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Human arylamine N-acetyltransferase 2 polymorphism and susceptibility to allergic contact dermatitis.

BACKGROUND: N-acetyltransferase 2 (NAT2) polymorphism may be involved in the pathogenesis of allergic contact dermatitis. OBJECTIVE: The present study was designed to evaluate whether acetylation polymorphism plays a role in the susceptibility to p-Phenylenediamine (PPD) sensitization. METHODS: The frequencies of seven NAT2 point mutations, namely G191A, C282T, T341C, C481T, G590A, A803G, and G857A, and genotypes were determined by PCR/RFLP in a total of 70 patients with allergic contact dermatitis to PPD and 100 control subjects with no history of allergy, atopy, lung disease, diabetes mellitus and cancer. RESULTS: Genotypes coding rapid acetylation were detected in 52.9% and 37.0% of patients with contact dermatitis and control subjects, respectively (P = 0.04). The frequency of the NAT2*4 allele and NAT2*4/*4 genotype, coding for rapid acetylation, were also significantly higher in the contact dermatitis patients than in the control subjects (P = 0.003). CONCLUSION: Our results suggest an association between rapid acetylation polymorphism and susceptibility to PPD sensitization.

Acetylation↗

Patch test results in schoolchildren. Results from the Information Network of Departments of Dermatology (IVDK) and the German Contact Dermatitis Research Group (DKG)

Our aim was to explore the current spectrum of contact allergens in schoolchildren, as a basis for diagnosis and prevention of allergic contact dermatitis. Results of patch tests in children 6-15 years old, performed in the years 1990-1995 by 22 centres of the German Contact Dermatitis Research Group and filed by the Information Network of Departments of Dermatology, were analysed and evaluated retrospectively, including epidemiologic data. Children with positive tests (62 out of 156 boys and 108 out of 260 girls tested) had a higher frequency of allergic contact dermatitis and a lower frequency of atopic dermatitis than patch test negative ones. 16 distinct allergens elicited positive reactions in > or = 1% of the children tested. Reactions to nickel sulfate occurred in 15.9% of all children tested, but in 25.0% of girls 14/15 years old, and in only 4.5% of boys 6-13 years old. Double-sensitizations with cobalt salts, potassium dichromate and palladium were seen. Mercury compounds were found in 2nd place (thimerosal: all children: 11.3%; 6-13 years old: 14.3%; 14/15 years old: 8.0%), followed by fragrance allergens. We conclude that contact allergy in children is related to their sex and age. Prophylaxis against nickel, mercury, and fragrance allergy needs to be improved. A shortened standard series may be sufficient for testing children.

Adolescent↗

Acrylates induced rhinitis and contact dermatitis.

Acrylates are a well-known cause of occupational contact dermatitis due to its widespread use in several settings such as dentistry, orthopaedic surgery, graphic industry and cosmetics. We describe the case of a manicurist who developed occupational rhinitis and allergic contact dermatitis induced by the application of acrylic-sculptured nails.

Acrylates↗

Occupational allergic contact dermatitis caused by decorative plants.

12 cases of occupational allergic contact dermatitis caused by decorative plants were diagnosed in a 14-year period. The patients were middle-aged, and their average exposure time was 13 years. The plant families and plants causing occupational contact dermatitis were Compositae (5 patients; chrysanthemum, elecampane, gerbera, feverfew), Alstroemeriaceae (5 patients, Alstroemeria), Liliaceae (4 patients; tulip, hyacinth), Amaryllidaceae (2 patients; narcissus) and Caryophyllaceae (2 patients; carnation, cauzeflower). The known chemical allergens causing dermatitis were tuliposide-A and sesquiterpene lactones, such as alantolactones and parthenolide, in the Liliaceae and Compositae families. 7 of the 12 patients were able to continue their work; 5 were not because of severe relapses of skin symptoms. The plant allergen and extract series currently available are of great help in the diagnosis.

Adult↗

[Patch test of mercury compounds and disinfectant solutions and the clinical picture of mercury contact dermatitis].

