C. R. Srinivas

Sensitivity to various ingredients topical preparation following prolonged use

63 selected patients, with features suggestive of allergic contact dermatitis and histories of prolonged use of numerous topical preparations, or of exacerbation or spread of dermatitis following the use of such preparations, were studied with respect to age, sex, and site. All were patch tested with 45 different allergens supplied by Chemotechnique Diagnostics AB, Malmo, Sweden. In addition, relevant topical preparations were tested, as is. Van der Bend Square Chambers were used for patch testing.

Footwear dermatitis due to bisphenol A

According to the manufacturers statement and the appropriate literature, this is the 1st reported case of sensitization by subcutaneously injected recombinant interferon a 2c. Allergic reactions involving the production of anti-interferon antibodies have been described previously (1). Our patient also showed a positive ELISA test to interferon a 2c, while prick testing was negative. As yet, no instance of cell-mediated delayed hypersensitivity to interferon has been reported. SHORT COMMUNICATIONS

Patch testing in contact cheilitis.

and medicaments, from which sensitization is also described in spite of its low concentrations (3, 4). Hairdressers’ screening series mainly include hair dyes and permanent waving chemicals (5–8), the same series being proposed for hairdressers’ clients (9). However, preservatives, including chloroacetamide, were positive in more than 5% of patients tested in a recent report on occupational allergies in hairdressers (10). Screening series may need to be extended for hairdressers and their clients.

Allergenic agent in contact dermatitis from Holigarna ferruginea

9 of 10 patients who developed dermatitis following contact with Holigarna ferruginea and 5 of 35 asymptomatic volunteers showed a positive patch test reaction to 2% W/V acetone extract of the plants resinous exudate. 6 albino rats were sensitized following 3 weekly applications of the same extract. Laccol (3‐heptadecadienyl catechol) was identified as the active principle in the exudates.

Photopatch test reaction to amitriptyline.

Discussion Since its introduction in 1990 (8), the SL mix has been incorporated into our standard series. However, its ability to detect all Compositae allergy has been questioned (9–11). By adding the Compositae mix (9, 11), we are diagnosing allergic contact dermatitis in food handlers that would otherwise be missed. With the exception of case nos. 5 and 6, none of these patients were gardeners and their sole exposure to Compositae was occupational, the 1 factor common to all 6 being the handling of lettuce. In 4 of the 6 cases, dermatitis resolved with allergen avoidance. This group of patients is much younger than the typical Compositae-allergic patient, who is over 60 years and a gardener. In addition, all cases presented with hand dermatitis rather than an airborne distribution (12). Compositae dermatitis in food handlers may be commoner than recognized and the Compositae mix may detect previously unsuspected allergies.

Macular hyperpigmentation in a furnace worker.

Case Report A 46-year-old man presented with hyperpigmentation over the medial aspects of both forearms for 3 years. He had been employed in an iron and steel foundry for the past 22 years and worked near an open furnace where ferrosilicon was produced for 2–8 h daily. He used to wear a short-sleeved cotton shirt and shoes made from tyres. No apron or other protective clothing was used. A mixture of charcoal, quartz and scrap iron was used in the furnace, which formed vapours. Hyperpigmentation developed over the medial aspects of both forearms, which spread to involve the lower 2/3 of the upper arms, including the cubital fossae. Within 6 months, similar hyperpigmentation had developed over the posterior aspects of the legs. There was associated pruritus, which increased with sweating. He had received topical corticosteroids and antihistamines, with no benefit. A skin biopsy revealed hyperkeratosis and acanthosis with effacement of the rete ridges, overlying fibrocollagenous tissue with proliferating fibrobasts and adnexal structures. Mild mononuclear infiltration and melanophages were present in the upper dermis. Patch testing with the Scandinavian photopatch series (Chemotechnique Diagnostics AB, Sweden) revealed photocontact sensitivity to musk ambrette and contact sensitivity to hexachlorophene. The minimal erythema dose was determined using a solar simulator. Using a 305 nm filter, erythema developed at 30 J/m2, but not with a 345 nm filter. The patient was advised to change his job, and to use a long-sleeved shirt and gloves while working, along with applying topical hydroquinone 4% and physical sunscreens. Within 6 months, there was a 25% improvement in the hyperpigmentation and more than 50% after 14 months. He had changed to a loading job and had not been further exposed to the furnace.