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We present a case of occupational protein contact dermatitis caused by herring in a dolphinarium worker. The in vivo and in vitro tests results indicated a type I allergic mechanism. In vivo cross-reactivity among fish belonging to the Clupeiformes order was observed.
A 30-year-old man presented with eyelid dermatitis and was diagnosed with occupational allergic contact dermatitis to an epoxy resin based on the monomer diglycidyl ether of bisphenol F. He did not react to the standard epoxy resin based on bisphenol A, but reacted to a diluted sample of epoxy resin taken from his workplace, an adhesives manufacturing plant. The diagnosis would not have been made had he not brought samples from work, which were patch tested after appropriate dilution. The material safety data sheet provided additional evidence that the epoxy was not based on bisphenol A. The patient's symptoms subsided after avoidance of the identified product.
A contact dermatitis due to to povidone-iodine (PI) which seemed to be a strong irritant reaction is described. Nevertheless, patch-test results suggested an allergic reaction that is cell mediated.
We report a case of acute contact dermatitis caused by exposure to 2-chloracetophenone tear gas in the face. Within 3 days the contact dermatitis had disappeared without medical treatment, but 7 days after exposure, a scaly pruritic eruption developed at the site of the original exposure although no new contact with 2-chloracetophenone had taken place.
A 63-year-old man with hepatocellular carcinoma consequent to chronic viral hepatitis C presented with severe dermatitis on the lower right side of the back after transcatheter arterial chemoembolization (TACE) via the 10th intercostal artery, because his hepatic artery had already collapsed due to repeated usage for TACE. The regional skin showed redness and hardness with pustules. Histologically, there was epidermal and appendage necrosis, as well as exocytosis of red blood cells. With a diagnosis of skin injury due to leakage of lipiodol ultrafluid, mitomycin, and epirubicin, administered via the 10th intercostal artery, onto the skin tissue, topical application of 0.06% fluocinonide-containing cream was prescribed. After several weeks of conservative local treatment, the leakage skin injury improved significantly, leaving pigmentation, hardness, and a small necrotic mass, as reported elsewhere (Honda T, Matsushima S, Fujii S, et al. A case of skin injury following transcatheter arterial chemotherapy through intercostal artery for hepatocellular carcinoma. Skin Res 2003; 2: 18-22). Subsequently, the patient again consulted the Dermatology Department with further dermatitis in an almost identical skin region on the right side of the abdomen (irregularly spreading erythematous and edematous eruptions with itching; Fig. 1). As he had undergone an ultrasonic examination 2 days earlier, allergic contact dermatitis from the ultrasonic gel was suspected. The contact dermatitis was treated with a topical corticosteroid hormone-containing ointment. Patch testing was performed with Ultra Phonic Conductivity Gel (Pharmaceutical Innovations Inc., Newark, NJ, USA), with which the patient had undergone a series of ultrasonic examinations, and Sono Jelly (Toshiba Medical Supply Co., Ltd., Tokyo, Japan) as a reference, as well as white petroleum as a negative control. A positive result was obtained for Ultra Phonic Conductivity Gel, whereas Sono Jelly was negative (Fig. 2a). Pharmaceutical Innovations Inc. kindly supplied the ingredients of the gel: propylene glycol (PG), preservative in PG, color in PG, thickener 1, and thickener 2. The company gave no further details about the preservative, color, and thickeners. Patch testing was performed using these five materials, resulting in a positive reaction for PG, preservative in PG, and color in PG. Thickeners 1 and 2 and lipiodol ultrafluid were negative (Fig. 2b). On the assumption that the causative chemical was PG, commercially obtained PG, free of preservative and color, was then patch tested (original, 10% aqueous, 1% aqueous, and 0.1% aqueous solutions), resulting in original strongly positive, 10% positive, and 1% and 0.1% weakly positive (Fig. 2c). The medical records showed that the patient had received 16 ultrasonic examinations with the same ultrasonic gel before the leakage skin injury. The 17th examination was performed 2 days after leakage dermatitis, and the 18th 3 months after the injury, when contact dermatitis occurred. The 19th examination was performed using Sono Jelly, which contains no PG, and no skin problems were observed.
