Nurses and occupational contact dermatitis.
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Dermatitis, Allergic Contact↗
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Allergic contact dermatitis to Alstroemeria.
Two female florists developed dermatitis of the fingertips. Patch testing revealed allergic contact dermatitis to the flower, Alstroemeria, used in floral arrangements. They had positive patch tests to portions of Alstroemeria, and to tuliposide A, the allergen in this plant. Vinyl gloves were not helpful since tuliposide A readily penetrates through these gloves. Nitrile gloves may be protective since they prevented positive patch test to tuliposide A.
Adult↗
Contact dermatitis in infants, children, and adolescents.
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Adolescent↗
The effect of grenz rays on the expression of allergic contact dermatitis in man.
To investigate the effect of grenz rays on the expression of allergic contact dermatitis, six patients hypersensitive to nickel were studied. They were given 3 Gy of grenz rays, once a week for 3 weeks, to a defined area of the back. Twenty-four hours after the last treatment serial dilution nickel patch tests were applied on the grenz-ray-treated area and on untreated control skin. There was an almost total suppression of the allergic contact dermatitis at the site of grenz ray treatment. Biopsy specimens were taken from nickel-challenged and unchallenged skin, both from the grenz-ray-treated area and from the control area. Different cell populations in epidermis and dermis were identified by monoclonal antibodies (Leu 2, 3, 4, 7, Leu M1, B1, OKT6). In the grenz-ray treated epidermis there was a pronounced reduction of OKT6-positive cells, regarded as Langerhans cells. No other differences were observed between control and grenz-ray-treated skin. Our results suggest that Langerhans cells might be required also for the effector phase of the allergic contact dermatitis.
Adult↗
Legislative and preventive measures related to contact dermatitis.
Legislation can be a useful tool in the prevention of contact dermatitis. This is particularly true for dermatitis due to exposure to the many contact allergens that are chemical substances in products. A brief review is given of the most important European legislation--the EU Nickel Directive, the Cosmetics Directive, the Hazardous Substances Directive and the Hazardous Preparations Directive--and of some national regulations and standardization projects. It is concluded that it is essential that experts on contact dermatitis support, with their expert knowledge, national and European authorities.
Allergens↗
Occupational airborne allergic contact dermatitis from 2-aminothiophenol.
We report a case of occupational airborne contact dermatitis in a chemical technician working in the pharmaceutical industry, following accidental exposure to the vapors of 2-aminothiophenol (an aromatic hydrocarbon used as a chemical intermediate for chemical and biomedical research). Patch testing showed positive reactions to 2-aminothiophenol 0.1% and 0.01% eth. The importance of patch testing with substances used at work to investigate occupational contact dermatitis is stressed.
Adult↗
Involvement of the cannabinoid CB2 receptor and its endogenous ligand 2-arachidonoylglycerol in oxazolone-induced contact dermatitis in mice.
The possible involvement of 2-arachidonoylglycerol (2-AG), an endogenous ligand for the cannabinoid receptors (CB1 and CB2), in contact dermatitis in mouse ear was investigated. We found that the level of 2-AG was markedly elevated in the ear following a challenge with oxazolone in sensitized mice. Of note, the swelling following the challenge was suppressed by either the administration of SR144528, a CB2 receptor antagonist, immediately after sensitization, or the administration of SR144528 upon the challenge. The effect of AM251, a CB1 receptor antagonist, was marginal in either case. It seems apparent, therefore, that the CB2 receptor and its endogenous ligand 2-AG are closely involved in both the sensitization phase and the elicitation phase of oxazolone-induced contact dermatitis. In line with this, we found that Langerhans cells (MHC class II(+)) contain a substantial amount of CB2 receptor mRNA, whereas keratinocytes (MHC class II(-)) do not. We also obtained evidence that the expression of mRNAs for proinflammatory cytokines following a challenge with oxazolone was markedly suppressed by treatment with SR144528. We next examined whether the CB2 receptor and 2-AG participate in chronic contact dermatitis accompanied by the infiltration of tissues by eosinophils. The amount of 2-AG in mouse ear dramatically increased following repeated challenge with oxazolone. Importantly, treatment with SR144528 attenuated both the recruitment of eosinophils and ear swelling in chronic contact dermatitis induced by repeated challenge with oxazolone. These results strongly suggest that the CB2 receptor and 2-AG play important stimulative roles in the sensitization, elicitation, and exacerbation of allergic inflammation.
Animals↗
Allergic contact dermatitis in the dog. Principles and diagnosis.
Allergic contact dermatitis is a rare hypersensitivity disorder in the dog. Clinical diagnosis is not easy. Primary lesions are transient. Secondary lesions caused by chronic inflammation and self-trauma are commonly present on typical areas, especially in sparsely haired regions and on the feet. A presumptive diagnosis can be made based on the history, clinical signs, and positive standardized closed patch testing. Histopathology and basophil degranulation testing may also be helpful in supporting the diagnosis and in identifying the offending allergens. However, a definitive diagnosis can be made only after restriction-provocation testing. With better understanding of the pathogenesis and clinical signs, and with increased availability of diagnostic tests (especially a standardized closed patch test), increased recognition of this dermatosis is expected.
Animals↗
Common pathogenetic pathways in allergic and irritant contact dermatitis.
