for subsidized patients (31 vs. 22 months), but this was not statistically significant. A significant proportion of the patients had a history of atopic disease and endogenous dermatitis. The most frequent sites for allergic contact dermatitis were the face, hands and the exposed areas of the limbs. The most common allergens were nickel, cobalt and fragrance in the paying patients; and nickel, chromate and fragrance in the subsidized patients. CONCLUSION: More female patients with allergic contact dermatitis and more atopic patients were seen in the private clinics. The forearms, fingers, feet and ears were more commonly affected in the subsidized patients.
Allergic contact dermatitis (ACD) is a rare cause of peristomal skin problems. Only 23 cases have previously been reported in the literature. We report the case of a colostomy patient with a severe disabling blistering peristomal dermatitis. Patch testing to a British Contact Dermatitis Society standard series, medicaments and a plastics and glues series was negative. Patch testing to the patient's own products gave a positive reaction (+) at D2 and D4 to Dansac soft paste and Stomahesive paste. Further patch testing to the components of Dansac soft paste showed a positive (+) reaction at D2 and D4 to ester of polymethyl vinyl/maleic acid copolymer (Gantrez-ES) only. This is the first reported case of ACD due to Dansac soft paste. ACD to Gantrez has previously been reported but in different products. We also review the other previously reported cases of ACD causing peristomal dermatitis and stress the importance of patch testing in these cases, in particular to the patient's own products, as avoidance of identified allergens can have a large impact on the quality of life.
Three cases of contact dermatitis due to additives in animal feed substances are described occurring in animal feed workers. There were two cases of sensitivity to ethoxyquin and one to halquinol.
In a series of 545 consecutive contact dermatitis clinic patients, 274 (50.3%) were men, 56 (20.4%) of whom had hand dermatitis alone, 40 (71.4%) being allergic. The common sensitizers were dichromate in cement, nickel on metal gates, colophony, epoxy resins and rubber chemicals. 48 (85.7%) of the hand cases came from occupational sources. Half of the patch-test-negative men worked in wet jobs. The hands of Nigerian men appear to be less tolerant to irritant wet jobs than those of women who had the opportunity of becoming hardened from childhood.