Allergic contact dermatitis (ACD), an immunological reaction of the skin resulting from contact with reactive compounds occurring in plants was shown to the enantiospecific (animals sensitized to a compound do not react to its nonsuperimposable mirror image). Thus, when guinea pigs were experimentally sensitized to (+)-tulipalin B (a compound present in tulip bulbs) they did not react to its enantiomer, (-)-tulipalin B. This was also true for (+)- and (-)-beta-hydroxy-gamma-methyl-alpha-methylene-gamma-butyrolactones.
Paederus dermatitis is a linear, blistering contact dermatitis caused by pederin, a potent vesicant agent that is contained in insects belonging to the genus Paederus. This form of dermatitis usually occurs accidentally in those who have contact with this insect during the summer season. We report a peculiar case of a patient developing severe chemical burnlike lesions after application to her skin of many crushed Paederus fuscipes that she collected from the soil of a riverbank in the early spring for the treatment of her vitiligo.
This study attempts to demonstrate the existence of allergic contact dermatitis from grass, and to develop a patch test series to screen patients with grass intolerance. 6 common grass species from lawns and military training areas were collected. Solvent extracts of polar, non-polar and volatile fractions were prepared and used for patch testing in 20 control subjects and 46 patients with a history of grass intolerance. The 20 controls had negative responses to patch testing. 5 out of 46 patients had positive patch tests to Axonopus compressus (carpet grass), Ischaemum muticum (seashore centipede grass), Imperata cylindrica (lalang), Panicum maximum (Guinea grass) and Pennisetum purpureum (elephant grass). Reactions to the non-polar fraction for all 5 species were noted. This study demonstrates the existence of allergic contact dermatitis from various common species of grass. In our series, this is seen in 11% of those with a history of grass intolerance.
This report is about occupational contact dermatitis found in 3 out of 6 workers of a chemistry laboratory using Lowicryl embedding media, which contain (meth)acrylate monomer mixtures of known composition. The notation (meth)acrylates is used to refer to both acrylates and methacrylates. (Meth)acrylate monomers will polymerize in the absence of oxygen when induced by metal ions, peroxides, heat or ultraviolet light. The monomers are of low viscosity and remain in the liquid state at temperatures far below 0 degree C. The volatile compounds, some of which exhibit a most pungent odour, have a tendency to penetrate all tissue and to permeate into the finest fissures, a property which makes them suitable as sealants, glues, embedding material, etc. This and their toxicity may represent a danger to the health of individuals who need to work with them, especially if no precautions are taken. We show with patch testing that one patient reacted strongly to the compound 2-hydroxyethyl acrylate at the dilutions tested (0.5 and 1% v/v), but not at all to 10 other (meth)acrylates. In the same test, 3 volunteer controls were negative to 2-hydroxyethyl acrylate. We demonstrate that at maximum working concentration, 2-hydroxyethyl acrylate penetrates both latex and vinyl gloves and elicits irritant/allergic reactions on the patient and irritant reactions on a control. Finally, we discuss the necessary protective measures.
We report an outbreak of occupational allergic contact dermatitis from 1,6-diisocyanatohexane (old name hexamethylene diisocyanate or HDI), in the anti-pill finish Evafanol AS-1, in 2 clothing factories. The 19 operatives from 2 dressmaking mills all complained of work-related dermatitis. 5 of the subjects had positive patch tests to the fabric with which they were working, and when all 19 were patch tested to Evafanol AS-1 (1% aq.), 11 were positive. 6 of these 11 were patch tested to HDI (1% pet.) and all 6 were positive. It appears that HDI in our group of clothing workers acted as a potent sensitizer affecting around 10% of the workforce.
