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Flare-up of allergic contact dermatitis in the mouse after topical distant provocation.

Flare-up of contact dermatitis after exposure to the antigen on another skin area was studied in the mouse. Animals were sensitized and challenged with picryl chloride. After healing, the ear dermatitis flared up following provocation on abdominal skin. Likewise, nickel-sensitized mice flared in one ear when exposed to the antigen on the other ear. This model could be of use in pathogenetic studies on secondary eruptions which occur so frequently in contact dermatitis.

Abdomen↗

The burning mouth syndrome: lack of a role for contact urticaria and contact dermatitis.

BACKGROUND: The burning mouth syndrome is poorly understood and mainly affects postmenopausal women. Dental allergens have seldom explained the burning. OBJECTIVE: Eight patients (seven women, one man) (mean age 62.5 years) who wore dentures and had the burning mouth syndrome were investigated to determine whether contact urticaria, allergic contact dermatitis, or pressure urticaria played a role. Only patients who had minimal to no erythema of the mucosa were included. METHODS: A complete blood cell count, fasting chemistry profile, and potassium hydroxide examination and cultures for Candida and dermatophytes were obtained. Contact urticaria and patch testing with control substances were performed with a panel of 25 potential denture allergens. RESULTS: Complete blood cell counts and fasting chemistry profiles were normal. One positive Candida culture was found, but no improvement in the symptoms was noted after treatment. All patients tested positive to histamine and to at least two of the nonimmunologic urticaria controls. No patient had a positive urticarial reaction to the potential dental allergens. Two patients with nonimmunologic urticaria to cinnamic aldehyde improved with avoidance. All patch tests were negative. In the six patients tested for pressure urticaria, the results were negative. CONCLUSION: We cannot indict contact dermatitis, contact urticaria, or pressure urticaria as a cause of the burning mouth syndrome in the denture-wearing patient who has a normal-appearing mucosa. The burning symptoms in this syndrome may be secondary to a simple frictional phenomenon of the denture on the mucosa.

Blood Cell Count↗

[Toxic ulcerative contact dermatitis due to prefabricated concrete (cement burns)].

In the present report the case of a toxic ulcerous contact dermatitis (cement burns) by pre-fabricated concrete is described. This can be clearly distinguished by anamnesis, findings and development from the allergic and cumulative-toxic contact dermatitis caused by cement and related substances. It is pointed out, that in the few cases of "cement burns" made known up to now, pre-fabricated concrete was always the triggering agent.

Burns, Chemical↗

Occupational contact dermatitis.

The two commonest forms of occupational skin disease are irritant and allergic contact dermatitis. Morphology and history are used to establish the diagnosis and the relation of the disorder to work exposure, respectively. Diagnostic patch tests are used to define further the diagnosis and aetiology of the dermatitis.

Dermatitis, Atopic↗

Allergic contact dermatitis from dipentene in honing oil.

Three independent cases are reported of allergic contact dermatitis from dipentene in the same brand of honing oil. The manufacturers have since removed dipentene from the formulation and replaced it with a technical alternative.

Adult↗

Do barrier creams and gloves prevent or provoke contact dermatitis?

Barrier creams and gloves play an important role in the prevention of contact dermatitis, and various in vivo and in vitro methods have been developed to investigate their efficacy. However, their actual benefit in the workplace is still being debated. This article reviews both the benefits and adverse effects of barrier creams and gloves.

Dermatitis, Contact↗

Occupational contact dermatitis to textile dyes in airline personnel.

BACKGROUND: Reports of textile dye allergic contact dermatitis are becoming frequent in the literature. Occupational exposure to textile dyes has been reported, but less frequently. OBJECTIVE: To report 2 cases of allergic contact dermatitis to Disperse Blue dyes 106 and 124 occurring in airline personnel. METHODS: The patients were patch tested to the European or North American standard series, a textile dye series, and 1 patient was tested with pieces of textile from an airplane seat. RESULTS: Patch testing elicited in both patients a 2+ reaction to Disperse Blue dyes 106 and 124, and a 1+ reaction to paraphenylenediamine in one patient. CONCLUSION: We describe 2 cases of occupational textile dye allergy occurring in airline personnel. Both cases showed the utility of Disperse Blue dyes 106 and 124 to serve as the screening allergens for textile dermatitis. Mandatory uniforms might be an occupational hazard in certain professions.

Aircraft↗

Evaluation of contact dermatitis using the TRUE patch test.

Patch testing is a dermatological diagnostic procedure for contact dermatitis utilizing selected allergens. It has been suggested that suspected cases of contact dermatitis cannot be definitively diagnosed without a patch test. Physicians have avoided the use of patch testing for a variety of reasons, chief of these being inconvenience and inconsistency. The TRUE patch test (Pharmacia AB, Uppsala, Sweden) offers a test modality that circumvents these problems. Background information on the TRUE test is presented along with two studies demonstrating its efficacy.

