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Various forms of contact dermatitis from Pinus radiata sawdust are described and illustrated by three cases. The sawdust causes industrial dermatitis which can be chronic and the purpose of the paper is to alert Australian practitioners.
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The present work is the first epidemiological study carried out by the Spanish Contact Dermatitis Research Group during 1977. During this year 2806 patients were studied with patch test among 30873 dermatological patients. The 60-62% of the totality had reactivity to one or more patches. Four major groups of allergens were able to consider, following the incidence in their power of sensitize. First group with strong incidence include: Nickel, Chromate, Cobalt, T.M.T.D.,P.P.D.A., Mercapto mix., and Wood tars. Second and third groups with medium incidence contain: Caines, Carbonates, Neomycin, Balsam of Peru, Mercury, Lanolin, Naphtyl mix., Formaldehyde, Benzalkonium chloride, P. P. D. A. mix, and Turpentine. Four group show very low incidence substances, as: Epoxi, Sulfonamides, Etilendiamine, Parabens, Chinoform, Colophony and Cinnamon oil. Few comments about age and occupations are included.
The authors report a study of allergic contact dermatitis in 329 Portuguese children of 14 years or younger. 170 children (64 male and 106 female) reacted to 1 or more allergens. Most of these were in the 11-14 years group. The main allergens were nickel, thimerosal, cobalt, mercury, fragrance-mix and potassium dichromate. Nickel reactivity predominated in females over the whole group, but a greater number of males younger than 5 years reacted to nickel. The number of positive reactions increased with age, but this was not accompained by an increase in the % of relevant tests. 12 children, all of them 13 or 14 years-old, had an occupational allergic contact dermatitis.
Experimental contact dermatitis has been induced in 2,4 dinitrochlorobenzene (DNCB) sensitized guinea pigs. The developing dermal infiltrate was excised and the infiltrating cells were obtained by mechanical extraction alone as well as by the combination with collagenase and elastase treatment. The most viable cells appeared in the elastase and mechanically extracted samples and the least in those subjected to mechanical treatment alone. The most cells in the enzyme-treated samples were present 24 h after re-exposure of the sensitized animals to DNCB consisting mainly of lymphocytes and of polymorphonuclear granulocytes. The optimum conditions for the action of enzymes including optimum duration of the treatment, buffer milieu, aspecific proteolytic effect on foreign substrate and action on T and B cell receptors have been elaborated. It was concluded that 80 min of collagenase treatment with gentle mechanical extraction under specified conditions does not affect any measurable immunologic properties of the liberated cells resulting in the second best yield. A comparison of these data with earlier reports and their significance is being discussed.
In the IInd Department of Dermatology, Vienna University, 200 patients (143 female, 57 male) suffering from leg ulcers due to chronic venous insufficiency underwent patch testing with routine allergens, vehicles and their ingredients, as well as topical antibiotics. 114 patients (57%) had contact allergy. Balsam of Peru heads the list of allergens with postive reactions in 22%, closely followed by oil/water emulsions such as Drointin (21%), Ultrasicc (20%) and Ung. emulsificans aqu. (15,5%). The causative agents in these preparations were emulsifiers on the one hand (Lanette O, E, N) and preservatives (parabens) on the other hand. In comparison, allergic reactions to water/oil emulsions were less common. The low index of sensitivity to local antibiotics was also surprising. The results of the present study, in accordance with other reports in the literature, underline the need (1) for full label diclosure of cosmetics and topically-applied drugs and (2) for patch-testing every patient suffering from leg ulcers of long duration.
Eight men employed in the manufacture of ultraviolet cured inks developed allergic contact dermatitis predominantly on the exposed areas. Patch testing revealed sensitization to trimethylol propane triacrylate in seven employees, to 1,6-hexanediol diacrylate in six employees, to pentaerythritol triacrylatylate in four employees and to epoxy acrylate oligomers in three employees. Either cross-sensitization or concomitant sensitization may have accounted for the multiple reactions in several employees. One sensitized employee was patch tested with four different commercially available epoxy acrylate oligomers and reacted only to two, suggesting that variations possibly in chain length between these oligomers are important variables in the allergic reactions. The polyfunctional acrylic monomers and certain epoxy acrylate oligomers should be handled carefully to avoid the development of allergic contact dermatitis.