The results of patch tests with mercury compounds and disinfectant solutions as well as the clinical picture of mercury contact dermatitis are presented and discussed. During the period from Nov. 1983 to Dec. 1986, 686 patients were tested with mercury compounds. During the 13 year period from 1974-1986, 118 patients were tested with disinfectant solutions and 59 patients with mercury contact dermatitis were seen. Among the disinfectant solutions tested, the highest incidence of positive reaction, 11.5%, was obtained with thimersal. Cross sensitization has been shown between mercurochrome and ammoniated mercury, but no statistical correlation existed that demonstrated cross sensitization between mercury and thimerosal until our study. Therefore, the allergen in mercurochrome contact dermatitis is mercury. No statistical correlation could be established between the occurrence of atopic dermatitis and the patch test reactions to mercury compounds. The contactants were mercurochrome, thimerosal, and broken thermometers in 49 out of 59 cases of mercury contact dermatitis. Consequently, the number of occurrence of mercury dermatitis can be reduced by the elimination of the use of these two disinfectant solutions and the substitution of electric thermometers for mercury thermometers.

Adolescent↗

Epidermal keratinocyte production of interferon-gamma immunoreactive protein and mRNA is an early event in allergic contact dermatitis.

Previous work has indicated the importance of cytokine cascades in the induction of contact dermatitis, but there is little information on the cellular localization of cytokines in human skin, particularly during the early phases of the inflammatory response to contact allergens. Using in situ hybridization for mRNA and immunocytochemistry on biopsies from a series of 16 patients with known allergic contact dermatitis, we examined the kinetics of early cytokine production after challenge with relevant or irrelevant antigen. We show that epidermal keratinocytes from patients challenged in vivo with allergen, but not irrelevant antigen, rapidly synthesize (within 4 h) mRNA for interferon-gamma and produce immunoreactive interferon-gamma. Interleukin-1alpha and interleukin-8 mRNA were also detected but showed no correlation with relevant antigen challenge. This study demonstrates that keratinocytes can produce interferon-gamma and that this production is linked to challenge with relevant antigen in allergic contact dermatitis. These findings indicate that keratinocytes may amplify allergen-specific T-lymphocyte-triggered interferon-gamma dependent responses and might partially explain the speed of reaction in this common disease and other delayed hypersensitivity reactions involving the skin.

Adult↗

Dentist's occupational asthma, rhinoconjunctivitis, and allergic contact dermatitis from methacrylates.

BACKGROUND: Allergic contact dermatitis (ACD) caused by (meth)acrylates (MA) is common in dental personnel. MAs have also caused asthma and rhinoconjunctivitis, but asthma, rhinoconjunctivitis and ACD caused by MAs in the same patient appears to be very rare. METHODS: Occupational asthma and rhinoconjunctivitis were diagnosed in a dentist according to patient history, PEF monitoring, and a work-simulated bronchial provocation test. ACD was diagnosed by skin-patch testing with MAs with the occlusive Finn Chamber-technique. RESULTS: The patient's skin-prick test reactions to common environmental allergens and MAs were negative. The total IgE was not elevated. Occupational asthma was diagnosed by a specific inhalation challenge test in which the patient handled liquid dental MAs for 30 min causing a delayed 23% reduction in FEV1. The provocation test also resulted in rhinoconjunctivitis. On patch testing, positive reactions were provoked by several MAs including 2-hydroxyethyl methacrylate (2-HEMA) to which the patient was occupationally exposed. The patient has not been able to continue her work with dental MAs. CONCLUSIONS: A case of occupational asthma, rhinoconjunctivitis and ACD caused by dental acrylate compounds is presented. Patients with respiratory hypersensitivity from MAs have to stop working with MAs, whereas patients with ACD from MAs need to avoid direct contact with MAs, but can often continue in their present job if they use no-touch techniques.

Asthma↗

Contact dermatitis due to budesonide: report of five cases and review of the Japanese literature.