Dermatitis, Contact↗

All the things I knew were true about contact dermatitis that aren't.

Twenty-five years of experience in evaluating people with irritant and allergic contact dermatitis has taught me that many of my preconceived notions were false. No patients are more challenging and interesting to investigate or more rewarding to help than those with long-standing histories of undiagnosed contact dermatitis. Furious resolve during investigation coupled with a willingness to be proven wrong and to find the unexpected is most likely to result in a successful outcome for patients with contact dermatitis.

Adrenal Cortex Hormones↗

Occupational allergic contact dermatitis caused by thiourea compounds.

Thiourea compounds are mainly used as accelerators in the rubber industry, but also in other industries, e.g., as antioxidants in the graphics industry. Thiourea compounds may provoke allergic contact dermatitis, although the number of reported cases is relatively low. During 1985-1991, we had 5 patients with allergic patch test reactions caused by thiourea compounds. 1 of our patients had to use a knee brace after an occupational accident. He developed allergic contact dermatitis caused by the knee brace, probably because he had become sensitized to diethylthiourea. 2 patients were probably sensitized by diphenylthiourea in neoprene gloves. A florist had an allergic patch test reaction to diphenylthiourea and might have been sensitized by fungicides or pesticides, which break down into thioureas. It is often difficult, however, to detect the source of thiourea compound sensitization. If the patient has contact dermatitis and has been exposed to products that may contain thiourea compounds (or compounds that break down into thiourea compounds), such as rubber, PVC plastic or adhesive, diazo paper, paints or glue remover, anticorrosive agents, fungicides or pesticides, patch testing with a series of thiourea compounds needs to be performed. If patch testing with thiourea compounds is not performed, allergic contact dermatitis caused by thiourea compounds is not likely to be diagnosed.

Adult↗

Allergic contact dermatitis from a natural deodorant: a report of 4 cases associated with lichen acid mix allergy.

BACKGROUND: Botanical ingredients used in personal care products are a significant and underreported cause of allergic contact dermatitis. OBJECTIVE: To evaluate allergic contact dermatitis from a widely-used botanical deodorant. METHODS: We conducted patch testing in four patients who were using the botanical deodorant and were referred to the contact dermatitis clinic; three patients had axillary dermatitis and one had dermatitis of the external ear. RESULTS: All four patients had positive patch test reactions to lichen acid mix and D-usnic acid. Of the three patients who were patch tested to the botanical deodorant, all had positive reactions. LIMITATIONS: We did not test to the specific lichen used in the natural deodorant but rather used our own lichen acid mix and d-usnic acid in addition to testing to the actual product. One of the patients declined to be tested with the natural deodorant, but did test positive to the lichen acid mix and d-usnic acid. CONCLUSION: Personal care products such as deodorants may represent a new route of exposure to lichen extract, a known allergen.

Adult↗

Mercury allergy in a contact dermatitis clinic in Northern Ireland.

441 consecutive patients (294 female, 147 male) with suspected contact dermatitis were patch tested to the European standard series, mercury metal (1% pet), ammoniated mercury (1% pet.), and mercuric chloride (0.1% aq.). 14 patients (3.2%), 12 of whom were female, showed a positive response to 1 or more mercury compounds; none reacted to mercuric chloride alone. Primary sensitization was most likely due to either inoculation with vaccines containing merthiolate preservatives or amalgam dental restorations. Mercury allergy was of historical clinical relevance in only 2 patients, both women who developed gingivostomatitis following insertion of amalgam dental fillings. 1 of these women subsequently developed allergic contact dermatitis from contact lens solutions, shampoos and cosmetics which contained mercury preservatives. On the basis of these findings, we recommend patch testing with both metallic mercury and ammoniated mercury in patients with suspected mercury allergy.

Adult↗

Differential analysis of experimental hypermelanosis induced by UVB, PUVA, and allergic contact dermatitis using a brownish guinea pig model.

In moderately colored guinea-pig skin, UVB, PUVA, and allergic contact dermatitis were shown to induce hyperpigmentation that resembled the pigmentary changes observed in mongoloid human skin. Using this model, we examined the effects of chemical agents, including tyrosinase inhibitors and sunscreen agents, on the color changes induced by UV irradiation. The daily exposure of brownish guinea-pig skin to UVB irradiation at a variety of energies for 3 successive days induced clearly visible black pigmentation on the irradiated rectangular areas of the flank within a few days of irradiation, the maximum being reached about 1 week after irradiation, i.e., similar to the changes that occur in pigmented human skin. Split epidermal sheets prepared from untreated pigmented guinea pigs exhibited 200-400 melanocytes/mm2; 1 week after UV irradiation, the applied areas show an increased number of strongly dopa-positive melanocytes with stout dendrites (800-1,000 cells/mm2). UVA irradiation following an intraperitoneal injection of 8-methoxypsoralen (8-MOP) also produced black pigmentation 1 week after irradiation, and this was paralleled by a marked increase in the number of dopa-positive melanocytes in dopa-reacted split epidermal sheets. Allergic contact dermatitis produced by the application of 1-phenylazo-2-naphthol induced hyperpigmentation after an interval of about 14 days in 10 of the 21 allergy-acquiring animals examined. This induced pigmentation was accompanied by an increase in the number of dopa-positive melanocytes as compared to the number seen in controls. In contrast, allergic contact dermatitis produced by the application of dinitrochlorobenzene failed to induce such a high ratio of postpigmentation, with only 3 of the 21 allergy-acquiring animals showing hyperpigmentation and 5 showing depigmentation; in the latter, there was a slight decrease in the number of dopa-positive melanocytes. To study the preventive effect of tyrosine inhibitors on UVB-induced pigmentation, daily topical applications of these compounds were performed after three daily UVB irradiations. Treatment with 10% hydroquinone for 10 days interrupted UVB-induced pigmentation and resulted in a marked reduction in the number of epidermal melanocytes as compared to the number found in UVB-irradiated, untreated control skin.

