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The Nyloprint process is becoming more frequently used in Great Britain. We report a case of contact dermatitis in a 60-year-old man who was employed in the production of Nyloprint formes. The process is described in detail. Patch tests showed him to be very sensitive to an acrylamide derivative, which is used as a monomer in this process.
With the expanding interest in the environmental causes of disease, carefully performed, differential patch testing in suspected cases of contact allergy becomes a vitally important part of the investigation. Although all of the necessary allergens have not yet been released by the FDA for U.S. manufacture and distribution, it is hoped this will occur within the next few months. The thousands of patients with work-related allergic contact dermatitis can then hope for to learn the exact source of their disease, which can then lead to suitable work adjustments.
Eight dentists and one dental assistant have developed allergic contact dermatitis caused by exposure to (di)methacrylates, especially those found in resins, in dentin bonding agents, in rebasement and in prosthetic materials. The eczema is characterized by its location on the first, second and third finger of the left hand showing redness, desquamation, fissuring and excoriations. Patch testing with various test substances revealed positive reactions towards EGDMA in eight cases. It is suggested that this reaction was a cross-reaction and that the sensibilization was caused by MMA, TEGDMA, HEMA and/or BUDMA. One of the eight dentists had to give up practising.
The cutaneous metabolism of exogenous arachidonic acid and endoperoxide (PGH2) to prostaglandins and hydroxy-fatty acids was investigated in experimental contact dermatitis in guinea pigs and compared to normal skin, unsensitized animals treated with the allergen dinitrochlorobenzene, and Trafuril-induced irritant dermatitis. The main alterations of cutaneous arachidonate metabolism in contact dermatitis comprise: (1) an inhibition of PGD2 synthesis; (2) a switch from predominant PGD2 production to a predominance of PGE2 and (3) a marked inhibition of the lipoxygenase activity.
Patch testing of 40 patients with chronic inflammatory ear disease demonstrated medicament allergic contact dermatitis in 35%. The most frequent sensitizers were neomycin, framycetin, clioquinol and gentamicin. Although allergic contact dermatitis to dewaxing ear drops was unusual, irritant reactions were common.
A case of allergic contact dermatitis to a shampoo containing zinc pyrithione associated with an eruption of pustular psoriasis is reported. The patient had had stable psoriasis for 5 years, and never any other skin disease. Within 1 week she developed severe generalized pustular psoriasis with many lesions where the shampoo was applied. Treatment with cyclosporin, 200 to 300 mg daily, cleared the eruption within 4 weeks, except for psoriasis of the scalp. Extensive patch testing revealed a relevant sensitization to zinc pyrithione. This case illustrates that a generalized pustular psoriasis can be provoked by a substance present in a hair shampoo. Short-term treatment with cyclosporin is valuable in exacerbations of psoriasis caused by allergic contact dermatitis.
A superficial peripheral lymph vessel draining the skin of the upper and medial part of the foot was cannulated on the lower leg of six healthy human volunteers. After 2 days an irritant contact dermatitis was induced by application of 10% sodium lauryl sulphate to the area of skin drained by the lymph vessel. Three days later the spontaneously regressing skin reaction was treated with clobetasol propionate. Lymph was collected twice daily for 7 days, and the levels of various cytokines (IL-1 alpha, IL-1 beta, IL-2 and soluble IL-2 receptors, IL-6, IL-8, TNF-alpha, GM-CSF) were determined by ELISA technique. In the majority of the volunteers all cytokines examined were detected in several lymph samples, with the exception of IL-1 alpha and IL-8. In parallel with the clinical symptoms of the contact dermatitis the levels of IL-6 and TNF-alpha increased 8-10-fold, whereas for IL-1 beta, IL-2, IL-2 receptors, and GM-CSF there was a delayed, 2-3-fold increase. These results suggest that cytokines, in particular IL-6 and TNF-alpha, may actively participate in the immunological reactions in the skin and in the regional lymph nodes during contact dermatitis.
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Glutaraldehyde (pentanedial) is an effective topical therapeutic agent for patients with hyperhidrosis of the soles. A usage test was performed on the soles and antecubital fossae of six previously documented glutaraldehyde-sensitive subjects. All had negative usage test reactions to 25% glutaraldehyde on the soles. But when tested on the antecubital fossae with 2.5% glutaraldehyde, they developed a severe dermatitis within 48 hours. These data demonstrate a striking variation by which glutaraldehyde-sensitive patients tolerate or react to its use in two diverse anatomic sites.
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