Despite their different pathogeneses, allergic and irritant contact dermatitis show a remarkable similarity with respect to clinical appearance, histology, and immunohistology. To further analyze this apparent contradiction, our study was designed to meticulously compare cellular infiltrates in irritant and allergic patch-test reactions by immunostaining with a broad panel of monoclonal antibodies. For this purpose, skin biopsies from allergic and irritant patch-test reactions of similar inflammatory degree were obtained from the same probands. We found that after 72 h both types of reaction were characterized by an identical dermal infiltrate consisting mainly of memory T cells, many of which were activated, and macrophages. Dermal and epidermal Langerhans cell density and HLA--DR expression of keratinocytes were also virtually identical. Our results show that antigen recognition by specific memory T cells as well as irritants can finally induce the same pattern of inflammation, including activation of T cells obviously independent of exogenous antigen.
Adult↗
Allergic "contact" dermatitis from disulfiram implants.
Two cases of allergic "contact" dermatitis to implanted disulfiram (tetraethythiuramdisulfide or TETD) pellets are described. This side effect has never been reported before. Other local complications from disulfiram implantations are reviewed.
Adult↗
Brilliant Lake Red R as a cause of pigmented contact dermatitis.
Twenty-three patients suffering from pigmented contact dermatitis caused by cosmetics containing Brilliant Lake Red R were observed. Commercial samples of Brilliant Lake Red R proved to contain many ethyl acetate extractable impurities; 1-phenylazo-2-naphthol and azobenzene were isolated and identified. To determine the responsible allergens, five patients were examined by patch tests with purified samples of azo-dyes and the unidentified fractions of ethyl acetate extractable impurities. Three out of five showed weaker reactions to purified samples of Brilliant Lake Red R and the other two showed equal reactions compared to the commercial product. 1-Phenylazo-2-naphthol was found to be a strong allergen in all cases but none showed a positive reaction to azobenzene. Some unidentified fractions also gave positive results. Patch tests were performed with 4-phenylazo-1-naphthol, 4-phenylazo-1-naphthol-2-carboxylic acid, and 2,4-bis(phenylazo)-1-naphthol, as structurally related compounds derived from 1-naphthol. All gave negative and they were not detected in the ethyl acetate extractable impurities by thin-layer chromatography.
Adult↗
Contact dermatitis in children.
It is generally admitted that contact dermatitis seldom appears in children. Eighty-seven cases, however, have been diagnosed at the Department of Allergology of the Dermatological Clinic in Strasbourg in the past 10 years (1969-1978). No element of atopic diathesis could be found in any of them. We have reviewed the cases with a positive patch test to try to derive both theoretical and practical conclusions.
Adolescent↗
Lymphomatoid contact dermatitis due to ethylenediamine dihydrochloride.
A case of contact sensitivity to ethylenediamine dihydrochloride is reported. The clinical and histological features were in keeping with early mycosis fungoides. The eruption cleared with avoidance of the allergen. Continued contact with the allergen was traced to its retention in a trouser pocket lining. The term "lymphomatoid contact dermatitis" should be confined to cases where the lymphomatoid features are due to a positively reacting allergen.
Adult↗
Allergic contact dermatitis from ethylene thiourea.
A case of allergic contact dermatitis to the rubber additive material ethylene thiourea (ETU) is presented. Testing for cross-sensitivity gave a positive reaction to the fungicide Maneb, manganous ethylenebisdithiocarbamate, but this reaction was probably due to ETU which was detected in Maneb by thin-layer chromatography. Different sources of ETU are reported.
Dermatitis, Contact↗
Allergic contact dermatitis from epoxy resin in nasal canulae.
Allergic contact dermatitis from not fully cured epoxy resin in nasal canulae is reported. Patch testing and chemical analysis utilizing the actual batch are stressed.
Aged↗
Contact dermatitis from Primula obconica Hance.
15 cases of contact dermatitis to Primula obconica Hance are reported, 14 female and 1 male. None were of occupational origin. The incidence among our patients increased from 0.45 to 3.4% when we included an ether extract of primula in our standard series. A doubtful patch test reaction was found in 19.6% of the patients tested. Active sensitization was observed in 5 of 20 patients retested 1-16 months later.
Dermatitis, Contact↗
Contact dermatitis in Nigeria. (III). Dermatitis of the neck.
Out of 545 consecutive contact dermatitis clinic patients, 73 (13%) had dermatitis of the neck of whom 18 (25%) were nickel positive. 7 had clothing dermatitis and 3 of them reacted to chromate in military uniforms. 5 patients were sensitised to perfume and 4 to medicaments used to treat existing dermatitis. 3 patients were sensitised to hair dyes. Nickel dermatitis, was clinically overdiagnosed, mainly due (for various reasons) to inability to make a firm diagnosis of atopy.
Adult↗
Allergic contact dermatitis from topical corticosteroids.
22 cases of allergic contact dermatitis from topical corticosteroids were observed in Strasbourg and previously published. 7 further cases are reported here and the vehicle and concentration of corticosteroids for patch tests are discussed. A 0.1% concentration in petrolatum seemed adequate for testing the 4 molecules (triamcinolone acetonide, dexamethasone, desonide and amcinonide) responsible for the 7 new cases. In 1 case, several cross-reactions were seen. A corticosteroid screening series permits patch testing of the suspected molecule(s) in a selective way. Without this series, long delays are required to make the correct diagnosis by patch testing. We have reviewed more than 60 papers on corticosteroid allergy published up to now.
Administration, Topical↗