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Allergic contact dermatitis to All-trans-retinoic acid; epicutaneous and leukocyte migration inhibition testing.

Two male prison volunteers had severe cutaneous reactions to the initial patch testing of All-trans-retinoic acid containing products being evaluated for irritancy. Muliple patch testing procedures performed throughout one year, along with leukocyte migration inhibition studies, speak strongly for delayed hypersensitivity reactions in these subjects. The failure to document a previous exposure in subjects living in a controlled environment suggests that these responses were cross-reactions to a prior sensitizer, perhaps unique to this environment.

Adult↗

Allergic contact dermatitis and conjunctivitis to corticosteroids.

This is a report of two patients suspected of having allergic dermato-conjunctivitis due to corticosteroids. Both were tested with the constituents of the ointments they were using, that is, corticosteroids, antibacterial agents, preservatives, and other active ingredients of the ointment bases. Both patients showed positive allergic patch test reactions to the respective corticosteroid betamethasone valerate, and one to hydrocortisone, neomycin, and a rubber additive. The importance of routine patch testing in ophthalmic practice to detect sensitizers in cases of allergy is mentioned. Hydrocortisone (25%) in petrolatum is recommended for patch testing.

Administration, Topical↗

Delayed hypersensitivity in females. The development of allergic contact dermatitis in females during the comparison of two predictive patch tests.

Ten chemically different compounds were applied to the skin of the backs of male and female volunteers to induce delayed hypersensitivity responses. The 10 compounds had a low, moderate, high or unknown allergenic potential and were divided among five test panels (modified Draize) consisting of 150 subjects each. In each panel, 75 subjects (mean age 31 years) were always male prisoners (50% Caucasians) and the remaining 75 subjects (greater than 90% Caucasians) were divided, age-matched free males and females (mean age 24 years). Three compounds, each on different panels, had a significantly higher sensitization rate in females than in free males or total males. The remaining compounds produced sensitization, usually in lower numbers, but females dominated in sensitization rates. Viewed as absolute rates of sensitization for the 10 compounds, females were higher on eight test compounds and tied on two when compared to all males. These studies show that females develop significantly more cell-mediated immune responses to some chemical haptenes than men and the data also points to an overall higher rate of haptene recognition. Seven of these 10 compounds were simultaneously tested for their sensitization potential by the modified Maximization method (all males) in order to compare the two tests' ability to disclose potential sensitizers. Female sensitizations on the modified Draize accounted for this test's superiority.

Adult↗

Contact dermatitis to PPD rubber in Maleki shoes.

The Persian cloth shoe (Maleki) which has been in use for more than 800 years has a strong cloth sole and a woven cotton upper. In the last 20 years, used car tires have become readily available in Iran and the soles of some shoes are now made from these. A man with the typical picture of rubber dermatitis on the soles of his feet is described. On patch testing he gave a 2+ positive to PPD rubber and this was thought to be due to the fact that he had worn Maleki shoes for several years.

Dermatitis, Contact↗

The vehicle tray revisited: the use of the vehicle tray in assessing allergic contact dermatitis by a 24-hour application method.

Over 700 patients were screened by patch testing for sensitivity to the components of a vehicle tray from July 1974 through June 1976 at the Mayo Clinic. A modified version of the vehicle tray originally suggested by Fisher et al. (1971) was used, containing 14 substances commonly found in vehicles. Patches were applied for 24 rather than the usual 48 hours. Our percentage of reactivity compares favorably with the 48-h application method, thus demonstrating the efficacy of this time-saving technique. The method and usefulness of determining a percentage of irritancy are discussed. This was found to be a valuable tool in assessing false-positive reactions among our percentage of reactivity. Four irritants were demonstrated: phenylmercuric acetate (0.05% pet.), sodium lauryl sulfate (1% aq), thimerosal (0.1% aq) and hexachlorophene (1% pet.).

Dermatitis, Contact↗