ALLERGY TO LICHENS; ALLERGIC CONTACT DERMATITIS FROM USNIC ACID PRODUCED BY LICHENIZED FUNGI.
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Two patients with contact dermatitis from an ostomy agent are described. Detailed patch testing revealed contact allergic dermatitis to one of the twelve groups of ingredients which largely comprised citronella oil. The problem of dermatitis is discussed in relation to the perfume ingredients of the ostomy agent.
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It is known that the topical application of cyclosporin A (CsA) has a significant suppressive effect on allergic contact dermatitis. In this study, we investigated the effect of topical CsA on toxic (non-allergic) contact dermatitis. Topical CsA significantly suppressed the toxic contact reaction to croton oil. This suppressive effect was short-lived and reversible. Significant inhibition of the reaction to croton oil persisted for 3 days after stopping the CsA. The toxic reaction was blocked when CsA was applied within 6 h of the croton oil application, but when application of CsA was delayed until 12 h after the oil application there was no significant suppressive effect. Topical administration of CsA could become a valuable tool for treating toxic and allergic contact dermatitis without producing the adverse reactions caused by systemic therapy.
Two cases of allergic contact dermatitis from soldering fluxes are reported. Both were caused by rosin (colophony). One case was confirmed by a positive patch test to rosin purchased from a commercial European patch test supplier. The other could be confirmed only by a positive patch test to the specific rosin used to flux the solder; repeated patch tests to rosin purchased from the same European supplier were negative. Dermatitis from soldering fluxes is reviewed.
Contact dermatitis is the most common form of occupationally acquired skin disease. Eligibility for coverage under the workers' compensation laws of all states requires only reasonable probability that dermatitis directly resulted from, or was aggravated by, employment. The responsibility for this determination ultimately resides with the examining physician, who must critically evaluate the medical history and cutaneous findings. This article proposes seven objective criteria that may be used to assess the probability of a causal relationship with employment.
A laboratory technician developed allergic contact dermatitis to hydroxyethylmethacrylate associated with nausea, diarrhoea and persistent paresthesiae of the fingertips. The gastrointestinal symptoms were reproduced by patch testing. Hydroxyethylmethacrylate was demonstrated to pass through vinyl gloves. Cross reactions occurred to methyl-, ethyl-, propyl- and isopropylmethacrylate but not to butyl- or isobutylmethacrylate.
Keratinocytes expressed major histocompatibility complex class II antigens during the development of irritant contact dermatitis, and during the induction of contact hypersensitivity, as well as in established allergic contact dermatitis. A battery of anti-class II monoclonal antibodies, some of which are specific for class II subregion products (DP, DQ, DR), was used in an immunohistochemical study of the sequential changes in the allergic challenge reactions to dinitrochlorobenzene (DNCB) and nickel, the irritant response to anthralin, and the induction of sensitization to DNCB. The induction of keratinocyte class II expression paralleled the influx of Leu-3a+ T cells into the skin and had occurred by 24 or 48 h in each type of reaction. Differential expression of class II subregion products on keratinocytes was noted: DR was the most frequently expressed molecule, followed by DP and DQ, although in the irritant response, DP expression was not observed. The importance of these observations can be decided only by functional studies.
The dermatologist should be aware of the many facets of occupational skin diseases, which can be caused by physical, chemical, and biological insults. The most common manifestation of occupational skin diseases is contact dermatitis (both irritant and allergic). Three factors point out the importance of occupational skin diseases as diseases that have a public health impact: 1) occupational skin diseases are common; 2) they often have a poor prognosis; and 3) they result in a noteworthy economic impact for society and for an individual. They are also diseases amenable to public health interventions. Specific industries and exposures may put a worker at risk of occupational contact dermatitis. The accuracy of the diagnosis of occupational contact dermatitis is related to the skill level, experience, and knowledge of the medical professional who makes the diagnosis and confirms the relationship with a workplace exposure. Prevention of occupational contact dermatitis is important, and a variety of prevention strategies are available.
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