BACKGROUND: Contact allergy to corticosteroids has recently gained increased attention. METHODS: Five cases of contact dermatitis due to budesonide, a nonhalogenated steroid, are described. The Japanese literature was reviewed for reports on this allergy, and the occurrence due to budesonide was compared with that of other dermocorticosteroids. RESULTS: Budesonide use can cause contact dermatitis. CONCLUSIONS: Although budesonide may be beneficial because of its anti-inflammatory effects, clinicians should be alert to its potential for causing contact dermatitis.

Administration, Topical↗

Contact dermatitis in students practicing sports: incidence of rubber sensitisation.

BACKGROUND: Over the last few years, changes in cutaneous homoeostasis resulting from sports activities have been reported. In particular, alterations in sweating mechanisms, the hydrolipid barrier, and surface bacterial flora, together with exposure to atmospheric conditions and the need to use medicaments, detergents, and other topical substances, predispose subjects to allergic contact dermatitis. OBJECTIVE: To evaluate the incidence of allergic contact dermatitis in a group of young people practising sports activities. METHODS: Patch tests were performed to confirm the diagnosis of irritant or allergic dermatitis; in addition, the radioallergoabsorbent test (RAST) to latex was evaluated in the group studied. RESULTS: Allergic contact dermatitis caused by thiourams (23.3%) and mercaptobenzothiazole (20.9%) was prevalent. Other haptens, such as benzocaine and nickel, which are contained in clothing, equipment, topical medicaments, and creams used for massage, were also allergenic. In two cases, RAST positivity to latex was registered. CONCLUSIONS: -The results suggest that close contact with sports equipment may increase the incidence of allergic contact dermatitis. Students practising certain sports may have "professional" allergic contact dermatitis to additives used in the production of rubber.

Adult↗

Allergic contact dermatitis from acrylates in artificial nails.

Artificial nails are an increasingly popular cosmetic enhancement to the natural nail. Several forms are available, including sculptured nails, photobonded nails, and preformed nails. Reactions to artificial nails have included paronychia, onychodystrophies, and dermatitis at contact areas and at sites distant to the contactant. We present a patient who developed erythema and painful pruritic vesicles of the paronychial tissue several hours after the application of sculptured nails. A strong reaction of erythema and edema occurred at the site of methyl methacrylate and ethylene glycol dimethacrylate testing. Removal of the artificial nails resulted in resolution of the reaction.

Acrylates↗

Allergic contact dermatitis prevalence in patients with otitis externa.

A statistical analysis of the relationship between otitis externa and various clinical and etiological variables was carried out in 64 patients. Between 1988 and 1989, true eczema of the auditory canal was found in 43 of the 64 patients seen sequentially. 23.5% of all the patients found to have dermatitis could be regarded as having allergic contact dermatitis and the allergen identified. This incidence is less than the 40% and the 58% found in other previous studies. We did not find any specific difference in sex and age between the allergic and non-allergic groups. In the allergic group, topical drugs were the commonest sensitizing agents, followed by chemicals and resins found in the ear prosthesis. Twenty-one patients with negative patch tests were classified as seborrheic dermatitis and 11 as atopic dermatitis. The other 19 patients, who were discharged before patch testing, were diagnosed as having psoriasis (8) or chronic bacterial (6) or fungal infections (5), without true blister reaction. We think that accurately selected series must be used for these studies because of the low incidence of allergic contact dermatitis.

Adolescent↗

Decreasing allergic contact dermatitis frequency through dermatotoxicologic and epidemiologic based intervention?

Allergic contact dermatitis (ACD) affects millions of people worldwide. In an attempt to decrease the incidence of contact dermatitis, several countries have implemented legislations to reduce the population's exposure to known sensitizers. To determine whether these legislations have been effective, we reviewed several studies examining trends in patch test reactivity before and after implementation of these legislations. Common sensitizers studied include nickel, gluceryl monothioglycolate fragrances, chromate, and thiuram. Overall, the evidence suggests a decreasing trend of ACD with appropriate formulation changes, however some of the data may be confounded by biases, and additionally, exposure to the sensitizer may still exist via non-compliance to regulations by small manufacturers. In the future population based studies should be conducted to more accurately assess trends in ACD.

Allergens↗