Our purpose was to ascertain the irritant contact dermatitis potential of sodium lauroyl glutamate (SLG) and to assess its possible anti-irritating potential in a surfactant mixture on human skin, using visual scores and measurement of transepidermal water loss (TEWL). 15 healthy adult volunteers free of skin disease and with no history of atopic dermatitis were treated with sodium lauryl sulphate (SLS) solution (1%, 0.75%, 0.50%, 0.25%), 1% SLG solution, and 1% surfactant mixture solutions, M1 (75/25), M2 (50/50), M3 (25/50) (SLG/SLS). We applied 100 microliters of solution using a polypropylene chamber for 24 h. Application sites for each solution were randomized to minimize anatomical bias. We measured baseline TEWL before test solution application. After removal of the patches, each site was visually graded and TEWL recorded with an evaporimeter daily for 4 days. The visual scores and TEWL values of 1% SLG solutions were lower than those of the other test solutions, except the vehicle control (deionized water). 1% surfactant mixture solutions showed lower visual scores and TEWL values than 1% SLS solution. Increase of SLG concentration decreased the visual scores and TEWL values. Comparing the visual scores and TEWL values of M1 and 0.25% SLS solution, M2 and 0.50% SLS solution, and M3 and 0.75% SLS solution, M1, M2, and M3 showed lower values, although not statistically different. These findings suggest that SLG is a mild surfactant and its utilization can decrease irritation potential in SLS and possibly other mixtures. This model may offer a facile system for screening the surfactant and other mixtures for decreased irritancy potential.
Irritant contact dermatitis to croton oil in BALB/cByJ, C57Bl/6J and six recombinant inbred CxB strains of mice was investigated in relation to variations in endothelial migration inhibitory factor (MIF) reactivity. MIF has been shown to be a mediator of cellular immunity and operates as a differentiation signal inducing an inflammatory type of macrophage. The intensity of the ear swelling response reached a maximum 8 h after induction of contact dermatitis, with highest values in BALB/cByJ and CxB4/ByAH mice and weak reactions in CxB2/ByAE, CxB7/ByAK, C57Bl/6J and CxB1/ByAD mice. After the same time period (8 h) cryostat sections were immunostained for capillary endothelium expressing MIF. The most pronounced MIF expression was observed in BALB/cByJ mice, and CxB4/ByAH mice showed intermediate reactions and the other strains weak reactions. Endothelial MIF expression correlated well with the intensity of ear swelling (Pearson's correlation coefficient 0.82). Patterns of endothelial MIF expression in recombinant inbred strains suggest that endothelial MIF expression is not under the control of a single gene. Our data support the hypothesis that endothelial MIF expression plays a prominent role in inflammatory events and correlates with the severity of inflammation.
Reactive dyes are used especially for colouring natural fibres (cotton, silk and wool) that are widely used in Western countries, particularly Italy, in the production of clothes. The aim of our study was to investigate sensitization to the most commonly used reactive textile dyes in patients undergoing patch tests, and to assess the clinical relevance of contact sensitization to these dyes. 1813 consecutive patients underwent patch tests with the GIRDCA standard series and an additional textile series of 12 reactive dyes. 18 of these patients were sensitized to reactive dyes (0.99%) (4 only to reactive dyes). The dyes most frequently responsible for positive patch tests were Red Cibacron CR and Violet Remazol 5R (respectively, 8 and 5 positivities). In 5 cases only was a history of intolerance to particular garments given; of 4 patch tests performed with pieces of garment, 2 were positive. In 1 occupationally-exposed patient, airborne contact dermatitis was suspected. Owing to the lack of up-to-date patch test series, some cases of allergic contact dermatitis from textile dyes are probably misdiagnosed: new colouring agents are continuously introduced to the market, so that a close relationship with textile industry is necessary to improve our diagnostic tools.
Cyclophosphamide given before allergen and recombinant interleukin-12 administered at the time of allergic sensitization substantially increase the acquisition of allergic contact dermatitis in the mouse. Since their immunoadjuvant mechanisms appeared different, it seemed probable that combining cyclophosphamide pretreatment with interleukin 12 administration would result in a more intense allergic contact dermatitis than when either agent was used alone. This was tested in different groups of mice sensitized to dinitrofluorobenzene or to oxazolone. Consistently, immunopotentiation of allergic contact dermatitis was significantly greater with the two immunoadjuvants than with either alone. This immunoadjuvant combination is likely to find use in immunization protocols designed to induce a Th-1 helper cell response.
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