Two types of irritant contact dermatitis are described: the acute and the cumulative toxic contact dermatitis. The acute contact dermatitis causes many different lesions on the skin. The most frequent irritants are acids and alkaline solutions. Chemical burns by hydrofluoric acid are the most dangerous of all injuries caused by acids and need special treatment. Cumulative toxic dermatitis is often observed on the back of the hands and forearms after exposure of several weeks or months. Repeated skin contact by harmless products can also cause cumulative toxic dermatitis. Xerodermatitis is the most frequent type of cumulative toxic dermatitis. Phototoxic reactions of the skin are not caused by immunologic factors, and they are only observed at sun-exposed areas. Drugs can cause frequently phototoxic reactions. The lesions on the UV-A-exposed skin are mainly erythema and blisters.
13 formaldehyde-sensitive contact dermatitis patients and 5 healthy subjects were exposed to formaldehyde (FM) at a concentration 0.5 mg/m3, in an exposure chamber for 2 hours. There was no significant decrease of the ventilatory parameters either in healthy subjects or in contact dermatitis patients following the exposure Bronchial hyperreactivity to histamine (PC20) increased in one healthy and two patients with contact dermatitis. Neutrophils were isolated from whole venous blood before the test and 30 minutes and 24 hours after the exposure. All subjects with allergic contact dermatitis had chemiluminescence higher before the FM provocation in a comparison with the healthy ones. It increased significantly 30 minutes post the exposure and was much higher 24 hours after the exposure in the comparison with the neutrophil chemiluminescence before the test.
Allergic contact dermatitis can be acute or chronic and is caused by delayed hypersensitivity to allergens in the surroundings. This retrospective study, the first of its kind in the Negev district, included 150 patients with allergic contact dermatitis. Nickel was the most frequent allergen causing contact dermatitis in both females and males, while chrome was second in frequency. Most of those with positive reactions to patch tests, were females. In females it appeared relatively early, in the 3rd and 4th decades, while in males it tended to appear later. The first lesions most frequently appeared on the dorsal aspect of the hands.
A study was made to evaluate the effects of vehicle and challenge concentration on response of human subjects to potential allergens. In the vehicle studies the modified Draize test was used to test the response of subjects to cinnamic aldehyde and to costus oil, administered at two skin sites, in petrolatum and in 95% ethyl alcohol. In two tests of costus oil, alcohol proved to be more effective in eliciting a response than petrolatum; on the other hand, in one test with cinnamic aldehyde, no difference in results was obtained with these two vehicles. In the concentration studies, subjects known to be sensitive to the test substance were tested by the Al test with costus oil (three concentrations), chloracetamide (four concentrations), or thimerosal (three concentrations); petrolatum was used as the vehicle in each case. Results of the vehicle test showed no compelling reason for the selection of one vehicle rather than another. Results of the concentration tests indicated that concentration does have an effect on the intensity and frequency of reactions to potential allergens.
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Contact dermatitis of the external genitalia is added to the list of entities that can cause urinary retention with hydroureteronephrosis in a child. The urinary tract returned to normal following successful treatment of the acute penile edema with topical and systemic steroids.
Ten patients with contact dermatitis to nickel, confirmed by patch testing, were investigated by the leukocyte migration test. Specific inhibition of leukocyte migration was obtained with nickel protein complexes. Bovine albumin, human albumin and human epidermis protein were used as carrier proteins in the complexes. Specific inhibition of leukocytes from patients with positive patch test to nickel could not be demonstrated with the hapten alone.
Contact dermatitis was induced in BALB/c mice by means of cutaneous application of dinitrochlorbenzol (DNCB) solution. Peritoneal macrophages from DNCB-sensitized and intact mice were cultivated in flat tubes for 48 hours after the 20th day of the experiment, when the DNCB cutaneous test became positive. A suspension of the peripheral lymph node lymphocytes was added to this culture. The lymphocytes fromthe DNCB-sensitized mice had a cytotoxic effect (CTE) on the target cells (peritoneal macrophages) during the co-incubation; the STE was tested with trypane blue in 48 hours. No macrophage lysis was observed in combined incubation of cells from the intact mice.
Five out of 26 men employed formulating radiation drying printing ink developed eczematous dermatitis. Positive patch tests were obtained with two polyfunctional acrylic monomers, pentaerythritol triacrylate and trimethylol propane triacrylate and with formulations containing these in four affected employees. Cross sensitization was observed to dipentaerythritol monohydroxy pentaacrylate in each case. A fifth employee appeared to have developed irritant dermatitis from contact with these materials.