Animals↗

What is the best duration of steroid therapy for contact dermatitis (rhus)?

Scant evidence exists for the best duration of steroid therapy for contact dermatitis due to plants (rhus). Review articles recommend 10 to 21 days of treatment with topical or oral corticosteroids for moderate to severe contact dermatitis due to plants (strength of recommendation [SOR]: C, based on review articles). The primary reason given for the duration of 2 to 3 weeks is to prevent rebound dermatitis.

Dermatitis, Contact↗

Occupational contact dermatitis in nurses with hand eczema.

Occupationally related dermatitis is a common problem in nurses, who are exposed to a wide variety of allergenic and irritant substances. In a group of 44 nurses with hand dermatitis (40 female, 4 male), 18 were thought to have a predominantly allergic contact dermatitis, 15 an irritant dermatitis, 7 other form of eczema, 3 atopic dermatitis and one pompholyx. 10 of the 15 irritant cases were diagnosed as occupational. Of the 18 patients with allergic contact dermatitis, the allergens were thought to be occupationally relevant in 8 cases. In 6 of these 8 the dermatitis was due to natural rubber latex (3) or other rubber chemicals (3). 2 had additional evidence of immediate-type hypersensitivity to natural rubber latex (one was patch test allergic to latex, the other to thiuram mix). Natural rubber latex allergy, both delayed and immediate, is a significant problem, and nurses at risk should be tested for both types of hypersensitivity, as well as being patch tested to standard, rubber and medicaments series.

Adult↗

Allergic contact dermatitis due to urethane acrylate in ultraviolet cured inks.

Seven workers exposed to ultraviolet printing inks developed contact dermatitis. Six cases were allergic and one irritant. A urethane acrylate resin accounted for five cases of sensitisation, one of which was also sensitive to pentaerythritol triacrylate and another also to an epoxy acrylate resin. One instance of allergy to trimethylpropane triacrylate accounted for the sixth case of contact dermatitis in this group of workers. An irritant reaction is presumed to account for the dermatitis in the individual not proved to have cutaneous allergy by patch tests. In this instance trimethylpropane triacrylate was thought to be the most likely irritating agent. Laboratory investigation proved urethane acrylate to be an allergen. The results of investigations of the sensitisation potentials of urethane acrylate, methylmethacrylate, epoxy acrylate resins, toluene-2,4-diisocyanate, and other multifunctional acrylic monomers in the albino guinea pig are presented. The interpretation of such predictive tests is discussed.

Acrylates↗

Irritant contact dermatitis. Traumiterative and cumulative impairment by cosmetics, climate, and other daily loads.

Based on the results of exposure experiments on living human skin a working hypothesis is launched concerning the possible pathogenesis of irritant contact dermatitis. Below a certain and critical degree of exposure there is no alteration in clinical aspect of the exposed region. However, instrumentally (watervapour-loss measurements, impedance measurements) it is usually possible to register subclinical effects in such a field. These are interpreted as signs of impairment of metabolic homoiostatic systems. It is possible in certain cases to show that the skin is able to adapt its functions to a repeated load (illustrated with exposure experiments to DMSO). It seems useful to distinguish between a traumiterative irritant contact dermatitis (a result of too early repetition of just one type of load; see Aquabrom experiment) and a cumulative irritant contact dermatitis (resulting from a too early repetition of exposures differing in type; see experiment with soap and detergent solutions). In cumulative irritant contact dermatitis the sequence of the different loading factors is of importance: first soap and then detergent or the reverse.

Climate↗

The prognosis of occupational contact dermatitis.

Despite the development of new drugs and improvements in working conditions, the prognosis for recovery from contact dermatitis has not changed significantly over the past 50 years. This chapter reviews the prognosis for both irritant and allergic contact dermatitis and discusses the main reasons that contact dermatitis persists, including misdiagnosis and continued exposure to irritants and allergens.

Dermatitis, Occupational↗